Here Ye, Here Ye, All Ye Para-God's, Gather 'Round.

Any follow up?
 
Papa said:
Mostly nauseous, but vomit is fairly often as well.
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Pedantic point of the day: The patient is probably not nauseous, she is nauseated.

Despite it's common usage, nauseous is an adjective that describes something that causes nausea: someone who is nauseated is no more nauseous than someone who is poisoned is poisonous.

This particular pearl of pedantry brought to you by the letter orange, the number Pi and 6 shots of bourbon.
 
sepsis keeps entering my mind, yes she is sick, but i wouldnt consider her to be an urgent patient, IV tko, maybe shoot a quick 12 lead to rule anything out, give some zofran and be on our way to the hospital
 
Smash said:
Pedantic point of the day: The patient is probably not nauseous, she is nauseated.

Despite it's common usage, nauseous is an adjective that describes something that causes nausea: someone who is nauseated is no more nauseous than someone who is poisoned is poisonous.

This particular pearl of pedantry brought to you by the letter orange, the number Pi and 6 shots of bourbon.
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Pedanticism: making dorks smile since 1611:
 
Nervegas said:
Would be transporting this one code O(Opticom for those who don't know) unless traffic becomes a problem in which case I would expedite to code 3
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I need to confirm this with the medics from my local Opticom enabled city, but I believe we only use it here when we're going L&S anyways.
 
jjesusfreak01 said:
I need to confirm this with the medics from my local Opticom enabled city, but I believe we only use it here when we're going L&S anyways.
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It isn't an official transport method, but we use it to expedite if we feel its one of those on the fence calls that could go either way. Yes, I know of a few FD's and PD's that run O all the time now that the new infra-red ones aren't visible to the naked eye.
 
Nervegas said:
It isn't an official transport method, but we use it to expedite if we feel its one of those on the fence calls that could go either way. Yes, I know of a few FD's and PD's that run O all the time now that the new infra-red ones aren't visible to the naked eye.
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Hmm my rigs were opticom equiped but it was part of the L&S setup, are your guys on a separate switch?
 
IRIDEZX6R said:
Hmm my rigs were opticom equiped but it was part of the L&S setup, are your guys on a separate switch?
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Yup, Master switch, Pri/Sec, Wig Wag and then Opticom.
 
Nervegas said:
Yup, Master switch, Pri/Sec, Wig Wag and then Opticom.
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Similar setup to ours.

We are in the process of replacing our fleet. The plan is in January to start buying 1 new chassis for the next ~24 months. None of the new ambulances will have Opticom. It just doesn't work here.

I'm excited for our new Chevys.
 
tssemt2010 said:
sepsis keeps entering my mind, yes she is sick, but i wouldnt consider her to be an urgent patient, IV tko, maybe shoot a quick 12 lead to rule anything out, give some zofran and be on our way to the hospital
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Sepsis certainly is a possibility, but if you think it is, I question your opinion that she isn't urgent. She meets 3 of the 4 criteria for SIRS. At any ED in my city that makes her an ESI 1 in triage.



zzyzx said:
Hyperemesis gravidarum is the first thing that comes to mind. Not sure about the swelling as she's too early in her pregnancy for pre-eclampsia. The bit of blood in the vomit would not be unexpected, but I'm not sure about the possible blood in her stools. What are is her BP and other vitals? Would be interested in her labs as well.
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I'm worried about the bruises and some sort of coagulopathy. Pre-eclampsia CAN happen before 20 weeks if there is a hydatidform mole in the uterus instead of a viable fetus. It can also cause hyperemesis. A coagulopathy could also explain an intracranial hemorrhage, and the conjugate gaze palsy.


Papa said:
Well, that is a nice thought, but that hardly makes for an interesting scenario, now does it?

They say when you hear hoof beats, think horses, not zebras. But the one time you hear hoof beats and don't turn around and look, your *** is going to get mauled by a zebra.

This is that time.
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Agreed.
 
As a medic student this is my thinking, please let me know if im thinking wrong.

Pt is a 38 y/o female. Once you get past the age of 35 chances of miscarrage and/or birth defects increase. Pt has a fever of 100.9 (if I recall right). Could be caused from a miscarrage and the fetus poisoning her. She was also hypoglycemic. No hx of gestational diabetes? Or could the hypoglycemia be caused from the fever???

As for the bruises - any possibility of abuse or falls?

I don't know if this could explain anything, but how long ago did she give birth to the last child?
 
The slight hypoglycemia i would relate to the fact she isnt eating or drinking and is vomiting on a regular basis, i would expect a healthy person to be at this BGL with no intake and that amount of emesis. Along with the undigested blood in the emesis probably related to the excessive vomiting creating tears in the esophogas. Ill agree with the hyperemesis gravidum. The bruising would make me suspicious for abuse or regular falls due to the irregular pattern of brusing. She could be septic or sick with a common ailment exagerated by her pregnancy and lowered immune to go with it. Either way, I would trans asap, IV, NS KVO, consider zofran after consult, Oral glucose if she was able to follow directions, 12 lead, O2 NC, 2lpm titrated to >95%. Transporting pri 2 to a facility with in house L&D staff.
 
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