How To Treat Pulmonary Edema | NYC Ambulance 🚑 | NYC EMT Paramedic / Medical Doctor

[@medic2807]

CPAP is a game changer. I was a paramedic from 1998-2012, now I'm an ER PA in a rural hospital. When I started EMS, no CPAP or RSI. So we used to nasally intubate a lot of patients (also, pre glide scope, bougie). A very perishable skill. It was also pre vent, so if your patient was with it enough, they could sometimes bag themselves if you had a 40 minute transport time and needed to do other stuff! Once we got RSI and CPAP that skill went away. I haven't nasally tubed a flash pulmonary edema patient in a long time. Glad to see you have CPAP in the "big city". Are they giving you guys video scopes?

[@nycstreetsmd]

Hey thanks for commenting. Yes we have video scopes. Do you enjoy using them?

[@medic2807]

@@nycstreetsmd nice to have them when you need them. I'm kinda old school. I still go with a 3 Mac and a bougie 90% of the time, but the glide scope has saved my ass several times.

[@BenjaminBriu]

It’s great to see what y’all “doctors” would do, think and point of views of best way and different way! Best for patient and us! Thanks

[@nycstreetsmd]

hermano mio - I am here for you!

[@HarryPotter-kd3bh]

@@nycstreetsmd if you have an MD, why not take a position as a doctor in a hospital? I'm not aware of any ambulatory services which employ MDs in NY state. This smells like fraud...

[@rosss61]

@@HarryPotter-kd3bh he hasn’t done his residency yet. He made a video on why he didn’t go into residency yet.

[@HarryPotter-kd3bh]

@@rosss61 I'm pretty sure if he hasn't done residency then he's not licensed to give medical advice without a legally-approved disclaimer statement. KZbin is recognized as a business expense at the end of the day (earnings are taxable) and therefore these videos are illegal. This guy needs to reupload these videos with the proper disclaimer statements and get the vids approved by a state-licensed attorney before giving medical advice... Your data proves it's definitely fraud. I've reported this channel as such. Let the authorities take care of this gentleman's situation. An irrelevant note, it's surprising to see how this type of insensibility gets past medical training. We need more doctors and ones who go through the proper avenues to get content like this out to the public rather than going rogue the way this person has. It just paints a bad image...

[@rosss61]

@@HarryPotter-kd3bh he’s also a medic, he can give medical advice because he is licensed.

[@BenjaminBriu]

This is awesome!! Keep it up!!

[@nycstreetsmd]

Colega klk hablame de ti!!!! Thank you brother, let's make a video together!

[@claytonyoung9941]

Furosemide also lowers your potassium levels. So if the pt has missed or stopped dialysis early (along with getting that fluid out of their body) lowering their potassium level any way possible is imperative to prevent them from going into a(n) arrhythmia.

[@claytonyoung9941]

Side note: do not use Succinylcholine to RSI, as this drug INCREASES your potassium level by .5 and is a short acting paralytic. Roc or Vec I think would be a much better paralytic to use in that instance if you didn't have an Igel or king tube nearby.

[@nycstreetsmd]

Thank you for the feedback brother!

[@keeptyrannyfromamerica8519]

Perhaps too old fashioned but I still prefer manual BP cuffs. In the early days of EMS we had up to an hour run to get to a facility with an MD/DO. Resorting to rotating tourniquets on 1 pt that was in fulminate failure about 20 miles offshore. No Coast Guard helicopter available. Got him on dry land alive. Tough SOB lived another 7 years and had aneurysm blow at his 80th birthday party.

[@nycstreetsmd]

wow- where was this?

[@keeptyrannyfromamerica8519]

South Carolina

[@chriscopeland2507]

Dreaming, about Fictional calls! NYC MEDIC I AM PROUD OF YOU! What New York City borough do you work in?

[@ilovebigfoot9195]

I was diagnosed last night at hospital with acute pulmonary edema.I had a heart attack few yrs ago.

[@nycstreetsmd]

I am sorry to hear that - I hope all is well!

[@katherinethorp5641]

Awesome! Thank you so much for this video. Keep em coming!

[@nycstreetsmd]

will do!

[@nycstreetsmd]

Feel free to ask any questions!

[@ilovebigfoot9195]

Can you give me some sdvice .my Appointment to see a doctor isnt till july 11th.I could be dead by then.

[@nycstreetsmd]

I hope all is well!

[@fredopoku458]

I need it my sister is suffering from same issue but I don’t have the oxygen how do I go about it her whole body is swelling and coughing can’t lay down to sleep please I need your help

[@nycstreetsmd]

I am sorry you have to deal with this. Please call 911 immediately!

[@reaiahearvin32]

So how long does it take for the Lasix to start working?

[@johnlewis399]

Takes awhile. 1 to 2 hrs.

[@keeptyrannyfromamerica8519]

Varies I’ve had it take 30 minutes to kick in up to 3 hours that’s on me.

[@nycstreetsmd]

Def. take a while. The onset of action is not immediate.

[@johnlewis399]

If they're on dialysis and not moving urine due to kidney failure what's the point of lasix?

[@nycstreetsmd]

My brother thanks for the question. Furosemide is a diuretic that aids in abolishing hypertonicity in the renal medulla and this leads to a decrease of concentrated urine. Also, this medication stimulates prostaglandin which leads to a vasodilation of the afferent arteriole that is near the glomerulus. The glomerulus and its surrounding Bowman's capsule constitute a renal corpuscle, the basic filtration unit of the kidney. The later mentions serve as an aid (“a helping hand”) for the failing kidney in said patient. I hope this helps!

[@TheFortunateTragedy]

Great video

[@nycstreetsmd]

Thanks for that!