Possible Seizure

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cannonball88

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You're dispatched to assist law enforcement at the side of a state highway. You arrive in a one-man rapid response vehicle (ALS) to find a woman with her hands cuffed behind her back laying on her left side at the side of the road. She appears to be convulsing. Three police officers are standing in a semi-circle around her. One speaks up, saying "I was taking her to jail for assault, she blew a 0.15. She was in the back of my car and she suddenly started this."

What do you do and/or ask next? Your ambulance with two EMT-Basics is about 10 minutes out. You have a full arsenal of ALS supplies in your E-Car.
 
Blood sugar. Fix if low. Vitals. Fix what's wrong. Benzodiazepines. Stop that shaking.
Airway if you need to.
Wait for ambulance.
Put in ambulance.
Drive to hospital.
Wait for next one.
 
Airway's open, she's breathing around 26/min. BLG 94 mg/dL. BP 146/96. 5 of Versed IM given. Still shaking. She starts grunting and chokes out "Undiagnosed brain tumor."

Next steps?
 
Sounds like incarcaritis to me. But, she can have more versed.

And we drive to the hospital.
 
DEmedic said:
Sounds like incarcaritis to me. But, she can have more versed.

And we drive to the hospital.
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This. Check pupils (part of normal assessment) and then a nice transport to the hospital.
 
How do you know you have a brain tumor if it's undiagnosed?


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Handsome Robb said:
How do you know you have a brain tumor if it's undiagnosed?


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Click to expand...
 
DEmedic said:
Sounds like incarcaritis to me. But, she can have more versed.
And we drive to the hospital.
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The term I used was "stainless steel allergy."
Handsome Robb said:
How do you know you have a brain tumor if it's undiagnosed?
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That was my question too.

The end result? 10mg Versed total. Turns out she has a history of going into "seizures" when under arrest, but one of the more convincing I've witnessed.
 
"...One of the more convincing ones I've witnessed."

The fact that she was talking and telling you she has a brain tumor while "convulsing" would be an indication that she is not having a true seizure.

That said, I have also been fooled a few times, even after years of experience and seeing many fakers. I remember one guy who was super tachy while "seizing," and I didn't even question that one until I brought him to the ER and the doc told me that he was malingering.
 
How long has she supposedly been fitting?

What has our response time been since responded by Control?

Is she having a tonic clonic seizure? What sort of movements is she making?

I'd wait 2-3 minutes to see if she stops; most seizures spontaneously terminate after a few minutes.

If not, I'd give her 15 mg of IM midazolam (provided she is not very small or very old and if she were I'd reduce the dose to say 7.5 mg) and see what happens.
 
cannonball88 said:
Airway's open, she's breathing around 26/min. BLG 94 mg/dL. BP 146/96. 5 of Versed IM given. Still shaking. She starts grunting and chokes out "Undiagnosed brain tumor."

Next steps?
Click to expand...
"She's all yours gents"
Go to QT.
Get taquitos and Gatorade.
Celebrate another life saved.
 
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