Frequently Asked Questions (or should be)
! DISCLAIMER !Meph is a dumbass and actually knows far less than Meph thinks he does. Any dispute between what Meph says and any other source should be understood as the other source being correct. |
Question: "What is the proper method of performing a glucose test?"
Meph's Answer: As I have learned, don't prick from the index finger but instead the side of the middle or ring fingers. Since you clean the finger with an alcohol swab before the poke, you need to wipe the alcohol off after the poke with a 3x3 and then milk the finger or hand for the sample. Failure to do so may provide a contaminated sample that yields an incorrect blood-sugar result.
Question: "How can I remember all the history questions for pregnant expecting patients?"
Meph's Answer: PRIMAL FUDGE!!! I totally came up with this myself too (with some help from friends * ).
P = Pain? (contractions - how far apart? how long?)
R = Rupture of membranes? (water broke? Color? Smell?)
I = Infectious diseases?
M = Medications?
A = Allergies?
L = Lifestyle (drugs? alcohol? smoking?)
F = Flow (bloody show?)
U = Urge to push?
D = Delivery complications? (regular doctor visits? cesareans? twins? etc.)
G = Gravida, para?
E = Estimated date of confinement? (due date?)
Question: "What is the Deadly Dozen?"
Meph's Answer: Deadly Dozen - relate to major thoracic injuries and there are 2 catagories....
the Lethal 6:
airway obstruction, tension pneumothorax, cardiac tamponade, open pneumothorax, massive hemothorax, and flail chest.
the Hidden 6:
thoracic aortic disruption, tracheobronchial injuries, blunt myocardial injury, diaphramatic tear, esophageal injury and pulmonary contusion.
Question: "What is the most effective way to obtain a blood pressure?"
Meph's Answer: Blood pressures are easily tainted by background noise and poor scope placement. If you don't have the bell of your scope over the artery, then how can you be positive of your systolic pressure? The auditory lubb-dubbs won't come through when they should, and if the patient is hypertensive it may not be heard properly and come across as normotensive (and normotension may present as hypotension).
Here is a guide and a link that should improve your understanding of the importance of a good pressure.
Question: "what is the purpose of the fetal circulation differences?"
Meph's Answer: Fetal circulation is slightly different for good reason: to complete the circuit required to operate, and to oxygenate the body.
Oxygenated blood from the mother is delivered to the fetus through the placenta to the umbilical vein into the inferior vena cava via the ductus venosus, and into the right atria. The oxygenated blood is intermixed between the right and left atria through a small opening called the foramen ovale. The blood from the right atria is pumped into the right ventricle and out the pulmonary arteries where it is shunted to the aorta (instead of the lungs) through the ductus arteriosus. The blood from the left atria enters the left ventricle and out to the aorta. The O2 blood is carried from the aorta to the tissues of the fetus' body as normal. The deoxygenated blood (and waste products) is returned to the vena cava and to the mother's circulation through the 2 umbilical arterties and back out through the placenta.
This is accomplished to prepare and maintain circulation in the fetus as the lungs are not yet functioning (they are compressed and not air-filled) and blood would not otherwise return from the lungs to the left side of the heart and create a backup pressure and failure. More importantly, with no oxygenated blood in the left side, the heart would die since it is fed through the cardiac arteries from the left side.
Question: "what is the difference between Aspirin and Tylenol?"
Meph's Answer: Aspirin (ASA) seems to be very similar to Acetaminophens (APAP) however for a few minor differences. They are both primarily used as analgesics and antipyretics, such as for headaches, muscle aches, backaches, toothaches, menstrual cramps, arthritis, and the aches and pains that often accompany colds.
Acetaminophen (Tylenol) is less likely than aspirin to irritate the stomach. However, unlike aspirin, acetaminophen does not reduce the redness, stiffness, or swelling that accompany arthritis.
I could be wrong about this, but it would seem that the dosage delivered is different as well. In the pre-hospital setting we may administer between 160-325 mg of aspirin to patients when directed. Acetaminophen's usual dosage for adults and children age 12 and over is 325-650 mg every 4-6 hours as needed. No more than 4 grams (4000 mg) should be taken in 24 hours.
Why is this important? Patients telling you that they take aspirin may mean an acetamenphen or ibuprofen (Advil, Motrin) and the dosage they take could be confusing -- ask for the bottle as part of the patients medications to be collected.
Question: Feel free to ask me a question and I'll do what I can to answer it.
Send questions or comments to MEPH.