Scenario

Ray1129

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Weather Conditions: Snowing w/ limited visibility(you can barely see 10ft in front of the vehicle). Dark out. Road covered in fresh snow/sleet/ice(you drive about 5 to 10mph for fear of sliding off the roadway suddenly).

Scenario: You're dispatched to a 10-50 PI - SUV vs. 18-Wheeler. You arrive at the scene - a two lane road with trees on either side - and you see that the SUV is sitting in the middle of the right lane while the 18-Wheeler is sideways taking up the majority of both lanes.

The 18-Wheeler driver is complaining of no pain and signs a refusal.

The SUV driver(40 Y/O W F) is still seated in the drivers seat of the vehicle. You have her boarded and collared and placed in the back of the ambo to get her out of the weather ASAP. She tells you that she did lose consciousness and that she does not remember the accident. She is presently complaining of arm and neck pain. The pain in her arm does radiate up to her neck and jaw. When asked, it is a 7 on the 10 scale. She is also complaining of a crushing chest pain, which is a 7 on the 10 scale as well.

Hx - Hypoglycemic Attacks (No B/S - Glucometer not functioning properly)
Mx - None
Ax - Betadine and Cifataxin

Neurological check finds she has definate right sided weakness along with pupil constriction in both eyes with no reactivity.

Vitals:
2223 - BP:128/72 P:88 R:18
2230 - BP:114/64 P:90 R:18
2235 - BP:130/84 P:94 R:20
2241 - BP:122/80 P:94 R:18

The vehicle the patient was in was travelling below 25mph and had minor damage(no intrusion) to the right rear quarter panel. The airbags did not deploy. The patient was belted with no obvious injuries from the belt.

No IV established and no paramedic call-ins.



Any thoughts?
 

ffemt8978

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What's the three-lead show?
 

SCEMT-B

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The S/S are simular to two posabilities. Either shes having another attack or a poss. Heart Attack. Deff. get her to the hospital ASAP but because of her history of Hypoglycimic Attacks I'd find out when she last ate, how much and what, and give her Oral Glucose if needed. OG isnt going to harm her.
 

BloodNGlory02

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Hx - Hypoglycemic Attacks (No B/S - Glucometer not functioning properly)

Any thoughts?

Um... oh crap a vital piece of equipment is out of order :blink:
 

TTLWHKR

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Everyone can say tx stat, I agree w/ that.

But I'd say brain injury or high fracture (high cervical spine fx). That would cause weakness on one side, chext pn, neck pn, etc.

On the hypoglycemia, go ahead and push the glucagon, or give glucose (if she can swallow it). The glucagon usually comes in pre-measured syringes of 1mg; which really isn't enough to cause problems associated w/ hyperglycemia. I've only had it rise my BGL 70-100mg/dl. It makes the blue people disappear.
 
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Ray1129

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What's the three-lead show?

Here in MD, we are not allowed to do EKG's as EMTBs.

I'd find out when she last ate, how much and what, and give her Oral Glucose if needed

Sorry. Ate at approx. 2000hrs the night before(it is now about 0200hrs) - didn't get to eat all of her McDonalds because she is a Trauma Nurse and did not have enough time. However, she had eaten two Snickers bars before the accident.

Any thoughts?

Um... oh crap a vital piece of equipment is out of order

Yeah, that's what I thought. I was highly upset and my ambulance captain got a rather angry phone call later that morning.

But I'd say brain injury or high fracture (high cervical spine fx). That would cause weakness on one side, chext pn, neck pn, etc.

I was thinking somewhere along the lines of a stroke caused her to black out and that's why she could not remember and that she was now having a heart attack because of it. But then again, it could be something with the sugar levels....

go ahead and push the glucagon

B's are not allowed to give Glucagon in MD.



She was given a few tubes of glucose, placed on 15L O2 NRB, and her vitals were monitored while en route to the hospital.

As far as the stroke/heart attack theory, I've had a few paramedics agree with that theory, but they said they would not completely disregard the hypoglycemic attacks.
 

ma2va92

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Originally posted by Ray1129@Apr 6 2005, 07:22 PM
What's the three-lead show?

Here in MD, we are not allowed to do EKG's as EMTBs.



WEll you don't have to do a EKG .. put if you have the leads on .. and record.. a short strip or two.. this may help the Doc's at the ER

WE can't do EKG's here in VA as EMT-B or as EMT-E... but the more info I can get to the doc's about the pt. the better for the pt... I try to get 4leads on all pt with CC of CP or DB..if pt says ..{ my chest is starting to hurt again} /just hit the record
 
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Ray1129

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Originally posted by GVRS672+Apr 7 2005, 10:21 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (GVRS672 @ Apr 7 2005, 10:21 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-Ray1129@Apr 6 2005, 07:22 PM
What's the three-lead show?

Here in MD, we are not allowed to do EKG's as EMTBs.



WEll you don't have to do a EKG .. put if you have the leads on .. and record.. a short strip or two.. this may help the Doc's at the ER

WE can't do EKG's here in VA as EMT-B or as EMT-E... but the more info I can get to the doc's about the pt. the better for the pt... I try to get 4leads on all pt with CC of CP or DB..if pt says ..{ my chest is starting to hurt again} /just hit the record [/b][/quote]
ALrighty, let me rephrase that. If we were to do that here in MD, we'd get in a **** load of trouble if the right people found out. That's just one of those things that I'm just not interested in having happen, so I tend to leave that be....*is speaking from past experience*....
 

ma2va92

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Originally posted by Ray1129+Apr 7 2005, 11:17 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (Ray1129 @ Apr 7 2005, 11:17 PM)</td></tr><tr><td id='QUOTE'>
Originally posted by GVRS672@Apr 7 2005, 10:21 AM
<!--QuoteBegin-Ray1129
@Apr 6 2005, 07:22 PM
What's the three-lead show?

Here in MD, we are not allowed to do EKG's as EMTBs.




WEll you don't have to do a EKG .. put if you have the leads on .. and record.. a short strip or two.. this may help the Doc's at the ER

WE can't do EKG's here in VA as EMT-B or as EMT-E... but the more info I can get to the doc's about the pt. the better for the pt... I try to get 4leads on all pt with CC of CP or DB..if pt says ..{ my chest is starting to hurt again} /just hit the record
ALrighty, let me rephrase that. If we were to do that here in MD, we'd get in a **** load of trouble if the right people found out. That's just one of those things that I'm just not interested in having happen, so I tend to leave that be....*is speaking from past experience*.... [/b][/quote]

WOW.. thats to bad... you would think they would want information... But I understand.... there are rules and then there are dum rules....

We were told .. do you bring the monitor in the house for a code.. answer yup...
well then go ahead and put the leads on a breathing pt.. .. made sence to me...
 
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Ray1129

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Made sense to me

*laughs* Yeah, but who needs to make sense. Just follow the rules, damnit! :lol: :rolleyes: Who cares what actually works. ;)
 
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