the best quote I have heard in a long time

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Veneficus

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When speaking about a very unstable patient in the Cardiac SICU the head of CT surgery states:

"Don't get too caught up in all these fancy numbers, all they do is help you build a trend to anticipate the patient getting better or crashing before clinical signs appear."

"No matter what your numbers say, if the patient is mentating, cap refil is good, the urine bag is full, and the chest drainage is empty, then everything is fine."
 
Excelent advice, it's a shame so many people get fixated the numbers themselves and not clinical corelation.

As an aside, I keep trying to tell certain coworkers that you can't do anything with a sinlge set of vital signs, it takes at least two to see which way they are/aren't moving before you have a clear picture.
 
I like the way he worded that. That really does make a whole lot of sense.
 
I think I'm going to start using that when dealing with some of the EMT's in our department.
 
Nurses around here would do well to heed those remarks. In LA, no one is more obsessed with numbers than nurses, and the paramedics don't know what they mean anyway.
 
We recently got the nasal ETCO2 for our monitors. I'm fearful that some will rely on it too heavily, not reassessing L/S post neb if the waveform improves, using it to count resps, using it to diagnose hyperventilation syndrome, etc.

Also, the less educated get by by doing all conceivable tests, such as a 12, temp, BGL, etc. etc. but don't know what to make of it. They appear to be thorough an competent because they're checking everything, but there's no rhyme or reason. The low speed MVA neck and back (only) gets a 12 and a BGL. Why? That "cover the bases CYA" approachworks fine for 90% of our pts, until someone actually requires tx.
 
Very good words of advice! Like, what was pointed out; if one cannot understand or interpert what the numbers and readings indicate it is worthless acessories.

R/r 911
 
... how true.... never loose touch with your pt. ( physical and visual touch )
 
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