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Posted: Sun Mar 16, 2008 3:13 pm
by PFO
[quote="musketeer"]Neither obese nor a piss tank. Athletic build, (quite nice actually) I didn't say that :oops: Yea I did think TIA and gave him a quick stroke test but inconclusive. Handballed to hospital cause I like covering my bum!![/quote] handballs are great, they should be knighted and called sir handball and given the respect that the handball deserves :lol: :lol:

Posted: Sun Mar 16, 2008 5:23 pm
by Ambul8
musketeer wrote:Handballed to hospital cause I like covering my bum!!
Nothing less than the right call, especially if there is any amount of doubt, no matter how small.

Remember the golden rule: IF IN DOUBT, SHIP EM OUT!!!!!

On a side note, we are getting some bedside trop test kits for work. Bloody expensive.

Posted: Mon Mar 17, 2008 12:42 pm
by Markmywords
Q: Preferred method off intubation ? ET Tube or laryngeal mask

Minesite cowboys ? How do you spot one !!!

Posted: Mon Mar 17, 2008 12:56 pm
by PFO
[quote="Markmywords"]Q: Preferred method off intubation ? ET Tube or laryngeal mask

Minesite cowboys ? How do you spot one !!![/quote] ETT for me, LMA pre-hospital i have concerns with. Many patients who require airway maintenance have an increased risk of aspirating especially with shock and cardiac patients that go into trismus. Have to be pretty quick if that occurs lol. At the end of the day,whatever skill level. OPA BVM, ETT as per protocol, if on a minesite perhaps Combi as long as criteria is met. I dont know if SJA carry them or not. Used to carry them with ALAS just before rfds finished, but for me i would keep them for patients in theatre who have been fasting and at a reduced risk of aspiration.

Minesite cowboys.......Hhhmmm let me see.......... ah...... 1) all talk and 2) Paperwork ( lack of and poor quality handovers ) Shell be right mate ill treat the machine and not the patient lol. and to save the best for last " ill just keep sticking him with this 23g butterfly until i get a vein" :lol: :lol: :lol: same butterfly :roll:

ET or LMA

Posted: Mon Mar 17, 2008 12:58 pm
by Para
I prefer ET intubation - protects the airway from aspiration and provides an additional drug route.

The use of an LMA is extremely limited, its merely an "internal" face mask, really dont like its use prehospital, unless there is a failed intubation I wouldn't use it. Really it only rests your other hand by providing constant face seal.

Posted: Mon Mar 17, 2008 4:50 pm
by Ambul8
Markmywords wrote:Q: Preferred method off intubation ? ET Tube or laryngeal mask

Minesite cowboys ? How do you spot one !!!
ET, carry LMA for failed intubation drill.

Spot? Its hard to spot anything when ur drunk.... :P

yeeehaaaaaaaaaaaaa

ETT?LMA

Posted: Tue Mar 18, 2008 1:57 pm
by musketeer
ETT if trained and authorized to do so.




Now where did I hear that!!!!

Ambul8

Posted: Tue Mar 18, 2008 4:16 pm
by musketeer
"On a side note, we are getting some bedside trop test kits for work. Bloody expensive"quote
How expensive, and how often do you think you would be called upon to use one!!
Not very often, in my experience, as it is usually used for prolonged chest pain(cardiac origin) of more than a day at least. I would hope we ship 'em out before that!!!
Just a thought, are you that remote?

Posted: Tue Mar 18, 2008 6:17 pm
by Markmywords
If in doubt ship them out:

Which one you use more

local ambos/rfds or transfer yourself

Posted: Thu Mar 27, 2008 5:47 pm
by munchkin1981
scenario

mid 20's female comes to you with ankle/leg pain had for past 2 days getting progressive worse swelling bruising pain goes up the outside of the leg when weight is applied ice make pain worse ..........
what would any of you suggest

Posted: Thu Mar 27, 2008 6:10 pm
by Toottoot
munchkin1981 wrote:scenario

mid 20's female comes to you with ankle/leg pain had for past 2 days getting progressive worse swelling bruising pain goes up the outside of the leg when weight is applied ice make pain worse ..........
what would any of you suggest

Three weeks in the stirrups.

Pain

Posted: Thu Mar 27, 2008 7:18 pm
by jasonjag
Toottoot wrote:
munchkin1981 wrote:scenario

mid 20's female comes to you with ankle/leg pain had for past 2 days getting progressive worse swelling bruising pain goes up the outside of the leg when weight is applied ice make pain worse ..........
what would any of you suggest
Three weeks in the stirrups.
I use wheat heat bags for pain treatment, wrapped in woolen tea towel, use crutches to take weight of joint,need to see a orthopedic surgeon, Peter Honey is the best.. 94812856

Posted: Fri Mar 28, 2008 7:12 am
by PFO
[quote="munchkin1981"]scenario

mid 20's female comes to you with ankle/leg pain had for past 2 days getting progressive worse swelling bruising pain goes up the outside of the leg when weight is applied ice make pain worse ..........
what would any of you suggest[/quote] Is there a mechanism of injury.
CWMS? . any xrays, scans done?when ice is applied very common for pain to increase with fractures and dvts. is leg hot to touch and skin colour distally in comparison to other limb. does pain increase on dorsi or plantar flexion?

22 year old female

Posted: Fri Mar 28, 2008 8:22 am
by musketeer
Are the distal pulses bilateraly similar?
Is the pain when weight goes on or comes off?
Is there any altered sensation between legs?
Has she just flown or had a long car journey?

Posted: Fri Mar 28, 2008 8:27 am
by PFO
is she obese, small, any pmhx.