the 100% directionless thread

[CritterNurse]

If I developed anisocoria with the absence of any other symptom, I'd probably wait for it to go away on it's own.

Well, she had also posted that she wasn't feeling well earlier. The ER did a CT scan, and it came back normal. Long story short, they said to keep an eye on it and if it doesn't go away, or get worse, come back.

 

[Handsome Robb]

It is for Chuck Norris

Also learned when your gut tells you to take a firefighter you should listen to it. Luckily they didn't arrest until after I had given my report at the ER.
After today I'll take the 5 seconds to listen for an apical pulse when there's no palpable peripheral or central pulses though. Pretty entertaining to watch the ER RN get smacked in the face when he started doing compressions, even after I had told them she had no palpable pulses but had an apical pulse and slipped "an art line and a central line would probably be a good idea..."

Another thing I learned, the fact that my sense of smell absolutely sucks is a blessing. While everyone is gagging and coughing and eyes are watering I'm sitting there like "what the hell is wrong with y'all?"

Apical pulses are a must when there's no palpable peripheral or central pulses. Pretty entertaining to watch

I knew jaundiced patients could get pretty yellow but this lady was literally as yellow as the smileys on this site.

 

[Clare]

So I went to the supermarket; I got a pre-made spinach salad, deli roasted chicken and a pack of bread rolls .... I was so proud of myself; then I happened past the giant display of peanut slab chocolate blocks on special and bought two of them .... I mean normally I would have resisted temptation but this stuff is like chocolate crack.

Also, its raining, boo!

 

[Aprz]

Also learned when your gut tells you to take a firefighter you should listen to it. Luckily they didn't arrest until after I had given my report at the ER.
After today I'll take the 5 seconds to listen for an apical pulse when there's no palpable peripheral or central pulses though. Pretty entertaining to watch the ER RN get smacked in the face when he started doing compressions, even after I had told them she had no palpable pulses but had an apical pulse and slipped "an art line and a central line would probably be a good idea..."

Apical pulses are a must when there's no palpable peripheral or central pulses. Pretty entertaining to watch

That's interesting! If you are unable to palpate the carotid pulse and the patient is symptomatic eg unconscious, pale, maybe cool to touch, does it ever matter if they have an apical pulse when considering doing chest compressions? I feel like their blood pressure and cerebral perfusion pressure is so poor that they could benefit from chest compressions.

 

[Veneficus]

22 pages of a study on adipose endorcine dysfunction in PCOS corrected and submitted in less than 19 hours!

I am a machine.

I should get an award.

Maybe a bonus.

 

[CritterNurse]

:beerchug:Happy St. Paddy's Day, folks!:beerchug:

I'm sitting down to the corned beef that's been brining in the fridge for the past 2 weeks.

Play it safe out there!

 

[DesertMedic66]

Well, she had also posted that she wasn't feeling well earlier. The ER did a CT scan, and it came back normal. Long story short, they said to keep an eye on it and if it doesn't go away, or get worse, come back.

I see what you did there

 

[VFlutter]

That's interesting! If you are unable to palpate the carotid pulse and the patient is symptomatic eg unconscious, pale, maybe cool to touch, does it ever matter if they have an apical pulse when considering doing chest compressions? I feel like their blood pressure and cerebral perfusion pressure is so poor that they could benefit from chest compressions.

I had a patient with significant vascular disease that had no palpable peripheral pulses and a barley palpable carotid. I had to Doppler pulses every 2 hours. Per the vascular surgeon blood pressures were 80 points higher han the NIBP readings. It was a weird feeling giving Lopressor when the monitor was reading 40/10.

For me, no carotid pulse and unconscious = CPR regardless if there is an apical pulse. But I am on a cardiac floor so tamponade and PEA are more common. If they wake up and slap you then great, they aren't dead. It happened to me once when a lady had a 6 sec pause.

If they have signs of life and an apical then they get dopplered and probably an Art line

 

[NomadicMedic]

My quote of the day, "If I'm pacing somebody and they're not really bothered by it, they probably needed it."

 

[Anjel]

22 pages of a study on adipose endorcine dysfunction in PCOS corrected and submitted in less than 19 hours!

I am a machine.

I should get an award.

Maybe a bonus.

PCOS is the devil.

 

[CritterNurse]

I see what you did there

Yikes. That was completely unintentional, I swear!

 

[RocketMedic]

new onset aphasia, 73 yo f, bp 240/90, unusually belligerent = stroke.

Also, Medusa charting sucks.

 

[NYMedic828]

Today I discovered the magic of the crockpot/slow cooker.

Where has this thing been all my life.

 

[Wheel]

Today I discovered the magic of the crockpot/slow cooker.

Where has this thing been all my life.

Magical, right?

 

[DesertMedic66]

Full scale MCI drill tomorrow (paid and 8 hours of CEs) followed by a protocol update class on my birthday (Wednesday) followed by going out with a group of friends to celebrate. Should be a pretty good week.

 

[adamjh3]

I hate FISDAP with a passion

 

[Aprz]

I hate FISDAP with a passion

You have to do that stupid thing too? I hate them also. I think they aren't even helpful if my instructor doesn't give me feedback on it either, and it doesn't help that I've already lost my trust in my instructors because of how often they've said something that, in my opinion, is wrong.

 

[adamjh3]

You have to do that stupid thing too? I hate them also. I think they aren't even helpful if my instructor doesn't give me feedback on it either, and it doesn't help that I've already lost my trust in my instructors because of how often they've said something that, in my opinion, is wrong.

The thing that kills me most is that we have to keep both a paper log and do FISDAP. If it was one or the other I wouldn't mind as much. And yeah, feedback would be great. I have no idea if my charting is acceptable at the ALS level or not and probably won't know until I'm in the field.

 

[Handsome Robb]

That's interesting! If you are unable to palpate the carotid pulse and the patient is symptomatic eg unconscious, pale, maybe cool to touch, does it ever matter if they have an apical pulse when considering doing chest compressions? I feel like their blood pressure and cerebral perfusion pressure is so poor that they could benefit from chest compressions.

I honestly don't know.

When the ER tried she promptly knocked the nurse square I'm the face.

She was moaning and moving about on the gurney for me basically the entire time so I knew she had a pulse. Hence why I was so worked she was gonna dislodge my IO. Wouldn't lay still.

I asked the doc what she thought about an art line multiple times, never saw one go in while I was there. Still were using my IO ~ 45 minutes later as I was leaving, they may have gotten an IV as well that I didn't see I'm not sure.

 

[Aprz]

I honestly don't know.

When the ER tried she promptly knocked the nurse square I'm the face.

She was moaning and moving about on the gurney for me basically the entire time so I knew she had a pulse. Hence why I was so worked she was gonna dislodge my IO. Wouldn't lay still.

I asked the doc what she thought about an art line multiple times, never saw one go in while I was there. Still were using my IO ~ 45 minutes later as I was leaving, they may have gotten an IV as well that I didn't see I'm not sure.

Oh, if she's moaning and moving a lot, then chest compressions probably wouldn't benefit her, lol.