# Difficulty Breathing 16 Y/O Male



## dominic22 (Dec 31, 2011)

You are on the medic and you are dispatched to a difficulty breathing, along with an engine company. You arrive on scene of a 16 year old male at a police academy who is lying down in the boxing room covered with blankets.
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An EMT-B is already on-scene (not FD personnel) and notifies you that the patient was doing physical fitness and became light headed and felt sick. The patient went to the locker room and 2 other people were by his side. Tne patients condition deteriorates and was placed on the floor where the EMT checked his pulse (140). Pupils are PEARRL. 

You begin your assessment of the patient.

The patient appears to normal

Eyes are 3/4 closed.

Patient Info

Age: 16
Weight: 110
Height: 5'07

(I am not an EMT, however, I am extremely interested and I am planning on trying to become a paramedic soon, so please excuse my lack of information, if you have questions please ask. This is based off of a real run.)


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## FourLoko (Dec 31, 2011)

How did a 16 year old get in the police academy?


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## Handsome Robb (Dec 31, 2011)

AA&O?
GCS?
Blood sugar?
You said pupils are PERRL, is it bilateral or unilateral?
Blood pressure?
Respiratory rate?
Rhythm on the monitor?
If he truly is having difficulty breathing he wont tolerate lying down.
Lung sounds?
SpO2? Are we lucky enough to get a waveform with that SpO2?
Skin signs?
Is his pulse regular or irregular?

History?
Allergies?
Medications?
Smoker?
Drinker?
Drug user?

Did he vomit in the locker room?
Any recent trauma? You said he's in the boxing room, did he get KTFO? Did he fall? 
Describe "felt sick"? Dizzy? Nauseous? Palpitations? Seizure activity? Headache? Shortness of breath? Chest pain?

With no formal education this may not go the way you want it to.

Why do I feel like this was your buddy that was this 16 year old?


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## Smash (Jan 1, 2012)




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## Handsome Robb (Jan 1, 2012)

Smash said:


>



Add to the questions then?

You always have better questions than I do and I learn more from your responses than I do from some of my medic instructors. 

I'll add a few:
Work of breathing?
Cyanosis present?
Any obvious laryngeal edema? 
What was he doing when this started?


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## Veneficus (Jan 1, 2012)

Percuss the borders of the heart?

deydration status?

workout supplements?


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## Smash (Jan 1, 2012)

Sorry Rob, that wasn't at you.  I'm just a touch suspicious of the first post from this person, who is not an EMT, asking questions about a real run...
Maybe I'm a touch more paranoid than usual, but it looks like a fishing expedition to me.

Your questions are good ones by the way.  I struggle with these sorts of scenarios, I find it extraordinarily difficult to have any kind of approach when I can't utilise my gestalt eyeballing the patient.


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## Handsome Robb (Jan 1, 2012)

Smash said:


> Sorry Rob, that wasn't at you.  I'm just a touch suspicious of the first post from this person, who is not an EMT, asking questions about a real run...
> Maybe I'm a touch more paranoid than usual, but it looks like a fishing expedition to me.
> 
> Your questions are good ones by the way.  I struggle with these sorts of scenarios, I find it extraordinarily difficult to have any kind of approach when I can't utilise my gestalt eyeballing the patient.



We have similar suspicions, my friend.


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## Veneficus (Jan 1, 2012)

Smash said:


> Sorry Rob, that wasn't at you.  I'm just a touch suspicious of the first post from this person, who is not an EMT, asking questions about a real run...
> Maybe I'm a touch more paranoid than usual, but it looks like a fishing expedition to me.
> 
> Your questions are good ones by the way.  I struggle with these sorts of scenarios, I find it extraordinarily difficult to have any kind of approach when I can't utilise my gestalt eyeballing the patient.



So what?

His friend got sick and he is curious about it. 

Most of these scenarios are fishing expeditions.

I agree about the eyeballing, physical exam is still the best test performed. The more you know, the more you see.

The purpose of my post was to add food for thought, if you expect a cardiac myopathy, look for it. You don't need an ultrasound or an x-ray.


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## dominic22 (Jan 1, 2012)

Yes, this 16 year old is my bud, and I am just interested in certain conditions are treated, and rather then reading about the SOPs for a difficulty breathing I'd much rather have a wide variety of people reply.

Sorry that this strikes people as "suspicious". I would like to continue this, if others do not mind.

Work of breathing? I think I understand your question, normal breathing.
Cyanosis present? No.
Any obvious laryngeal edema? No. 
What was he doing when this started? Cardio exercise

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AA&O? Awake, semi-alert, oriented
GCS? Unknown
Blood sugar? Within normal range (unknown of exact)
You said pupils are PERRL, is it bilateral or unilateral? Unknown, normal though. 
Blood pressure? 136/78
Respiratory rate? 
Rhythm on the monitor? Sinus Tachycardia
If he truly is having difficulty breathing he wont tolerate lying down. I'm guessing that the call went over as a difficulty breathing, I can't be 100% certain, it may have went out as an unconscious, due to knowing the fire departments dispatch policy and then what he told me.
Lung sounds? Unknown
SpO2? Are we lucky enough to get a waveform with that SpO2? 100% NRB 15L and unfortunately no.
Skin signs? Warm - dry 
Is his pulse regular or irregular? Regular just tachycardia

History? Passed out on way to school once - dizzy spells
Allergies? No
Medications? Adderall 
Smoker? No
Drinker? No
Drug user? No

Did he vomit in the locker room? No
Any recent trauma? You said he's in the boxing room, did he get KTFO? Did he fall?  No, he was carried into the boxing room by the EMT and a few other guys.
Describe "felt sick"? Dizzy? Nauseous? Palpitations? Seizure activity? Headache? Shortness of breath? Chest pain? Dizzy, nauseous, shortness of breath

With no formal education this may not go the way you want it to. - I know a few things here and there, my main goal is learning about this, and when I was notified of this incident I wondered what would other EMT's do? So I came across EMTLife and I seen "scenarios" and decided to post it.

Why do I feel like this was your buddy that was this 16 year old? He is my buddy.
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No workout supplements 

Plenty of water


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