56 Cardiology Exam II

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(21:40) Ron took his second cardiology exam this week. Also learned about aberrant conductions rhythms, and practiced the pushing of adenosine. During listener questions you will learn two ways for paramedics to do 2 finger CPR.

Mentions:

Listener VinceD’s comment on Kelly’s comment on hypomagnesemia.
PHTLS blanket extraction technique

Listener Questions

David ask if we have any tips for preparing for paramedic school.
Ryan – Hey, the other day we had to back board someone on a blob. In case you don’t know, a blob is like a giant air pillow in a lake, and you jump on it. Anyway, we ended up having to do a clothes drag after applying a c-collar. I was wondering if kelly had any suggestions on how he would have handled it.
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  • Hey, I was listening to this podcast this morning on my way home from work.  I heard Kelly talk about the 11 seconds of Asystole after giving Adenosine,and yes,there is a true “pucker” factor whenever you give it.  I have a friend that used to work with Kelly at Acadia back in the 90’s and he told me that they had eliminated the initial 6mg dose in their protocols and they were to start with the 12mg dose.  I’ve given Adenosine many times and usually get conversion with just 6mg.  I’ve probably only had to go to the 12mg dose once or twice.  I’m wondering if that is still the protocol or if they’ve gone back to 6-12-12. 

    To share a quick story, I had a regular SVT patient who used to actually ASK for “that medicine that slows your heart down”.  I had given her adenosine on 4 or 5 occasions, always converting to NSR after 6mg.  Having had my own issues with SVT and had a cardiac ablation, I would talk to her about seeing a cardiologist and seeing if that was an option for her.  After not making her for several months, I made a run on one of her neighbors and she came over and I asked her how her SVT was doing.  She told me that she took my advice, saw a cardiologist and had the ablation done and hasn’t had an issue since. 

    Always remember to ask yourself, “Am I doing this FOR my patient or TO my patient”.  I’ve been at it for 15 years and I still run that through my head before doing any interventions.