Over The Hill Gang , Old Farts with Young Cars

[BOETIE]

Any ol Farts around

[Xanthos]

Originally Posted by BOETIE

Any ol Farts around

I'm around, but I'm far too young to be an old fart.
- X

[SSE 4 2SS]

Originally Posted by Xanthos

I'm around, but I'm far too young to be an old fart.
- X

Hey X, are you having any trouble in any particular areas... study wise...???

[Xanthos]

Originally Posted by SSE 4 2SS

Hey X, are you having any trouble in any particular areas... study wise...???

Not really. I've been having some trouble remembering the different types/stages of shock and their various symptoms and also some of the various brain injuries, but otherwise not too bad. Also still trying to remember the GCS...
- X

[SSE 4 2SS]

Originally Posted by Xanthos

Not really. I've been having some trouble remembering the different types/stages of shock and their various symptoms and also some of the various brain injuries, but otherwise not too bad. Also still trying to remember the CGS...
- X

Keep it simple,

First, I'm a 25 year paramedic and taught or proctored at least 500 practicing medics in and around Texas....I am still state certified, never having sat for the National Registry, but people I've talked to said it's really no different than the State Boards I took...
few quick questions....Car wreck, steering wheel is bent at the top half, windshield is spider web'ed... what kind of shock do you suspect and why... simple answer is fine....
More in a minute if you are interested...on shock...
Brain injuries.... are you talking about subural versus epi dural, or are you talking about the symptoms and how to treat them... Cushings Triad is your friend with brain injuries... I'll explain it if you are not familiar with it....
CGS= GCS, glasgow coma scale....????

[Xanthos]

Originally Posted by SSE 4 2SS

Keep it simple,

First, I'm a 25 year paramedic and taught or proctored at least 500 practicing medics in and around Texas....I am still state certified, never having sat for the National Registry, but people I've talked to said it's really no different than the State Boards I took...
few quick questions....Car wreck, steering wheel is bent at the top half, windshield is spider web'ed... what kind of shock do you suspect and why... simple answer is fine....
More in a minute if you are interested...on shock...
Brain injuries.... are you talking about subural versus epi dural, or are you talking about the symptoms and how to treat them... Cushings Triad is your friend with brain injuries... I'll explain it if you are not familiar with it....
CGS= GCS, glasgow coma scale....????

Yeah - talking about remembering the difference between subdural and epidural and stuff like that.

And yeah, I mean GCS (glascow) not CGS - I editted it before you got your post in.

As for the shock question... Um, you'd expect spinal shock right? Because of damage to the brain stem/cervical region?
- X

P.S. - Its remember the stages of shock that makes me want to bite my fingernails completely off. LMAO. I have trouble remembering the symptoms of stage 1, stage 2, etc.

[SSE 4 2SS]

One critical thing about testing, read the question, throw out the distractors, determine what they are asking and then and only the look at the answer options.... Two of the options will be way off, and two of them will be close.... If you don't know the answer right away, go no to the next question.... i can almost promise you, there will be a simular question later on that will either tell you the answer, or jog your memory to be able to determine between the two remaining choices which is correct...

[Xanthos]

Originally Posted by SSE 4 2SS

One critical thing about testing, read the question, throw out the distractors, determine what they are asking and then and only the look at the answer options.... Two of the options will be way off, and two of them will be close.... If you don't know the answer right away, go no to the next question.... i can almost promise you, there will be a simular question later on that will either tell you the answer, or jog your memory to be able to determine between the two remaining choices which is correct...

Can't go on to the next question on the National Registry. Its done by computer, gives you one answer at a time, and kicks you off when you've gotten enough right or wrong to pass or fail. Very similar to the RN testing.
- X

[SSE 4 2SS]

Originally Posted by Xanthos

Yeah - talking about remembering the difference between subdural and epidural and stuff like that.

And yeah, I mean GCS (glascow) not CGS - I editted it before you got your post in.

As for the shock question... Um, you'd expect spinal shock right? Because of damage to the brain stem/cervical region?
- X

As for the testing, don't get wound up about the differences between the different types of intra-cranial injury... Remember, we cant do anything different about it in the field, and the testing reflects that.... They just teach more in the classroom so you have a more solid background.... Cushings triad.... in the event of brain injury,
A. what does the blood pressure do, B.) what does the heart rate do, and C.). respirations... again,keep it simple.... See in basic terms if you can explain why these things occur...

Spinal Shock....Neurogenic Shock, correct, think about the mechanism of injury when trying to figure out what the patient is telling you with symptoms.... If you keep these in the back or your mind as long as the patient is in your care, you will be able to be proactive rather than reactive.... good for the patient, and great for your stress level...

[SSE 4 2SS]

Originally Posted by Xanthos

Can't go on to the next question on the National Registry. Its done by computer, gives you one answer at a time, and kicks you off when you've gotten enough right or wrong to pass or fail. Very similar to the RN testing.
- X

Ouch , ok, new testing technology.... forget what I said about that.... and the rest of it still applies, read the question, throw out the distractors, and determine what they are asking, then look at the answer options, again, two of them will be way off...

[SSE 4 2SS]

In a minute, I'll ask you a trick queston I have asked pretty much every student I ever worked with....

[Xanthos]

Originally Posted by SSE 4 2SS

In a minute, I'll ask you a trick queston I have asked pretty much every student I ever worked with....

Ok. You're making me nervous.
- X

[SSE 4 2SS]

You have a traumtic head injury patient, lets say for continuity, the same one that hit the windshield above..... the initial vital signs are BP 190/130, HR 48, respirations are 30 and shallow....you do everything in your power to stabilize the patient... and after a few minutes, you check the vitals again, and you get BP 120/70, HR 78, Respirations are 20 and non labored.... are you ready to congratulate yourself on a good job or are you scared to death, and thinking about everything you have learned, seen and done for this particular patient.... ? Why...?

[SSE 4 2SS]

Personally I'm scared to death, and the patient is either not injured that bad in the first place, or they are circling he drain...
Simplified explanation.... to get from 190/130 to 0/0 you pass through 120 / 70, and as the blood pressure decreases, the heart rate will increase.... respiration will do whatever... again, this is Cushings Triad....With rising intracranial pressure, BP will increase, consequently HR will decrease, and respirations will do whatever, increase or decrease.... Think of the blood vessels in the brain, if you increase the pressure outside of them, the internal diameter will decrease, and this creates back pressure on the circulatory system... so, with increased resistance, the HR will decrease... it's working harder to pump the blood and any pump that is loaded, will slow in rate....