Give me a differental, please...

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emtfarva

emtfarva

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Ok, my partner and picked up a Pt from a doctor's office today. 44 y/o f with only h/o MS. The Pt had been in "remission" from MS since 2004. Pt's CC was feeling ill. She was febrile. She also had chills and whole body tremors. I don't think it was a sz because she was talking to me the whole time the she had the involuntary movements. She was slightly tachy at 104. her b/p was 120/80. She was hot and dry. Looking at my partner's mon. I think she was sinus. She was c/o LLQ abd pn, and pn in her joints. Her LMP was in sept. Could it be possible for an eptopic pregnancy? We never asked if she was sexually active, or if she could be pregnant.

I am sure if we had a longer transport (transport was only 5 min) that question would of come up.

What do you think?
 
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The MS is still present as it is not cured by saying remission. Anything, especially the flu or some similar illness, can cause a flare-up or a new immune attack on the myelin.

If her LMP was in September, did she look pregnant? Was there a physical exam in the area of the pain or questions pertaining to onset?

The medications that she may have taken or is taking such as corticosteroids and interferon can interfere with the menstrual cycle and may also influence the onset of menopause.
 
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I wanted you to ask me questions about this call. Her abd was soft non-tender. as for meds I am not sure. the Remission thing was her words not mine. And I know about MS. That is why I quoted the remission. She told us that she tries to eat well and exercises regularly. She appeared very healthy and non-pregnant. I was just looking for a possibilities. What else would you like to know?
 
emtfarva said:
I wanted you to ask me questions about this call. <snip> What else would you like to know?
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That is certainly not what you asked for in the original post, lol.
 
Ok, What I really want is for everyone to ask me questions and I will answer to the best of my knowledge and what could be wrong with her. Better?
 
emtfarva said:
as for meds I am not sure.
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You're not sure if she's taken these meds or you didn't get the list of current meds?

Breath sounds?
N/V?
Cough?
Sputum?
Onset of current symptoms?
Anyone else sick around her?
Recent injury? Even if it seems minor to YOU.
Last followup labs for MS with CSF and blood?
 
emtfarva said:
Ok, What I really want is for everyone to ask me questions and I will answer to the best of my knowledge and what could be wrong with her. Better?
Click to expand...

For someone asking for help, your sarcasm is sure off putting.
 
You're not sure if she's taken these meds or you didn't get the list of current meds? nope not my call I was just the driver. My partner got that info. She is a medic. And I was busy on other things when she asked those questions.

Breath sounds? Clear
N/V? no
Cough? no
Sputum? no
Onset of current symptoms? this morning
Anyone else sick around her? unknown, she lived alone.
Recent injury? Even if it seems minor to YOU. none
Last followup labs for MS with CSF and blood? unknown but the Dr had found trace blood in her urine.
 
Nephrolithiasis?
Cystitis?

Seen both present with all of the above symptoms. Febrile?
 
emtfarva said:
You're not sure if she's taken these meds or you didn't get the list of current meds? nope not my call I was just the driver.
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?!?!?!?!?

emtfarva said:
My partner got that info. She is a medic. And I was busy on other things when she asked those questions.
Click to expand...
Essentially we are missing a huge part of the scenario because you consider yourself just an ambulance driver?

emtfarva said:
Last followup labs for MS with CSF and blood? unknown but the Dr had found trace blood in her urine.
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Was she being treated for a UTI? Antibiotics? Major information needed here.

Fever and UTI can equal serious sepsis if allowed to progress.

Liquid intake...further dehydration?

Last food intake? Nice to know as part of the intubation prep at the hospital.
 
emtfarva said:
Ok, my partner and picked up a Pt from a doctor's office today. 44 y/o f with only h/o MS. The Pt had been in "remission" from MS since 2004. Pt's CC was feeling ill. She was febrile. She also had chills and whole body tremors. I don't think it was a sz because she was talking to me the whole time the she had the involuntary movements. She was slightly tachy at 104. her b/p was 120/80. She was hot and dry. Looking at my partner's mon. I think she was sinus. She was c/o LLQ abd pn, and pn in her joints. Her LMP was in sept. Could it be possible for an eptopic pregnancy? We never asked if she was sexually active, or if she could be pregnant.

I am sure if we had a longer transport (transport was only 5 min) that question would of come up.

What do you think?
Click to expand...

Yes she was febrile, 101.6
 
VentMedic said:
?!?!?!?!?


Essentially we are missing a huge part of the scenario because you consider yourself just an ambulance driver?



Was she being treated for a UTI? Antibiotics? Major information needed here.

Fever and UTI can equal serious sepsis if allowed to progress.

Liquid intake...further dehydration?

Last food intake? Nice to know as part of the intubation prep at the hospital.
Click to expand...

When My partner asked those questions while I was busy Driving us safely to the Hosp, with the seirns on it is kind of hard to hear a quiet Pt talking. And no I don't think of myself as just a driver or else I wouldn't be asking this question. I just happened to be driving when those questions were being asked. As far as the Uti, no. My partner was dumpping a 250ml bolus of NS into her during the transport. Most of the sample history was done enroute to the hosp. And the Dr wanted to r/o sepsis. And I couldn't look at my partner's report because of another call. I will ask her tomorrow for the meds.
 
Why did this patient warrant lights and sirens?
 
Why were you transporting with sirens? :wacko:

And no, temporal is not anywhere near the core of the body. Temporal is temporal, which doesn't directly correlate to a standard temperature reading. Having not used such a device, I don't know what that means. But I would suspect that there is something in the literature that describes what standard reading the temporal reading correlates to. Have you read the documentation that came with the device you are using?
 
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Sasha said:
Why did this patient warrant lights and sirens?
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If it were me it would be for :censored::censored::censored::censored:s and giggles.
 
Sasha said:
Why did this patient warrant lights and sirens?
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It was dispatched as an emergency. And my partner thought that this was life threating. the hosp even booked it as a high priority and placed the Pt on a cardiac protocol.
 
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