the 100% directionless thread

Old Tracker said:
Dunno where to ask this. I'm in the first stages of an AEMT class and we are going through Acid-Base balance (airway management). The book is talking about hyperkalemia and hypercalcemia, which I see the Ps discussing quite often here. They are also part of the H's and T's. My question is how do you know, how do you measure that with any certainty? Am I getting ahead of myself? Thanks.
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Whenever possible I take a look at the most recent labs for a patient. If you don't have that then your next best bet is something like an iStat so you can draw your own CMP... but most of us don't have that luxury. There are some signs and symptoms to watch for when the levels get too out of sorts but when the patient is dead (why we'd run down the H's and T's)...
 
Old Tracker said:
Dunno where to ask this. I'm in the first stages of an AEMT class and we are going through Acid-Base balance (airway management). The book is talking about hyperkalemia and hypercalcemia, which I see the Ps discussing quite often here. They are also part of the H's and T's. My question is how do you know, how do you measure that with any certainty? Am I getting ahead of myself? Thanks.
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I can't really measure with certainty, there are just things to look for that lead you in those directions.
 
Unless the clinics sends them to the hospital for admission, or the Mexican ambulance brings them from their hospital we rarely, if ever, see labs. Thanks.
 
Old Tracker said:
Unless the clinics sends them to the hospital for admission, or the Mexican ambulance brings them from their hospital we rarely, if ever, see labs. Thanks.
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Peaked T waves on the ECG is an indication of hyperkalemia. Hypercalcemia is something we didn't cover all that much in didactic but I could imagine that it would have something to do with repolarization. Maybe (after a quick google search) shortened ST segment? Aside from changes on the monitor I don't know of any indications other than labs in the hospital.
 
Thank you, I am probably getting ahead of myself because ECGs are a couple of weeks down the road, so we'll see. Thanks again.
 
When you wake up and walk outside and it's 72 degrees instead of 90... in August... in the desert... what is going on?
 
CALEMT said:
When you wake up and walk outside and it's 72 degrees instead of 90... in August... in the desert... what is going on?
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I'm really jealous of you right now.
 
CALEMT said:
When you wake up and walk outside and it's 72 degrees instead of 90... in August... in the desert... what is going on?
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Why would you even question such splendor?
 
For those of you who have ran TCA OD's, what range did you see QRS changes if any? RN seemed worried the dude was gonna be having problems down the road after we dropped him off. 500mg+- was taken. The very brief Google fu I've done between calls doesn't make me too worried about about 500.
 
StCEMT said:
For those of you who have ran TCA OD's, what range did you see QRS changes if any? RN seemed worried the dude was gonna be having problems down the road after we dropped him off. 500mg+- was taken. The very brief Google fu I've done between calls doesn't make me too worried about about 500.
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All of the TCA ODs I have seen had significantly prolonged QRS, some almost sine wave, but were massive overdoses whom I assume took a whole bottle. Not sure for mild overdoses but I seem to recall over 1g being potentially life threatening. Quick search says >10mg/kg is bad and >30mg/kg is really bad. How long ago was the ingestion?

https://lifeinthefastlane.com/toxicology-conundrum-022/
 
VentMonkey said:
Am I the only one tired of, and/ or who's noticed the reindeer games that have been going on here quite frequently lately?
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You know how I feel. No need to validate it.
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Chase said:
All of the TCA ODs I have seen had significantly prolonged QRS, some almost sine wave, but were massive overdoses whom I assume took a whole bottle. Not sure for mild overdoses but I seem to recall over 1g being potentially life threatening. Quick search says >10mg/kg is bad and >30mg/kg is really bad. How long ago was the ingestion?

https://lifeinthefastlane.com/toxicology-conundrum-022/
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It was probably 20-30 before we got there. He had lower dose pills from what I've found (25mgx20). Based on what I've seen and you said, his dose wasn't good, but not close to the oh **** level. No concerning changes to his ekg while I was around.

RocketMedic said:
To the bicarb!
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More like nice quiet ride to the ED once PD got there. Fortunately didn't have to do any type of aggressive managment on this dude.
 
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