# 2-in-1



## Angel (Feb 23, 2014)

I want to put up some more scenarios, mostly out of boredom. they may or may not be brain busters. but fun none the less. I will put a couple here, just QUOTE the one you are replying to. if its too confusing I can make separate posts. just let me know.

Scenario #1

81 yo F, you are dispatched to the home because pts daughter called because her mom was not acting 'normal'. You recall you took her ~1.5 weeks prior and ask get a quick history. Daughter states mom was released from the hospital this AM and was treated for pneumonia. When the daughter tried to get her out of the car, mom was unusually weak and daughter noticed diarrhea in her diaper. She hands you a med list (insulin, coreg, Coumadin, lisnopril, Albuterol and darvon) along with documents stating she (the daughter) has power of attorney. 

The patients presentation appears to be lethargic and not quite 'with it' she does not make eye contact, though she tries to stick a cigarette in her mouth while attached to home O2 for COPD. Other history includes HTN, diabetes and TIAs.

LS:rhonchi
Pupils: Perrla
HR: UTO
BP: UTO, medic partner responds they can barely palp anything, 
RR: 16
Skin sx: slightly pale, warm, dry

What else do you want, what are your DDX? Anything (else) you want to ask daughter before you leave? 





Scenario #2

32 yo M found sitting in grassy area adjacent to gas station after being slipped by a truck travelling ~5 mph (car slowed down on impact) pt states he has pain to his L tibia, Engine crew on scene states limb was +CMS, +deformity (looks to be 'indentend' mid shaft) and 8/10 pain, it is being splinted and you don't get a chance to look for yourself. pt admits to drugs and alcohol use, you notice meth falls out of his pants pocket and he quickly retrieves it. 

BP: 80/72
HR: 98
RR: 22

Denies any allergies, no PMHx besides drug use

note: he is balancing between sobs and being funny, pt states he crawled from street where he was hit to grass. 

is he ALS/BLS? Treatments and interventions, what else do you want to know, what do you want to do, or reconsider?


BLS please chime in!


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## StudMartin (Feb 23, 2014)

*Hmmmm...*

Sorry for the brevity, reading quick at work

#1:  possible sepsis.  maybe c-diff with the diarhhea?  What was her POC?

#2:  given the admitted/observed/obvious drug use I'd say definitely ALS.  I'd want to see what he was on the monitor.


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## NomadicMedic (Feb 23, 2014)

In the future, please create separate threads.


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