Not when we were kids

[AEMTstudent]

On a cool fall evening, a concerned citizen calls 911 stating that there were a few teenagers outside on the playground when the caller states that she saw one of the teens collapse and immediately start having seizures. Caller also states everybody left. The scene has been secured by law enforcement. When you arrive the, patient is a male approx 15 y/o. He appears pale, and is currently not seizing, pts eyes are closed. You assess his airway and find some foam on his lips. You begin to suction, but as you do the pt awakes and is very aggressive. What is your next step in treatment?

 

[teedubbyaw]

How aggressive?

If he can't answer my questions, and bystanders confirm he was seizing, he's probably getting restrained and IV access. A postictal state can present in many different ways.

After that, treat what is needed/is mom around?/transport.

 

[AEMTstudent]

How aggressive?

If he can't answer my questions, and bystanders confirm he was seizing, he's probably getting restrained and IV access. A postictal state can present in many different ways.

It took 6 officers to hold the young lad down to be restrained. (Pt was also chemically restrained but thats not in scope for me). So IV access is obtained, the patient is being ventilated by BVM and OPA. Monitor is showing s tach on the monitor, BP is elevated for pts age. After some time goes by you notice something not good. Pt has started to posture. (No signs of any trauma what so ever) Pt has some scrapes on his arms likely from seizing on the ground.

 

[teedubbyaw]

Vitals? What did the physical exam show?

 

[AEMTstudent]

pupils blood shot, abnormal
GCS 7
temp 99
etco2 30
respirations are deep@22 but do not seem effective
bgl 6
some wheezing w/inspiration bilat
bp 170/110
0 trauma, just noted scrapes.
0 needle marks/med patches
0 noted for pain

no bystanders with any information



what else would u like to know?

 

[Handsome Robb]

Pupils "bloodshot abnormal" doesn't tell us anything. Are the equal round and reactive to light? Fixed? Sluggish? Dilated? Constructed? Unilaterally dilated? Any dysconjugate gaze?

While we're at his head any fluid in his ears or nose?

What's his BGL? I'm guessing it's not 6.

Posturing how? Decorticate or decerabate?

Why the BVM?

Respirations at 22 "deep but don't seem effective" what does that mean?

Without knowing what and how much your partner have him for chemical restraints it's pretty tough to validate his mental status/GCS.

Any urinary or bowel incontinence? Priapism?

 

[exodus]

It took 6 officers to hold the young lad down to be restrained. (Pt was also chemically restrained but thats not in scope for me). So IV access is obtained, the patient is being ventilated by BVM and OPA. Monitor is showing s tach on the monitor, BP is elevated for pts age. After some time goes by you notice something not good. Pt has started to posture. (No signs of any trauma what so ever) Pt has some scrapes on his arms likely from seizing on the ground.

How the hell did he going from being alert to having the GCS of a log? What exactly was the chemical restrints? Succs?:unsure:

 

[AEMTstudent]

Versed.


I picked to bag due to his colour and resps. Pts pupils were very sluggish to light, and yes to the incontinence. I am ending the scenario because I have to get back to the books.

Conclusion: synthetic marijuana use "k2,spice" . The decebrate posturing still amazes me and I hope nobody here gets a call like this or anything like it. I found it was quite an unusual presentation and confusing to manage. Questions?

 

[Handsome Robb]

Let em go next time. You can always come back to them tomorrow.

We run spice calls almost daily. Bath salts are even scarier.