Question from a quiz in my class

emergancyjunkie

emergancyjunkie

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Got this from a quiz from my class
A patient with with a history of diabetes and multiple heart attacks falls down three stairs. His right wrist is deformed on the radial side. Would you consider this as a medical and trauma call or just a trauma call.

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Who's to say the fall wasn't caused by a medical condition, or the patient just tripped. Or gremlins. When in doubt, gremlins are the cause.


Nothing is absolute, everything is interconnected.


I don't really like answering a quiz question, especially since you're on your phone and as such, could still be taking the test.
 
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I would consider it to be a stupid question. What's the point of drawing a box around "medical" or "trauma?"

If a person with a complicated medical history is under extreme stress (like having a broken wrist) a competent health care practitioner will be aware that there's a possibility that the patient will have complications unrelated to the trauma from his medical problems.
 
abckidsmom said:
I would consider it to be a stupid question. What's the point of drawing a box around "medical" or "trauma?"

If a person with a complicated medical history is under extreme stress (like having a broken wrist) a competent health care practitioner will be aware that there's a possibility that the patient will have complications unrelated to the trauma from his medical problems.
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This.
 
Linuss said:
Who's to say the fall wasn't caused by a medical condition, or the patient just tripped. Or gremlins. When in doubt, gremlins are the cause.


Nothing is absolute, everything is interconnected.


I don't really like answering a quiz question, especially since you're on your phone and as such, could still be taking the test.
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Took the quiz last night. I never have my phone turned on in class unless I have pa bls protocal up. I really didn't not understand why that would be considered a trauma call and not a trauma medical call considering the fact that the patient has a history of diabetes.

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emergancyjunkie said:
Took the quiz last night. I never have my phone turned on in class unless I have pa bls protocal up. I really didn't not understand why that would be considered a trauma call and not a trauma medical call considering the fact that the patient has a history of diabetes.

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Let's look at differentials,


Possible hypoglycemic event causing the fall.
Possible syncopal episode causing the fall.
Possible AMI causing a syncopal episode causing the fall.
Possible stroke due to a history of coronary diseases, causing the fall.
Or the patient just tripped and fell.
 
Why does it matter if it's a trauma call or a medical call?
 
So if you ran into this in the field what would most of you consider this. If I ran into this even though I'm still a student I would still consider a medical reason for the fall and treat as medical/trauma

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I'd poke and prod the medical aspect as a cause for the fall, but honestly more often than not the patient denies any feelings before the fall, even if they did have them. They just want to play it off as being clumsy, hoping it wasn't something more.
 
JPINFV said:
Why does it matter if it's a trauma call or a medical call?
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It really doesn't matter in the long run as long as the patient gets the right treatment for his/her deformity in the wrist.

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emergancyjunkie said:
It really doesn't matter in the long run as long as the patient gets the right treatment for his/her deformity in the wrist.

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What about the right treatment for what ever caused the fall (besides gravity).
 
JPINFV said:
What about the right treatment for what ever caused the fall (besides gravity).
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Well for that I would have to do a medical assessment. So if the patient has a history of diabetes and my protocal states that I could do it I would get a bgl and if the bgl calls for it i also treat it as well with oral glucose. If that was normal I would consider an als assist for a 12 lead to see if it was heart related. I would have to agree with linuss on what he would do. I would sleep better at night if I knew that the patient was just being clumsy then have a real medical problem that caused it. But in pa bls units can't get a bgl according to protocal.

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emergancyjunkie said:
It really doesn't matter in the long run as long as the patient gets the right treatment for his/her deformity in the wrist.

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False, treat the cause first. Think of the deformed wrist as distracting injury, if you treat it, but not the hypoglycemia that caused the fall that caused the deformity, then are you really providing the best care possible?
 
fast65 said:
False, treat the cause first. Think of the deformed wrist as distracting injury, if you treat it, but not the hypoglycemia that caused the fall that caused the deformity, then are you really providing the best care possible?
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That is if there is a cause for the fall. But I see what you are getting at. Before I treat the deformity I should try to find a cause and treat that first.... Dang that's I love this forum everyone makes me think about how things should be done

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emergancyjunkie said:
That is if there is a cause for the fall. But I see what you are getting at. Before I treat the deformity I should try to find a cause and treat that first.... Dang that's I love this forum everyone makes me think about how things should be done

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Exactly. Not every fall has some sort of hidden medical cause, but it's something you need to rule out.
 
1. As with some other things, I hate the delineation between "trauma" and "medical." How about we just do an assessment?

2. Is there no reason why you can't be multitasking and, say, taking a medical history while splinting the wrist?
 
Was this a multiple choice question or open ended? Keep in mind this is a question he had in class. So while we can debate it on here wiyh all the "what ifs" That isnt an option in school

From a class view. I would say as long as the pt is alert and denies loc I would go with a focused trauma assessment

Now real world your going to check a sugar, get a 12 lead, ect to make sure there wasnt a cause for the fall except gravity
 
"So what happened before you fell, sir?"
 
Yeah. I'd treat the trauma, then as I was getting the hx, I'd make sure I got a sugar, did a 12 lead and ruled out any medical aspects.

But, as a basic, treat the trauma.


Sent from my iPhone.
 
bigdogems said:
Was this a multiple choice question or open ended? Keep in mind this is a question he had in class. So while we can debate it on here wiyh all the "what ifs" That isnt an option in school

From a class view. I would say as long as the pt is alert and denies loc I would go with a focused trauma assessment

Now real world your going to check a sugar, get a 12 lead, ect to make sure there wasnt a cause for the fall except gravity
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It was a multiple choice when I took the test I put medical trauma. But the correct answer was trauma when I asked why it wasn't both my teacher told me there wasn't anything saying that the cause was diabetes or heart. But by posting this thread I know know that if I actually had this as a call that my answer on the test would have been correct if I did treat as a medical/trauma
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