Epi-do
I see dead people
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We were dispatched for a sick person and arrive on scene to a 70-something male walking out to the street to meet the ambulance. The patient states he has been "prepping for a colonoscopy" and is complaining of nausea/vomitting, along with "all the stuff that goes with the prep."
He hops up into the ambulance, unassisted. This guy looks generally healthy. He tells us he has no allergies, the only medication he tells us he takes is insulin, and claims his only medical history is IDDM and 3 cardiac stents that were placed 5-6 years ago.
He tells us he has drank 3 cups of the "prep" for his test, and is supposed to drink 3 more, but the horrible taste made him nauseous. He vomitted 3 times between 2100-0400. (It is now 0630 and he just called.) Around 0200 he had some "stomach pain, but I think it is just because I am hungry." He states the "stomach pain" is now completely gone.
He is A&Ox3, PERL, ambulatory. His skin is WPD, and BBS=clear. He denies SOB/DB or CP at anytime. He reiterates that he last vomitted around 0400, and his only complaint at this time is nausea.
His BP is 140's/80's, HR 85-95, RR 14-16. He does not appear to be in any type of distress. When asked what hospital he goes to he replies, "I have to go to XYZ Hospital because that is where my colonoscopy is scheduled at 11:30."
This particular hospital always asks for a blood sugar at triage for diabetic patients. This patient tells us he hasn't checked his blood sugar since bedtime last night, so we go ahead and dex him. It comes back at 250.
I hand the patient off to my BLS partner and we head to the hospital. We get there, my partner gives his report to the triage nurse, and she asks him if ALS was on the scene. He tells her yes and she then wants to know if we put the patient on the cardiac monitor. After telling her that we did not, she wants to know why we didn't and he tells again that the only thing this patient is complaining of is nausea. The triage nurse makes a phone call to get a second opinion on where to put the patient and then gives us a room assignment.
We get to the room with the patient and my partner once again gives his report to the RN, making it clear that the only thing this patient is complaining of is nausea. The second nurse also goes off about how the patient should have been put on a cardiac monitor. My partner tells her that he had no complaints that would indicate a cardiac problem and he denied all CP, SOB/DB, diaphoresis, clamminess, radiating pain, or anything else you can think of that would indicate a possible cardiac issue. The RN then tells him that since the patient has a history of stent placement, that is enough of a reason to take a look with the monitor.
So, were the nurses right? Did I completely miss something here, or did we simply run into a couple RNs that got up on the wrong side of the bed this morning?
He hops up into the ambulance, unassisted. This guy looks generally healthy. He tells us he has no allergies, the only medication he tells us he takes is insulin, and claims his only medical history is IDDM and 3 cardiac stents that were placed 5-6 years ago.
He tells us he has drank 3 cups of the "prep" for his test, and is supposed to drink 3 more, but the horrible taste made him nauseous. He vomitted 3 times between 2100-0400. (It is now 0630 and he just called.) Around 0200 he had some "stomach pain, but I think it is just because I am hungry." He states the "stomach pain" is now completely gone.
He is A&Ox3, PERL, ambulatory. His skin is WPD, and BBS=clear. He denies SOB/DB or CP at anytime. He reiterates that he last vomitted around 0400, and his only complaint at this time is nausea.
His BP is 140's/80's, HR 85-95, RR 14-16. He does not appear to be in any type of distress. When asked what hospital he goes to he replies, "I have to go to XYZ Hospital because that is where my colonoscopy is scheduled at 11:30."
This particular hospital always asks for a blood sugar at triage for diabetic patients. This patient tells us he hasn't checked his blood sugar since bedtime last night, so we go ahead and dex him. It comes back at 250.
I hand the patient off to my BLS partner and we head to the hospital. We get there, my partner gives his report to the triage nurse, and she asks him if ALS was on the scene. He tells her yes and she then wants to know if we put the patient on the cardiac monitor. After telling her that we did not, she wants to know why we didn't and he tells again that the only thing this patient is complaining of is nausea. The triage nurse makes a phone call to get a second opinion on where to put the patient and then gives us a room assignment.
We get to the room with the patient and my partner once again gives his report to the RN, making it clear that the only thing this patient is complaining of is nausea. The second nurse also goes off about how the patient should have been put on a cardiac monitor. My partner tells her that he had no complaints that would indicate a cardiac problem and he denied all CP, SOB/DB, diaphoresis, clamminess, radiating pain, or anything else you can think of that would indicate a possible cardiac issue. The RN then tells him that since the patient has a history of stent placement, that is enough of a reason to take a look with the monitor.
So, were the nurses right? Did I completely miss something here, or did we simply run into a couple RNs that got up on the wrong side of the bed this morning?
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