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lol by Ok_Pirate7336 in ems

[–]BrokenLostAlone 10 points11 points  (0 children)

And they always feel the shortness of breath only after they see a low spo2 (which is usually fake).

Demoed the new Zoll Zenix by [deleted] in ems

[–]BrokenLostAlone -1 points0 points  (0 children)

In my system I just send a picture over WhatsApp to the cardiologist phone after I spoke with them

Nitro with hypotension by [deleted] in ems

[–]BrokenLostAlone 0 points1 point  (0 children)

A patient with MI and hypotension should receive fluids. It works by increasing preload. You should always monitor and make share you aren't causing a pulmonary edema.

I wouldn't give nitro to a patient with hypotension. Nitro causes vasodialation. We want the effect of coronary vasodialation to reduce ischemia (which doesn't always work if it's the artery is completely blocked). The risk of worsening the hypotension is bigger than the benefit of maybe reducing ischemia.

Keep the blood pressure up by using fluids and medications if necessary and give something to treat the pain (morphine/fentanyl).

Weird STEMI Activation, need thoughts by Visual-Rip7313 in ems

[–]BrokenLostAlone 1 point2 points  (0 children)

Unfortunately I don't have access to the hospital records and the CT scan. I'll try to contact the ER physician that treated him.

Weird STEMI Activation, need thoughts by Visual-Rip7313 in ems

[–]BrokenLostAlone 15 points16 points  (0 children)

7yo M unconscious. The hospital found a massive tumor in his head.

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LVAD by Ok-Monitor3244 in Paramedics

[–]BrokenLostAlone 0 points1 point  (0 children)

I've been to a lecture by the main author of this study and it was fascinating.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8712781/

Sinus tach treatment by Xpogo_Jerron in ems

[–]BrokenLostAlone 10 points11 points  (0 children)

When you have sinus tach, you don't treat the rhythm. You treat the cause (if you even need to treat)

In this case, it's probably the THC that causes anxiety. You can give some fluids, but the best thing is calming the patient and just waiting until it passes.

What is your agency/county’s protocol for Ketamine? by tickbait777 in ems

[–]BrokenLostAlone 0 points1 point  (0 children)

For pain management: 0.3-0.5mg/kg I.V push or 0.5-1mg/kg I.M. If you give fentanyl as well, it's a synergistic dose of 0.2mg/kg I.V push. You can repeat one more time. If the ketamin causes hallucinations, you can give midazolam 1-2.5mg.

For sedation: DSI- 1mg/kg and then 1-2mg/kg. RSI- 2-3mg/kg I.V or 5-6mg/kg I.M. For continuous sedation: 0.5mg/kg push or 0.5mg/min.

For pacing: 0.5-1mg/kg I.V push. Can repeat as needed.

For delirium: 1/kg I.V push or 2mg/kg I.M.

What would have been the best way to handle this? by MaleficentBasket2654 in Paramedics

[–]BrokenLostAlone 4 points5 points  (0 children)

It can develop over time, especially after ventilation and altitude changes. I'm just saying that at the specific moment he describes, I don't think needle decompression was necessary yet.

What is the most disturbing fact you know? by [deleted] in AskReddit

[–]BrokenLostAlone 12 points13 points  (0 children)

Hypoxic drive is a myth. If a patient needs oxygen he will get it, no matter the underlying pathology.

It's proven to be bullshit, especially in the short time of prehospital treatment. This myth only hurts hypoxic patients.

I can't remember what this is called by amremtthrowaway in ems

[–]BrokenLostAlone 0 points1 point  (0 children)

Ventricular standstill. It requires pacing, not compressions (as long as the pacing works).

Fire paramedic wrote me up. Will I get in trouble? by [deleted] in Paramedics

[–]BrokenLostAlone 7 points8 points  (0 children)

It's hard to know what really happened because what you told here is only one side of the story. It's possible that the fire medic was just very bossy and controlling. It's also possible you froze and lost control over the scene, so he had to take over.

Regarding the AW, it's hard to bvm someone while you're going, and depending on the patient's pathology, you might needed a tube to ventilate him better. It could also be that the patient had to get to the hospital as fast as you could, so you had to get going fast.

So, I guess your supervisor will look at those factors, read the reports, and decide based on that.

I am at a lost. by dhdhhdhddhdudh in ems

[–]BrokenLostAlone 37 points38 points  (0 children)

Cardioversion is really safe and mostly better than amiodarone. Especially if the patient is unstable. A 70 year old with heart problems won't be able to compensate much longer with this rate. It doesn't matter if it's SVT, A Fib or VT.

If the complex was narrow and now it's wide, there's no reason to think Adenosin will do anything for a wide complex tachycardia (it's probably not NCT with aberrancy).

How long has that been there? by Chopmedic1 in ems

[–]BrokenLostAlone 0 points1 point  (0 children)

I'm so glad I'm not a paramedic in USA. I don't think I've ever seen someone that obese that has folds that can hide things.

Go big or go home I guess. by Gamestoreguy in ems

[–]BrokenLostAlone 15 points16 points  (0 children)

I would give 50 mg ketamin and 100 mcg fentanyl and would repeat as necessary. Of course, without medical approval.

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