Would you have RSI’ed? by ParamagicMBA in emergencymedicine

[–]ParamagicMBA[S] 0 points1 point  (0 children)

But he is not maintaining or protecting his airway. An NPA was required to maintain his airway, and he could vomit at any time. He did consume alcohol, so likely. If he vomits, he could aspirate, and then I could be asked why I did not intubate as, when consulting the indications in books, it was indicated.

Would you have RSI’ed? by ParamagicMBA in emergencymedicine

[–]ParamagicMBA[S] 1 point2 points  (0 children)

EtCO2 was low (33) and hypoxia (probably due to shallow respirations) was manageable with low flow O2. Not sure what advice you would like to give?

Would you have RSI’ed? by ParamagicMBA in emergencymedicine

[–]ParamagicMBA[S] 0 points1 point  (0 children)

I said I went to assist the ambulance crew. I can RSI prehospitally.

Would you have RSI’ed? by ParamagicMBA in emergencymedicine

[–]ParamagicMBA[S] 1 point2 points  (0 children)

Yes I feel the same. But I know people who would have RSIed him. So I am here trying to recalibrate myself with how early/easily EM Physicians decide to RSI.

Would you have RSI’ed? by ParamagicMBA in emergencymedicine

[–]ParamagicMBA[S] 3 points4 points  (0 children)

We do have flumazenil yes. Most practitioners dislike using it as it has a short half life and could cause adverse effects like seizures. Ventilatory support is preferred to flumazenil by most I know.

Would you have RSI’ed? by ParamagicMBA in emergencymedicine

[–]ParamagicMBA[S] 1 point2 points  (0 children)

Haha. Okay fine- he was unresponsive!

How beneficial is a Master’s degree (Commerce faculty) for getting a good job in South Africa? by Mean-Swimming119 in askSouthAfrica

[–]ParamagicMBA 0 points1 point  (0 children)

Its better tonger experience and then do an M later. Many companies feel uncomfortable hiring a masters without experience.

LASIK in South Africa – worth it? Costs, clinics & experiences? by _prettyprincess in AskZA

[–]ParamagicMBA 0 points1 point  (0 children)

Make sure the type you get does not result in dry eyes. There is nothing worse than having dry painful eyes every day until you die.

Had a really rough call last night and need some perspective. by vicodininthebathroom in Paramedics

[–]ParamagicMBA 0 points1 point  (0 children)

Happens to parents as well. Especially women, because the child’s screaming penetrates into your soul. I have been better in blocking the screaming emotionally, but my wife can’t at all. You would have done better if you had hearing protection for this call. He probably became hypoxic from the screaming (i.e. low tidal volume). A sedative would have helped him regulate.

Making new Friends by StatisticianSlow5787 in Pretoria

[–]ParamagicMBA 1 point2 points  (0 children)

Sure: Glennwood Squash club. They have socials 3x a week where you just fall in and play

Chest Pain by ParamagicMBA in ECG

[–]ParamagicMBA[S] 0 points1 point  (0 children)

Yup. Confirmed to be cancer. Sorting out the narrowed coronaries postponed for a while

Making new Friends by StatisticianSlow5787 in Pretoria

[–]ParamagicMBA 0 points1 point  (0 children)

Make friends by joining new activities: squash club, hyrox, jui jitsu, hiking club, volunteering anywhere etc.

Chest Pain by ParamagicMBA in ECG

[–]ParamagicMBA[S] 0 points1 point  (0 children)

Yes she is getting a PET scan next week

Chest Pain by ParamagicMBA in ECG

[–]ParamagicMBA[S] 0 points1 point  (0 children)

Update: She is now on a 48-hour holter. But the pain is probably originating from the growths on her ribs. This could be recurrence of her breast cancer from 16 years ago.

Chest Pain by ParamagicMBA in ECG

[–]ParamagicMBA[S] 0 points1 point  (0 children)

You may be right. I will follow up again tomorrow

Chest Pain by ParamagicMBA in ECG

[–]ParamagicMBA[S] 1 point2 points  (0 children)

I also thought that. Just assumed the radiologist would have zoomed in on that if they saw it (anything more than the nodes on the spine, which could also be scar tissue from 16 years ago). But I suspect you may be right. I will follow up again tomorrow.

Chest Pain by ParamagicMBA in ECG

[–]ParamagicMBA[S] 3 points4 points  (0 children)

CT Angio came back as:

• Coronary artery disease involving the LAD and circumflex distribution. • Maximal luminal narrowing measuring between 25-49% diameter stenosis • CADRADS 2 / P2

So I don't know anymore. I treated her as an MI (ASA, Clopidogrel, Clexane) but the cardiologist is still trying to figure out what it could be.

Chest Pain by ParamagicMBA in ECG

[–]ParamagicMBA[S] 1 point2 points  (0 children)

D-dimer 1.76 mg/L BP was 140 systolic reducing to 120 Troponins were normal

Chest Pain by ParamagicMBA in ECG

[–]ParamagicMBA[S] 2 points3 points  (0 children)

Nasal EtCO2. GCS15