Guest guest Posted August 5, 2010 Report Share Posted August 5, 2010 Without checking a pulse??? Which by the way is present. Sent from my iPhone > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > Just my 2 cents' worth. > > Trousdale, EMT-I > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > Attorney at Law/Licensed Paramedic > > Austin, Texas > > > > > > Sent from my iPad > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2010 Report Share Posted August 5, 2010 Without checking a pulse??? Which by the way is present. Sent from my iPhone > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > Just my 2 cents' worth. > > Trousdale, EMT-I > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > Attorney at Law/Licensed Paramedic > > Austin, Texas > > > > > > Sent from my iPad > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 I am always amazed how people associate “unresponsive†with cardiac arrest. From: texasems-l [mailto:texasems-l ] On Behalf Of Wes Ogilvie Sent: Thursday, August 05, 2010 6:51 PM To: texasems-l Subject: Re: Re: New challenge Without checking a pulse??? Which by the way is present. Sent from my iPhone On Aug 5, 2010, at 11:45, trousdale_david trousdale_david@...> wrote: > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > Just my 2 cents' worth. > > Trousdale, EMT-I > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > Attorney at Law/Licensed Paramedic > > Austin, Texas > > > > > > Sent from my iPad > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 I am always amazed how people associate “unresponsive†with cardiac arrest. From: texasems-l [mailto:texasems-l ] On Behalf Of Wes Ogilvie Sent: Thursday, August 05, 2010 6:51 PM To: texasems-l Subject: Re: Re: New challenge Without checking a pulse??? Which by the way is present. Sent from my iPhone On Aug 5, 2010, at 11:45, trousdale_david trousdale_david@...> wrote: > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > Just my 2 cents' worth. > > Trousdale, EMT-I > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > Attorney at Law/Licensed Paramedic > > Austin, Texas > > > > > > Sent from my iPad > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 Which may prove that an AED is smarter than many medics... Wes Sent from my iPhone > I am always amazed how people associate “unresponsive†with cardiac arrest. > > From: texasems-l [mailto:texasems-l ] On Behalf Of Wes Ogilvie > Sent: Thursday, August 05, 2010 6:51 PM > To: texasems-l > Subject: Re: Re: New challenge > > > > Without checking a pulse??? Which by the way is present. > > Sent from my iPhone > > On Aug 5, 2010, at 11:45, trousdale_david trousdale_david@...> wrote: > > > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > > Just my 2 cents' worth. > > > > Trousdale, EMT-I > > > > > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > Attorney at Law/Licensed Paramedic > > > Austin, Texas > > > > > > > > > Sent from my iPad > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 Which may prove that an AED is smarter than many medics... Wes Sent from my iPhone > I am always amazed how people associate “unresponsive†with cardiac arrest. > > From: texasems-l [mailto:texasems-l ] On Behalf Of Wes Ogilvie > Sent: Thursday, August 05, 2010 6:51 PM > To: texasems-l > Subject: Re: Re: New challenge > > > > Without checking a pulse??? Which by the way is present. > > Sent from my iPhone > > On Aug 5, 2010, at 11:45, trousdale_david trousdale_david@...> wrote: > > > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > > Just my 2 cents' worth. > > > > Trousdale, EMT-I > > > > > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > Attorney at Law/Licensed Paramedic > > > Austin, Texas > > > > > > > > > Sent from my iPad > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 Isn't that one of the steps of CPR, just after responsiveness, airway, breathing...... Re: Re: New challenge Without checking a pulse??? Which by the way is present. Sent from my iPhone > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > Just my 2 cents' worth. > > Trousdale, EMT-I > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > Attorney at Law/Licensed Paramedic > > Austin, Texas > > > > > > Sent from my iPad > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 Circulation…..CPR…what the heck they both start with “C†From: texasems-l [mailto:texasems-l ] On Behalf Of TX1@... Sent: Friday, August 06, 2010 10:16 AM To: texasems-l Subject: Re: Re: New challenge Isn't that one of the steps of CPR, just after responsiveness, airway, breathing...... Re: Re: New challenge Without checking a pulse??? Which by the way is present. Sent from my iPhone On Aug 5, 2010, at 11:45, trousdale_david trousdale_david@...> wrote: > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > Just my 2 cents' worth. > > Trousdale, EMT-I > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > Attorney at Law/Licensed Paramedic > > Austin, Texas > > > > > > Sent from my iPad > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 I've had at least two patients in this class, and there were almost a dozen similar cases noted on the CCM-L in the past couple of weeks on a thread about the efficiency of CPR in brain function preservation. ck In a message dated 8/6/2010 17:00:18 Central Daylight Time, Grayson902@... writes: I once worked a resuscitation on an MI patient in the ED, who arrested as we were giving him tenecteplase. He was in classic, coarse VF. Not VT, not Torsades, not some weird wide-complex rhythm that perfuses just a little bit, I'm talking VEEE EFFF. And as long as we did CPR compressions, his eyes would stay open, focus on you, look around the room, and try to speak. Stop compressions, and his eyes would roll back and he'd be unresponsive in seconds. Start compressions again, and he'd wake up within 5 seconds. Needless to say, we didn't stop compressions much. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 Well, you can't argue with the fact that people in cardiac arrest are unresponsive. G Re: Re: New challenge Without checking a pulse??? Which by the way is present. Sent from my iPhone On Aug 5, 2010, at 11:45, trousdale_david trousdale_david@...>; wrote: > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > Just my 2 cents' worth. > > Trousdale, EMT-I > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > Attorney at Law/Licensed Paramedic > > Austin, Texas > > > > > > Sent from my iPad > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 I guess we don't have any Mel fans... >>> On Fri, Aug 6, 2010 at 4:38 PM, in message 8CD03C6D8D9E2E5-15AC-43E5@...>, wegandy@...> wrote: Well, you can't argue with the fact that people in cardiac arrest are unresponsive. G Re: Re: New challenge Without checking a pulse??? Which by the way is present. Sent from my iPhone On Aug 5, 2010, at 11:45, trousdale_david trousdale_david@... ( mailto:trousdale_david%40yahoo.com ) >; wrote: > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > Just my 2 cents' worth. > > Trousdale, EMT-I > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > Attorney at Law/Licensed Paramedic > > Austin, Texas > > > > > > Sent from my iPad > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 You missed my response - way back at the beginning. Of course, if my name had been Thorndyke . . . By the way, sis anyone ever ask for vitals? Patient history? Anything? > Not gonna hazard a guess on field diagnosis, but if she is unresponsive I would probably initiate CPR first. My guess for movie reference is " Shutter Island " > Just my 2 cents' worth. > > Trousdale, EMT-I > > > > > > You and your partner have been sent to the Psychoneurotic Institute for the Very Very Nervous on an unknown call. Upon arrival, you and your partner are greeted by the charge nurse who informs you that they have a 47 year old female patient who is receiving inpatient therapy for bipolar disorder. She went back to her room after a therapy session. The patient normally has a manic phase lasting several days, but during her manic phase, she returned to her room and has, according to the staff, " passed out. " The nurse is unable to provide much more information about the patient other than the bipolar diagnosis. Upon patient contact, you observe a 47 year old female who is completely unresponsive. > > > > What is your treatment plan and field diagnosis? Bonus points to anyone who catches the movie reference. > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > Attorney at Law/Licensed Paramedic > > Austin, Texas > > > > > > Sent from my iPad > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 Weeeellll... here's an exception to that statement that ought to peg your Weird Crap-O-Meter: I once worked a resuscitation on an MI patient in the ED, who arrested as we were giving him tenecteplase. He was in classic, coarse VF. Not VT, not Torsades, not some weird wide-complex rhythm that perfuses just a little bit, I'm talking VEEE EFFF. And as long as we did CPR compressions, his eyes would stay open, focus on you, look around the room, and try to speak. Stop compressions, and his eyes would roll back and he'd be unresponsive in seconds. Start compressions again, and he'd wake up within 5 seconds. Needless to say, we didn't stop compressions much. That went on for the first 10 minutes of the code. We eventually lost him, but not for lack of trying. wegandy@... wrote: > > > Well, you can't argue with the fact that people in cardiac arrest are > unresponsive. > > G > > Re: Re: New challenge > > Without checking a pulse??? Which by the way is present. > > Sent from my iPhone > > On Aug 5, 2010, at 11:45, trousdale_david trousdale_david@... > >; > wrote: > > > Not gonna hazard a guess on field diagnosis, but if she is > unresponsive I would probably initiate CPR first. My guess for movie > reference is " Shutter Island " > > Just my 2 cents' worth. > > > > Trousdale, EMT-I > > > > > > > > > > You and your partner have been sent to the Psychoneurotic > Institute for the Very Very Nervous on an unknown call. Upon arrival, > you and your partner are greeted by the charge nurse who informs you > that they have a 47 year old female patient who is receiving inpatient > therapy for bipolar disorder. She went back to her room after a > therapy session. The patient normally has a manic phase lasting > several days, but during her manic phase, she returned to her room and > has, according to the staff, " passed out. " The nurse is unable to > provide much more information about the patient other than the bipolar > diagnosis. Upon patient contact, you observe a 47 year old female who > is completely unresponsive. > > > > > > What is your treatment plan and field diagnosis? Bonus points to > anyone who catches the movie reference. > > > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > Attorney at Law/Licensed Paramedic > > > Austin, Texas > > > > > > > > > Sent from my iPad > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2010 Report Share Posted August 6, 2010 Many years ago I participated in a mock trial with Jim Page at EMS Today and the scenario was exactly that except that a fire captain was being disciplined for finally stopping the resuscitation efforts. It was based on a real case, and the patient would respond by trying to pull the rescuers' hands away from her chest. Now that's some good CPR. GG Re: Re: New challenge > > Without checking a pulse??? Which by the way is present. > > Sent from my iPhone > > On Aug 5, 2010, at 11:45, trousdale_david trousdale_david@... > >;; > wrote: > > > Not gonna hazard a guess on field diagnosis, but if she is > unresponsive I would probably initiate CPR first. My guess for movie > reference is " Shutter Island " > > Just my 2 cents' worth. > > > > Trousdale, EMT-I > > > > > > > > > > You and your partner have been sent to the Psychoneurotic > Institute for the Very Very Nervous on an unknown call. Upon arrival, > you and your partner are greeted by the charge nurse who informs you > that they have a 47 year old female patient who is receiving inpatient > therapy for bipolar disorder. She went back to her room after a > therapy session. The patient normally has a manic phase lasting > several days, but during her manic phase, she returned to her room and > has, according to the staff, " passed out. " The nurse is unable to > provide much more information about the patient other than the bipolar > diagnosis. Upon patient contact, you observe a 47 year old female who > is completely unresponsive. > > > > > > What is your treatment plan and field diagnosis? Bonus points to > anyone who catches the movie reference. > > > > > > Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > Attorney at Law/Licensed Paramedic > > > Austin, Texas > > > > > > > > > Sent from my iPad > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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