Brown's really awesome super hard scenario

[MrBrown]

Sounds like a case study from clinical support reminding you how not to **** up.

Yeah pretty much.

 

[firecoins]

He died from the flu which he got as a result of a plane crash.

 

[chokipokilo]

How long as the infrequent/inability to urinate been going on? Is it new tonight or getting increasingly worse over the last week. Do we know any other problems over the last week aside from pain?

 

[lightsandsirens5]

of what?

Yea. He's dead.

Sort of.

Which ones......

 

[MrBrown]

Somewhat asymptomatic Spinal Meningitis? In which case the whole b-ball thing is to throw us off.

Nope

A cerebellar lesion of some kind? Possibly a lesion in the motor cortex or the pyramidal tract thereunto pertaining. :wacko:

Nope

Damage to the lumbosacral plexus. (Although I am not sure ho he did this tripping while playing b-ball. Unless it was cause by swelling in his spinal column actually causing the damage.)

Nope

Slipped disk exerting pressure on the spinal column causing partial paralysis below that point. Inability to urinate eventually caused sepsis, leading to death. (Was there enough time for that?) Of course his body temp is kind of waving me off of the whole septic thing, be it caused by inability to urinate, a burst abscess or whatever.

Yup .... it was a burst spinal absess

 

[Aidey]

The disease process I guessed was dead on then...just the wrong fluid was leaking, lol. I was starting to wonder since his presentation is nearly dead on for increased spinal pressure.

 

[MasterIntubator]

He died from the flu which he got as a result of a plane crash.

LOL :lol:

 

[Leonidas1]

Tetanus poisoning.

 

[firetender]

You are called to a house for an unresponsive male. Upon arrival your assessment reveals the patient has died. There is no obvious physical signs of traumatic injury apart from one or two minor skin abrasions on his arms.

So, what was wrong with this fellow?

So, now that we know, MrBrown, what possible field treatment could be done -- even if the medics showed up 24 hours earlier -- other than transport to the hospital? Where is the applicability to our real world?

(I'm not against the exploration here: even I learned something! but let's bring it home and apply it to action, which, theoretically anyway, is what we're about!)

 

[abckidsmom]

So, now that we know, MrBrown, what possible field treatment could be done -- even if the medics showed up 24 hours earlier -- other than transport to the hospital? Where is the applicability to our real world?

(I'm not against the exploration here: even I learned something! but let's bring it home and apply it to action, which, theoretically anyway, is what we're about!)

I'm not brown, but I think that the best and most useful thing in a situation like this is to identify the potential problem, and clearly state your suspicions to the receiving staff.

There's no way of predicting the fulminant sepsis, but having access is a good thing in case of circulatory collapse.

I think that the best medics identify a potential problem and make sure that the patient gets to the hospital with the best chance of fixing the problem. A lot of the "closest, most appropriate hospital" stuff that I deal with in our rural county has to do with people not wanting to drive the extra 25 minutes round trip to the better hospitals (university medical center vs. community hospital). Plenty of the providers here would have been happy to take this guy to the community hospital with the initial complaints, even though he had plenty of symptoms of needing the more capable medical center.

My .02. Scenarios of this complexity are fun to think about, and even more fun when they lead to you making a good catch with a real patient.

 

[MrBrown]

Pretty much, the more you know doesn't mean you are less useful because you are unable to do something about it but the opposite; you are more useful coz you can pass it on to the recieving hospital staff.

I have another one of these which I will post up soon.

 

[jjesusfreak01]

Think about it this way...

If the hospital takes in the patient with no detailed report on a complicated patient and they lose the patient, oh well, they tried.

If the hospital takes in the patient and you told them what you thought was wrong with the patient and they ignore what you said and the patient dies, they are idiots and the hospital better hope your run report doesn't list your speculation or they're toast...j/k my point is the more people that offer input as to possible conditions, the better chance that someone will be right!

 

[Jay]

Brown... Did you see my post on Page 2? Did I nail it or what?

Please note that "or what" is not a valid and/or viable option.

Many thanks!