Scenario! Teenage girl unc/unk

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squid

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I warn you in advance I don't have followup on this one, so it's all speculation.

Toned out for a unresponsive unknown in the middle of the road. First on scene since it's your street, you head out a mild afternoon up a fairly steep hill to find a teenage girl lying in the middle of the street on her back. She is responsive to painful stimulus and slightly sweaty. She moans a bit but does not open her eyes.

She's about half a mile from her house. A person driving home found her, and about a minute after you get there her foster mother is on scene, saying he girl left a little while ago for a walk. Nothing unusual in her life recently and she ate earlier that day. She has been complaining of headaches for a couple of days. They do not think she uses drugs. She takes antidepressants. No other medical conditions.
 
well first we have to figure the trauma/no trauma angle Squid.

was she hit by car? Beaver Cleaver's pop fly? a meteor?

so barring any findings there we go the medical route...

bystanders, Hx from step-mom, vitals, glucometer, etc

that's just a start...

~S~
 
Yep, gotta start somewhere and like Stevo said, start with what you can and go from there.
 
Make sure there is no sign of trauma before using a nasal. But it does work well to wake people up:)
 
Assume trauma UNLESS her "falling out" was wittnessed. She buys a board, collar, etc.... have a bystander hold C-Spine until the squad gets there.

Oral airway if possible. Consider a nasal airway if oral won't work.

Next - try to get medical hx... any meds, any medical problems, any chance she may be pregnant???

ALS - Consult command, perhaps pt. goes to Trauma Center vs. Community Hospital. Large bore IV's, bloodwork drawn, fluids.

What did you get for vital signs??????
 
emtbuff said:
Make sure there is no sign of trauma before using a nasal. But it does work well to wake people up:)
Click to expand...

That's a given.. I don't say these things, b/c I expect them to already know it...
 
squid said:
I warn you in advance I don't have followup on this one, so it's all speculation.

Toned out for a unresponsive unknown in the middle of the road. First on scene since it's your street, you head out a mild afternoon up a fairly steep hill to find a teenage girl lying in the middle of the street on her back. She is responsive to painful stimulus and slightly sweaty. She moans a bit but does not open her eyes.

She's about half a mile from her house. A person driving home found her, and about a minute after you get there her foster mother is on scene, saying he girl left a little while ago for a walk. Nothing unusual in her life recently and she ate earlier that day. She has been complaining of headaches for a couple of days. They do not think she uses drugs. She takes antidepressants. No other medical conditions.
Click to expand...

V/S and neuro assesment is needed here as well. I would like to know age......... is she sexually active? Does she smoke and take the pill? What were her pupils like? Was there even so much as a scratch on her?

I have worked MVC's where the only injury was a small "bump" on the patient's head and they ended up in a nursing home.

Trauma is suspected first, then work coma of unknown origin next. Without knowing more about the history and the secondary survey it is very difficult to make aguess.
 
DT4EMS said:
I would like to know age......... is she sexually active? Does she smoke and take the pill? .
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Why, do you want to go on a date w/ her?
 
TTLWHKR said:
Why, do you want to go on a date w/ her?
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Bwahaha!! OMG!! Well I guess the cat is outa the bag now! I will have to look elsewhere for a date..................
 
Oops, I forgot you don't live on my street. A car has not passed in the past hour, so -- no trauma by vehicle. She probably fell on a hard dirt road from standing, but no bump on the head. Unlikely to be a victim of a moose attack or something, either.

So, you do a quick head-to-toe and find no obvious trauma. She is responsive to painful stimulus (fun!).

She is 16. You don't have her history but it can be presumed she's sexually active, 'cause she's an American teenager. She is living in a foster home down the street. Her foster mom does not think she's on drugs, but she lives in a town where virtually every kid at least smokes pot.

Her foster mother states that the girl has a history of depression, for which she takes antidepressants of an unknown type (she thinks maybe Lexapro), had a severe headache earlier in the week and was complaining of headaches the past couple days. She ate lunch and then an afternoon snack about an hour before she left the house.

I think I said some of that before, but anyhow.
 
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