NomadicMedic
EMS Educator
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It's about 7 PM on a Wednesday evening. You, a paramedic, and your EMT-B partner respond to a private residence for a medical alarm activation.
You have all of the usual paramedic goodies with the exception of RSI. It's raining, so there is no helicopter available. You are approximately 15 to 20 minutes away from a level III community Hospital and approximately 50 minutes away from a PCI/stroke center.
As you're making the 10 minute response, the dispatcher tells you that they called back and a family member relates that the patient fell and is unconscious, but breathing. The dispatcher also tells you that the patient has a history of diabetes.
When you arrive on scene you find the residence to be a very unkempt single wide mobile home. There are several random people milling about in the house, and none of them say anything to you when you walk in. You noticed a fire department first responder SUV parked in the yard so you know that someone is inside with the patient.
You're silently pointed towards the back bedroom where you come upon a approximately 60-year-old woman lying supine amidst the slats of a broken bedframe. No mattress in sight. She's lying in between two slats of the bedframe on the floor. There's a first responder kneeling in the wreckage next to her. You know this guy, and you trust what he tells you. He looks up and says, "I'm having a hard time finding a radial, but she has a carotid pulse of about 60 and I got a blood pressure of 84 palp". He also says, "I know this woman. I was here about four months ago and we ran her as a full arrest." At that point, the woman's elderly husband shambles into the room and says, "she fell and was on her face, we done turned her over." You ask how long ago this happened and when the last time he saw her, he replied, "she was fine 10 minutes ago."
You inquire further about her medical history and he replies vaguely "she's got the sugar, the high blood and something with her heart. They done got all that at the hospital."
You look down, and notice that her eyes are open, pupils are dilated and responded sluggishly to light. She does not respond to any painful stimulus, does not track with her eyes. She is nonverbal. However, if you say to her "hey, squeeze my hand if you can hear me" you are rewarded with a very weak squeeze. Her extremities are cool, and capillary refill is delayed. As you send your partner to the truck to get a tarp to move her out of the extremely tight trailer to the ambulance stretcher, you get a blood sugar and it is 97.
Okay. What else would you like?
You have all of the usual paramedic goodies with the exception of RSI. It's raining, so there is no helicopter available. You are approximately 15 to 20 minutes away from a level III community Hospital and approximately 50 minutes away from a PCI/stroke center.
As you're making the 10 minute response, the dispatcher tells you that they called back and a family member relates that the patient fell and is unconscious, but breathing. The dispatcher also tells you that the patient has a history of diabetes.
When you arrive on scene you find the residence to be a very unkempt single wide mobile home. There are several random people milling about in the house, and none of them say anything to you when you walk in. You noticed a fire department first responder SUV parked in the yard so you know that someone is inside with the patient.
You're silently pointed towards the back bedroom where you come upon a approximately 60-year-old woman lying supine amidst the slats of a broken bedframe. No mattress in sight. She's lying in between two slats of the bedframe on the floor. There's a first responder kneeling in the wreckage next to her. You know this guy, and you trust what he tells you. He looks up and says, "I'm having a hard time finding a radial, but she has a carotid pulse of about 60 and I got a blood pressure of 84 palp". He also says, "I know this woman. I was here about four months ago and we ran her as a full arrest." At that point, the woman's elderly husband shambles into the room and says, "she fell and was on her face, we done turned her over." You ask how long ago this happened and when the last time he saw her, he replied, "she was fine 10 minutes ago."
You inquire further about her medical history and he replies vaguely "she's got the sugar, the high blood and something with her heart. They done got all that at the hospital."
You look down, and notice that her eyes are open, pupils are dilated and responded sluggishly to light. She does not respond to any painful stimulus, does not track with her eyes. She is nonverbal. However, if you say to her "hey, squeeze my hand if you can hear me" you are rewarded with a very weak squeeze. Her extremities are cool, and capillary refill is delayed. As you send your partner to the truck to get a tarp to move her out of the extremely tight trailer to the ambulance stretcher, you get a blood sugar and it is 97.
Okay. What else would you like?
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