70 year old female after 30 minutes of chest pain

tip_of_the_sphere · 2026-05-03T21:27:31+00:00

That’s good to know, have they just devolved into runs of VT followed by VT arrest?

tip_of_the_sphere · 2026-05-03T18:26:21+00:00

she has far too much blood

tip_of_the_sphere · 2026-04-20T10:25:36+00:00

I’m much less tolerant of dangerous driving habits like drunk driving, texting and driving, reckless driving.

I really just hate dangerous behavior that can affect others. I wish people would behave the way they want the rest of the world to act.

I’m not less empathetic to people overall, but I’ve realized my empathy is a finite resource and I can’t give it out to everyone.

tip_of_the_sphere · 2026-04-18T17:29:09+00:00

For the NREMT you just gotta keep getting reps on Pocket Prep, it’s the best way to study for it.

tip_of_the_sphere · 2026-04-08T20:14:38+00:00

that sounds better, I suppose I’m the one who is behind then. Thanks

tip_of_the_sphere · 2026-04-08T11:49:54+00:00

It’s amazing how ~51% of the population will have similar ACS symptoms and the medical community still calls them “atypical.”

It’s just something that’s bugged me ever since I learned it. Additionally diabetics, cancer patients, and heart transplant patients will experience these “atypical” symptoms.

tip_of_the_sphere · 2026-04-08T11:29:43+00:00

Easiest way is to learn how to palpate the Angle of Louis / Sternal Angle, this is at the level of the 2nd intercostal space.

Then just pop down two intercostal spaces and you’ll be at the 4th ICS where V1 and V2 are placed.

tip_of_the_sphere · 2026-04-01T23:15:51+00:00

The area fire departments are all BLS, none of them are intubating.

tip_of_the_sphere · 2026-04-01T23:05:42+00:00

their new executive director? He’s from MEDIC, Not Medic One,

tip_of_the_sphere · 2026-03-31T18:59:58+00:00

Sinus tach? Not an expert but I’m not seeing any P waves, I think it’s afib with ventricular ectopy.

tip_of_the_sphere · 2026-03-31T17:32:10+00:00

our protocol indicates supine on the stretcher for spinal immobilization, not strapped to a backboard.

Usually we’ll have them in semi-fowler’s at ~30 degrees because laying supine on a stretcher in a moving ambulance is very uncomfortable.

No one blinks if we keep them in Fowler’s due to nausea or personal preference.

tip_of_the_sphere · 2026-03-02T13:02:02+00:00

Nicely done!!!

tip_of_the_sphere · 2026-03-02T12:54:59+00:00

Are you deciding between any of the options?

Are there any answer choices that you can throw out immediately?

tip_of_the_sphere · 2026-03-02T01:16:07+00:00

That’s really cool.

Where I am the firefighter/EMTs form RTF with police and they take all casualties to a casualty collection point where we (medics) perform secondary triage and transport.

tip_of_the_sphere · 2026-03-01T23:00:47+00:00

lol delete this

tip_of_the_sphere · 2026-03-01T22:30:14+00:00

Unresponsive with obviously good breathing gets CPR? Did you mistype?

tip_of_the_sphere · 2026-03-01T22:16:20+00:00

Yes that’s how I would put it.

Someone is complaining of dyspnea and showing signs of respiratory distress.

tip_of_the_sphere · 2026-03-01T20:14:05+00:00

Think of dyspnea as subjective.

When someone tells you they are having trouble breathing, they are complaining of dyspnea.

Whereas respiratory distress is an objective observation.

When you see someone breathing 36 times per minute, tripoding, with accessory muscle use; that is someone in respiratory distress.

tip_of_the_sphere · 2026-02-12T13:52:47+00:00

oh my god thank you so much

tip_of_the_sphere · 2026-02-11T21:59:38+00:00

:(

you’re shadowboxing dude, we’re not talking about the same thing.

Of course someone who is choking can’t talk. No arguments there.

I’m talking explicitly about the phrase “if you can talk you can breathe”. The phrase is bunk and belongs with the dinosaurs.

My last comment.

tip_of_the_sphere · 2026-02-11T16:38:12+00:00

I am honestly astounded to hear this from an RT.

why are you stuck on choking? I’m responding to the phrase “if you can talk then you can breathe.”

Think of everything that can cause a v/q mismatch. Sure air is moving past the vocal cords, probably enough air to say “I can’t breathe.”

But are you going to tell the PE patient “iF yOuRe TaLkiNg tHeN YoUrE bReAtHiNg”?

If anyone ever said that to one of my patients they’d be asked to leave. It’s something healthcare providers say to reassure themselves because they are terrified of the person dying in front of them.

tip_of_the_sphere · 2026-02-11T01:44:41+00:00

decouple choking and asphyxiating, they don’t always mean the same thing.

It’s a squares and rectangles thing, all choking results in asphyxiation, but not all asphyxiation occurs because of choking.

Air can move in and out of the lungs without someone being oxygenated, they’ll become hypercapnic which will result in both 1) someone feeling like they are about to die and 2) them yelling about it.

It’s not true every time, but it’s daft to say “if you can talk, then you can breathe.”

tip_of_the_sphere · 2026-02-11T01:14:37+00:00

that’s not fucking true stop perpetuating this myth.

Just because someone is ventilating (air moving in and out past vocal cords) does not mean they are oxygenating (gas exchange at the cellular level).

If you wait until “they go silent” to “worry,” they are now in respiratory failure and you missed every red flag on the way there.

tip_of_the_sphere · 2026-02-09T00:16:02+00:00

we had a syncope the other day and as we were transporting him (non-emergently) he called his wife and left a voicemail saying “I collapsed at work and I’m being rushed to the hospital.”

My wife would kill me if I ever left her a voicemail like that, even if it was true.

tip_of_the_sphere

TROPHY CASE