the 100% directionless thread

VentMonkey said:
The numbers (values) themselves are mostly a commit to memory thing.

Putting two and two together is also reading the whole clinical picture of the patient and the hemodynamics that go alongside (e.g., neurogenic shock obviously being one of the easier ones) them.

The videos you’re referring to make so much more sense to me almost 5 years after first learning this stuff, so I know the boat you’re currently in. You’re lacking the ICU-level component of your paramedic thinking. That mostly comes with time.

When you actually test, just like any exam read the scenario and it will clue you in as to what type of shock you’re dealing with.

And finally, there’s the sad reality that these values are seldom used in the transport setting anymore, but that may also vary from program to program as well.

Haha, gotta love the IBSC. GL.
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Forgot about that last part. For test taking purposes, you wedge the catheter. In reality, you dont.
 
Aprz said:
By the way, do you have any tricks or resource for trying to use stuff like CI, PAWP, PA, SVR, etc to figure out what shock it is? I feel like I did have a hard time with learning that and going to go over it again. I know the values, but I can't seem to figure out shocks without pure memorization. The IA Med video was talking about trying to follow the heart to figure out where the problem is, but it actually still didn't make sense to me. I am starting to think it is just pure memorization, but the guy in the video was making it seem like there was a pattern if you follow the flow of the heart/lungs.
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Swans are very rarely used, I have seen one in the past ten years. There is a lot of literature which has demonstrated swans increase LOS and complications, so we only really use them when we absolutely must. These studies go back over two decades so it surprises me that IBSC and AACN hold on to this essentially vestigial tool so closely. It may be more difficult now, but I would recommend studying the actual physiology as it will be more helpful when you actually see the data that we use from the cath lab, bedside echos, nicom, flotrac, et cetera.
 
Peak said:
Swans are very rarely used, I have seen one in the past ten years. There is a lot of literature which has demonstrated swans increase LOS and complications, so we only really use them when we absolutely must. These studies go back over two decades so it surprises me that IBSC and AACN hold on to this essentially vestigial tool so closely. It may be more difficult now, but I would recommend studying the actual physiology as it will be more helpful when you actually see the data that we use from the cath lab, bedside echos, nicom, flotrac, et cetera.
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I imagine it's just that they've never bothered to update the way they teach hemodynamics. A PA cath and the numbers that they generate offer a practical and familiar (to us dinosaurs, anyway) conceptual model for how blood flows through the great vessels, the chambers of the heart, and the peripheral container and how changes in flow and pressure those spaces can affect the others.
 
Talked a doc I’m friendly with into letting my new guy tube a very ill patient we brought in and while I would have liked a tube myself, it felt pretty good to be able to get him that opportunity.

oh and we successfully precordial thumped a 26 year old who had a VTach arrest while seizing.
 
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Just accepted an offer to be the health officer this summer at a BSA camp that I camped/worked at when I was a teenager. That'll be fun. Spend a whole summer in the beautiful Northwoods of WI, handing out popsicles to homesick youth.
 
Jim37F said:
SCTU?
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It’s a Specialty Care Transport unit. The trucks that move neonates and the like.
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Seirende said:
Just accepted an offer to be the health officer this summer at a BSA camp that I camped/worked at when I was a teenager. That'll be fun. Spend a whole summer in the beautiful Northwoods of WI, handing out popsicles to homesick youth.
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Uhhhhh...nope.
 
Seirende said:
Just accepted an offer to be the health officer this summer at a BSA camp that I camped/worked at when I was a teenager. That'll be fun. Spend a whole summer in the beautiful Northwoods of WI, handing out popsicles to homesick youth.
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Just don't end up in a Meatballs remake.
 
Haha I had to look up what "nookie" meant. I was pretty sure from context, but again, a bit before my time.
 
It was Bill Murray’s first starring role in a movie! Total classic.
 
Funny that a CHOP truck was posted because we have a contract with them. I’m looking forward to working the CHOP truck next year even though I can only drive. I’ll get to see some interesting stuff.
 
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Every time I ask EMT students if they know who Johnny and Roy are, I get fewer and fewer hands. Only one guy knew the show in my last batch.

i guess “KMG-365 10-4” will end with this last Bach of EMS dinosaurs.
 
NomadicMedic said:
Every time I ask EMT students if they know who Johnny and Roy are, I get fewer and fewer hands. Only one guy knew the show in my last batch.

i guess “KMG-365 10-4” will end with this last Bach of EMS dinosaurs.
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Bet they’d know the names to the characters in Chicago Fire, and 9-1-1 though...
 
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