the 100% directionless thread

Things that are rad: getting out of p school early on test day.

Things that are not rad: Driving an hour to the station from said class and getting a transfer to Denver (90 miles) immediately. And then on the way home after rush hour, getting stuck behind a fatality accident for an hour.

Six hours of fun.
 
Akulahawk said:
So glad today is now over... long day, good learning experience with hyperK with a great outcome.
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Aprz said:
I wanna hear about hyperK.
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Cue HIPAA... Yes, I won't be posting many details of this case lest the patient be recognized...

I had a patient come in with some relatively vague complaints, basically general malaise and nausea/vomiting. This patient is on dialysis and hasn't been to a few sessions. After drawing the typical labs, I was notified that the patient had a K+ of 6.9... This patient had been on monitor from early on in the case. Vitals were quite stable, with the HR 80-96. As I was going to get the meds that were ordered for this patient, I eyeballed the monitor and noticed that the HR was basically in a junctional escape at about 35/min, without change in mental status (I was amazed about that, BTW), notified the Doc, finished getting the meds and started pushing them. Patient got: Calcium Chloride, D50, Insulin, albuterol, and everyone's 2nd most tasty favorite: Kayexalate.

This patient was getting ready to code and it would have been bad... The above meds got this patient turned around in a hurry, so a crisis was averted.

What did I learn with this? First off, be suspicious about dialysis patients complaining about malaise/nausea if they've missed any sessions. Their kidneys don't work so K+ can increase quickly. Vascular access was obtained early, labs were drawn, and patient was put on monitor right away. All good things. If you can put your monitor into diag mode and display it, that's a good thing. You might see T wave issues or early QRS segment issues. Watch for loss of P waves... Gathering those meds took some time. On the ambulance, they were right across from my face, in easy reach, but I no longer work on an ambulance. Fortunately the patient didn't go so far as to display a sine wave on the monitor. Lots did go right and contributed to catching the developing problem.

Next time, I'm going to pre-position most of those meds as all but one doesn't require refrigeration. That alone would have shaved 2-3 minutes.

Like I said, good learning experience, I learned a lot and the patient didn't leave in a body bag.
 
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Akulahawk said:
Cue HIPAA... Yes, I won't be posting many details of this case lest the patient be recognized...
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Darn it! I wanted details like the patient's full name, social security, credit card numbers, the name of their first pet, and their favorite movie.

Good case of hyperkalemia. Thanks for sharing.
 
Not EMS related, but still in the Public Safety realm. Most of you know I manage a group of six radio stations, today we held a marathon live broadcast to collect clean up supplies for the people who've been ravaged by the floods in Columbia South Carolina. It does my heart good to see the amazing community response. In under six hours we filled a semi with wet dry vac's, generators, garbage bags, mops and brooms and more. There are still good people out there.
 
ViolynEMT said:
Ooooops. Was it CALEMT?
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I think that was me. I carry a G19 and my girl carries a G43 a bought her.

I got the 43 for a steal, paid like $510 OTD with the gun, tax, background and 100 rounds.
 
So, was at work( coffee shop) when this guy approaches me. He says that he's not feeling good and that he's going to sit down for a few minutes. It take 2 people to help him walk to a seat and I start doing a little bit of an assessment. He was complaining of dizziness, started seeing stars, and tightness in the chest. I gave him 2 options of either calling someone to take him to a hospital or I call an ambulance. Even though I told him I would feel better about him going via ambo, he chose to call a friend. Found out today that he was told that he has vertigo. I've never heard of someone having tightness in the chest with vertigo.
On the other hand, I got to do my first medical assessment and it wasn't a drunk person. I don't think I could've done anything different, but still spent the day wondering what the h*ll was going on.
 
DesertMedic66 said:
So at our interventional stroke center we are completely bypassing the ED and going directly to CT if the patient is under an 8 hour time frame from time of onset. So the time from wheels stopped to CT scan is just a matter of minutes.

There is also rumors of us bypassing the ED and going directly to cath lab for STEMI patients.
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Dude we've been doing that for like 2 and a half years :P
 
Handsome Robb said:
Your partner is smokin' from what I saw in the Facebook banana picture.
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Makes my life easy. The firefighters always offer to carry our gear and lift things for her.
 
DesertMedic66 said:
Well you're not in SoCal haha
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True. We do both STEMI and CVA patients with field labs on both and trauma patients as well. Cardiologist meets us at he doors, hospital snaps a 12-lead and off we go.

For CVA teams the Stroke Team meets us at the doors, ERP does a quick assessment, off to CT then the neurologist generally will be meeting us at the ER room by the time we're finished with CT.
 
EMT2015 said:
So, was at work( coffee shop) when this guy approaches me. He says that he's not feeling good and that he's going to sit down for a few minutes. It take 2 people to help him walk to a seat and I start doing a little bit of an assessment. He was complaining of dizziness, started seeing stars, and tightness in the chest. I gave him 2 options of either calling someone to take him to a hospital or I call an ambulance. Even though I told him I would feel better about him going via ambo, he chose to call a friend. Found out today that he was told that he has vertigo. I've never heard of someone having tightness in the chest with vertigo.
On the other hand, I got to do my first medical assessment and it wasn't a drunk person. I don't think I could've done anything different, but still spent the day wondering what the h*ll was going on.
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Probably was pretty anxious with the dizziness and spinning that goes on with vertigo.
 
Handsome Robb said:
Probably was pretty anxious with the dizziness and spinning that goes on with vertigo.
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That's what I'm thinking. He said that the dizziness had been happening since Monday. He looked pretty bad when he walked out of the shop.
 
Handsome Robb said:
I think that was me. I carry a G19 and my girl carries a G43 a bought her.

I got the 43 for a steal, paid like $510 OTD with the gun, tax, background and 100 rounds.
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I'm actually going to get the 43 with the Blue Label discount for $355. No background check here and 100 rounds will cost me $50. :p:D

I shot the G19 and 17. Too big for my tastes. Especially the 17.
 
StCEMT said:
Is it because you are one of those firefighters CAL?
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No, its because when I'm working its like pulling teeth to get fire to carry the bags back to the ambulance.
 
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