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Thread: Help!

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    Default Help!

    Calling all paramedics/ paragods/ nursing folks...

    Looking for a math wizard for some tips on dosing solutions...
    and some 12 lead interpretations... need refreshment!!!

    PM me please!

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    Default Re: Help!

    Try this one of for size. 59 YO male with what the ex-wife reports as seizure like activity lasting about 30 to 40 seconds. PMH of psyc issues and taking no meds. Patient himself has no verbal complaints, is alert x3 however answering questions slowly.

    Below is the initial rhythm strip and 2 12 lead ECG.

    Sorry for the piss poor quality, their scans of the copies.
    Attached Files
    Last edited by PSYCtest040; 08-10-2009 at 02:38 AM.
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    Default Re: Help!

    Ditchdoc gave me a great formula for dopamine. And now I can't remember it to save my life...
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    Default Re: Help!

    Quote Originally Posted by medic pathetic View Post
    Ditchdoc gave me a great formula for dopamine. And now I can't remember it to save my life...
    Ohhh please remember....(Ditch Doc maybe you can chime in here) Because if I were let loose on the world now, I'd kill someone administering Dopamine. I don't know why but it's the one calculation I botch 100% of the time.
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    Default Re: Help!

    Quote Originally Posted by PSYCtest040 View Post
    Ohhh please remember....(Ditch Doc maybe you can chime in here) Because if I were let loose on the world now, I'd kill someone administering Dopamine. I don't know why but it's the one calculation I botch 100% of the time.
    I just got done with my 12 lead class this weekend. I will send you some stuff when I get to a computer that has some power. I forgot half of my power cord at home so my laptop is about to go into asystole.

    There are two ways that you can figure Dopamine. I like the clock method. There is also a method that uses pounds. Don't ask me I like the clock.

    I will get the 12 lead information and send it to you.

    I could always use a refresher and constant studying.
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    Default Re: Help!

    Quote Originally Posted by CombatMedic View Post
    I just got done with my 12 lead class this weekend. I will send you some stuff when I get to a computer that has some power. I forgot half of my power cord at home so my laptop is about to go into asystole.

    There are two ways that you can figure Dopamine. I like the clock method. There is also a method that uses pounds. Don't ask me I like the clock.

    I will get the 12 lead information and send it to you.

    I could always use a refresher and constant studying.
    We are going to start our (in depth) 12 lead classes in September, I can hardly wait. Right now I'm reading the Dubins 12 lead for dummies book and it's helping but I'm all about getting all the information I can get my hands on. Thanks.

    Never heard of the clock method for calculating dopamine, be interested in seeing it. My old partner taught me the pounds version a couple of years ago but I promptly forgot it. My instructor wants us to calculate it EXACTLY during class, after that........

    Sorry for the thread hijack TJ.
    Last edited by PSYCtest040; 08-10-2009 at 07:05 AM.
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    Default Re: Help!

    Quote Originally Posted by PSYCtest040 View Post
    Try this one of for size. 59 YO male with what the ex-wife reports as seizure like activity lasting about 30 to 40 seconds. PMH of psyc issues and taking no meds. Patient himself has no verbal complaints, is alert x3 however answering questions slowly.
    Hmmmmmmmmmmmmmm... looks a bit like a stable ventricular tachycardia w/possibly a bundle branch block(s). But your mileage may vary.
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    Default Re: Help!

    Kind of irregular with no p-waves so I'm calling it afib RVR with completed LBBB.

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    Default Re: Help!

    I would also call it atrial fibrillation with RVR and LBBB. The irregular rhythm is not typical for ventricular tachycardia. Additionally, the axis appears fairly normal. This is another finding that suggests something other than ventricular tachycardia.

    I know of the down and dirty Colorado dopamine formula: You take the patients weight in pounds and divide by 10, then subtract 2. This will give you the rate in ml/hr for a dose of 5 mcg/kg/min. For example: 180 pounds/10 = 18. 18 subtract 2 = 16. 16 ml/hr.

    CAVEAT LECTOR: This formula only works in a 1,600 mcg/ml concentration. Therefore, it will NOT work with any other concentration. In fact, I strongly advise people not to use formulas and do the math for every infusion they set up or have to manage. This is especially true with facility transports where different facilities mix their medications with different concentrations. Using formulas like this as a crutch is a med error waiting to occur.
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    Default Re: Help!

    I was thinking A-Fib, since it is irregularly irregular, but the QRS complexes seemed a bit too wide. I stand corrected though. :)
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