the 100% directionless thread

Jim37F said:
Was having some insomnia, like ~4hrs of sleep at home no calls or whatever. (The night before we got chewed the F*** out was a sub 4hr night) Tried taking some melatonin supplements including a sublingual spray, felt like it just screwed me up more.

Bought a bottle of ZzzQuil, the clear "no additives" stuff, label says 30ml dose nightly, only been taking 15ml at home (none at work) and even at station this whole last week all 7, 7½hrs ea night, feel Soooooooo much better
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Try Doxylamine. Its great. Less groggy feeling than Benadryl.
 
I saw a lady get cardioverted by adenosine and she didn't flatline. Is that normal?
 
DragonClaw said:
I'm not sure what all the way means.

I mean he hr was like 220 and now it's like 110 (at the time)
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sounds like it worked well. Adenosine doesn’t always cause a classic asystole so that’s good.
 
RenegadeRiker said:
sounds like it worked well. Adenosine doesn’t always cause a classic asystole so that’s good.
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Shared my story with my buddies and everyone was all like "Oooh you saw her flatline" and I'm like... umm no asystole

So I thought maybe it only kinda worked
 
Are sinus arrest, or a sinus pause no longer applicable terminology?

One last day of a long rotation.

Also, having a teen and a soon-to-be tween distance learning while trying our best to still respectfully SD within guidelines is proving to be a daunting task. This is old.

Also, R.I.P. Black Panther.
 
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Jim37F said:
Was having some insomnia, like ~4hrs of sleep at home no calls or whatever. (The night before we got chewed the F*** out was a sub 4hr night) Tried taking some melatonin supplements including a sublingual spray, felt like it just screwed me up more.

Bought a bottle of ZzzQuil, the clear "no additives" stuff, label says 30ml dose nightly, only been taking 15ml at home (none at work) and even at station this whole last week all 7, 7½hrs ea night, feel Soooooooo much better
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Lunesta. No groggy effects. No sleep walking.
 
VentMonkey said:
Are sinus arrest, or a sinus pause no longer applicable terminology?
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Depends who you are talking to. I doubt many outside cardiology or EP necessarily care to understand
 
VFlutter said:
Depends who you are talking to. I doubt many outside cardiology or EP necessarily care to understand
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//shrugs// That's how I was taught/ learned them in paramedic school.
 
DragonClaw said:
I saw a lady get cardioverted by adenosine and she didn't flatline. Is that normal?
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Yes. Asystole doesn't always happen. Sometimes adenosine just applies the brakes and slows heart rates way down to the point where you can see what the rhythm is. Sometimes what happens is the rate stays slow afterward. Sometimes you do get the asystole and it's interesting to see, along with the restart. The patient on the other hand usually doesn't like having that done...
 
Akulahawk said:
Yes. Asystole doesn't always happen. Sometimes adenosine just applies the brakes and slows heart rates way down to the point where you can see what the rhythm is. Sometimes what happens is the rate stays slow afterward. Sometimes you do get the asystole and it's interesting to see, along with the restart. The patient on the other hand usually doesn't like having that done...
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Is it a matter of dose or the body's metabolism and physical ability to adjust to the medication or something unknown that determines if it slows down vs asystole?

She said it felt funny, but didn't hurt and afterwards was feeling better.

I stared at the strip. There appeared to be "legible" rhythms before and after. It wasn't just like crazy artifact or unknown electrical activity.

Just one beast was the fast rate and the next was half that and it continued on like that.
 
DragonClaw said:
Is it a matter of dose or the body's metabolism and physical ability to adjust to the medication or something unknown that determines if it slows down vs asystole?

She said it felt funny, but didn't hurt and afterwards was feeling better.

I stared at the strip. There appeared to be "legible" rhythms before and after. It wasn't just like crazy artifact or unknown electrical activity.

Just one beast was the fast rate and the next was half that and it continued on like that.
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Adenosine is taken up by a variety of cells including peripheral vascular tissue and RBCs. If the delivery of the drug is slow and resultingly there is a small plasma concentration by the time it reaches the heart you are going to see less clinical effect. A small does may or may not be enough to break a re-entry pathway without causing a significant sinus pause/arrest.

Delivery method is critical to the effectiveness of adenosine in the field. A CVC or RA is ideal but unlikely to be present in the field or ED. A large bore proximal IV with a large flush given as rapidly as possible is typically the best you will get otherwise.
 
To get back off topic, I'll say one good thing about Californians...they know how to merge. They see a truck in the right lane that can't get over they step on it and merge, instead of trying to challenge the laws of physics.
 
First time trying melatonin... kept waking up from dreams. I guess vivid dreams are a side effect of melatonin and I have had them with a supplement I tried a long time ago (Amoryn) although those were straight nightmares.
 
The Spring 2020 cohort just finished the Fitch “Ambulance Service Manager“ Program. This was supposed to be a class that had 2, one week, on site leadership development sessions with a 6 week break in the middle to complete a group research project. First week in Jacksonville went fine. Then C19 loomed it ugly head and through several postponements and ”maybe we’ll hold it live” email, we finally completed the second week via zoom.

Leadership development via zoom, when networking and interpersonal interaction is a key part of the program, was difficult... but we’ve finished the curriculum and through post class feedback, it seems as though we've all come away with some valuable new information and insight about our personal management and leadership practices.

if you’re in a leadership role, or moving in that direction, I’d put it on the short list for positive career development programs.
 
The ZzzQuil I've been using lately is Diphenhydramine HCI (why is the "L" lowercase?) 50mg per 30ml solution.

Very definitely better results for me than any Melatonin supplements. I dont really recall any dreams... but just a general feeling of "yeah I was technically asleep but not actually getting any sleep" i.e. just very restless like I was constantly on the verge of waking up.

So far so good with the ZzzQuil (I bought the "No High Fructose Corn Syrup, No Alcohol, No Artificial Dyes and Flavors" bottle so its a clear liquid vs the normal purple). Working well enough I don't feel a particular need to go and try those other supplements, but I do have issues with occasional recurrence of insomnia so I'll def keep a note of those to try, sadly I'm sure eventually I'll have trouble falling asleep again after this bottle is done....
 
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