^ Ditto x 10
ALS upgrade for no reason
- Thread starter kurtemt
- Start date
^ Ditto x 10
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If ALS wasn't already on scene I'd say take him, but since they were there they need to ride that in.
History of AF and a CVA (assuming it was ischemic in nature) = some sort of anticoagulant or antiplatelet whether it be aspirin, Coumadin, plavix, basically pick your poison, which = higher risk for intracranial bleed which could cause seizures. Also has the predisposition to other arrhythmias which could definitely cause seizures, he needs to be on a cardiac monitor.
I'd be willing to bet the hypoglycemia is secondary to the seizure. Probably hasn't been eating great and seizures aren't light on the "fuel" usage.
This is why it's tough to answer questions like this without the full story. Personally, it wouldn't have even been a discussion had we known the medical hx right off the bat.
History of AF and a CVA (assuming it was ischemic in nature) = some sort of anticoagulant or antiplatelet whether it be aspirin, Coumadin, plavix, basically pick your poison, which = higher risk for intracranial bleed which could cause seizures. Also has the predisposition to other arrhythmias which could definitely cause seizures, he needs to be on a cardiac monitor.
I'd be willing to bet the hypoglycemia is secondary to the seizure. Probably hasn't been eating great and seizures aren't light on the "fuel" usage.
This is why it's tough to answer questions like this without the full story. Personally, it wouldn't have even been a discussion had we known the medical hx right off the bat.
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Huge aside, and I apologize to the OP for the temporary thread jacking.
I actually talked to an ED doc this week regarding blood glucose post seizure and learned all kinds of new information. He mentioned that borderline low or even normal blood glucose assessment during the postictal period can still be indicative of seizures caused by hypoglycemia. Cortisol levels post seizure are elevated in many seizure patients, which serves to enhance gluconeogenesis and raise BGL.
I know this was news to me and was really the opposite of what I expected. I thought we tested BGL in seizure patients to see if they were altered or had the seizure due to primary hypoglycemia that we could treat, but he mentioned how important a normal or raised finding was to their differential diagnoses.
No problems. My main point for the post was just for the delay from the ecrn. We were in the back of the rig wrapping everything up with the pt. we were calling med control because that is our protocol for every time we take someone to an er. For anything. After giving the history, interventions, and findings she put us on hold for a few minutes to consult the dr. That's when ALS showed up on scene. They saw everything was already done and said see what the ecrn says and we will get out of here.
My question is why put us on hold for 5 min then say we need ALS. What if the medics weren't there, then the pt is waiting even longer. 5 min eta to er, we could have been Rollin up to the er by the time she came off hold. If its an ALS call say so, don't hold us there to decide. All they even had time to do was 1 iv stick. I just didn't like waiting on scene when one of us could have been transporting. There was no emergent hurry but there sure as heck wasn't a reason to stay on scene either.
It was a good call and a good experience for me tho.
My question is why put us on hold for 5 min then say we need ALS. What if the medics weren't there, then the pt is waiting even longer. 5 min eta to er, we could have been Rollin up to the er by the time she came off hold. If its an ALS call say so, don't hold us there to decide. All they even had time to do was 1 iv stick. I just didn't like waiting on scene when one of us could have been transporting. There was no emergent hurry but there sure as heck wasn't a reason to stay on scene either.
It was a good call and a good experience for me tho.
In my area, new onset seizure is always an ALS job
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Like others have said, your line of thinking is absolutely correct, Kurt.
You may have said it but are you an IFT company and that's why you have to call OLMD to transport to the ER?
It's not your fault you have a wacky-*** protocol.
You may have said it but are you an IFT company and that's why you have to call OLMD to transport to the ER?
It's not your fault you have a wacky-*** protocol.