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thinkfree wrote:Sigboy40 is the greatest asshole I have ever had the pleasure of knowing
curphy wrote:I tried to read through most of the posts (although 147 is a bit much to handle), but I don't recall anyone mentioning the following additions:
Portable suction device/canister - you can improvise one with your irrigation syringe(s), but it won't be nearly as effective as the real thing, and for compromised airways, suction is an absolute necessity.
Also, consider adding suppository meds to supplement the oral ones (i.e. PR analgesics, anti-emetics etc), because if nausea/vomiting is an issue, oral meds are worth about as much as a warm bucket of hamster vomit. You probably had some sort of stool softener (i.e. Senokot or colace) in there, which is a good idea for treating opioid induced constipation, assuming that the person survives and hospitalization is not an option. Did you have nitrostat SL for angina/AMI?
I liked that you added the obstetric kit, since stressful events (PAW) and even minor trauma can cause early/unplanned labor in pregnant women.
You might want to also add a pediatric cervical collar, as well as a couple more sizes of King LTs (I believe I only saw one?). As you mentioned, an AED, oxygen and pulse oximeter would be nice adds. Oximeters are extremely easy to use... you just have to remember that cold can affect the results, as well as shock and even carbon monoxide poisoning, which is why you always treat the patient and not the machine, so to speak. Oxygen can be life saving, and act as a comfort measure and analgesic.
Lol, about all you were missing is packed RBCs, ffp, platelets and concentrated clotting factors
Raybo wrote:I see that you have a Blood glucose monitoring kit and strips. In my practice I insist that my patients replace the meters every 2 years as after that point about 50% are no longer accurate…Not to mention the strips are very perishable and highly Temperature sensitive. Additionally, even if you do find hyperglycemia in a patient, do you have the Meds (insulin) and supplies to safely control it without killing a patient? In the ICU I run insulin drips and have to adjust fluids and Electrolyte balance based on lab work that is run Hourly in the early phases of ICU admission and is based on mathematical protocols that factor all of these issues into the equation. Incorrect management could easily be more fatal that simply providing hydration and watchful waiting.
Raybo wrote:In a situation in which society as we know it has broken down, medical care would revert back 100 years and simply be a case of triage and doing the best you can with what you have been able to squirrel away. As an example, my average DKA patient who is admitted to the ICU uses enough fluids, supplies and Meds to fill the space of a 55 gallon drum over the 2-3 days they are an inpatient and half of those supplies would be used in the first 12 hours of their care. They also require the training and 24 hour a day availability of highly trained Doctors, Nurses, Laboratory, and respiratory personnel.
crypto wrote:So, yeah, well be fucked when theres no more antibiotics, but so will all the old people without boners.
And you are spot on about hypoglycemia being more dangerous than hyperglycemia in the short term. Recent studies have shown that attempting to too tightly control BG in ICU pts can result in hypoglycemia and increase Mortality. I now try to target 100-150 for my ICU pts.
Not to snipe at you, but remember we are trained to do this, and we can and do titrate dosages off the top of our heads based on our training and experiance. in lessor trained hands sever hypoglycemia is a probablity. just as it is in my first year residents who struggle to gain the touch to quickly bring down a BG without dumping the Patients BG into the 30-40's.
I feel that sometimes knowing when to say when, is the better part of valor and will save pts needless suffering.
Dave Carroll wrote:ok, i've searched here and the web. what does S.T.O.M.P. stand for?
shrapnel wrote:Shut the fuck up, you'll meet me and you'll like me or I'll fucking cut you.
SMoAF wrote: I collect foodstuffs so that I can stay alive long enough to exhaust my ammo supply.
And on the eighth day Man forged a knife and took survival into his own hands.jamoni wrote:You win. I hope it helps you get chicks.
BBRAH wrote:I've been a lurker on ZS for a while and felt compelled to finally join on the basis of this wonderful thread.
Paragon wrote:Perhaps a couple of bottles of 5-Hour energy drink or even some NoDoz tablets would be a good addition to help fight off fatigue and drowsiness.
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