rhan101277
Forum Deputy Chief
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Assertiveness doesn't change the "I don't know, this is my first night with this patient"
I get this alot as well.
Assertiveness doesn't change the "I don't know, this is my first night with this patient"
If I attempted to get a chart myself they would be on the phone with my supervisor faster than I could spell the patient's name. I have never seen a place that had the charts in an open area where anyone could walk up and grab one. If it is sitting on the tabel in the room, sure I might snag it, but I'm not going to go to the nurse's station and start pawing through stuff.
That's great, but without seeing the thought process and rational it is very difficult to convince adult learners initial education was flawed.
You know, because of the number of hospice calls my service does I've actually learned there are NCs that are designed to do this...I give them 15 lpm via nasal cannula.
You know, because of the number of hospice calls my service does I've actually learned there are NCs that are designed to do this...
Yeah but not your run of the mill cannula and its humidified which i have never seen.pregospitally.
Yep, it would be, poor form to do this with a normal NC to say the least.
I dont think a normal cannula would tolerate it. When we tried to push 10lpm through a 6lpm percent lock it popped off the o2 tree im sure the same would happen exceedingthe flow rate for a cannula
I may have... witnessed someone accidentally turn the regulator on a D tank to 20 LPM with a nasal cannula attached and on the patient. It didn't pop off in the short time between bumping the regulator dial and noticing the unexpectedly loud hissing sound. The patient found it uncomfortable, but she had other things on her mind.
I'm not entirely sure why our portable regulators even go to 25 LPM, as most of them on the BLS trucks don't have the attachments for CPAP.
There's also an interesting article I first saw here about using 15 LPM via NC during intubation to passively oxygenate the patient.
So, permissive hypotension is a good thing. However, I personally believe there should be a difference in permissive hypotension and permissive exsanguination. h34r:
Is there possibly a need for products like hetastarch in the prehospital setting?
I may have... witnessed someone accidentally turn the regulator on a D tank to 20 LPM with a nasal cannula attached and on the patient. It didn't pop off in the short time between bumping the regulator dial and noticing the unexpectedly loud hissing sound. The patient found it uncomfortable, but she had other things on her mind.
I'm not entirely sure why our portable regulators even go to 25 LPM, as most of them on the BLS trucks don't have the attachments for CPAP.
There's also an interesting article I first saw here about using 15 LPM via NC during intubation to passively oxygenate the patient.
In terms of "permissive exsanguination" the solution is simply to stop the bleeding.
Stands to reason pushing more water at higher pressure through a leaky hose would do what except make it leak more?
One of the major problems in hemorrhage is the lack of metabolite carrying capacity. Water doesn't do it.
I think everybody can agree with that statement. And you obviously know substantially more about products like hetastarch than I do. But, along the lines of what Brown said, I can't help but think there can be a place for HBOC products in the future, or something like that. Not as a definitive solution but as a better means of support until the pt's reach definitive care.
Oh i figured you thought I need to quit smoking