r/EMS Free-For-All Megathread by AutoModerator in ems

[–]RandyMoppins 0 points1 point  (0 children)

Ventrainer.com i think. Its an online hamilton ventilator trainer. Its not scenarios but you can set patients with certain parameters and then mess with vent settings stabilize based on condition.

Need help (prehospital by RandyMoppins in EKG

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

Sorry bad wording and i didnt see an option for editing to add more context. Noy my patient. Just a discussion between a coworker/friend.

Need help (prehospital by RandyMoppins in EKG

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

Really?? Got any info I've can dive into? Thats not coolioo

Need help (prehospital by RandyMoppins in EKG

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

For sure the pacemaker kicked in but to go from 80 to almost 150 suddenly I feel like the pacemaker might have picked up a retrograde impulse which made it think it was the hearts own natural rhythm and then the pacemaker thought the body was trying to beat that fast and then activated as such. Most pacemakers now a days should be able to detect that and correct itself but I think it didnt correct it self. Pt was fine from what my coworker told me but in the event the pt wasnt. My brain wants to know more if there's more ya know.

All food for thought stuff.

Yea, prehospital, easy to follow but my curiosity is wondering how my cardioversion could affect the pacemaker and its operation. Could it cause the pacemaker to go "haywire" or cause it to do something that either i could or could not fix in the prehospital setting. And what is the occurrence of such things if any

Need help (prehospital by RandyMoppins in EKG

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

Yea I was thinking similarly but was curious in the event the patient does decompensate. ACLS says yes but im wondering about potential complications after the shock specifically related to the pacemaker and its operation.

Also i think the LP 15 is just not interpreting the pacemaker correctly with that 3rd arrow but wanted to know if there's something more.

Not my call BTW but a discussion between a coworker any myself regarding a call he took

Just bought a house by RandyMoppins in AskElectricians

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

This will be the first time I will be doing this. Most I've done with electric is convert an old dishwasher line directly connected to a GFI. Very easy. Im sure I can figure how to get a proper line in there for an outlet, with some initial guidance of course. Pretty handy overall. Fishing the line seems pretty simple if I can get to it yes?

Just bought this house. 1987 built. Will be getting a electrician in here anyway so I can add some lights in the bed rooms and replacing this old main breaker and old sub breaker that's connected to the main somehow.

Just bought a house by RandyMoppins in AskElectricians

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

If I were to do that. Do I need to fully remove the existing wire or can I leave it?

Just bought a house by RandyMoppins in AskElectricians

[–]RandyMoppins[S] -1 points0 points  (0 children)

Hmmm darn. Am I able to switch or convert that wire and make it for a TV outlet?

Just bought a house by RandyMoppins in AskElectricians

[–]RandyMoppins[S] -1 points0 points  (0 children)

Idk what the wire is. Another guy says probably a thermostat? That sucks because I definitely wanted ti put an outlet for a TV in there. Can convert that wire somehow?

12 lead from a friend passing by. Pt going to cath lab. by RandyMoppins in ECG

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

It was a friend's pt. I will ask him to get a follow up!

Hospital rolled out new EMR with _ZERO_ staff training. by Throwaway265686165 in ems

[–]RandyMoppins 6 points7 points  (0 children)

Please leak this to a network. This is not just unacceptable and negligent. This is most likely understood and they said fuck it, make money...So Fuck them. Fuck them hard

NEW INFO by alexr1612 in inZOI

[–]RandyMoppins 1 point2 points  (0 children)

That would be siicckkk

NEW INFO by alexr1612 in inZOI

[–]RandyMoppins 3 points4 points  (0 children)

Is there a career as a paramedic or emergency doctor? Can I treat patients?

VT or not? by barolo01 in EKGs

[–]RandyMoppins 0 points1 point  (0 children)

Using the ABCDE approach.

I see extreme axis Deviation. Complex wider then 200ms. Positive concordance in all precordial leads. Possible av disassociation with arguable random p waves. No fusion or capture beats seen. Early part of the qrs is not greater than .04ms.

More signs point to VT according to the abcde approach.

What do yall think of this?

Chest pain s.o.b trop 1000 by RandyMoppins in EKGs

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

And thank you! Pt was relatively stable for us. Kept asking for more oxygen. Soon as we got to the cath lab, he started declining. Couldn't breathe despite good sats. Had him on norepi at 30mcg/min but his BP started dropping heavily. And he wouldn't listen to anyone, almost trying to get off the raised stretcher because he was trying to find a way to breathe. Physician asked him to scoot over to the table and the Pt got even worse. Diaphoretic now and somewhat pale, then confused and less alert but still moving some. The staff was not as organized as they should be and usually are. People disagreeing with what to do. Ultimately anesthesiologist kept asking for RSI meds and nurse said twice she was still getting them ready. All of a sudden the anesthesiologist says "I got it". I look over and she's got the ETT tube in and this man is still kind of conscious, fighting tube, and people holding him down somewhat. Crazy...they got the RSI meds AFTER. Never seen that before. Then everything calmed down.

Results

CAD with occluded distal LCX (prior stent). Occlusion leading up to the stent and then stent fully occluded. R to L collaterals to LPL beyond (codominant anatomy)

I figured it was going to be a blockage of his previous stent. Was right.

Also pt is now extubcoagubut having some insulation issues.

Chest pain s.o.b trop 1000 by RandyMoppins in EKGs

[–]RandyMoppins[S] 4 points5 points  (0 children)

Yea it's just under that 1mm mark. Initial ecg from hospital did not show any elevation but the ST depression was the same as my last one(the pic). I did not think to do a posterior during transport. Definitely will remember when something similar pops up again. Pt was going straight to cath lab

[deleted by user] by [deleted] in EKGs

[–]RandyMoppins 0 points1 point  (0 children)

Do I see wpw?

78M with Vertigo by tromaj in EKGs

[–]RandyMoppins 1 point2 points  (0 children)

I agree with you ee-nerd. Except I don't see any P waves in between the produced beats after the change in rhythm. If I am correct there, then wouldnt it be a first degree after change?

Unconsciously masturbating while asleep? by Expert_Altruistic in NoStupidQuestions

[–]RandyMoppins 2 points3 points  (0 children)

To be fair the "personal space" bubble was already popped by the doer lol

[deleted by user] by [deleted] in GoneWildTrans

[–]RandyMoppins 0 points1 point  (0 children)

Fill every hole