the 100% directionless thread

All the other calls were either a transport from one hospital to another or they didnt want to be transported.
 
LaceyA said:
Well had my frist clinical on a truck saturday! I learned a few things but most important DONT DO METH! LOL.... my first meth pt! It was the best call of the day!
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Yeah... meth is a great drug... Meth heads that work at a metal fabrication shop can get kind of interesting, 3 entire days at a time...
 
My shifts have been fun the last week. Status ep., hemorrhagic stroke RSI, geriatric w/ SVT + successful adenosine conversion.
 
Really frustrated with my test I had today. I cannot master ABGs to save my life.

They gave us:

pH- 7.35
Pco2- 39
Hco3- 22

Those all seem pretty normal to me, but apparently it is compensated metabolic acidosis. I don't get it.
 
So, Clute, if I work for you (even if it's a short time), I expect a paycheck on payday...glad I left.

Anjel, the pH is the giveaway.
 
Anjel said:
I would go with the HMO. Usually stuff like office visits will not apply to the deductible so you just have your standard $20 copay. Referrals really aren't that big of a deal.

With the other... Every time you go to the doctor you will be paying the contracted amounts for the whole visit. Usually around $100 or so. Once and if you meet that 2k then you will only pay $30 every time you go. Then as far as hospital stays go... That's when you would most likely meet that out of pocket max. From my experience there is usually a 20% co insurance for hospital benefits. So if you have a $100,000 bill for some major surgery. Then you only have to pay 10 grand.

It is confusing. But if you are relatively healthy... The HMO is the way to go.

I did insurance billing for a few years and wanted to kill my self lol
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Remember, there will be differences between each PPO and HMO; for instance with my current PPO I pay nothing for a simple doctor's visit for a checkup. This is where it falls to each individual to look into the specifics of each plan available to them.

The bolded portion...that's the catch. I am relatively healthy, don't have anyone else on my plan, and don't (knock on wood) plan on having kids anytime soon. BUT...while some HMO's might be a better deal than the one that was available to me if I stay healthy, when I compared my current PPO to the HMO I had the option of choosing, if I ever do get sick, the PPO is a far, far better choice. I do pay slightly more per month (I think it was only something like 10 or 20 bucks more), but that will pay off in the end if I ever need it.

Others may have different experiences, but again, this is where everyone really needs to evaluate the plans available to them, as well as consider what will happen if they have to use said plan.
 
Anjel said:
Really frustrated with my test I had today. I cannot master ABGs to save my life.

They gave us:

pH- 7.35
Pco2- 39
Hco3- 22

Those all seem pretty normal to me, but apparently it is compensated metabolic acidosis. I don't get it.
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Because 7.4 is considered the middle ground.
 
RocketMedic said:
Anjel, the pH is the giveaway.
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No, actually it isn't.

In a compensated metabolic acidosis you'll find a normal pH, and a lower than normal HCO3 and PaCO2; these fall squarely into the "normal" range, with the pH being on the very low end of "normal."

Angel- if there was a scenario that went with those values, that's probably where you'll find the reason for the given answer.
 
There wasn't. It was just those values. So even though the pH is normal it's below the middle so therefore it's acidosis?

I thought normal was 7.35-7.45 for pH. 35-45 for Co2. And 22-26 for bicarb.
 
It's still within normal range so that's why it's compensated.

It's a pretty silly abg set to get on a quiz, though.
 
Anjel said:
There wasn't. It was just those values. So even though the pH is normal it's below the middle so therefore it's acidosis?

I thought normal was 7.35-7.45 for pH. 35-45 for Co2. And 22-26 for bicarb.
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It is; all the values are normal, but a very low normal; saying squarely wasn't the best of terms...I blame a new bottle of rum for that. If the question was just "what do these values indicate" with nothing else to guide you, technically you would be correct in saying "it's normal" though a low normal. With more information to go off of, it would be easier to see why they call that a compensated metabolic acidosis.
 
While the ABG is normal, it may be trending toward metabolic acidosis. This is because the pH is on the low end of normal and the bicarb is also on the low end of normal. I wouldn't call it "compensated" anything because the pCO2 isn't at the point where the body's trying to blow off CO2 to raise the pH and all values are in a normal range... so far.
 
I wouldnt call it compensated because it's not acidotic...yet.

You can't compensate a normal value. Bad test question.
 
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The answers I had to choose from were respiratory acidosis or alkalosis- compensated or uncompensated.

Or metabolic acidosis/alkalosis- compensated/uncompensated.

I guess just by process of elimination it would be metabolic because the co2 is in the middle of normal.

My brain just hurts. It doesn't seem like it should be that hard to understand lol
 
On a side note, it's a little disturbing that when I come to this site without logging in there's an ad for "thaimatches.com" at the top...just what in the hell sites have I been visiting!?
 
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