# Whats wrong with this PT?



## EmtTravis (Aug 15, 2010)

You get called out to a male with unknown medical emergency.  when you arrive on scene you find a man slumped up against a building with a blanket covering him.  As you approach he starts yelling at you belligerently telling you he's a doctor and to stay away.  When you reach the patient and you can not see any physical trauma.  You take vitals and do a quick assessment.  As you remove the blanket you see he is wearing a orange jumpsuit with doctor on it.  What is wrong with this patient?


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## Smash (Aug 15, 2010)

Sounds like MrBrown gave his carer the slip and got into the methylated spirits again. Call for police to assist returning him to the secure ward.


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## MrBrown (Aug 15, 2010)

Hush you, I am deemed a low risk and only have a lady coming over twice a week for a half hour.

Vital signs?
GCS?
Odours or signs of any ingestion?
Primary survey?
Scene impression?

Move to ambulance, full vital sign survey and do a quick ECG


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## EmtTravis (Aug 15, 2010)

MrBrown said:


> Hush you, I am deemed a low risk and only have a lady coming over twice a week for a half hour.
> 
> Vital signs?
> GCS?
> ...



vital signs are normal.

empty brown bottle laying about 3 feet away. looks like it could of rolled from the hand.

pt appears to be in good physical condition except a lil contusion to the right side of head.  

gcs is 15.

As police arrive pt puts arms out to side and starts spinning in circles making helicopter noises saying weeeeeeeeeee im flying


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## Akulahawk (Aug 15, 2010)

Well, at least he's not barking like he was last time...


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## MrBrown (Aug 15, 2010)

Have the cops take him back to the funny farm.

Well, seems HEMS got something that *wasn't* an RTA with persons trapped and a lot of calls saying its serious for a change, but seriously .... this almost seems worse


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## firetender (Aug 15, 2010)

*No worries!*

It is God; no harm can come to Him; He just THINKS He's Mr. Brown.


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## LucidResq (Aug 15, 2010)

Doctor in detox suspected of stabbing nurse 

^ this guy finally broke out?


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## EmtTravis (Aug 15, 2010)

LucidResq said:


> Doctor in detox suspected of stabbing nurse
> 
> ^ this guy finally broke out?



he apparently learned how to get on emtlife.com and post lol


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## JPINFV (Aug 15, 2010)

Just a quick statistical note. Physicians have an extremely high suicide rate, and the highest "suicide complete" rate. Be very afraid of the suicidal physician as they are very good at being successful in that endeavor.


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## Melclin (Aug 15, 2010)

MrBrown said:


> Hush you, I am deemed a low risk and only have a lady coming over twice a week for a half hour.



Half an hour? Man, your know they have nasal sprays that can fix that particular lady issue ;-) 



JPINFV said:


> Just a quick statistical note. Physicians have an extremely high suicide rate, and the highest "suicide complete" rate. Be very afraid of the suicidal physician as they are very good at being successful in that endeavor.



And paramedics. At least, in Australia. We have some :censored::censored::censored::censored:ty mental health.


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## citizensoldierny (Aug 15, 2010)

Did the pt. lose bowel or bladder control?


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## ems4gd_185 (Aug 15, 2010)

*Oh brother lol*

A couple of things for this pt. Either he's high on some sort of hallucinogen like LSD, too much marijuana, too much alcohol, or mental issue. AKA PD should handcuff him either way and get him off the street B)


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## EmtTravis (Aug 15, 2010)

ems4gd_185 said:


> A couple of things for this pt. Either he's high on some sort of hallucinogen like LSD, too much marijuana, too much alcohol, or mental issue. AKA PD should handcuff him either way and get him off the street B)



I believe PD is planning on tazing  him if he doesn't stop spinning around in circles and making helicopter noises.  Also once he see's PD he pisses down his leg


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## Lifeguards For Life (Aug 15, 2010)

bad day for brown...


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## AtlantaEMT (Aug 15, 2010)

Sounds like a fun patient.  My psych patients lately have been boring and honestly I'm probably more psychotic than they are.

And I would love it if my doctor came in wearing an orange jump suit!


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## CowboyMedic (Aug 15, 2010)

whats the D-stick say? 
And maybe he is just air lifting himself to safety!


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## AtlantaEMT (Aug 16, 2010)

CowboyMedic said:


> And maybe he is just air lifting himself to safety!



I've heard the lifeflight programs have been having some budget issues but that is ridiculous.


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## Jay (Aug 20, 2010)

EmtTravis said:


> You get called out to a male with unknown medical emergency.  when you arrive on scene you find a man slumped up against a building with a blanket covering him.  As you approach he starts yelling at you belligerently telling you he's a doctor and to stay away.  When you reach the patient and you can not see any physical trauma.  You take vitals and do a quick assessment.  As you remove the blanket you see he is wearing a orange jumpsuit with doctor on it.



Hmmm... Tough one... I would have to say that the scene may not be safe because Brown may have a broken bottle of ripple* hiding under the blankie that he intends to use as a weapon later on. Perhaps we will need to get an LEO and ALS for our additional resources; the LEO to ensure scene safety and ALS to start a line** and introduce some thiamine because of his unruly levels of ETOH. I am just trying to figure out how I would get close enough to get a baseline set of vitals before the arrival of the fun committee (a/k/a our additional resources.)



EmtTravis said:


> What is wrong with this patient?


I would have to go with high levels of ETOH along with severe dehydration (the blanket was hot what can I say.) Of course I can be wrong and the simple answer is ask the man in the jumpsuit orange because HEMS doctors*** are well above my paygrade.

*Notes*

***  Ripple:   A low end fortified wine by E & J Gallo Winery that is no longer being produced here in the states.

****  line, IV:  A banana bag would not be a bad idea here because we get the thiamine along with many other wholesome vitamins and minerals that will quickly replenish and detoxify.

*****  HEMS Doctors:  Brown, just kidding here, we all enjoy your posts and know that some day after the chemistry is finally demystified you will make one h-ll of a HEMS Doc B)


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## EmtTravis (Aug 20, 2010)

im sure brown understands we are all joking.  this just came to me one night while sitting in quarters not being able to sleep and reading his posts on here. and i agree that one day he will make one hellofa hems doctor


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## Sassafras (Aug 20, 2010)

Brown is such an awesome sport about things and graciously permits us to learn at his expense.


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## MrBrown (Aug 20, 2010)

Sounds like the patient had a spare two thousand bucks to drop on a jumpsuit (seriously those things aren't cheap) but couldn't afford a top of the range bargin basement approved cherry or fortified wine.

At least I will make a better HEMS Doctor than this guy, I mean bloody hell he's wearing a polo shirt and suit pants!


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## Hepinghand (Aug 21, 2010)

It seems this could be a pyscheatric emergency.If this is a  pyscheatric emergency I would  have me and my partner get out and call law enforcement.


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## reaper (Aug 21, 2010)

psychiatric!


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## EmtTravis (Aug 21, 2010)

Hepinghand said:


> It seems this could be a pyscheatric emergency.If this is a  pyscheatric emergency I would  have me and my partner get out and call law enforcement.



Mr brown doesn't have psychiatric emergency's.  He IS a walking psychiatric emergency lol


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## MrBrown (Aug 21, 2010)

EmtTravis said:


> Mr brown doesn't have psychiatric emergency's.  He IS a walking psychiatric emergency lol



Hey shut up!


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## jroyster06 (Aug 23, 2010)

Im thinking Dstick, LR, thiamine and Narcan possibly. Just as a basis of what i have been given here but im gonna have the dudes with a gun n tazer take care of billy badarsh first


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## Jay (Aug 23, 2010)

jroyster06 said:


> Im thinking Dstick, LR, thiamine and Narcan possibly.


Interesting thought however it sounds an awful lot like a protocol that has become quite antiquated in most jurisdictions (at least since the mesozoic era) which was formerly known as "coma of unknown origin." Per that protocol; after starting a line required a combination of D-50, Thiamine and Naloxone to battle the most common causes of acute unresponsiveness. The problem here is that Brown is responsive so using such a heavy hit would be a bit of an overkill. In general, in the field we like to treat the patient and not guess as to why the patient may be presenting as lethargic as a "Mr. Potato Head," namely by asking what specifics does the patient present with and not just what his or her numbers say along with the overall picture. I personaly would gravitate towards ETOH or blood sugar (the smell of ETOH can suggest one or both) but not opiates because the lethargy involved with an opiate overdose would cause more severe respiratory depression and tiredness. Personally, I think Brown is more of a drinker anyhow (though he swears that he has better taste than _*ripple*_, after-all as a future HEMS physician we must give him some credit) 

Just to ensure that I go to bed happy, I will save someone the time and post it for you on the following line...

+1

'Night Folks B)


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## EmtTravis (Aug 23, 2010)

Ok so what I would do with this pt *mr brown*  I'd walk up to him all nice and calm like.  Ask if I could see the back of his *orange jump suit* and as he turns around I'd clobber him on the head and knock his butt out and then get him in one of those nifty *hug yourself* jackets and then drop him off back at home *the psych ward*.  Simple enough call if you ask me


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## Jay (Aug 23, 2010)

Oh, one more post, I couldn't help myself...

Look carefully now, it's like playing Where's Waldo® with MrBrown.


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## Sasha (Aug 23, 2010)

> Im thinking Dstick, LR, thiamine and *Narcan* possibly.



Why? He's alert, oriented and playing airplane. Why the Narcan? If he's on some drugs, let him stay on them, he's awake. If he becomes violent, sedate or restrain him.


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## Jay (Aug 29, 2010)

Sasha,

I like what you are saying but did you read my earlier post on this?


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