Ask A Medic

Is there anything I should read, brush up on or get a head start on?

 

Any of you guys know if the NIBP tubing for the lifepak 12's are compatible with the new LP15's?

About to order a cuff and tubing for work because there are only a few monitors that we have that has a BP cuff with it...PITA to take manuals with every pt...but we are going to switch to LP15's "soon" so I dont want to waste the $50 if I will just end up buying another one.

 

I think they are, but I have only used the LP15 on OT days at another station...we get one last. It doesn't seem like the type of thing they would have upgraded, although they should, because the LP12 NIBPs are notoriously unreliable. ours are usually 10-20mm/hg off. + or - .....

I had 2 significant ACLS calls so far (this year) where I wished I would have gotten the chance to, or remember to get a manual BP first as a baseline, as i was never able to get a reliable one the whole call....

shit happens tho.it always works out in the end..its just not as easy to explain later when you miss something simple. I have had one to two CQI calls almost every week this spring it seems..

first one was an unresponsive (symptomatic) Bradycardic Afib Pt,(looked like IVR at HR of 30 with no palpable carotid pulse. I had to auscultate heart tones to get his rate) but the LP12 showed BP well over 100 sys...
initially. he did get paced when his BP when under 100, but it shoulda been sooner...the pads were in place, i was just being cautious about the A-fib. he ended up terminally coding in the ED hours later.

The other was a chest pain-er who went into V-tach just as soon as we put him on the monitor...we were shocked. lol, no wait we were suprised....HE got shocked...(cardioverted, of course...) and he got a trip straight to the cath lab,eventually(40+ minute transport from BFE mutual Aid district with a AMI stat pt. lovely.) but he was awake to say thanks in the ED.... both calls were learning experiences big time.

on a sort of related note we have EZ IO drills now. Now thems are the shiznit....

 

Ok medics. Got a medical question for you. Had a series of Xrays and MRIs done after I got back from Afghanistan. Doc has me come in to talk about the results. Spinal stenosis, 2 bulged disks and damage to the nerves exiting my spinal column. The pain in my back started while in Iraq in '08 but the docs said I was faking it trying to get meds. Now the pain doesn't stop, sometimes gets nearly unbearable and I sometimes loose feeling in my left leg. Is this something that a doctor should prescribe a years supply of 800mg ibuprofen for??? Id say no considering the downside of the med. Sorry, I know the answer, I just need someone to side with me to make myself feel better about it.. LOL. Bitch session complete. Have a nice day.

 

I'm not a medic but to me ibuprofen is better than doping you up opiates. I watched a friend with a slipped disk get addicted to opiate painkillers almost 5 years ago. He was a good-looking kid who got A's in every class in college and had his own business with 50 employees before he even graduated from high school. Now he's a loser, hie's gained a lot of weight and has this weird bloated look all the time, lives with his parents and failed every class for 2 years until the university kicked him out. He drinks, takes 8-10 pills every day and when he runs out of pills he buys crack cocaine and meth.

I'd take a little liver damage over long-term opiate use.

 

Question: I've heard people using IV therapy the day after a long night of drinking to help cure a hangover. Does an IV NS or bananabag actually help releive a hangover as well as I've heard? And is doing so actually legal?

Just curious, thanks.

 

Many of the symptoms of a classic hangover are due to dehydration. Firstly, alcohol is not water so drinking it does not hydrate you and secondly, without getting too technical, alcohol causes a change in the body's hormones, which results in the kidneys excreting more water.

Of course, intravenous fluid replacement can help but you need a prescription for an IV. Also, a bag of IV solution and administration set will cost you upwards of a hundred bucks -- welcome to the world of corporate medicine. Not to mention that as an untrained person you would probably find it difficult to successfully start an IV on yourself.

It's better to prevent the hangover in the first place by not being dumb enough to drink to excess. I have no sympathy at all for people with hangovers due to the fact that I've seen so many people killed by drunks.

If you want to have a few beers on a hot day and can keep your wits about you drink two glasses of water for every beer you drink and you probably won't have a hangover.

 

Wow. Drinking and drunk driving are two separate issues. You can drink too much and have a hangover without killing someone.

Easiest way to avoid a hangover: when you are done drinking, before you go to bed drink 2 glasses of water. Problem solved. I've had some legendary nights but never so much that 2 glasses of water couldn't take care of it.

 

Speaking of hydration, it's important to remain hydrated when diving too as several factors combine here to have a diuretic effect similar to that caused by alcohol. Dehydrated divers have a much harder time out-gassing and are much more susceptible to decompression sickness. Tossing off a couple of beers before or between dives just exacerbates the problem. Not to mention that the euphoric effect of nitrogen at depth combines with the intoxicating effect of alcohol and can render divers a danger not only to themselves but to others.

If a person can handle their drinking or other "recreational" drug use without causing harm then good for them. However, well over half of all emergencies in the US are related in some way to the use of alcohol or drugs.

 

I am a Doctor of Pharmacy and I've never considered doing this and I actually abstain from alcohol all together. My buddy lives in Vegas and consumes alcohol heavily at times - he has a buddy who is a medic and "hooks him up". it spiked my curiousity, that's all. Thank you.

 

I am a Doctor of boobies. I consider all boobies. Please allow me to examine them.

 

I would do what the doc told him to do. Long term NSAID use is not a joking matter. There is no such thing as "a little liver damage". Your liver is much too important to be treated like a red headed step child.

Bananabag can only be had in an ER since it is a prescription.
I have seen the effects of an IV bag to one very hung over individual. It helps. Since most of the time you don't feel like drinking more (water). Fluids are very important.

Exactly. I usually do a glass of water or a large chug of Gatorade since it has electrolytes

 

I heard that too. But we just got a new shipment of F350s with the gas engine and new paint jobs.

lucky. I have to slouch pretty good to fit in the mod. I like the space though. Would not got back to a twinkie ambulance.

Awww, a booblogist

 

Indeed, and Boobiologist.

I also have one of the only diesels in the county.

Hate gassers. So fucking gutless.

 

So peaceful at night though. Not loud at all

 

I drive with music. Peaceful at night means sleepy time. Additionally it's not that much louder than my truck with MTZs and a Borla exhaust. I'm kinda used to the extra sound.

And we get so much wind here, with gassers I can literally be pedal to the metal and still only max out at 55-60mph. Diesel? Not a problem.

 

I need to upgrade my license before taking my PCP course, how do I and what vehicle do I need to get my hands on to take the test?

 

instant hangover cure is a 5hr energy and a gatorade. it works wonders

 

Love/ hate relationship with nights like last night. You "rest your eyes" just long enough where u get home and can't sleep knowing u got to go back to work at 1700. Good part we ran 2 calls before midnight and didn't do anything past 2330

 

So my application is in along wit 100 or so others and max seating is 45, so I need to show that I am the best candidate through an interview, and the CAAT test. any tips??

Also as part of being a ski patroller we work non ski events in the summer as MFRs. I think that I may pick up a pair of black EMS pants to do those. Any recommended pairs that are inexpensive? They don't have to be the greatest since they will be for non ski events/ski patrol clinic only.