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FW: Wheelie @100 mph

P. Hoffman trauma-list@trauma.org
Tue, 10 Jun 2003 14:26:02 -0400 

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Ok, I am but a lowly paramedic, so I'll risk looking dumb...

Unfortunately I deleted all of the original posts on this topic, but am I
seeing a gradual increase in systolic pressure and a very gradual decrease
in heart and respiratory rates?  Almost want to consider a closed head
injury...

Also, lots of reference to the automatic BP cuffs.  It is my understanding
that these are not always reliable.  Have the nurses/docs auscultated the
BPs?  Both arms?  Anything interesting here?

Heart tones?

"Patient asks when he can get back on a motorcycle."  I thought definite
head injury :), 'til I considered the testosterone effect!
  -----Original Message-----
  From: trauma-list-admin@trauma.org [mailto:trauma-list-admin@trauma.org]On
Behalf Of KMATTOX@aol.com
  Sent: Tuesday, June 10, 2003 1:48 PM
  To: trauma-list@trauma.org; ccm-l@list.pitt.edu
  Subject: Re: FW: Wheelie @100 mph


  In the progress of this  case, it is now 5:30 PM in the afternoon.   The
orthopods have arrived at the bedside.   The ICU & trauma teams are there.
The nurse is at the bedside.  The orthopods are in the process of writing
their pre-op note.   The  surgeons stated that the patient has been "stable"
as described in the previous posts.   His HR is now 76, BP 145/47
(electronically taken by automatic cuff), his CVP is 4 cm water, RR 14. and
he has just signed the operative consent for the orthopods.    The patient
asks when he can get back on a motorcycle.     And then, and
then.....................................................

  (I am really really telling this story like it happened)

  k

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<BODY>
<DIV><SPAN class=3D820591318-10062003><FONT face=3DArial color=3D#0000ff =
size=3D2>Ok, I=20
am but a lowly paramedic, so I'll risk looking =
dumb...</FONT></SPAN></DIV>
<DIV><SPAN class=3D820591318-10062003><FONT face=3DArial color=3D#0000ff =

size=3D2></FONT></SPAN>&nbsp;</DIV>
<DIV><SPAN class=3D820591318-10062003><FONT face=3DArial color=3D#0000ff =

size=3D2>Unfortunately I deleted all of the original posts on this =
topic, but am I=20
seeing a gradual increase in systolic pressure and a very gradual =
decrease in=20
heart and respiratory rates?&nbsp; Almost want to consider a closed head =

injury...</FONT></SPAN></DIV>
<DIV><SPAN class=3D820591318-10062003><FONT face=3DArial color=3D#0000ff =

size=3D2></FONT></SPAN>&nbsp;</DIV>
<DIV><SPAN class=3D820591318-10062003><FONT face=3DArial color=3D#0000ff =
size=3D2>Also,=20
lots of reference to the automatic BP cuffs.&nbsp; It is my =
understanding that=20
these are not always reliable.&nbsp; Have the nurses/docs auscultated =
the=20
BPs?&nbsp; Both arms?&nbsp; Anything interesting =
here?</FONT></SPAN></DIV>
<DIV><SPAN class=3D820591318-10062003><FONT face=3DArial color=3D#0000ff =

size=3D2></FONT></SPAN>&nbsp;</DIV>
<DIV><SPAN class=3D820591318-10062003><FONT face=3DArial color=3D#0000ff =
size=3D2>Heart=20
tones?</FONT></SPAN></DIV>
<DIV><SPAN class=3D820591318-10062003><FONT face=3DArial color=3D#0000ff =

size=3D2></FONT></SPAN>&nbsp;</DIV>
<DIV><SPAN class=3D820591318-10062003><FONT face=3DArial color=3D#0000ff =

size=3D2>"Patient asks when he can get back on a motorcycle."&nbsp; I =
thought=20
definite head injury :), 'til I considered the testosterone=20
effect!</FONT></SPAN></DIV>
<BLOCKQUOTE>
  <DIV class=3DOutlookMessageHeader dir=3Dltr align=3Dleft><FONT =
face=3DTahoma=20
  size=3D2>-----Original Message-----<BR><B>From:</B> =
trauma-list-admin@trauma.org=20
  [mailto:trauma-list-admin@trauma.org]<B>On Behalf Of=20
  </B>KMATTOX@aol.com<BR><B>Sent:</B> Tuesday, June 10, 2003 1:48=20
  PM<BR><B>To:</B> trauma-list@trauma.org;=20
  ccm-l@list.pitt.edu<BR><B>Subject:</B> Re: FW: Wheelie @100=20
  mph<BR><BR></FONT></DIV><FONT face=3Darial,helvetica><FONT lang=3D0 =
face=3DArial=20
  size=3D2 FAMILY=3D"SANSSERIF">In the progress of this&nbsp; case, it =
is now 5:30=20
  PM in the afternoon.&nbsp;&nbsp; The orthopods have arrived at the=20
  bedside.&nbsp;&nbsp; The ICU &amp; trauma teams are there.&nbsp;&nbsp; =
The=20
  nurse is at the bedside.&nbsp; The orthopods are in the process of =
writing=20
  their pre-op note.&nbsp;&nbsp; The&nbsp; surgeons stated that the =
patient has=20
  been "stable" as described in the previous posts.&nbsp;&nbsp; His HR =
is now=20
  76, BP 145/47 (electronically taken by automatic cuff), his CVP is 4 =
cm water,=20
  RR 14. and he has just signed the operative consent for the=20
  orthopods.&nbsp;&nbsp;&nbsp; The patient asks when he can get back on =
a=20
  motorcycle.&nbsp;&nbsp;&nbsp;&nbsp; And then, and=20
  then.....................................................<BR><BR>(I am =
really=20
  really telling this story like it=20
happened)<BR><BR>k<BR></BLOCKQUOTE></FONT></FONT></BODY></HTML>

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