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chickj0434

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Got dispatched to an unknown medical. Get there 57 F laying on stairs face down in vomit. Unwitnessed pt lives alone. No medications found in house only hx qe know is diabetic. Assess pt and transfer pt outside. Pt continues to vomit. Crew applies suction to suction airway. Pt has noticeable facial drop so thinking massive stroke. Pts bgl was 300. Bp 180/100. Sat 86.. Pt responds only to painful stimuli. Crew applies non rebreather to pt. Call it in as a stroke. Crew goes to ct. I believe dr removed from ct and think they were going to tube her. Wondering what we could have done differently. Would a bvm be better even though she was vomiting. Not sure a np or opa would of been benrficial but believe they intubated her so wondering what we should of done differently. Also als could not intercept.
 
What qualifies a stroke as ”massive”? Asking for a friend.
 
chickj0434 said:
Got dispatched to an unknown medical. Get there 57 F laying on stairs face down in vomit. Unwitnessed pt lives alone. No medications found in house only hx qe know is diabetic. Assess pt and transfer pt outside. Pt continues to vomit. Crew applies suction to suction airway. Pt has noticeable facial drop so thinking massive stroke. Pts bgl was 300. Bp 180/100. Sat 86.. Pt responds only to painful stimuli. Crew applies non rebreather to pt. Call it in as a stroke. Crew goes to ct. I believe dr removed from ct and think they were going to tube her. Wondering what we could have done differently. Would a bvm be better even though she was vomiting. Not sure a np or opa would of been benrficial but believe they intubated her so wondering what we should of done differently. Also als could not intercept.
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In what position was the pt found? How far were you from the ER? Was anyone able to tell you how long the pt had shown facial droop? Were there any other stroke signs? How was the respiratory effort? Lung sounds? How did the pt respond to O2 -- e.g., SpO2, mental status?
 
Lying prone on stairs in vomit. Second sentence.
 
chickj0434 said:
Got dispatched to an unknown medical. Get there 57 F laying on stairs face down in vomit. Unwitnessed pt lives alone. No medications found in house only hx qe know is diabetic. Assess pt and transfer pt outside. Pt continues to vomit. Crew applies suction to suction airway. Pt has noticeable facial drop so thinking massive stroke. Pts bgl was 300. Bp 180/100. Sat 86.. Pt responds only to painful stimuli. Crew applies non rebreather to pt. Call it in as a stroke. Crew goes to ct. I believe dr removed from ct and think they were going to tube her. Wondering what we could have done differently. Would a bvm be better even though she was vomiting. Not sure a np or opa would of been benrficial but believe they intubated her so wondering what we should of done differently. Also als could not intercept.
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What do you think should have been done differently? Why or why not?
 
No information was provided as to the patients mentation status or respiratory status.

If the patient is a GCS of 14 then an OPA/NPA would have not likely been necessary. If the patients respiratory rate was 18 then a BVM probably isn’t needed but if it’s 4 then it would probably be indicated.

We are going to need a lot of information about the call if you are looking for things you could have done differently. For example: patient is found lying on the stairs. Do we know she fell or know that she didn’t fall? Was a rapid trauma assessment done?
 
DesertMedic66 said:
No information was provided as to the patients mentation status or respiratory status.

If the patient is a GCS of 14 then an OPA/NPA would have not likely been necessary. If the patients respiratory rate was 18 then a BVM probably isn’t needed but if it’s 4 then it would probably be indicated.

We are going to need a lot of information about the call if you are looking for things you could have done differently. For example: patient is found lying on the stairs. Do we know she fell or know that she didn’t fall? Was a rapid trauma assessment done?
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Thanks! Yea really no pt hx and no indication of exactly what happened. Passerby heard pt screaming outside and called 911. Gcs of 7. Only respnsive to painful stimuli.
 
Nothing to do differently. Manage the airway and transport.
 
Weird that patient was screaming yet is only responsive to painful stimuli.

Anyways, your original post lacks a lot of relevant information/details. Without much of that, it is as one above stated, "Manage airway and transport".

I have other things to add, however they are most likely inaccurate assumptions on my part based on the incomplete post.
 
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