How about that

[ChrisMed1]

Tones drop for a headache and general unwell.
HR 116 BP 117/69 O2 95% RR 14 BGL...... Well yikes. Patient is a diabetic with heart failure as well.

Afebrile, hemodynamics pretty stable, chest auscultation normal, nothing else on history. Exam did reveal also patient had some light sensitivity.


Opened patient her sweet tea bottle load and go went code 3 pretty standard. But look at that dexcom wow looks like my bank account.

 

[Akulahawk]

Tones drop for a headache and general unwell.
HR 116 BP 117/69 O2 95% RR 14 BGL...... Well yikes. Patient is a diabetic with heart failure as well.

Afebrile, hemodynamics pretty stable, chest auscultation normal, nothing else on history. Exam did reveal also patient had some light sensitivity.


Opened patient her sweet tea bottle load and go went code 3 pretty standard. But look at that dexcom wow looks like my bank account.





View attachment 5767

Was the patient alert/oriented or was the patient acutely altered? Was the BG level verified by a separate fingerstick reading? If the patient is acutely altered and can't take PO dextrose (or perhaps that very sweet tea), I can see/rationalize load & go with a code 3 transport if the crew is BLS only. If the patient is not acutely altered and can take PO dextrose / drinks that very sweet tea... RLS transport isn't indicated. Continue monitoring the blood glucose level and level of consciousness, transport Code 2 and upgrade to Code 3 if the patient becomes acutely altered.

If the crew is ALS, they have more options...

 

[ChrisMed1]

Was the patient alert/oriented or was the patient acutely altered? Was the BG level verified by a separate fingerstick reading? If the patient is acutely altered and can't take PO dextrose (or perhaps that very sweet tea), I can see/rationalize load & go with a code 3 transport if the crew is BLS only. If the patient is not acutely altered and can take PO dextrose / drinks that very sweet tea... RLS transport isn't indicated. Continue monitoring the blood glucose level and level of consciousness, transport Code 2 and upgrade to Code 3 if the patient becomes acutely altered.

If the crew is ALS, they have more options...

A&O x 3 so a little altered unknown acuity (patient states, "I don't give a f**k who the president is") we did do a fingerstick en route patient already started drinking her tea it was 61. We did go code 3 probably could have gone code 2 but that's up to the driver and medic I ride as the aid.

 

[Akulahawk]

Slightly altered (maybe), following commands, and treating with the sweet tea and improvement in BG level? I wouldn't take that one Code 3 to the hospital. Your medic and driver should have made a safer decision unless protocol by their EMS agency requires Code 3 travel for patients who are/were hypoglycemic regardless of orientation status or response to treatment.

 

[ChrisMed1]

Slightly altered (maybe), following commands, and treating with the sweet tea and improvement in BG level? I wouldn't take that one Code 3 to the hospital. Your medic and driver should have made a safer decision unless protocol by their EMS agency requires Code 3 travel for patients who are/were hypoglycemic regardless of orientation status or response to treatment.

Yeah I would have to review protocols to know for certain but I started volunteering like 2 months ago and haven't seen any code 2 transports. It's always been either code 1 routine or code 3 emergent.

 

[Akulahawk]

Yeah I would have to review protocols to know for certain but I started volunteering like 2 months ago and haven't seen any code 2 transports. It's always been either code 1 routine or code 3 emergent.

Code 1 is "routine"
Code 2 is urgent but no lights/sirens. Obey all traffic laws.
Code 3 is lights/sirens, drive with due regard for safety of others and don't throw the people in the back around...

Code 1 is basically that you're doing round-trips to/from medical appointments, dialysis, etc. It's basically a gurney run.
Code 2/3 are going to end up in the ER, or for interfacility trips, end up at another in-patient facility. Medical monitoring REQUIRED.

 

[DrParasite]

Is her BGL coming up following some sweet tea? She's mostly AOx3 (doesn't care about the president fine, but she's answering appropriately).... You know what the issue is, and have the tools to both assess and reverse her condition.

stay on scene, give her some more tea, and then have her take a nice easy ride to the ER.