Low HR/Good BP

[Akulahawk]

Given the 10 min transport time...

BLS: have a nice talk, paying close attention to mental status. Figure out what meds she's on and if she knows why her heart rate is so slow. Transport to ED.

ALS: Have a nice talk while acquiring a 12-lead, start a saline lock, nice quiet transport to ED with patient on monitor, and if she decompensates, well, we have options at our disposal and vascular access because of that lock...

In either case, patient is likely mostly asymptomatic, so a nice calm atmosphere is a good idea.

 

[Medicbob]

I think a 12 lead and monitor would be appropriate. A 3rd degree heart block might change your destination.

Yup, I'd go with some sort of heart block.

 

[NTXFF]

For many people, 95% on room air is normal, just plain normal.

Check out the Oxyhemaglobin Dissociation curve. There is little difference in 95 and 100% saturation in terms of PO2 (which is what we really care about).

I must say I always enjoy your responses. You're one smart tater tot!

 

[NTXFF]

Oh and I'd be doing a 12 lead in the house or facility, wherever I was at. I've had an asymptomatic 3rd degree heart block with a chief complaint of I don't feel right. It's something that will take 15 seconds to apply and run which could help you better prepare for what could go wrong. As many of you know 10 min can feel like 45 if a routine call takes a turn that you didn't at least consider.

 

[Tigger]

I must say I always enjoy your responses. You're one smart tater tot!

I have learned much from this very site. Hopefully it contributes to me ending up a half decent paramedic.

 

[Ensihoitaja]

Where I work the only thing that is routinely ordered held is metformin.

Is that because they're fasting or is there another reason?

 

[Brandon O]

Is that because they're fasting or is there another reason?

Risk for causing lactic acidosis.