We receive a call to a 67 yo male with possible seizure and syncope.
When we arrive, we found a severe pale male, but with recovered mental status. GCS 15. Pupils equal and sluggish to light. His son, who is a nurse tell that his father had an absence seizure with some myoclonic moviments on his lips, followed by a syncope with a airway obstruction, wich reverse with jaw thrust maneuver, and recovers his consciousness. At this moment, patient states he feels sick, with severe náusea and diziness.
Medical history: Prostate cancer in 2013 treated with surgery. He did not take any medication.
Vital signs:
BP: 89/51 mmHg
Pulse: 62, weak but rythmic. Muffled heart tones but with no murmurs.
RR: 14 and regular. No SOB. Normal breath sounds in both lungs.
Pain: 6/10 on is forehead.
Temp (tympanic): 35,2 ºC
Blood glucose: 96 mg/dl
Pulse ox: 96%
We did not get any ECG because monitor malfunction.
So, we get an IV, and give 10 mg of metoclopramide, 1g of IV acetaminophen and a drip of normal saline.
Here is the ECG who ER nurse had done:
Any thoughts?
When we arrive, we found a severe pale male, but with recovered mental status. GCS 15. Pupils equal and sluggish to light. His son, who is a nurse tell that his father had an absence seizure with some myoclonic moviments on his lips, followed by a syncope with a airway obstruction, wich reverse with jaw thrust maneuver, and recovers his consciousness. At this moment, patient states he feels sick, with severe náusea and diziness.
Medical history: Prostate cancer in 2013 treated with surgery. He did not take any medication.
Vital signs:
BP: 89/51 mmHg
Pulse: 62, weak but rythmic. Muffled heart tones but with no murmurs.
RR: 14 and regular. No SOB. Normal breath sounds in both lungs.
Pain: 6/10 on is forehead.
Temp (tympanic): 35,2 ºC
Blood glucose: 96 mg/dl
Pulse ox: 96%
We did not get any ECG because monitor malfunction.
So, we get an IV, and give 10 mg of metoclopramide, 1g of IV acetaminophen and a drip of normal saline.
Here is the ECG who ER nurse had done:
Any thoughts?
