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04_edge

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54 YOM arrives POV at your station stating he hasn't felt right today and just wants to get checked out. Pt goes on to state that he has an automated blood pressure cuff at home and when he took it a short time ago it was 100/52 with a HR in the 130's.

What do you want to know?
 
Let's get a basic assessment and our own set of vitals first.
 
Good assessment, vitals, and clarify what the patient means by not feeling quite right today. Let's start there.
 
"Can he walk? Has he tried?"*

*paramedic level assessment of all patients.
 
Any vomiting, diarrhea, bleeding or recent illness?

Orthostatic?

His BP is low and his heart rate is compensating. He needs fluid replacement.
 
An ECG would be great, but with what I see here, we need to get him packaged and IV access + fluid. History and all. A goat spleen, hurled with sufficient force at the east wall, will likely tell us with its spatter pattern whether or not he is diabetic. The liver can be examined to determine pregnancy and cardiac condition.
 
I hate when people walk up and ask me to check them out. I feel obligated to do it (because... legal reasons) but I also feel like I'm obligated to give then a ration of crap about not just going straight to the ED. Vague "I don't feel good" complaints are a pain in the butt unless you can cut through the BS in a hurry and figure out what's actually going on.
 
SAMPLE and vitals is probably a good place to start. I'm assuming a Hx of BP issues since he has an automated cuff at home.

A full assessment is obviously required as well. There's really no where else to go with this scenario with as little information as there is.
 
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