the 100% directionless thread

STXmedic

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TRSpeed

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I'm starting the pool. I say <6 months.
Haha idk this might be it.
It's a new yrs resolution for rocket. try to stay at your employer for a complete yr.


But that being said. I'm going for <6 mo
 

chaz90

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66768684229d0cdaee98a0301e3a75a8.jpg

Yes, this is exactly what I was hoping to see from my anteroseptal STEMI patient who keeps asking if he's going to die as we try to make it to the PCI capable facility 30 miles away in a blizzard at 0430.

"Sir, please advise your heart to knock off these funny looking beats and runs of v tach and cooperate for the next 30 minutes or so."

Good call though!
 

Carlos Danger

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Yes, this is exactly what I was hoping to see from my anteroseptal STEMI patient who keeps asking if he's going to die as we try to make it to the PCI capable facility 30 miles away in a blizzard at 0430.

"Sir, please advise your heart to knock off these funny looking beats and runs of v tach and cooperate for the next 30 minutes or so."

Good call though!

Does anyone's protocols call for lido or amio anymore in situations such as this?
 

chaz90

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Does anyone's protocols call for lido or amio anymore in situations such as this?
It would have to be sustained for us to administer amiodarone. If I noticed more of these runs I would have consulted with med control regarding his preference on 150 mg of Amiodarone (or lidocaine if he were feeling frisky I suppose). In this case, soothing words, crossed fingers, and slightly more O2 managed to chase the cardiac demons away for the remainder of my time with the patient.
 

NomadicMedic

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It would have to be sustained for us to administer amiodarone. If I noticed more of these runs I would have consulted with med control regarding his preference on 150 mg of Amiodarone (or lidocaine if he were feeling frisky I suppose). In this case, soothing words, crossed fingers, and slightly more O2 managed to chase the cardiac demons away for the remainder of my time with the patient.

If you had gotten Lido orders, you would have been Paramedic of the Year. And what's "sustained" in that case? A couple of runs of couplets? A run of 10?
 

chaz90

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If you had gotten Lido orders, you would have been Paramedic of the Year. And what's "sustained" in that case? A couple of runs of couplets? A run of 10?
I guess opinions may vary on what sustained means. I saw these runs happen twice several minutes apart before seemingly temporarily resolving. Each was ~4-5 beats, and the patient didn't seem to notice either. I think if there started to be more of them you could probably get away with running 150 mg of amiodarone without even calling in for orders. I think I probably could have called in for orders (or just done it) for my 2 episodes and some docs may have wanted it while others didn't.

And yes, the lidocaine orders would have been exceedingly unlikely. I wouldn't even have cared to ask and I don't know if any of the med control docs are huge proponents of lidocaine in the battle of the antiarrythmics.
 

MonkeyArrow

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It was weird. I could see site statistics. Were we hacked @Chimpie ?
 

MonkeyArrow

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I imagine it was just due to the site upgrades. They posted a warning on the Facebook at least.
Guess it would help if I had a Facebook...
 

Handsome Robb

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Does anyone's protocols call for lido or amio anymore in situations such as this?
I can hang amio on standing orders for runs of VT

We carry lidocaine but I'd have to call for it and it'd be rare for a MD here to grant the request, they really like amio for whatever reason.
 

DesertMedic66

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Does anyone's protocols call for lido or amio anymore in situations such as this?
We can call for orders for either amio or lido in symptomatic tachycardia with pulses. So if we were talking to the right doctor and pleaded our case we could get orders for it.
 

Angel

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Sacramento county has standing orders for amio 150 over 10 mins for pulsing asymptomatic vtach
Where I work we can only give it (standing) post ROSC if vtach and not already given
 

Handsome Robb

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Sacramento county has standing orders for amio 150 over 10 mins for pulsing asymptomatic vtach
Where I work we can only give it (standing) post ROSC if vtach and not already given
and not already given? Generally hanging a maintenance drip is standard in ROSC if conversion after administration during the arrest. Just seems odd to me that you wouldn't hang a drip in a ROSC patient after administering amio during the arrest but everywhere is different. I believe the AHA guidelines are to hang it if it was administered during the arrest.

We can hang it post VF/VT ROSC even if we haven't administered it if they continue to have runs post-ROSC.
 

Handsome Robb

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In other news...my app was accepted for the ALS non-transport FD here. Testing starts at the end of the month. Also have my last two interviews for TEMS the beginning of next week.

TEMS is my dream but Fire is a great career move...
 

Aprz

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I caught the cold. :(
 

Angel

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and not already given? Generally hanging a maintenance drip is standard in ROSC if conversion after administration during the arrest. Just seems odd to me that you wouldn't hang a drip in a ROSC patient after administering amio during the arrest but everywhere is different. I believe the AHA guidelines are to hang it if it was administered during the arrest.

We can hang it post VF/VT ROSC even if we haven't administered it if they continue to have runs post-ROSC.

Correct, we can only give (in rosc) if we did not in the initial arrest.
 
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