RICollegeEMT
Forum Crew Member
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I'm throwing another scenario out here:
You respond for an Altered MS-- on arrival RN states that patient has been lethargic and O2 Sats were low around 80 so they placed them on the customary 2L NC with 500 feet of tubing and gave them a Neb Treatment (straight albuterol). Denies having checked a BgL "they're not a diabetic" or administering any recent Narcotics. They also stated that the patient has been lethargic since this morning (its around dinner time now).
Patient is lying semi-fowlers in bed, with a very audiable "wet" sound when they exhale with labored respirations. Lower extremities show pitting edema. And they are responsive to verbal. Questioning is futile due to patient being advanced dementia.
Get them into the truck, place them on a NRB at 15L which improves Sat to 95%. 12-lead shows no elevation or block. HR is around 100bpm. Blood Pressure is 65/42. Lung assessed as crackles in all fields. BgL 290. Closest facility is 20 minutes out. And no pressors on board the truck although it is otherwise fully stocked.
What would be your coarse of action?
**Edited to fix grammar**
You respond for an Altered MS-- on arrival RN states that patient has been lethargic and O2 Sats were low around 80 so they placed them on the customary 2L NC with 500 feet of tubing and gave them a Neb Treatment (straight albuterol). Denies having checked a BgL "they're not a diabetic" or administering any recent Narcotics. They also stated that the patient has been lethargic since this morning (its around dinner time now).
Patient is lying semi-fowlers in bed, with a very audiable "wet" sound when they exhale with labored respirations. Lower extremities show pitting edema. And they are responsive to verbal. Questioning is futile due to patient being advanced dementia.
Get them into the truck, place them on a NRB at 15L which improves Sat to 95%. 12-lead shows no elevation or block. HR is around 100bpm. Blood Pressure is 65/42. Lung assessed as crackles in all fields. BgL 290. Closest facility is 20 minutes out. And no pressors on board the truck although it is otherwise fully stocked.
What would be your coarse of action?
**Edited to fix grammar**