Kushigs syndrome

[manfredvonrichthofen]

Ok so I have been lookin for this all day, and I just can't seem to find it in my textbook, and my exam tomorrow is on trauma and OB emergencies so I just don't see the correlation to what I am able to find online. What I am finding is that Kushings is related to cortisol in the boy. Any EMTs or Paramedics able to give me a hand?

[Al Sayre]

Try Cushings Syndrome, Wikipedia has a rather lenghty description with references...

[manfredvonrichthofen]

Thank you, i found that earlier, However, I am still having issues figuring out how it relates to trauma.

[capmedic]

You are thinking of cushing reflex and is related to ICP.

[Al Sayre]

I'm not a doctor, I don't play one on tv, and I didn't even stay at a Holiday Inn Express last night, but my first guess would that since corticosteroids are frequently given to reduce inflammation and people often purchase and use OTC topical corticosteroid ointments etc, that they may be contra-indicated in the case of trauma, (especially things like road rash and other abrasive injuries) where there is a likelyhood of secondary infection due to lowered immune response, and according to my understanding of the article, may result in Cushings Syndrome.  As I said I'm no expert, but I'd pick either that or C as my final answer. 

[manfredvonrichthofen]

Can you elaborate? I can't find cushings reflex at all in my textbook.

[capmedic]

In a head injury, with increase intracranial pressure, you may experience a patient who is having a cushing reflex.  This would display the following signs and symptoms:

decreased loc
increased systolic bp
widening pulse pressure
bradycardia
irregular respirations or apnea

most patients will die.

[manfredvonrichthofen]

Thank you CAPMedic!!! That is great!
Thank you Al Sayre, that is good info, I would never think about the contraindications, and that is one contra that I doubt we will ever touch on it in class but I will brig it up. I am really glad to have you guys around. Thank you.

[capmedic]

glad i could help.

[Private Investigator]

You ever thought about being a police officer?

Tests are easier   

[manfredvonrichthofen]

I did, I originally wanted to after I got out of the Army, but found out I couldn't be ause I am blind in one eye. I don't quite get that one. So I went for EMT, I love to help people who need help the most, so I figured EMT was my other option. And I am glad I took it, I love the course so far, and am almost done, and I thoroughly enjoined my clinical shifts. So I think it will fit.

[Private Investigator]

I know several police officers who have only one eye. You have to look at a smaller agency.

Example LAPD medically retired an officer who lost an eye in a shoot out. He applied to Fullerton PD and got hired.

[Major Lord]

Cushing's is often ( mostly) caused by steroid use, but the chances of you making it worse by administering inhalable steroids in the field are very low. If you suspect Cushing's its a good idea to look for the "moon face" sign so typical of long term steroid use. Some people have no other options besides long term steroids, so its not always possible for someone to taper down and off the drug.  ( Not anabolic steroids so much) Of course, finding 37 empty bottles of prednisone in their bedroom is a good indicator. You can field test for excessive intracranial pressure by testing for Radovici's Sign ( Tell your instructors that is what you are checking for- you will blow them away!)

The world needs more EMT's, just remember, that if you go into that field, you are not going to have as many saves ( I can count my real "saves" on my fingers....) but it will make you an expert on bodily fluids, and once in a while, you will know that you have done God's work. You will probably kill a few people, and you have to be emotionally prepared to have the universe reject your will!

Major Lord

[MSG Mac]

There was a CMH recepient during Vietnam who was blind in one eye when he was initially inducted. He managed to remain in service for over 20 years.

[Major Lord]

I know several police officers who have only one eye. You have to look at a smaller agency.

Example LAPD medically retired an officer who lost an eye in a shoot out. He applied to Fullerton PD and got hired.

U.S. Marshall Rooster Cogburn in "True Grit" had only on eye, and he was John Wayne!

Major Lord

[manfredvonrichthofen]

I would love to be a cop, if I find the right agency that will take someone with one eye, the EMT cert can only help.

[CAP4117]

Another good resource for questions like this is the forum at www.emtlife.com. You can ask technical questions, questions about employment, training, etc.

[manfredvonrichthofen]

I will most definitely take a look at that... Tomorrow, for now it's time to hit the sack so that I can get up and go through my notes one more time for my exam and then rush the kids to school and rush myself to school.

[Flying Pig]

In 15yrs and 3 departments Ive never met an officer with one eye.  Staying a cop after losing an eye or getting picked up by another agency is a lot different than trying to get on as a new hire.  I dont know of any agencies that would hire a rookie missing an eye.  Its a [darn] shame a person like you is in that position.  From reading your posts you seem like youd be a solid addition to any dept.  If you do get hired just be ready to have to prove yourself on more ways than your peer rookies. I was an FTO for several years. Im wont sugar coat it. A cop missing an eye is at a huge disadvantage tactically.

[CAP4117]

I will most definitely take a look at that... Tomorrow, for now it's time to hit the sack so that I can get up and go through my notes one more time for my exam and then rush the kids to school and rush myself to school.

Good luck on your exam! I've got the trauma one next week