Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 Sorry, I was unable to participate in this interesting case, but good job Chris. Sent from my iPhone, McGee, EMT-P, EMT-T also to add the esophageal spasms are more prominante in overweight people and can cause shunting of blood to the GI track during the start of digestion which causes the feeling of being weak or sleepy. His acute problem which caused the heavyness in his arms tingling in his hands and elevated vitals was an anxiety attack which was brought on when he felt the spasms and made worse when the spasms continued. Again not as in depth as the other two scenerios, maybe even a little too on the basic side but that was the point!! Thanks for playing!! -Chris Rick got the underlying cause and although the condition is not immediatly life threatening I wanted to use this scenerio to point out a few things the first is the esophagel spams which can be mistaken for a cardiac issue the " fluttering " is the spasm which is felt during and after eating in the middle of the chest and can be followed by a feeling of exhastion and or pain in the chest. in my case the pain was not the same pain as heartburn, it was definatly more of a " crushing " pain. I had these episodes several weeks before I had a spell in the grocery store and went to the ER. I had a full cardiac workup and was told that my heart was in excellent shape and all of my blood work came back within normal range, I went to my PCP and I explained the " spells " to him he had me wear a monitor for 48 hours at which time I had several episodes, with no changes noted in my EKG. after further review and another meeting with the PCP we figured out that this was happening within 30 mins of a large meal. My PCP put me back on Prevacid and after a few weeks the spells subsided and have to this point gone away. Upper endoscopy revealed Barrette's esophagus which is pretty severe in my case. So why do I present this as a case scenerio? Well I have had the GERD for about ten years, several years ago I complained of " chest pain " as I was getting ready to leave work, the on coming crew said man you look like crap do you feel ok? I told them I didnt feel great I was a little sick to my stomach and I had this pain in my chest, they did a whole workup and we decided that maybe I should go be checked out so I did I went to my local ER and told them what was going on. I had a younger Dr. and when I said the magic words " pain in my chest " I was worked up for chest pain only I tried to explain to him that the pain was localized just under my sternum, and my nausea was getting worse but all he heard was chest pain. Sereral hours later when all tests were returned to no ones suprise I was officially not having a heart attack, however, had he done a series of CBC's and a rather unpleasent test most men over forty experience during regular checkups he would have discovered that my hematocrit was dropping pretty rapidly, and I had digested blood in my stool, instead I was discharged with a diagnosis of Angina. 6 hours later I was ghost white and if I lifted my head off the bed I lost consciousness, my roomate called an ambulance I was taken to a different hospital where I stayed in ICU for 4 days and was given 3 pints of blood. The point of this was not to tell my story but to stress that fact that assessment is your best friend, and listening to your patient is one of the most important things we do don't get that tunnel vision when you hear words like " chest pain " yes it is important to rule out everything in the field you can but remember that when you give your report to nursing staff and Drs. at the ER your attitude and presentation can mean the difference between them missing a serious condition or catching something vital based on your report alone. If you go in and stress something like chest pain, that tunnel vision can be passed on to staff at the ER. Remember it is hard to describe pain to someone else so when someone tells you they have chest pain they could be trying to describe something more specific than a cardiac issue!! -Chris Correct chronic problem Rick!! What is his acute problem? -Chris Sorry for the spelling and punctuation this was typed on tge tiny keyboard on my iPhone > Esophageal spasm? > Rick > Sent via Blackberry > > ________________________________ > From: texasems-l texasems-l > > To: texasems-l texasems-l > > Sent: Mon Jun 14 17:32:40 2010 > Subject: Re: FW: EMS Challenge (3) > > > > Detailed exam is unremarkable however several mins into the transport your pt. Feels the " Flutter " again and his respirations increase and he now has a " pain " in his chest EKG is Now tachy at 118 however rhythm is sinus with no ectopy an 12-lead remains unchanged after several mins the " flutter " subsides yet he now has tingling in his hands and the " anxious " feeling has returned. How would you treat him and what is going on? > > -Chris > > Sorry for the spelling and punctuation this was typed on tge tiny keyboard on my iPhone > > On Jun 14, 2010, at 16:46, shawn.binkley@... wrote: > >> Detailed exam shows what? >> Sent from my Verizon Wireless BlackBerry >> >> EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 Sorry, I was unable to participate in this interesting case, but good job Chris. Sent from my iPhone, McGee, EMT-P, EMT-T also to add the esophageal spasms are more prominante in overweight people and can cause shunting of blood to the GI track during the start of digestion which causes the feeling of being weak or sleepy. His acute problem which caused the heavyness in his arms tingling in his hands and elevated vitals was an anxiety attack which was brought on when he felt the spasms and made worse when the spasms continued. Again not as in depth as the other two scenerios, maybe even a little too on the basic side but that was the point!! Thanks for playing!! -Chris Rick got the underlying cause and although the condition is not immediatly life threatening I wanted to use this scenerio to point out a few things the first is the esophagel spams which can be mistaken for a cardiac issue the " fluttering " is the spasm which is felt during and after eating in the middle of the chest and can be followed by a feeling of exhastion and or pain in the chest. in my case the pain was not the same pain as heartburn, it was definatly more of a " crushing " pain. I had these episodes several weeks before I had a spell in the grocery store and went to the ER. I had a full cardiac workup and was told that my heart was in excellent shape and all of my blood work came back within normal range, I went to my PCP and I explained the " spells " to him he had me wear a monitor for 48 hours at which time I had several episodes, with no changes noted in my EKG. after further review and another meeting with the PCP we figured out that this was happening within 30 mins of a large meal. My PCP put me back on Prevacid and after a few weeks the spells subsided and have to this point gone away. Upper endoscopy revealed Barrette's esophagus which is pretty severe in my case. So why do I present this as a case scenerio? Well I have had the GERD for about ten years, several years ago I complained of " chest pain " as I was getting ready to leave work, the on coming crew said man you look like crap do you feel ok? I told them I didnt feel great I was a little sick to my stomach and I had this pain in my chest, they did a whole workup and we decided that maybe I should go be checked out so I did I went to my local ER and told them what was going on. I had a younger Dr. and when I said the magic words " pain in my chest " I was worked up for chest pain only I tried to explain to him that the pain was localized just under my sternum, and my nausea was getting worse but all he heard was chest pain. Sereral hours later when all tests were returned to no ones suprise I was officially not having a heart attack, however, had he done a series of CBC's and a rather unpleasent test most men over forty experience during regular checkups he would have discovered that my hematocrit was dropping pretty rapidly, and I had digested blood in my stool, instead I was discharged with a diagnosis of Angina. 6 hours later I was ghost white and if I lifted my head off the bed I lost consciousness, my roomate called an ambulance I was taken to a different hospital where I stayed in ICU for 4 days and was given 3 pints of blood. The point of this was not to tell my story but to stress that fact that assessment is your best friend, and listening to your patient is one of the most important things we do don't get that tunnel vision when you hear words like " chest pain " yes it is important to rule out everything in the field you can but remember that when you give your report to nursing staff and Drs. at the ER your attitude and presentation can mean the difference between them missing a serious condition or catching something vital based on your report alone. If you go in and stress something like chest pain, that tunnel vision can be passed on to staff at the ER. Remember it is hard to describe pain to someone else so when someone tells you they have chest pain they could be trying to describe something more specific than a cardiac issue!! -Chris Correct chronic problem Rick!! What is his acute problem? -Chris Sorry for the spelling and punctuation this was typed on tge tiny keyboard on my iPhone > Esophageal spasm? > Rick > Sent via Blackberry > > ________________________________ > From: texasems-l texasems-l > > To: texasems-l texasems-l > > Sent: Mon Jun 14 17:32:40 2010 > Subject: Re: FW: EMS Challenge (3) > > > > Detailed exam is unremarkable however several mins into the transport your pt. Feels the " Flutter " again and his respirations increase and he now has a " pain " in his chest EKG is Now tachy at 118 however rhythm is sinus with no ectopy an 12-lead remains unchanged after several mins the " flutter " subsides yet he now has tingling in his hands and the " anxious " feeling has returned. How would you treat him and what is going on? > > -Chris > > Sorry for the spelling and punctuation this was typed on tge tiny keyboard on my iPhone > > On Jun 14, 2010, at 16:46, shawn.binkley@... wrote: > >> Detailed exam shows what? >> Sent from my Verizon Wireless BlackBerry >> >> EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 Sorry, I was unable to participate in this interesting case, but good job Chris. Sent from my iPhone, McGee, EMT-P, EMT-T also to add the esophageal spasms are more prominante in overweight people and can cause shunting of blood to the GI track during the start of digestion which causes the feeling of being weak or sleepy. His acute problem which caused the heavyness in his arms tingling in his hands and elevated vitals was an anxiety attack which was brought on when he felt the spasms and made worse when the spasms continued. Again not as in depth as the other two scenerios, maybe even a little too on the basic side but that was the point!! Thanks for playing!! -Chris Rick got the underlying cause and although the condition is not immediatly life threatening I wanted to use this scenerio to point out a few things the first is the esophagel spams which can be mistaken for a cardiac issue the " fluttering " is the spasm which is felt during and after eating in the middle of the chest and can be followed by a feeling of exhastion and or pain in the chest. in my case the pain was not the same pain as heartburn, it was definatly more of a " crushing " pain. I had these episodes several weeks before I had a spell in the grocery store and went to the ER. I had a full cardiac workup and was told that my heart was in excellent shape and all of my blood work came back within normal range, I went to my PCP and I explained the " spells " to him he had me wear a monitor for 48 hours at which time I had several episodes, with no changes noted in my EKG. after further review and another meeting with the PCP we figured out that this was happening within 30 mins of a large meal. My PCP put me back on Prevacid and after a few weeks the spells subsided and have to this point gone away. Upper endoscopy revealed Barrette's esophagus which is pretty severe in my case. So why do I present this as a case scenerio? Well I have had the GERD for about ten years, several years ago I complained of " chest pain " as I was getting ready to leave work, the on coming crew said man you look like crap do you feel ok? I told them I didnt feel great I was a little sick to my stomach and I had this pain in my chest, they did a whole workup and we decided that maybe I should go be checked out so I did I went to my local ER and told them what was going on. I had a younger Dr. and when I said the magic words " pain in my chest " I was worked up for chest pain only I tried to explain to him that the pain was localized just under my sternum, and my nausea was getting worse but all he heard was chest pain. Sereral hours later when all tests were returned to no ones suprise I was officially not having a heart attack, however, had he done a series of CBC's and a rather unpleasent test most men over forty experience during regular checkups he would have discovered that my hematocrit was dropping pretty rapidly, and I had digested blood in my stool, instead I was discharged with a diagnosis of Angina. 6 hours later I was ghost white and if I lifted my head off the bed I lost consciousness, my roomate called an ambulance I was taken to a different hospital where I stayed in ICU for 4 days and was given 3 pints of blood. The point of this was not to tell my story but to stress that fact that assessment is your best friend, and listening to your patient is one of the most important things we do don't get that tunnel vision when you hear words like " chest pain " yes it is important to rule out everything in the field you can but remember that when you give your report to nursing staff and Drs. at the ER your attitude and presentation can mean the difference between them missing a serious condition or catching something vital based on your report alone. If you go in and stress something like chest pain, that tunnel vision can be passed on to staff at the ER. Remember it is hard to describe pain to someone else so when someone tells you they have chest pain they could be trying to describe something more specific than a cardiac issue!! -Chris Correct chronic problem Rick!! What is his acute problem? -Chris Sorry for the spelling and punctuation this was typed on tge tiny keyboard on my iPhone > Esophageal spasm? > Rick > Sent via Blackberry > > ________________________________ > From: texasems-l texasems-l > > To: texasems-l texasems-l > > Sent: Mon Jun 14 17:32:40 2010 > Subject: Re: FW: EMS Challenge (3) > > > > Detailed exam is unremarkable however several mins into the transport your pt. Feels the " Flutter " again and his respirations increase and he now has a " pain " in his chest EKG is Now tachy at 118 however rhythm is sinus with no ectopy an 12-lead remains unchanged after several mins the " flutter " subsides yet he now has tingling in his hands and the " anxious " feeling has returned. How would you treat him and what is going on? > > -Chris > > Sorry for the spelling and punctuation this was typed on tge tiny keyboard on my iPhone > > On Jun 14, 2010, at 16:46, shawn.binkley@... wrote: > >> Detailed exam shows what? >> Sent from my Verizon Wireless BlackBerry >> >> EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 NTG is a smooth muscle relaxer, esophagus is smooth muscle. Rick From: texasems-l [mailto:texasems-l ] On Behalf Of wegandy@... Sent: Tuesday, June 15, 2010 12:28 AM To: texasems-l Subject: Re: FW: EMS Challenge (3) Chris. A similar thing has happened to me although not the Barrets. I have had GERD for many years, now controlled with esomeprazole 40 mg q d. One day about 5 years ago I was driving between Albany and Abilene when I had a sudden onset of excruciating chest pain. At first I thought, Well, here it is---THE BIG ONE. But I also knew my history and the fact that my father had esophageal spasms and stenosis and had to be dilated about every 6 months. He was prescribed NTG for it and it always relieved it. So I thought, if this continues, I'm on my way to the hospital, but if it stops I'll go to the office and do a 12-lead on myself. Sure enough, in what seemed like the longest 3 minutes I've ever spent, it suddenly stopped. So I continued on and had a friend do the 12-lead which was totally unremarkable. I stuck a canister of NTG in my pocket and forget about it. About a week later, the same thing happened at home, so I took one spray of NTG and the pain stopped within 30 seconds. Next time I saw my PCP I told her about this, she got all bent out of shape at me for self-diagnosing (but she admitted that she would have done the same thing) and made do the Holter monitor and made me have an EGD which showed one little ulcer high in the esophagus. Heart was fine. Was put on Nexium and no further trouble. I carried the NTG for a long time but finally stopped since i haven't had another spasm since. Question: Why does NTG work for this, and what other drugs might relieve esophageal spasm? Gene G. EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 NTG is a smooth muscle relaxer, esophagus is smooth muscle. Rick From: texasems-l [mailto:texasems-l ] On Behalf Of wegandy@... Sent: Tuesday, June 15, 2010 12:28 AM To: texasems-l Subject: Re: FW: EMS Challenge (3) Chris. A similar thing has happened to me although not the Barrets. I have had GERD for many years, now controlled with esomeprazole 40 mg q d. One day about 5 years ago I was driving between Albany and Abilene when I had a sudden onset of excruciating chest pain. At first I thought, Well, here it is---THE BIG ONE. But I also knew my history and the fact that my father had esophageal spasms and stenosis and had to be dilated about every 6 months. He was prescribed NTG for it and it always relieved it. So I thought, if this continues, I'm on my way to the hospital, but if it stops I'll go to the office and do a 12-lead on myself. Sure enough, in what seemed like the longest 3 minutes I've ever spent, it suddenly stopped. So I continued on and had a friend do the 12-lead which was totally unremarkable. I stuck a canister of NTG in my pocket and forget about it. About a week later, the same thing happened at home, so I took one spray of NTG and the pain stopped within 30 seconds. Next time I saw my PCP I told her about this, she got all bent out of shape at me for self-diagnosing (but she admitted that she would have done the same thing) and made do the Holter monitor and made me have an EGD which showed one little ulcer high in the esophagus. Heart was fine. Was put on Nexium and no further trouble. I carried the NTG for a long time but finally stopped since i haven't had another spasm since. Question: Why does NTG work for this, and what other drugs might relieve esophageal spasm? Gene G. EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 Hm, I bet Toradol would help too (also good with smooth muscles). -Brad Sent via BlackBerry, the office that follows you. EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 Hm, I bet Toradol would help too (also good with smooth muscles). -Brad Sent via BlackBerry, the office that follows you. EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 and what OTC item can also be useful? ck In a message dated 6/15/2010 17:19:38 Central Daylight Time, wegandy@... writes: That's right. Now, let's go a little deeper. What are the two distinct types of esophageal spasm? Other than nitrates, what other drugs have been used to relieve the spasm and chest pain? Other than medications, what treatments are available? And finally, if a food impaction occurs (food gets caught in the esophagus and won't go down) what drugs can be specifically used for that situation? GG EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> [Non-text portions of this message have been removed] >>> >>> >>> >>> ------------------------------------ >>> >>> Yahoo! Groups Links >>> >>> >>> >> >> >> >> [Non-text portions of this message have been removed] >> >> >> >> ------------------------------------ >> >> Yahoo! Groups Links >> >> >> > > > > > [Non-text portions of this message have been removed] > > > > ------------------------------------ > > Yahoo! Groups Links > > > ------------------------------------ Yahoo! Groups Links [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 glucagon is NOT an OTC item.... please try again. ck In a message dated 6/15/2010 19:25:07 Central Daylight Time, toni_crippen@... writes: Glucagon. Toni Crippen, LP On Jun 15, 2010, at 6:07 PM, _krin135@..._ (mailto:krin135@...) wrote: > and what OTC item can also be useful? > > ck > > > In a message dated 6/15/2010 17:19:38 Central Daylight Time, > _wegandy@..._ (mailto:wegandy@...) writes: > > That's right. Now, let's go a little deeper. > > What are the two distinct types of esophageal spasm? > > Other than nitrates, what other drugs have been used to relieve the > spasm > and chest pain? > > Other than medications, what treatments are available? > > And finally, if a food impaction occurs (food gets caught in the > esophagus > and won't go down) what drugs can be specifically used for that > situation? > > GG > > EMS Challenge (3) > >>> > >>> For some reason I can't send to the list right now but if you > would > please > >>> forward this!!! > >>> > >>> -Chris > >>> > >>> Ok I got one it is not as involved as alyssa's but may be > something > you > >>> see pretty often in this case I am actually the person this is > loosely > based > >>> on. > >>> > >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is > sitting > in a > >>> chair in his living he room he say he is having a funny feeling > in his > >>> chest and he feels very weak what else you wanna know > >>> > >>> -Chris > >>> > >>> > >>> > >>> > >>> > >>> [Non-text portions of this message have been removed] > >>> > >>> > >>> > >>> ------------------------------------ > >>> > >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 you will be forgiven when you report which OTC product might help with an impacted meat bolus. ck In a message dated 6/15/2010 19:30:48 Central Daylight Time, toni_crippen@... writes: Yes. I realize that. Responded to the wrong question on my iPhone and a quick retraction wasn't possible. Please forgive me. Toni On Jun 15, 2010, at 7:25 PM, _krin135@..._ (mailto:krin135@...) wrote: > glucagon is NOT an OTC item.... > > please try again. > > ck > > > In a message dated 6/15/2010 19:25:07 Central Daylight Time, > _toni_crippen@..._ (mailto:toni_crippen@...) writes: > > Glucagon. > > Toni Crippen, LP > > On Jun 15, 2010, at 6:07 PM, __krin135@..._ (mailto:_krin135@...) _ > (mailto:_krin135@..._ (mailto:krin135@...) ) > wrote: > > > and what OTC item can also be useful? > > > > ck > > > > > > In a message dated 6/15/2010 17:19:38 Central Daylight Time, > > __wegandy@..._ (mailto:_wegandy@...) _ (mailto:_wegandy@..._ (mailto:wegandy@...) ) writes: > > > > That's right. Now, let's go a little deeper. > > > > What are the two distinct types of esophageal spasm? > > > > Other than nitrates, what other drugs have been used to relieve the > > spasm > > and chest pain? > > > > Other than medications, what treatments are available? > > > > And finally, if a food impaction occurs (food gets caught in the > > esophagus > > and won't go down) what drugs can be specifically used for that > > situation? > > > > GG > > > > EMS Challenge (3) > > >>> > > >>> For some reason I can't send to the list right now but if you > > would > > please > > >>> forward this!!! > > >>> > > >>> -Chris > > >>> > > >>> Ok I got one it is not as involved as alyssa's but may be > > something > > you > > >>> see pretty often in this case I am actually the person this is > > loosely > > based > > >>> on. > > >>> > > >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is > > sitting > > in a > > >>> chair in his living he room he say he is having a funny feeling > > in his > > >>> chest and he feels very weak what else you wanna know > > >>> > > >>> -Chris > > >>> > > >>> > > >>> > > >>> > > >>> > > >>> [Non-text portions of this message have been removed] > > >>> > > >>> > > >>> > > >>> ------------------------------------ > > >>> > > >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 In a message dated 6/15/2010 7:30:44 P.M. Central Daylight Time, toni_crippen@... writes: Please forgive me. This is EMS we do not forgive! LOL Louis N. Molino, Sr., CET FF/NREMT-B/FSI/EMSI Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant LNMolino@... (Cell Phone) " A Texan with a Jersey Attitude " " Great minds discuss ideas; Average minds discuss events; Small minds discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 I doubt that Maalox will help much with an impacted meat bolus. there is something, generally found in the spice aisle, that may help in some cases, albeit Glucagon would probably be my first line choice- I've had good enough results from it that I'd use it before I call the GI or Surgeon for a follow up scope. ck In a message dated 6/15/2010 20:02:53 Central Daylight Time, summedic@... writes: Malox Sent from my iPhone, McGee, EMT-P, EMT-T On Jun 15, 2010, at 6:16 PM, _wegandy@..._ (mailto:wegandy@...) wrote: A plumber's helper? G EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 that is it. and yes, if it doesn't work in a short period of time, the patient needs to be 'scoped. ck In a message dated 6/15/2010 20:10:34 Central Daylight Time, rob.davis@... writes: The old Adolph's Meat Tenderiser trick, I suppose. Years back, at a CME presentation, we were told that it tended to do the same number on the oesophageal mucosa as it did on the bolus though. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 that is it. and yes, if it doesn't work in a short period of time, the patient needs to be 'scoped. ck In a message dated 6/15/2010 20:10:34 Central Daylight Time, rob.davis@... writes: The old Adolph's Meat Tenderiser trick, I suppose. Years back, at a CME presentation, we were told that it tended to do the same number on the oesophageal mucosa as it did on the bolus though. Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 How do benzos work and how would they work in this case, if they would? G EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 That's right. Now, let's go a little deeper. What are the two distinct types of esophageal spasm? Other than nitrates, what other drugs have been used to relieve the spasm and chest pain? Other than medications, what treatments are available? And finally, if a food impaction occurs (food gets caught in the esophagus and won't go down) what drugs can be specifically used for that situation? GG EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 That's right. Now, let's go a little deeper. What are the two distinct types of esophageal spasm? Other than nitrates, what other drugs have been used to relieve the spasm and chest pain? Other than medications, what treatments are available? And finally, if a food impaction occurs (food gets caught in the esophagus and won't go down) what drugs can be specifically used for that situation? GG EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 Benzodiazepines work off of gamma-aminobutyric acid (GABA), and so act as a smooth muscle relaxers and anxiolytics. They are in the sedative/ hypnotic category, as they can also cause amnesia. They Aldo slow the respiratory rate, diminishing the effects of hyperventilation during an anxiety attack. Here, they will act by relaxing the smooth muscle of the esophagus. They would also aid any anxiety, however caution should be taken with the psychological aspect of it, because if you give the patient an anxiolytic and they develop something serious, they may not take it seriously. Benzodiazepines may also result in a loss of judgement alike to being inebriated. Alyssa Woods, FF/NREMT-B Sent from the itty bitty keyboard on my iPhone > How do benzos work and how would they work in this case, if they > would? > > G > > EMS Challenge (3) > >>> > >>> For some reason I can't send to the list right now but if you > would please > >>> forward this!!! > >>> > >>> -Chris > >>> > >>> Ok I got one it is not as involved as alyssa's but may be > something you > >>> see pretty often in this case I am actually the person this is > loosely based > >>> on. > >>> > >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is > sitting in a > >>> chair in his living he room he say he is having a funny feeling > in his > >>> chest and he feels very weak what else you wanna know > >>> > >>> -Chris > >>> > >>> > >>> > >>> > >>> > >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 IV glucagon for the impacted food bolus. It's supposed to decrease lower esophageal sphincter tone, but I'm not sure of the actual mechanism. wegandy@... wrote: > > > That's right. Now, let's go a little deeper. > > What are the two distinct types of esophageal spasm? > > Other than nitrates, what other drugs have been used to relieve the > spasm and chest pain? > > Other than medications, what treatments are available? > > And finally, if a food impaction occurs (food gets caught in the > esophagus and won't go down) what drugs can be specifically used for > that situation? > > GG > > EMS Challenge (3) > >>> > >>> For some reason I can't send to the list right now but if you > would please > >>> forward this!!! > >>> > >>> -Chris > >>> > >>> Ok I got one it is not as involved as alyssa's but may be > something you > >>> see pretty often in this case I am actually the person this is > loosely based > >>> on. > >>> > >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is > sitting in a > >>> chair in his living he room he say he is having a funny feeling in his > >>> chest and he feels very weak what else you wanna know > >>> > >>> -Chris > >>> > >>> > >>> > >>> > >>> > >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 A plumber's helper? G EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is sitting in a >>> chair in his living he room he say he is having a funny feeling in his >>> chest and he feels very weak what else you wanna know >>> >>> -Chris >>> >>> >>> >>> >>> >>> [Non-text portions of this message have been removed] >>> >>> >>> >>> ------------------------------------ >>> >>> Yahoo! Groups Links >>> >>> >>> >> >> >> >> [Non-text portions of this message have been removed] >> >> >> >> ------------------------------------ >> >> Yahoo! Groups Links >> >> >> > > > > > [Non-text portions of this message have been removed] > > > > ------------------------------------ > > Yahoo! Groups Links > > > ------------------------------------ Yahoo! Groups Links [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 Glucagon. Toni Crippen, LP > and what OTC item can also be useful? > > ck > > > In a message dated 6/15/2010 17:19:38 Central Daylight Time, > wegandy@... writes: > > That's right. Now, let's go a little deeper. > > What are the two distinct types of esophageal spasm? > > Other than nitrates, what other drugs have been used to relieve the > spasm > and chest pain? > > Other than medications, what treatments are available? > > And finally, if a food impaction occurs (food gets caught in the > esophagus > and won't go down) what drugs can be specifically used for that > situation? > > GG > > EMS Challenge (3) > >>> > >>> For some reason I can't send to the list right now but if you > would > please > >>> forward this!!! > >>> > >>> -Chris > >>> > >>> Ok I got one it is not as involved as alyssa's but may be > something > you > >>> see pretty often in this case I am actually the person this is > loosely > based > >>> on. > >>> > >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is > sitting > in a > >>> chair in his living he room he say he is having a funny feeling > in his > >>> chest and he feels very weak what else you wanna know > >>> > >>> -Chris > >>> > >>> > >>> > >>> > >>> > >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 Yes. I realize that. Responded to the wrong question on my iPhone and a quick retraction wasn't possible. Please forgive me. Toni > glucagon is NOT an OTC item.... > > please try again. > > ck > > > In a message dated 6/15/2010 19:25:07 Central Daylight Time, > toni_crippen@... writes: > > Glucagon. > > Toni Crippen, LP > > On Jun 15, 2010, at 6:07 PM, _krin135@..._ > (mailto:krin135@...) > wrote: > > > and what OTC item can also be useful? > > > > ck > > > > > > In a message dated 6/15/2010 17:19:38 Central Daylight Time, > > _wegandy@..._ (mailto:wegandy@...) writes: > > > > That's right. Now, let's go a little deeper. > > > > What are the two distinct types of esophageal spasm? > > > > Other than nitrates, what other drugs have been used to relieve the > > spasm > > and chest pain? > > > > Other than medications, what treatments are available? > > > > And finally, if a food impaction occurs (food gets caught in the > > esophagus > > and won't go down) what drugs can be specifically used for that > > situation? > > > > GG > > > > EMS Challenge (3) > > >>> > > >>> For some reason I can't send to the list right now but if you > > would > > please > > >>> forward this!!! > > >>> > > >>> -Chris > > >>> > > >>> Ok I got one it is not as involved as alyssa's but may be > > something > > you > > >>> see pretty often in this case I am actually the person this is > > loosely > > based > > >>> on. > > >>> > > >>> dispatched to a 30 y/o male for weakness upon arrival pt. Is > > sitting > > in a > > >>> chair in his living he room he say he is having a funny feeling > > in his > > >>> chest and he feels very weak what else you wanna know > > >>> > > >>> -Chris > > >>> > > >>> > > >>> > > >>> > > >>> > > >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 Malox Sent from my iPhone, McGee, EMT-P, EMT-T A plumber's helper? G EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 Malox Sent from my iPhone, McGee, EMT-P, EMT-T A plumber's helper? G EMS Challenge (3) >>> >>> For some reason I can't send to the list right now but if you would please >>> forward this!!! >>> >>> -Chris >>> >>> Ok I got one it is not as involved as alyssa's but may be something you >>> see pretty often in this case I am actually the person this is loosely based >>> on. >>> >>> dispatched to a 30 y/o male for weakness upon arrival pt. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 15, 2010 Report Share Posted June 15, 2010 The old Adolph's Meat Tenderiser trick, I suppose. Years back, at a CME presentation, we were told that it tended to do the same number on the oesophageal mucosa as it did on the bolus though. Rob Quote Link to comment Share on other sites More sharing options...
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