the 100% directionless thread

At the boyfriends apartment and a roommates girlfriend is over and she's laying down on the couch after being seemingly fine because she feels ill.

I get called over because... .... because??

This roommate previously tried to give me unsure and unsolicited advice about a burn I'd gotten because he "took a first aid class"

Not sure why he didn't first aid his gf now...

But she reports an 8/10 pain and says she's bleeding down there and has been on birth control before and got off it about a month ago. Complains cramps, nausea and general malaise.

She also says she has an ovarian cyst.

I'm not really sure what they wanted me to do. Ultrasound her?

You know what. There's a nearby hospital. Get in my car I'll drive you POV. That's what I'm supposed to do. Drive people to the hospital.

Just told her there's not much to be done without imagine/labs/a doctor/hospital.

I really don't know what they expected.
 
Anybody know of a website that offers up IABP timing errors in a quiz-like format?

I’m trying to brush up on them, and I know there’s one for ABG’s.
 
VentMonkey said:
Anybody know of a website that offers up IABP timing errors in a quiz-like format?

I’m trying to brush up on them, and I know there’s one for ABG’s.
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What is the one for ABG's?
 
Peak said:
Well, that website just told me that cardiac index increases in septic shock so...
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I’ve always thought of sepsis as down in all of the parameters, but have heard as of recent that it can be both(?). I’m no hemodynamics expert nor do I claim to be, so...

Also, I forgot how smooth gin is.
 
VentMonkey said:
I’ve always thought of sepsis as down in all of the parameters, but have heard as of recent that it can be both(?). I’m no hemodynamics expert nor do I claim to be, so...

Also, I forgot how smooth gin is.
Click to expand...

Depends on your intravascular fluid balance and if your heart function has taken a hit. Often in adults we see a sv of 20-45 before fluid resuscitation, and most adults just don’t tach up enough to get back to a normal CI.
 
I would disagree with that thought. A resuscitated adult septic patient does more often than not have a normal or hyperdynamic CO.
 
silver said:
I would disagree with that thought. A resuscitated adult septic patient does more often than not have a normal or hyperdynamic CO.
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I think that's hugely variable on how ill the patient actually is. The more critically ill the patient is after resuscitation the less often they have a normal or increased CI. Those who are fluid responsive and less ill do tend to maintain a normal or increased CI.
 
Patients in septic shock are usually hyperdynamic initially due to tachycardia and non-existent SVR which allows them maintain a reasonable SV until they become either profoundly hypovolemic or have cardiac dysfucntion from acidosis. The patients we see who actually have invasive hemodynamics are usually already in the latter stages of shock.
 
You can easily assess early and without invasive lines by using a nicom or clearsight
 
Lots of medical talk for the directionless thread.

Getting back off topic, one thing nice about driving through the remnants of a hurrican is I don't have to pay over $100 to wash all the bugs off my truck.
 
NomadicMedic said:
I think my 7 year old is a natural at field hockey. The coach is amazed at how well she plays.

I hope this is the sport she excells at. It's so much fun watching the kids play.
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How do you play field hockey. How would the puck move on grass.
 
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