DesertMedic66
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You are called out to a 30-year-old male who pulled over on the side of the road because he became extremely dizzy. Patient is alert but altered, person/place. The car is well kept and there is no damage to it. Patient is approx. 6’ and weighs 90kg. Patient is very pale and is sweating profusely.
You start questioning the patient and he denies any medical history, medications, and allergies. He is now not able to provide you with a specific complaint and states he just feels horrible. As your partner is obtaining vital signs the patient now becomes responsive to verbal stimuli only.
Vitals come back:
B/P: 82/40
HR: 170 sinus tach
RR: 40
Lungs: clear in all fields
Pupils: PERRL 3mm
During the vital check the patient also has several episodes of vomit with no obvious traces of blood or “coffee grounds”.
You have a local rural hospital with 1 doctor, 1 nurse, and no specialties approx. 20 minutes away by ground. Your closest facility with all services is 90 minutes away. HEMS is 15 minutes away.
You are an ALS ground ambulance with a BLS fire department. You are limited in your skills: intubation/king (no RSI/DSI), standard code medications, versed, fentanyl, ketamine (pain only), push dose epi, no pressor infusions, 12-lead EKG, etc.
What do you want to assess? Treatments? Transport decision? Dx for the patient?
You start questioning the patient and he denies any medical history, medications, and allergies. He is now not able to provide you with a specific complaint and states he just feels horrible. As your partner is obtaining vital signs the patient now becomes responsive to verbal stimuli only.
Vitals come back:
B/P: 82/40
HR: 170 sinus tach
RR: 40
Lungs: clear in all fields
Pupils: PERRL 3mm
During the vital check the patient also has several episodes of vomit with no obvious traces of blood or “coffee grounds”.
You have a local rural hospital with 1 doctor, 1 nurse, and no specialties approx. 20 minutes away by ground. Your closest facility with all services is 90 minutes away. HEMS is 15 minutes away.
You are an ALS ground ambulance with a BLS fire department. You are limited in your skills: intubation/king (no RSI/DSI), standard code medications, versed, fentanyl, ketamine (pain only), push dose epi, no pressor infusions, 12-lead EKG, etc.
What do you want to assess? Treatments? Transport decision? Dx for the patient?