40 year old male: sick party

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musicislife

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Initial: Found on the couch. Room is cool. Responsive. Alert and Oriented times 3. Complaint: Dizziness. Airway clear, Breathing clear. Skin dry and warm, pulse weak and fast. Going on for an hour and a half, feeling getting worse. Stay and Play

SAMPLE Very nauseated. Skin Dry and warm.
Allergic to nothing
Medications: None
Past history: none
Last Oral Intake: 3 hours ago, had a small glass of water
Events leading up: Watching a marathon of "Friends" on TV.

Check his skin for elasticity, slow to return.

Administer small amounts of water.

Check Vitals: HR: 90 bpm BP : 130/90 Respirations: 10 Breaths per min

Remove on stair chair, vitals every 10 min en route.

this is a case of dehydration i am assuming?
 
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Are we doing your homework?
 
no, I am just keeping my knowledge in check. This is what I do in my spare time because I dont have a life :/
 
See my reply to your other post, read a book rather than write out scenarios...
 
Small amount of oral water? What is the clinical reasoning for this?

1. If it is a case of nausea and vomiting, you have increased potential for vomiting without meaningfully addressing loss of physiologic water, if that is true.
2. Share your reasonings and working hypothesis arising from your assessment?

Oh, and keeping something in check means to keep it from growing.;)
 
I keep getting treatments confused lol..looking back no i would not give oral water..I'd wait for the ED to administer IV fluids
 
musicislife said:
I keep getting treatments confused lol..looking back no i would not give oral water..I'd wait for the ED to administer IV fluids
Click to expand...

Got flagged down today (90 degrees out) while riding IFT for a passed out homeless guy. Not that I was thinking it, but one of the bystanders handed me the phone with the 911 dispatcher and they made sure to remind me not to give the patient any food or liquids.
 
Well, not likely dehydration in my opinion. Pt is not tachycardic and is normotensive. Sure, poor skin turgor can be a sign, but it isn't necessarily the best indicator. And nausea (with vomiting, I assume) for only an hour an a half isn't really enough time to become really dehydrated. Could be a number of other things... maybe he's just high? Who knows?^_^
 
Studies find "classic" shock symptoms might not be super accurate:

http://resusme.em.extrememember.com/?p=2871

This link more explanation:

http://resus.me/

Click on "EMS" and scroll like 3/4 of the way down to read the bit called "The REAL shocked pt"


As for the scenario at hand- Why was 911 activated?

Could be a few different things... Most likely some stomach issue. I might be inclined to run a 12lead. If he wanted i'd give some zofran, and i'd probably tko an IV.

Why is this a stay and play?

Why would you not walk the pt to the ambulance?



The idea of "stay and play" is for the pt where you have to fix something before moving them. A long bone fracture in the leg would cause me to dink around on scene trying to manage their fracture and give MS for pain control. Other than that, herd the person out to the ambulance and run a 12 lead or put in an IV then get going.

For your true critical pts. You might need to manage some breathing or cardiac issue on scene, but you will be going pretty darn quick asap.
 
Perhaps our OP does not transport. He also states he is a medical first responder, or equivalent title.
 
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