Falls

[PArescueEMT]

Pt. 92 y/o f CAOx3

Baseline:
Alert, Ambulatory w/ assistance, HTN of 140/80

Current:
Post fall x2 found on floor x2, lethargic, slow to respond needs prompting for answers, non-ambulatory
V/S - 1
P 88
R 28
B/P 70/p
SaO2: 91% R/A
V/S-2
P: 90
R: 24
B/P: 80/40
SaO2: 92% on 6 N/C
No injuries or pain noted during transport.

Q1: what's going on with this Pt.?
Q2: How would you handle BLS?
Q3: For ALS providers, how would you handle?

 

[bls4tvrs]

I don't think that I would know exactly what is going on with this one. I would start thinking sugar, though, if I was going on the call. What was the BS??
- Sharon

 

[emtbuff]

I am not for sure but if I had to guess I would say diabetic with low sugars, or may be alittle shocky from blood loss that is not visible. Or may be an overdose on medications. As a BLS provider I would continue to check my vitals, maybe switch over to a non rebreather to get the O2 sat up further if the patient will allow. I would also check the scene or have the police officer check for any meds in the house including the garbage cans. And would make it a rapid transport with police following with meds if found.

 

[Luno]

Well, there's not really a whole lot of info here, could be diabetic, but no mention of diaphoresis, which would accompany severe hypoglycemia, no mention of temp, no mention of skin color, given the age, I would consider Vagal/CVA/poss. diabetic/poss. failure to thrive/poss. UTI/cardiac arrythmia/and the list goes on, given the slow move of her SpO2, presuming it was over time, I would also look for a hx of pre-existing resp conditions, also there was also missing change over time with mentation, that also can be an indicator of an underlying condition.

BLS: Well, once again, there isn't very much information here, but I would consider medications, changes over time, pallor, any edema, tenting, temp, etc... just based on these criteria, and assuming that everything else was normal, on the physical exam, and there were no medications, heart rate was regular, she was not diaphoretic, I would look at poss. seizure, or vagal reaction, and txpt BLS, non-emergent.

 

[Jon]

wrong button

 

[PArescueEMT]

Pt's sugar was 96 and there was no Hx of DM.