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Ctrl Alt Del -“Now as far as health is concerned : you are basically a 2 bit hack. With neither knowledge of medicine nor vocabulary.”
Ooh I’m so insulted.
“You are a great pretender but when You are put to the test you fail miserably.”
What test? Did you actually think I would even care to answer any silly question you post here?
“No amount of protestation on your part is going to change the facts.”
Whose protesting? Do you actually think I care two hoots about your opinion?
“By the way you are still misusing the word pithing. Do us all a favor finish paramedic school first then come to discuss medical issues in this forum.”
Ok whatever you say. Keep humoring yourself. I’m not explaining the insult. The reason you don’t understand it -is because the insult is so very true.
“As far as proving something to me of course you don’t have to. But now that you have not and have declined publicly, I am sure the rest of the cr is very interested in why you could not answer a simple question that is not googleable. Good night, doctor Google Cutandpaste”
I just answered a question from -“toomuch00 –
What did they recently discover the tissue from the inside of the Appendix can sometimes be useful for?” And I didn’t Google it.
Don’t you even read the posts here or are you so in your own little world that you see posts and scenarios that don’t exist?
They call people like you Psychotic. And you can Google it – if you don’t know what it means!
okay
approximately how many bones are there in a human infant, and how many in a human adult?
i say approximately because there is some natural variation and also differences in the definition of certain bones
Nasal flaring, tripod position and chest breathing are signs of respiratory distress even by an adult.
You can add see saw breathing to an infant.
Hatzlacha with your studies!
So Mods, no reply of mine is getting through eh? Since equal time is not being given to both parties please do me the courtesy of removing Health’s offensive posts from this thread.
300-350 bones in an infant’s body. Adult body has 206.
hi 2scents. thanx for your answer. i’m learning complex resp diseases this week and i’ll keep those s/s in mind.
Good.
and remeber that each situation is umique, base all your findings according the present situation.
As the saying goes, do not treat the monitor, treat the patient.
You should also work on obtaining experience in “door knob assesment”. which is getting a feel of whats going on just by entering the patients room.
Also, take the medical advice given on this (or any online) forum with a grain of salt!
again, Hatzlacha on all your studys.
thanx 2scents. i need it. esp in that first sweeping assessment. never heard of it as the ‘door know assessment’ though. that a ems term?
I read it in one of my cardiology books, I told it to a medic, he told me that it’s called that way.
That proff. Claimed that it shouldn’t take you more tha six seconds to know off hand if this patient is sick or not.
And that it takes her students four to six weeks to master this.
six seconds? in a pt w/ RR of 20 and HR of 80 thats 2 breaths and 4 heart beats. how much can you see to say the pt is sick? in 6 sec all i would have done is said Hi to my pt my name is how are you feeling! (and seen all the eqp/lines running) i guess the first assessment as emt/medic is very dif than the first assessment of the nurse. scratch that. i KNOW its very dif (met a few emt’s in school).
2scents – Some people never master it because they don’t care. I think there are books that are written on this -I think one is called “Sick /Not Sick”. I never read it though. I just think some people have a second sense when it comes to medicine – they learn how to read patients. I see a lot of practioners when they get called to a scene (EMS) or an ER for an emergency and the pt. is unconscious and then they go through ya know the ABC’s and go down the protocol -they think they are practicing medicine and are the best thing since sliced bread. I don’t consider this the practice of medicine.
This is what I consider practicing medicine and this story is Not meant to put down any type of practioner more than the next. I’ve seen lack of good care all across the spectrum. One of my rotations was in Geriatrics and I wanted something more challenging that just a regular Nursing Home floor. So I hooked up to the Vent floor. A lot of patients to say the least aren’t with it and they spend their life unconscious attached to a vent. The nurses do vitals I think 3 times a day. Now for these type of pts. the care can be very monotonous. As the student I got dumped with most of the routine paperwork. So I was doing the paperwork on this pt. and even though you do patient assessment on every pt. that you do this routine paperwork on – you basically don’t get any info. They don’t respond to anything and physical exam is usually Not Remakable. So I was holding by the putting down the vitals of this pt. and I asked the nurse for the vitals. The nurse gave me the notes and I noticed that she had recorded a slight fever. Since I don’t know the pts. I checked to see if this pt. has had fever before and this isn’t something new. But lo & behold this was a new onset -so I got the Resident and we did a septic workup. What I didn’t understand was why didn’t the nurse mention something to either me or to the Resident (it was usually a NP in charge of the floor but she was off that day)? Alerting the Staff to even a minute change is called practicing medicine. Watching s/o keel over and doing some protocol is just monkey skills!
I dont think you understood what I wrote.
Door knob assesment is sort of the general assesment (or initial assesment).
We are also required to take a full set of vitals from each patient (vitals are vital..).
However when you enter the patients room, you should be able to know within the first seconds if this is a sick patient or not. Before you interview or take vitals.
It’s not. Text book thing. Store iit in your mind for after you graduate.
Health.
Care is the right word.
I have seen lots of nurses that simply don’t care. And some that do. The difference is huge.
The same goes with first responders. Those that deliver excellent patient care, and those that make the patient feel miserable.
ya i totally misunderstood. thanx for explaining. i learned it as the initial assessment, including v/s, head to toe, etc. and based on the initial assessment plan a focus/focused assessment(s).
and your right that you can see if a pt is sick or not in that first glance. personally it was easier for me w/ the peds pt’s than it is w/ adults.
2scents -“Care is the right word.
I have seen lots of nurses that simply don’t care. And some that do. The difference is huge.
The same goes with first responders. Those that deliver excellent patient care, and those that make the patient feel miserable.”
And I’ve seen it from every type of medical practioner -from 1st responders to EMT’s to Medics to Lpn’s to RN’s to NP’s to PA’s to Doc’s and anything in between.
One group that you hardly find this incompetence by is these guys who take a real First Aid course like in college. I was already a medical professional, not what I am now, but I needed credits so I took a First Aid course in community college. Of course I didn’t tell them my level and that I’ve taken First Aid since 9th grade. I thought it would be a breeze, but it wasn’t that easy, esp. when you haven’t practiced these skills in years, if ever. But these guys & gals the way they dedicated themselves to learning everything would put a lot of professional providers to shame.
And I’m not joking.
If I happen to come on the scene of a sudden illness or injury I’d rather have these guys helping me out. Almost all the time I’ve dealt with the EMS whose territory it was -they were the most interested in running the show and kicking everybody else away. The very last thing on their mind was good pt. care! It seems like the more Gaavah they have -the less medicine they practice!
This I found on JEMS forum, but it would apply to any provider:
I understand what they mean, but after reading a lot of the posts there and the different opinions/disagreements it might be better to think to yourself Stable or not? Since we have some nurses here (not me), I’ll give an example using a nurse, even though I have a few different areas where I have degrees -never got a nursing degree, but I considered it more than once.
Btw, I’m just making this up as I go along. Anyway the head nurse sends you over to assess Mary who was just brought in complaining of you name it -everything & anything. You walk over and as soon as you open the curtain Mary sits straight -bolt up and says “I can’t believe the service in this hospital. Do you know how long I’ve been waiting here?”
Stable or Not? (Sick or not?)
Also, what’s the next step?
#2. The head nurse sends you over to assess Gertrude who was making a nusiance of herself in the nursing home and they got tired of her and shipped her to your ER (or ED for those who like to be technically correct). You open the curtain and Gertrude is lying there and you hear gurgling every couple of seconds.
Stable or Not?
Also, what’s the next step?
Chuckle chuckle…
CAD,
what is there to chuckle about?
What a thread! lol
Not sure if I should mention this, but there was a great Jerry Lewis movie called the Disorderly Orderly.
He was an orderly in a rehabilitation home and could not go on to become a doctor because he was so empathetic to the patients, when they explained their ailments, he would grimace and cringe or bend over or bite his lips..etc.
He would have a field day reading this thread and end up exhausted.
2scents, Health amuses me. So I chuckle.
Ok, at least your having a good time!
Well does any nurse or nursing student want to give my post a try?
i’ll do it. first pt is stable and not acutely having a problem. i would explain that she is not the only pt under my care, other pts need care right now but i will be back as soon as i can
pt 2 is not stable. first step is to maintain a patent Airway (abc’s). suction, ambu-bag, o2, call for help etc.
and what would you do now that i gave my answer?
Health,
Why in the world are you taking someones comments seriously?
I dont know if you are for real or not. neither do I care. (the same could and should be said about me)
But I cannot figure out why you get so all worked up when someone posts something against you.
Just move on!
Ooooh. I like this thread now. We can discuss cases we might have had (no names/facilities of course) and what management we have done/should have done. I love to hear other opinions on the more complex cases I have had. Or maybe just theoretical cases.
2scents -Health,
Why in the world are you taking someones comments seriously?
I dont know if you are for real or not. neither do I care. (the same could and should be said about me)”
I honestly don’t care.
“But I cannot figure out why you get so all worked up when someone posts something against you.”
I’m not as hard up as you think I am, but after awhile it gets to you. This guy has been after me since day one. Do you know how many years that is?
here is my question. Im taking A and P this year and had to know this for midterm.
describe the difference between an Axon with myelin sheath and without the myelin sheath
its part of physiology but thats connected to anatomy so should be simple enough for you
yentingyenta -“i’ll do it.”
Yay -you get a star for being the first one to jump in. * 🙂
Hopefully others will join too.
I made these first two scenarios easy for students.
“pt 2 is not stable. first step is to maintain a patent Airway (abc’s). suction, ambu-bag, o2, call for help etc.”
Correct, but I’m just going to Mefarish your words a little.
Check for unresponsiveness (Tap & shout). Maybe the pt. isn’t really unconscious. Next call for help. (If unconscious.) Open airway, place OPA. Check for breathing. If not breathing or not breathing adequately give rescue breaths. This should be done with whatever you have on you or next to you. It could be a pocket mask or a CPR shield or a BVM/Ambu bag. Check for pulse. This case the pt. has one. (So I don’t have to go down the whole protocol.) 🙂
Hopefully by now the troops have gathered and whomever does the intubation in your facility has been alerted. (Usually Anethesia or Respiratory therapy.)
“first pt is stable and not acutely having a problem. i would explain that she is not the only pt under my care, other pts need care right now but i will be back as soon as i can”
Remember I’m not here to criticize, but I’m just critiquing for learning purposes. You got as far as the first four words and after that nothing else is correct. Either you didn’t read case #1 so carefully or you became defensive. You don’t have to tell me. Either way -this is the next step. – First thing I’d say -“No I’m sorry -I really don’t know how long you have been waiting, but we have to go in order and treat the most serious pts. first. But the good news is -I’m here to help you now.” Remember you were sent to assess the pt. You can’t say -I’ll be back later or by her obnoxiousness know whether she has an acute problem or not.
The next step is to ask -“What made you come to the hospital today”? Chief Complaint, then HPI, then Sample History & so on & so on.
“and what would you do now that i gave my answer?”
This question -I don’t understand.
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