Wednesday, February 22, 2006

Peforming Self-CPR

My Uncle Fred & I have been having a discussion about an email he received instructing you how to save yourself in the event you begin experiencing chest pain and are by yourself or not close to a hospital.  In the email it instructs you to cough deep and as often as you can while you drive yourself to an ER or can call for help, perferrably 911.  The following is our conversation:

Opinion?    ‑fad‑
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This does work to some extent.  We have conscious patients do this all the time for the exact reasons stated.  Increasing cardiac output or to change an arrhythmia.  It doesn't always work and we are always busy doing other things at the same time.  But if you were alone, it is certainly worth the "effort".  But you better be pretty damn close to an ER and/or call 911.   Another potentially life saving step could be if your heart was beating regularly, but super fast (meaning greater than 150 or so a minute, usually around 200).  This is called SVT (super ventricular tachycardia) and is considered a "lethal" rhythm as it can progress into ventricular tachycardia (slower) and then into ventricular fibrillation (arrest).  One thing we have patients do while we are starting IVs and preparing medication is to do a carotid massage or a val salve maneuver (holding your breath and bearing down as if you were having a BM).  Both of these things could be done if by yourself and far from a hospital and have been known to "spontaneously convert" SVT back to normal sinus rhythm.   Did that help?   D   I could've used a few heart attacks last night at work instead of the bucket load of crazy people.  I swear, they were out in force!  ________________________________________________ 

Better to do something besides just wait, I suppose.  We have a friend here who claims to have hit himself on the chest until help arrived!    ‑fad‑
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Well...I've beat on a few chests before, but never my own.   Funniest story about beating on chests ever...   I had just been working in the ER for about 6months and I was in triage.  I went out and called the next name on the list that had an "urgent" complaint of "spells", but the person didn't answer.  So I called the name again...no answer.  Finally I hear this lady go "That's my husband and he's in the bathroom."    So I walk over to her and say "What kind of spells does your husband have?"   "Oh I don't know...he just kind of rolls his eyes in the back of head for a minute or two and then comes back".   "Well, is he shaking at all during these spells?"   "Oh no, just the thing with the eyes."   At this point I become a little concerned because what she is describing could be either seizures or a stroke so I say "How long has he been in the bathroom, do you think I should go check on him?"   "Oh no, here he comes now"   Normal enough looking guy.  No obvious distress.  No shortness of breath.  Not diaphoretic.  Ambulating without assistance or difficulty.  Good color.  Looks damn good to me.  Oh well, I get a wheelchair and take him into triage.  Ask him a bunch of questions and basically get the same response from him except he doesn't know about the eye rolling thing.  He just says "I get all tingly before the spell comes on and then I don't remember anything".  Sounds like a seizure right?   So I take him right back to a monitor bed and hook him up.  Just as I finish the patient goes "I feel one coming on..."  So I watch him and nothing.  He goes "oh no..."  I'm looking at him, right?  Eyes roll back into head, but no seizure.  So I glance up at the cardiac monitor...FLAT LINE!  Holy crap!  "Dr Brown come into Rm10 RIGHT NOW!"  It only takes a second for David to get into to the room and I've lowered the bed to a flat position and am about to initiate CPR when David pushes me back and pounds on the patient's chest with a big "THUMP" once, twice, three times.  Sinus rhythm.  Whew!   So then the guy wakes up a minute later and goes "What happened?  Oh man, I feel like someone just beat on my chest!"   "That is because we just did!"   The man had a complete heart block and been have periodic episodes of asystole.  So............tell your friend to beat away!  Can't hurt!  But if he can keep on beating on his chest he probably doesn't need to!   D

Saturday, February 18, 2006

"I"

Got this from Robin...I'm borrowing as usual.

I Live: in warm/sunny/dry AZ with my wonderful family

I work: as a Mom, Wife, and an Emergency RN

I Talk: way too much most of the time

I Wish: I could live closer to my family, but love AZ

I Enjoy: just doing nothing

I look: for happiness in the wrong places sometimes

I Find: I’m lost without my family

I Smell: too much at work (lol)

I Listen: as best I can and hope that it is good enough

I Hide: my feelings sometimes because it makes my world easier to live in

I Pray: for my family’s health, happiness & safety daily

I Walk: with shoes on almost the entire time I’m awake; when what I really need to do is walk in someone elses' shoes more often

I Write: about superficial things so I don’t have to think about what really worries me

I see: life through hopeful eyes

I Sing: off key

I Laugh: with my family and not enough at myself

I Can: save your life

I Watch: my children grow everyday with great pride and love, and I don’t wish they were smaller...just less opinionated

I Yearn: for inner peace

I Daydream: occasionally

I Fall: to pieces sometimes

I Want: to win the lottery (me too, Robin!)

I Cry: too much in the past few days

I Burn: memories when they are too painful (or at least try to)

I read: not nearly as much as I used to or want to

I Love: my family & friends

I Rode: a horse, a motorcycle, a bicycle, in the back of a truck, in a convertable…

I Sometimes: lie

I touch: other people's lives (at least I hope)

I hurt: deep in my heart right now

I Fear: being left out

I Hope: things get back to normal soon

I break: things when I’m mad

I Eat:  too much, especially if I am upset

I Bathe: daily (at least most of the time)

I Drink:  Diet Dr. Pepper, coffee & water all day long

I Stop: not often enough

I Save: too much junk

I Hug: not as often as I should or as much as I used to

I Meditate: never

I Play: not as much as I should

I Miss: a lot of people

I Hold: my family dear to my heart

I forgive: but find it difficult to forget or let the other person forget (so then do I really?)

I Drive: too fast (shhhhhhhhh!)

I Learned: too many things the hard way.

I Dream: occasionally, but have nightmares when I’m upset

I Have: a big butt and I hate it

I Don't: want my stepdaughter to ever live with us again and don't feel very guilty about it even though it hurts my husband

I Made: the President’s Honor Roll in nursing school 3 out of 4 semesters

I Believe: in Heaven & Hell and sometimes think I live in between

I Wait: impatiently

I Need: my family & my God

I Owe:  God for everything good & bad in my life and need to thank Him more often

I Hate: rude, lazy, working-the-system people, and drug-seekers who clog up the ER

I Feel: stressed at this very moment.

I Know: a lot about medicine/nursing

I Wonder: about too much that is out of my control

I Applaud: our military men and women...they give up so much for us every day (me too, Robin!)

I Also Applaud: Nurses, the unsung heros that are overworked, undervalued, and underappreciated...but are the ones you can count on to be there when you need them.

I support: my President & my country.  God Bless the USA!

I Love: too much or not enough and find it hard to balance

What Temperament Are You?

Got this from Robin.  

 You Have a Choleric Temperament You are a person of great enthusiasm - easily excited by many things.
Unsatisfied by the ordinary, you are reaching for an epic, extraordinary life.
You want the best. The best life. The best love. The best reputation.

You posses a sharp and keen intellect. Your mind is your primary weapon.
Strong willed, nothing can keep you down. Your energy can break down any wall.
You're an instantly passionate person - and this passion gives you an intoxicating power over others.

At your worst, you are a narcissist. Full of yourself and even proud of your faults.
Stubborn and opinionated, you know what you think is right. End of discussion.
A bit of a misanthrope, you often see others as weak, ignorant, and inferior.

Hmmmm....yep I would have to say this is pretty right on the money.  Especially got the stubborn & opinionated thing going on this week.

What temperament are you?

Saturday, February 4, 2006

Robin's 5'er 2/3/06

 PLAY ALONG WITH ROBIN!

 

Hi guys!!!  It's Friday and it is time for what I call "THE 5'er!" 

If you want to play all you do is cut and paste these questions into your journal. (there is no deadline as to when you can do "The 5'er) When you have answered them come back and leave a link in my comment section.  On the following Friday I will have a new set of questions! Have fun!

 This week’s theme is...Romance.  Why? Cause it is February for crying out loud!

LET'S PLAY!!!

1. What is the most romantic thing you have ever done or had done for you?  Ewwwwwwwww.  You picked a hard subject.  My husband usually buys me flowers and chocolate.  I beg him not to buy flowers because I kill them the minute they are in my house…don’t know why, just bad karma.  And the chocolates are for him cause I don’t really eat the kind of chocolates in the box.  I like to buy everyone PJs.  Don’t know why, just a family tradition.

2.  Your idea of a perfectly romantic evening would be...I’ll go with Robin and say a nice quite evening away from the kiddos.  Swanky restaurant.  Nice music.  And DIAMONDS!

3.  Have you ever forgotten a romantic occasion? Anniversary? Valentine's day?  What happened?  Well, I did forget our 3rd anniversary, but I had a valid excuse.  See I was in the hospital recovering from a c-section after having Mr. Caleb Marc.  So, I belatedly said “oh Hon…happy anniversary, here is your present” and handed him Caleb.

4.When you think of romance what flower comes to mind? And what color?  Anything that doesn’t die.  Oh, okay I’ll play along.  Roses.  It’s always about red & white roses.

5.  Do you remember your first kiss? Was it all you expected it to be?  If you could do it over again (now that you are more experienced) would you. Keeping in mind you would like be going back in time and it wouldn't be cheating or anything.  Yah…and it is something I’d rather forget!

Okay...light some candles, put on some Barry White and send me your answers! Smooches my little love cakes!

Alphetical Description of yourself

This is an Alphabetical, Describe yourself TAG I got from Betty.  What does each letter in the alphabet say about you?  Come up with the right word and Tag your Friends.

This was harder than I thought it was going to be and had to obtain a little bit of help. 

A: Annoying (or so I've been told)

B: Beautiful (at least that’s what one of my tattoo’s says in Japanese)

C: Caleb’s Mom

D: David’s Wife

E: Emotional (at times)

F: Fantabulous (all the time)

G: Ginormous (working on this not being true)

H:  Hannah’s Mom

I:  Incredible

J: Jordanesque (at times)

K: Krunk

L: Lover

M: Mary/Mom

N: Netizen (too much of the time)

O: Outgoing

P:  Psychodramtic (about once a month)

Q:  Quadragenerian (but still young at heart)

R:  Rhadamanthine (I hope)

S:  Space-Possession Dictatorial (just ask my co-workers/family)

T:  Taggin’ anyone who wants to play

U:  Uxorious (and I plan to stay that way)

V:  Vertically-Challenged (and no comments from the gallery)

W:  Worrywort (just ask anyone)

X:  Xanthippe (I’ve been known to be)

Y:   Yaud (especially at the end of a hard shift)

Z:  Zany