the 100% directionless thread

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DesertMedic66

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JPINFV said:
I'm not even thirty.

/but still... get off my lawn.
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I know. I just didn't want to call any of the CLs old because I don't really feel like a vacation. Since your not a mod you get the name calling haha
 
JPINFV

JPINFV

Gadfly
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Achilles said:
This brings up a good question.
What are the strangests things you have found in a woman's vagina or some other cavity in the body M or F
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I'll let you know after EM next year. Nothing on my OB/Gyn rotation... except babies. Lots of babies.
 
MrJones

MrJones

Iconoclast
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JPINFV said:
Is it equally inappropriate to shoot middle age men or young adults?

Apparently...

Dangerous:


Shoots rainbows:


Of course I could see if I could post a link to the dash cam video of the Vietnam Vet killing a police officer on a traffic stop. Hesitation killed that police officer because apparently old men holding rifles shoot bullets, not rainbows.
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You don't have to convince me; you have to convince the many people, "including members of the law enforcement community", whose opinion in turn convinced the supplier that the no hesitation targets in question were inappropriate.

Or you could just buy the rights to the targets and market them yourself.
 
RocketMedic

RocketMedic

Californian, Lost in Texas
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Chest Pain Day, and some mistakes...

1. Comorbid CHF and COPD, 49 y/o F, recent long interstate travel, noncompliant with all medications except for lortab and lovenox injections. "Chronic" chest pain + 5 pks/day + exertion of moving into a relative's place, exacerbation of chest pain and sensation of shortness of breath x30 minutes, pain is a 10/10. Long, long, long medical history with lots of cardiac stuff, strokes, heart attacks, A-fib and diabetes, among other things. Lung sounds were a little wet at the bases, capnography was pretty narrow (not that I expected great things from her lungs). Recent rapid buildup of edema, weakness, culminating in the new chest pain. I went down the CHF/ACS tree and CPAPed her with some relief, but held off on an inline nebulizer because I was worried about opening up her alveoli if it was a CHF exacerbation. Some relief in chest pain, some easing of SHOB with nitro and PPV- only to have the hospital look at me like I was retarded for not treating her as a COPD patient. I worked her as a CHF with underlying COPD, they flipped that. No biggie, she was admitted. Very, very sick.

55 y/o M hot, diaphoretic, recently sick with 'the flu', found in sinus tach/SVT at 170, c/o weakness and slight chest pain, GCS 14 CAOx3. Diabetic with extensive cardiac history, to include a-fib and multiple MIs. I worked him up as a cardiac patient- monitor showed a partial LBBB and kept saying "infarct" due to the STEMIs he was tossing at us in various forms, but my screwup came when we realized that he was going into what looked a lot like SVT and staying there (sustained HR 180 x30 seconds). We trialed a dose of adenosine with no effect, then elected to continue IV NS boluses and transport to the hospital. We were able to eliminate pain with nitro alone, the ER said 'pneumonia'. I was wrong on the adenosine though. We should not have pushed it.

Then a 66 y/o F who looked like she was having an NSTEMI and didn't react at all to our medications, to include morphine...and then bottom out to 90/60 from 110/60 from a nitroglycerin spray that didn't even help her pain. I probably should have held off on the last nitro, and I'm worried that our QI guy will rip me to shreds for the adenosine and not having my nitros perfectly five minutes apart.
 
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Epi-do

Epi-do

I see dead people
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For Christmas last year, my husband paid for me to go to a photography seminar at Wolf Park, a research and education facility near Purdue University. The seminar was this past Saturday and I had a blast! After lectures on photographing the wolves, wolf behavior, and safety procedures, we went into the enclosure with the pack and were able to take pictures, without the obstuction of the fence or other man-made things that you have to shoot through and around when at the park.

I took 900+ pictures in about 4 hours. I have only sorted through the first 200, made some edits and pulled out what I think are the best of them. I posted them to a public folder on facebook. Here is the link to the folder if you are interested in taking a look.

It was definitely one of the coolest things I have been able to do in a long time!
 
Epi-do

Epi-do

I see dead people
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9
38
Rocketmedic40 said:
Chest Pain Day, and some mistakes...

1. Comorbid CHF and COPD, 49 y/o F, recent long interstate travel, noncompliant with all medications except for lortab and lovenox injections. "Chronic" chest pain + 5 pks/day + exertion of moving into a relative's place, exacerbation of chest pain and sensation of shortness of breath x30 minutes, pain is a 10/10. Long, long, long medical history with lots of cardiac stuff, strokes, heart attacks, A-fib and diabetes, among other things. Lung sounds were a little wet at the bases, capnography was pretty narrow (not that I expected great things from her lungs). Recent rapid buildup of edema, weakness, culminating in the new chest pain. I went down the CHF/ACS tree and CPAPed her with some relief, but held off on an inline nebulizer because I was worried about opening up her alveoli if it was a CHF exacerbation. Some relief in chest pain, some easing of SHOB with nitro and PPV- only to have the hospital look at me like I was retarded for not treating her as a COPD patient. I worked her as a CHF with underlying COPD, they flipped that. No biggie, she was admitted. Very, very sick.

55 y/o M hot, diaphoretic, recently sick with 'the flu', found in sinus tach/SVT at 170, c/o weakness and slight chest pain, GCS 14 CAOx3. Diabetic with extensive cardiac history, to include a-fib and multiple MIs. I worked him up as a cardiac patient- monitor showed a partial LBBB and kept saying "infarct" due to the STEMIs he was tossing at us in various forms, but my screwup came when we realized that he was going into what looked a lot like SVT and staying there (sustained HR 180 x30 seconds). We trialed a dose of adenosine with no effect, then elected to continue IV NS boluses and transport to the hospital. We were able to eliminate pain with nitro alone, the ER said 'pneumonia'. I was wrong on the adenosine though. We should not have pushed it.

Then a 66 y/o F who looked like she was having an NSTEMI and didn't react at all to our medications, to include morphine...and then bottom out to 90/60 from 110/60 from a nitroglycerin spray that didn't even help her pain. I probably should have held off on the last nitro, and I'm worried that our QI guy will rip me to shreds for the adenosine and not having my nitros perfectly five minutes apart.
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I'm guessing you mean something different than what you said here, but not sure what. Possibly PVCs or PACs?

If something is said about the adenosine, listen to what they are telling you, and consider it a learning experience. We all make mistakes, and some of them are bigger than others.

In fact, given the limited information you have provided regarding the second patient, I don't think considering adenosine is too off the wall, and could be justified, depending upon all the other details that you at the time. And even if the details showed you something that would have made another medic decide against adenosine, ultimately, is sounds as if this time your patient didn't suffer any lasting ill effects from it. Learn from it and move on.
 
E

exodus

Forum Deputy Chief
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JPINFV said:
Is it equally inappropriate to shoot middle age men or young adults?

Apparently...

Dangerous:
BOB-GUN03.jpg



Shoots rainbows:
DHS_COVER.png


US_No-More-Hesitation-Pregnant-Woman.jpg



Of course I could see if I could post a link to the dash cam video of the Vietnam Vet killing a police officer on a traffic stop. Hesitation killed that police officer because apparently old men holding rifles shoot bullets, not rainbows.
Click to expand...

I'd shoot all of them if they pointed a gun at me.:unsure:
 
Anjel

Anjel

Forum Angel
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Ghetto whacker

agare6eq.jpg
 
D

DesertMedic66

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y2yre3yq.jpg


Getting paid to sit around a pool and enjoy the view. I'm probably gonna be really busy soon.

Mix 700 people (most under the age of 30) plus free alcohol plus a huge party by 4 pools and multiple fire pits = a disaster waiting to happen. Ooh and I'm the only EMT at the event.
 
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