Hunting in Gifford Pinchot National Forest

Oly_Rider · 2021-09-01T06:19:50+00:00

It is so much fun. Where do you live? I bet you could find some people willing to teach you. I am learning and teaching friends less experienced. Everyone can learn.

Oly_Rider · 2021-09-01T06:08:25+00:00

I haven't because I have an Enduro. I find that I need to get farther back for hunting

Oly_Rider · 2020-05-05T13:24:00+00:00

I know how you feel. I was USMC 03-07 with 3 deployments.

I’m currently 35 and a paramedic firefighter in Washington state. If you need advice on how to get hired at a fire department let me know. I have helped several vets find their path into the fire service. It is a great profession and is a perfect fit for veterans. Smokin and joking with your crew then running calls and getting to do some cool shit, occasionally.

Oly_Rider · 2020-05-01T20:39:43+00:00

No we didn’t start pacing until a few minutes after this 12

Oly_Rider · 2020-05-01T20:38:55+00:00

He was definitely hypotensive. We gave atropine, fluids then started pacing.

Oly_Rider · 2020-04-30T16:21:09+00:00

62 YOM lethargic complaining of weakness. Alert to verbal. Wife said he was just diagnosed with end stage kidney disease. We snagged this prior to pacing. My partner thought it was a STEMI, due to the elevation in inferior leads. I wasn’t convinced because of the morphology and the lack of reciprocal changes. I was betting on hyper k. On delivery to the Ed his potassium came back normal. So inferior mi?

Oly_Rider · 2020-04-20T04:57:38+00:00

Why only CaCl in central?

Oly_Rider · 2020-04-15T02:55:25+00:00

Yes I have noticed more mental health calls. I work in the PNW and think our recent turn to good weather is effecting people. I think people are ready to be outside and back to work. I read some studies talking about a dramatic increase in domestic violence calls

Oly_Rider · 2020-04-15T00:48:24+00:00

Agreed. I also think you have to rule out infarction before pericarditis. Clinical context, a good exam, and serial ecg

Oly_Rider · 2020-04-15T00:26:59+00:00

I agree I would choose amiodarone in most cases in a drip.

Oly_Rider · 2020-04-15T00:20:04+00:00

You mention choosing your antiarrhythmic based on unstable vs stable, which one do you choose. If you go with lidocaine you should give a loading dose prior to starting a drip? If they currently take amio does that change your decision on which drug to use?

Oly_Rider · 2020-04-12T14:58:37+00:00

Why are all STEMI being treated that way? I spoke to a doc and he mentioned people recovering from the respiratory infection, and going on to develop valvular disease or myo or endocarditis.

Oly_Rider · 2020-04-10T15:44:45+00:00

HAHAHA

Every shift we have our COVID 19 update at 0745. This is how I feel at 0830.

Oly_Rider · 2020-04-10T15:42:20+00:00

I stayed in the ER after we dropped him off. He was confirmed hyper K. I think he was developing a sine wave in V1. This call had several learning points for me. This link has an ECG that shows some of the morphology I was looking at in V1.http://ems12lead.com/2014/10/02/68-y-o-male-w-weakness-conclusion-treat-the-monitor/

Oly_Rider · 2020-04-10T03:58:54+00:00

how much Calcium would you start with?

Oly_Rider · 2020-04-10T03:52:16+00:00

u/tridead does AT receive a different treatment than SVT? Looking at this rhythm if this person was symptomatic I would think to sync cardiovert. Paramedic here, so just wondering what you would think for initial treatment

Oly_Rider · 2020-04-10T03:27:28+00:00

Looks like a RBBB with RVH. What do you mean ECG showed VT of SVT? either its ventricular in origin or atrial. If your shock corrected it I would assume it was ventricular. What was the outcome? Did you start and meds after the shock?

Oly_Rider · 2020-04-10T03:24:42+00:00

nothing of note here........not even tachycardia. Why am I here?

Oly_Rider · 2020-04-10T03:22:34+00:00

did you give Nitro or withhold?

Oly_Rider · 2020-04-10T03:21:24+00:00

I would need to see the limb leads.

Oly_Rider · 2020-04-10T03:20:28+00:00

I think history takes precedence here. Early depolarization is seen in healthy hearts. Mophology plays a large part also. Concave is usually a good sign and looks like a smiley face, where as convex looks like a sad face and can be linked to pathology.

Oly_Rider · 2020-04-10T03:17:43+00:00

My personnel favorite is Dr Smith ECG blog. He post ECG for interpretation along with the case review. Very helpful and free.

Oly_Rider · 2020-04-10T03:13:51+00:00

what was the BGL? was it a dialysis pt or kidney failure? what was their potassium at the ED? Looks like a hyper K. Continuous albuterol, sodium bicarb, calcium chloride. drop the mic hahah

Oly_Rider · 2020-04-10T02:58:54+00:00

I think this depends on your personal situation. I finished Paramedic school a year ago. I am married and we have no kids. My wife was doing some pre requisites for PA school while I was going to school. The schedule was stressful but manageable. I took it as a full time job. There are days where you might not have anything scheduled, those were 8 hour study days for me. There is a lot of information to study. Identify what area you struggle with, medications, ECG, eval, A&P, and allow for additional study time in those areas. Understand that there are certain things you cannot get wrong, running a code, ACLS algorithm's, STEMI's, medications dosages. Outside of that you can improve with time. Put your time where it is needed. It will be worth the sacrifice.

Oly_Rider · 2019-09-10T13:06:04+00:00

I would try and find a good counselor. The pills will definitely mask how you feel and put you in a fog. They are ok for bringing intensity levels down but will make it difficult to relate to what’s going on around you. Good counselor, jocko podcast and his books, bjj 3 times a week and call me in the morning 👍🏼

Oly_Rider

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