#61
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Re: Who Best At Your Side During Major Heart Attack?
I would not think that a suq q injection would be faster at e getting the medication into circulation. Fat cells are made to store fat and return it to the circulation slowly. An IM injection however is given in a very vascular area.
[/ QUOTE ] I stand corrected on absorption rates. IM is a better route assuming few risk factors, highly trained personel, and incipient hemodynamic insufficiency. Still: The major consideration is resolution WITHOUT complication. Tx is dictated based on severity of SX&SX, with minimal intervention to accomplish stabilization. Standard dosages assume all possible levels of care (including laymen, and first responders) Plus it still hurts less, (I know, you don't remember!) Altered loc says you probubly did get IM. What predicated attack? |
#62
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Re: Who Best At Your Side During Major Heart Attack?
Friend of mine says assume first 30 minites post onset symptoms. This change conclusion?
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#63
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Re: Who Best At Your Side During Major Heart Attack?
[ QUOTE ]
[ QUOTE ] Statistics say that an EMT is much better in a situation where CPR is required. Paramedics and doctors spend too much time pushing drugs and putting in et tubes. This causes brain damage because CPR is being ignored. The EMT has the tools and training to handle the situation the best. He can provide CPR and defib which are your best chance at survival. Doctors and Paramedics statistically have been shown to provide worse outcomes. More brain damage and more deaths. It is assumed this is due to breaks in CPR because they are focusing on other advanced treatments that arent as helpful during the initial stages of a heart attack. [/ QUOTE ] I am not sure how to put this politely so I will just say it. I think you may be the one who is brain damaged. Please pull the study that shows what you described above. That would be a fun read. [/ QUOTE ] Fabulous! Cardio PULMONARY resuscitation. Bag valve mask is extremely poor tool. Compression without adequate ventilation is a morbid skills code. |
#64
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Re: Who Best At Your Side During Major Heart Attack?
[ QUOTE ]
The main source of my anesthesiologist choice is Dr. Andrew Gibson of Danbury Connecticut and an another anesthesiologist associate of his. They were pretty adamament. Keep in mind though that you admitted they would be right in certain circumstances and I don't remember how I phrased the question to them. On the other hand if you still think he is clearly wrong even if you agreed on the question, I'd bet you were wrong. Teaneck High. Class of 1966. We don't make big mistakes. [/ QUOTE ] Uncle Dave, Have you noticed that it is a couple of anesthesiologist that have told you that it would be best to have an anesthesiologist at your side durring an MI? What would you have them to say????????? "Durring an MI your best bet is to have a plumber at your side?" Gee that would be like a couple of gamblers, writting a few books about poker that say "the way we play poker is the best. We have not won many big tourneys unless we were invited to play, but our way is better than the ways that the writers that win poker tell you." Do you see why? |
#65
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Re: Who Best At Your Side During Major Heart Attack?
[ QUOTE ]
What predicated attack? [/ QUOTE ] Allergy skin test. [ QUOTE ] Still: The major consideration is resolution WITHOUT complication. Tx is dictated based on severity of SX&SX, with minimal intervention to accomplish stabilization. Standard dosages assume all possible levels of care (including laymen, and first responders) [/ QUOTE ] Are you quoting a text book or what? The major consideration in my case was survival. I wanted the epi on board and I did not care how it got on board. Complications? Honest it was not an issue. Yea you have to be reading some textbook. |
#66
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Re: Who Best At Your Side During Major Heart Attack?
What's the matter? Need a dictionary to understand me?
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#67
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Re: Who Best At Your Side During Major Heart Attack?
I believe I invented this riddle soon after starting my poker career a couple of years ago:
What were the last words the heart specialist said to his hospital team and staff upon leaving his post to pursue a living playing poker? There is no "I" in cardiology. Cardology. Get it? |
#68
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Re: Who Best At Your Side During Major Heart Attack?
A guy with a time machine so you can go back in time to avoid the heart attack obviously
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#69
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Re: Who Best At Your Side During Major Heart Attack?
As a board certified internist and nephrologist this question is straight forward for me. If I or anyone I remotely care for is in the midst of a myocardial infaction, a cardiologist would be my first choice of managing this problem. I will assume that each profession is equally talented, skilled, and handles stress equally well. Standard care for anyone who is having chest pain that may or maynot represent a MI is to provide asprin and oxygen. Symptomatic control may be improved with morphine and nitrate (sublingual, trandermal, or IV). Quickly diagnosing the chest pain is crucial. In this scenario, the chest pain represent a major MI. Morbidity and morality with MI's center around the managment of heart failure and arrhythmias. The guidelines for the managment of heart failure and arrhythmias (Advanced Cardiac Life Support or ACLS) are the one the first things that medical students learn/trained prior to entering their clinical years. Assuming the cardiologist, ER specialist, and internist completed a certified training program, I believe all would equally be skilled to manage a major MI up to this point. A cardiologist though is best equiped at making major intervention decisions that would potentially alter mortality/ longterm morbity. These decisions include throbolytic agents vs percutaneous artiogram and throbolysis. ER specialist and internist are not trained to perform invasive cardiac procedures. Most of the anesthiologist I know panic whenever a patient is suspected of having an MI. Nevertheless, I am cofident that most could medically manage an MI as well as a cardiologist, ER specialist, and internist. EMS or first reponders in the setting of a "major" MI could also probably adequately manage an MI by simply following ACLS guidelines.
My list from best to worst: 1. Cardiologist 2. ER specialist 3. Internist 4. Anesthiologist 5. EMS If you remove any invasive cardiac procedure from the treatmet options then cardiologist would still lead the list based on experience. The reality of the situation is that the ER specialist at the first signs of an MI call the cardiologist for assistance and managment. |
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