# Unknown Etiology



## NPO (Jan 10, 2014)

You are dispatched to an elderly woman with  C/C of weakness. 

You arrive on scene to find a 90 year old woman seated in a chair. She is A/Ox4 appears tired but in no major distress. A friend tells you she had just finished a work out class when the pt told her she felt weak and sat down. The pt stated she was feeling a little better once she sat down. Medical history is unknown. 

Vitals all come back WNL, BP 130/80 HR 80 SPO2 97%. 

PT becomes unresponsive. She is awake but unresponsive. Pt is lowered to the floor. One EMT calls for ALS the other reassess vitals. Unchanged. Episods lasts 30-45 secknds. After some painful stimuli the pt slowly becomes more responsive to being able to respond to her name and accurately describe where she is. PT returns to A/Ox4. ALS arrives. BGL and EKG are clear. 

PT AMAs. BLS crew checked on the PT several hours later and she was doing fine. 

Any ideas what happened?


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## Aidey (Jan 10, 2014)

Absence seizure. Run of vtach if she wasn't still on the monitor.


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## mycrofft (Jan 10, 2014)

Agreed. And one more reason to use noxious stimuli (ammonia inhaler) which does't leave bruises etc. (pinching, knuckle rubs).


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## NPO (Jan 10, 2014)

That's what we were thinking but I wanted other eyes on it.


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## emt_abby_a (Jan 11, 2014)

Possible cataplexy.


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## unleashedfury (Jan 13, 2014)

theres a garden variety.

Absence seizure. 

cardiac related issues? especially after a workout? 

Story time with Uncle Fury kiddies sit down and get comfy :rofl:
I had a patient last year around this time to be exact, we were dispatched for a elderly male unconscious on a park bench. Arrived to find him conscious alert and oriented just said he has been having "spells" where he will get dizzy and wake up on the ground a few minutes later. No Hx only OTC meds initially wanted to AMA but I succumbed him into a transport. vitals were perfectly normal minus a little bit of hypertension got him in the ambulance hooked up the ECG, Nice Sinus rhythm then all of a sudden he says "I feel it coming on again" goes unresponsive and asystole on the monitor. last about 10 seconds and returns to a sinus rhythm and comes to. vital signs return to normal, even after being pretty much in arrest for 10 seconds. Needless to say he went to a cardiac center.


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