60 Licensed To Raise The Dead

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(25:57) Ron has his cardiology finals. Both the written, which was a third of my grade, and the practical which was 3% and got him his ACLS card. But it was 3% if you don’t pass, you don’t pass the course.
Now he’s asking Kelly, is cardiology really that hard?
Do you know when you are stressed out? Turns out the Newbie didn’t.

This episode sponsored by MedicsTest.com

Listener Questions

Mitchell

On the last podcast y’all talked a little about CPAP. Our CPAP protocol says to use our ETCO2 monitoring equipment which resembles a nasal cannula. I would think that using that would prevent a seal around the mask, defeating the purpose of using CPAP. What are your thoughts?

Lastly, say you have a patient with a respiration rate of 40 with a hx of COPD, and they are unable to speak in complete sentences. They have diminished lung sounds, however you can hear wheezes in the upper right lobe, slight cyanosis in their lips and nail beds, initial sat was 84% after a NRB with 10 LPM it comes up to 92%. Would you give a neb treatment to see if they improve or would you go ahead and attach the CPAP? I’m sure that I’m probably in the minority for EMS providers but my philosophy is to do the least invasive treatment which in this case would be CPAP before I begin to administer drugs.

Ron: Since you have been doing the schooling and have gone on a few calls, how has your view of EMS changed from your orginal thoughts of EMS in general? If so, what about?

Kelly: After all the years of schooling and the many calls you have run, has your thoughts or views on EMS as a whole changed, and if so, what about?

EMS Freak

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  • Mitchell

    Thanks for answering all of my questions guys!  I asked that scenario question because a few weeks ago we had a patient like that.  Even though with the oxygen their O2 sat increased, they were still cyanotic, a RR of 40, and a bit confused.  We decided not to administer a breathing treatment and go straight to CPAP which with a minute or two the patient improved almost back to normal. 

     The ER nurse asked why we didn’t administer a breathing treatment.  Of course the patient was totally different in the ER than they were initially, we just didn’t think that we should waste valuable seconds (since to the best of my knowledge our CPAP masks do not have the ability to administer a breathing treatment), my partner was beginning to think she would need to intubate if the patient got any worse!