# How'd I do?



## musicislife (Jun 9, 2012)

Ok so we were standing by for a children's triathlon

Patient was dizzy, and felt like she would puke (she had just finished)

outside temp was 60

A+O times 4...quite nervous, crying-had her cramp in her left side-9 yrs old female

Airway: unremarkable,

Breathing: very Fast , shallow

Circulation: Pulse bounding, regular, and fast. skin condition very flushed in the face, hot, and moist

pupils: PEARL

Ate a sugary cereal this morning

No medications, medical history or allergies reported


Vitals: BP: 118/80 didnt get rest, because by the time i took the BP, the mother RMA for the child

Treatment: we gave her an Ice pack...parents gave her some juice and an orange to suck on...and some water....no adverse reactions to that

other than that, kept my hand on the patients shoulder, talked to her, ect

This is all the info my partner and I got prior to the RMA (RMA was prior to rig's arrival)

patient was a lot better when we checked up 10 min later

this was the first time I got to treat someone


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## Chimpie (Jun 9, 2012)

More importantly, how did your supervisors think you did?


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## musicislife (Jun 9, 2012)

they said we did great


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## medichopeful (Jun 9, 2012)

musicislife said:


> pupils: PEARL



I'm guessing "pupils equal and reactive to light?"

I think "PERRLA" or "PERRL" is a better way to write this: "pupils equal, round, reactive to light, accommodation" or "pupils equal, round, reactive to light."  More descriptive and common.


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## JPINFV (Jun 9, 2012)

medichopeful said:


> I'm guessing "pupils equal and reactive to light?"
> 
> I think "PERRLA" or "PERRL" is a better way to write this: "pupils equal, round, reactive to light, accommodation" or "pupils equal, round, reactive to light."  More descriptive and common.




I don't, in general, like PERRLA at the EMT level because I have my doubts that most EMTs can explain, little less test, accommodation.


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## medichopeful (Jun 9, 2012)

JPINFV said:


> I don't, in general, like PERRLA at the EMT level because I have my doubts that most EMTs can explain, little less test, accommodation.



I won't argue with you there!


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## VFlutter (Jun 10, 2012)

JPINFV said:


> I don't, in general, like PERRLA at the EMT level because I have my doubts that most EMTs can explain, little less test, accommodation.



I am currently on a Neuro med/surg step down floor that requires q2 hour Neuro assessments so I am getting tons of practice. It's still somewhat difficult to pick a pupil size sometimes.


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## AnthonyM83 (Jun 10, 2012)

JPINFV said:


> I don't, in general, like PERRLA at the EMT level because I have my doubts that most EMTs can explain, little less test, accommodation.



It's my understand that accommodation is an internal process that one cannot observe by simply looking at the pupil. One can test the "near reflex", but one cannot actually see the internal lens change (which is true accommodation).


To the original poster, seems like everything went well. You did your assessment. Seems like the parents did the treatments, though. In which way was the cold pack used?


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## JPINFV (Jun 10, 2012)

AnthonyM83 said:


> It's my understand that accommodation is an internal process that one cannot observe by simply looking at the pupil. One can test the "near reflex", but one cannot actually see the internal lens change (which is true accommodation).


Pupil constriction is a part of the accommodation reflex, along with ciliary muscle/lense changes. Hence Argyll-Robertson ("prostitute") pupils, which is when the pupils don't react to light, but do react for accommodation because of damage done by syphilis.


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## AnthonyM83 (Jun 10, 2012)

JPINFV said:


> Pupil constriction is a part of the accommodation reflex, along with ciliary muscle/lense changes. Hence Argyll-Robertson ("prostitute") pupils, which is when the pupils don't react to light, but do react for accommodation because of damage done by syphilis.



Part of the reflex, but different things, no? Which is why you can have one without the other...At least that's how Bates explains it the physical exam book (not that it's the say-all)


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