Medical. : Medicine.

Good set of threads, though as I read them we have a few unanswered cases floating around.

Didn't check dates, so I don't know how old they are (and don't care)/

Unsolved one: Infectious diarrhea concerns. Question of when it IS NOT safe for loperamide. Basic answer, with minimal lab support, is if the troop has fever, signs of paralysis, of blood in the stoool. With a little bitty field "microscope" in an austere medics 'tool kit (you know the one, oto-ophthalmosope-fischer scientific tube mircoscope) you can looke for WBC's as well. Actually, that is the only time antibiotics are indicated for diarrhea, besides C-DIFFICILE , which is an infectious diarrhea typically resulting from antibiotics.

Unsolved two: Zone two injury. I see no concern about AIR EMBOLISM voiced (Zone 1 and 3 are at the root of the nek and base of skull, you figure out which is which. Don't forget about MAJOR DEEP aortic, svc, or lung invlovement with a blade in zone 1.

Doc Pacer
 
Incomplete 3: amitriptyline

While you have hit the anticholinergic syndrome, you have partially missed the boat on the critical toxicity of Tricyclic antidepressants.

What does the ECG Show?

I expect intial tachycardia, followed by a widening QRS interval, followed by ideoventricular and arrest.

NaHCO3 (actually for the sodium initially, the HCO3- is helpful in reducing the ionization) given stat plus an alkalinization drip will help to reduce the cardiac toxicity of the drug, and the risk of cardiac arrest. As I recall, the use of most anti-arrythmics (especially procain/amiodarone) is contraindicated.

Check out either AHLS (Advanced HazMat Life Support or Ellenhorns' Medical Toxicology)

Doc Pacer
 
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