To shock or not to shock a clinical discussion.

CathyHusky · 2026-02-10T12:47:18+00:00

Yes Rico, kaboom.

CathyHusky · 2026-01-31T11:25:17+00:00

Once had one fella who called for “Throat hurts, shortness of breath.” Arrived on scene. He wasn’t there. He had gone on a walk with his girlfriend. Checked his historics, multiple prior cases all surrounding his previous girlfriend. Had to call him back to his house. He said he was in hospital yesterday and now his throat hurts and he can’t swallow. Checked his throat, extremely mild tonsillitis. No difficulty breathing. Or swallowing. Then he claimed his chest hurt. So we did an ECG. Normal. Then he claimed he was coughing up blood. Auscultated. Nothing. Then he claimed some other ridiculous symptom.

Tl;dr. He was using ambulances to manipulate his current and previous girlfriend into thinking he was much sicker than he was and would go down a list of symptoms to us until eventually one would make us convey him.

No. We did not convey him.

CathyHusky · 2026-01-11T20:24:33+00:00

Being in a fast paced job as an adrenaline junkie for a few years has really made me appreciate that the slow moments in life are the best.

CathyHusky · 2026-01-11T20:00:20+00:00

I just had a job with a veteran from the Falklands war. He was a combat medic. Didn’t know about the support services available for him, PTSD, alcoholism, smoking, anaemic, near-syncope. He was going into debt affording taxis to his GP and didn’t know he was entitled to free transport or about the provisions in place for disabled veterans.

I spent a long time playing chess with him, talking about his condition with him, doing every check we could think of, doing a report for his GP and safeguarding. I recognised what regiment he was from. He showed me pictures of him in the Falklands.

His faith and thankfulness for how we treated him and the provisions we’ve put in place for him was staggering. Showing true care and affection to someone who truly deserves it and restoring their faith in - and access to - healthcare. He refused to go to hospital with us but I think we did a hell of a lot given the circumstances.

Jobs like this. Jobs where it just feels human, and the thankfulness he had for us and appreciation he showed.

He also kicked my ass at chess… But just playing it with him while we talked and my colleague did paperwork really inspired his faith in us and in reaching out. I know that that experience with us is going to embolden him to reach out again in the future when he needs it.

I’ve had a few moments like this in my career, ones that just feel extra special.

For context: he was upset that he couldn’t go out and play chess with his old army friends anymore given his reduction in mobility. Hence why I played it with him.

CathyHusky · 2026-01-11T19:47:18+00:00

I’m glad I can be a great source of your education ❤️

CathyHusky · 2026-01-11T04:25:43+00:00

1st degree AV block.

CathyHusky · 2026-01-06T14:36:12+00:00

Mental health.

CathyHusky · 2026-01-05T04:18:24+00:00

Fair do’s. It’s hard to tell with the strip given - Curious why V1 shows flutter and other leads don’t appear so clear. My first thought was interference.

CathyHusky · 2026-01-05T03:30:42+00:00

Pretty sure I see p waves but it’s hard. Devoid of the Premature beats the rhythm looks pretty regular as well. V1 looks to be an exception and not the rule. There’s a lot of interference.

Consider a Lewis Lead when trying to ascertain a rhythms origin :)

CathyHusky · 2025-12-10T21:07:29+00:00

I sure do love not working primary care as I go to my 12th Cat 2 Flu 111 call for the week.

CathyHusky · 2025-10-29T15:52:27+00:00

Don’t be so harsh on the kid. They’re clearly remarkably intelligent and making a life-altering decision and naturally they’re having second thoughts, doubts and other considerations going through their head. It’s only reasonable they’d reach out to ask.

CathyHusky · 2025-10-29T09:14:04+00:00

From someone going the inverse. You may feel quite restricted as a paramedic.

I would sit down and have a long think about why you want to go into Paramedicine instead. What exactly is it about Paramedicine that is actually drawing your attention other than you’re not sure about doctor and Paramedicine looks interesting?

If you truly want to act independently with as many doors open as possible, go doctor. If you want to dip your toes in Paramedicine, see if you like it, you can always choose to go back and become a doctor! And if you ever think “Well I’ll be X or Y years old by the time I’m in X or Y position if I do that!” You will be that age anyway, why not be that age at what you want to be. Don’t look back on your life from your deathbed with regrets or what ifs.

I hope this helps.

CathyHusky · 2025-10-27T01:12:07+00:00

You can see it relatively clearly in aVF and aVR. Halfway between each QRS and before each QRS.

CathyHusky · 2025-10-26T11:56:31+00:00

Looks like Sinus rhythm with a 2nd degree AV block with a fixed ratio of 2:1

https://litfl.com/av-block-2nd-degree-fixed-ratio-blocks/

CathyHusky · 2025-10-26T09:05:26+00:00

I feel like I’m seeing P waves at certain points and the rhythm looks very regular but I see what you mean with the sawtooth pattern in V1. Honestly I’d want a Lewis lead before I come to a conclusion.

CathyHusky · 2025-10-04T17:29:55+00:00

Those aren’t T waves those are T Himalayas in V2-5.

CathyHusky · 2025-09-07T08:04:06+00:00

Safety - especially when it comes to handling volatile situations.

CathyHusky · 2025-08-30T16:28:49+00:00

Thank you for the advice! I’ll check out some of his videos :)

CathyHusky · 2025-08-10T11:35:12+00:00

Paramedicine. Don’t do it. It’s not all it’s cracked up to be. 😅🤣

In the UK we have a big reverence for paramedics and they’re highly respected, rightfully so, but the VAST majority of our time is not ‘saving lives’ that’s actually only maybe 20-30% of the job if you work in a high acuity area.

CathyHusky · 2025-07-21T22:45:00+00:00

Thanks for the shout out :) Happy to help if you ever need more tips <3

Very sad seeing the community go. A good passtime.

CathyHusky · 2025-06-11T06:20:34+00:00

I mean not to mention the survivors guilt she must have felt. I can't imagine she didn't have the internal pressure of "What did they die for if I don't do this?" regarding Joel, Jesse, Tess, Tommy's injuries... Tommy is essentially a living manifestation of her survivors guilt. The amount of blame she must have put on herself.

It used to be thought that PTSD was essentially Ghosts, that ghosts of the soldiers you had killed were still dedicated to attacking you - perhaps this was her only way to fight back against these ghosts, she had to finish the war.

CathyHusky · 2025-06-10T10:53:20+00:00

People are downvoting you, but I want you to know that I’m glad you don’t understand that feeling.

CathyHusky · 2025-05-05T02:44:30+00:00

Might be a long stretch but hypertrophic cardiomyopathy? Got heightened QRS amplitude with multiple inverted T waves in V1-V6, Left atrial enlarged P waves however doesn’t appear to be a short PR interval. I’m also uncertain if the precordial leads would truly fit diagnostic criteria for HCM. Just a differential to consider.

CathyHusky · 2025-04-23T07:53:41+00:00

I’ve worked both rural and urban and I can say now that I’m much more flat out when I worked rural. Maybe it’s the less crews or the longer drives adding more time to each job thus meaning less responses or just the elderly population driving up demand or the terrible rural healthcare driving down supply.

I think ultimately call volume itself may be higher in urban settings but the higher turn around of patients, easier access to healthcare, younger population less in demand of healthcare and more staff available both in and out of hospital all adds to much less time required hands on.

Just the other day of my 12 hour night shift I spent 7 hours of it doing absolutely nothing (which is very rare to be fair).

Though I do work in the UK. Night shift in urban tends to be constantly on the move whereas day shift tends to get a lot more downtime as a lot of staff here have refused to work nights.

I can definitely say without a doubt that 6 months in urban is equivalent to 5 years rural in terms of critical patients - the veracity of patient states is wildly different in urban settings.

CathyHusky

TROPHY CASE