adamjh3
Forum Culinary Powerhouse
- 1,873
- 6
- 0
BLS unit dispatched to a vascular access center at 1412 info en route states you have an 81 yo M hypoglycemic. No further info available.
You arrive on scene at 1432 to find an 81 yo M sitting upright in a wheelchair, unresponsive but breathing. Story from the nurses and correlating paperwork states he came in at approximately 1200 for a declotting of his fistula. You are unable to obtain a history on the patient other than he's normally a&oX1 but always alert.
At about 1230 s/p scheduled procedure the patient goes unresponsive. Facility nurses then recorded a bgl of 45 and administered 2 amps of D50 via IV. bgl rechecked at 1345 and is recorded at 234, pt remains unresponsive. Facility calls pts son to authorize bls transport to a hospital 15 minutes away.
Pts vitals are as follows
P:110 with a fib/flutter on the facilities monitor. Palpated pulse correlates and is strong at the radial site
R:12 full and effective w/clear lungs W/spO2 @98% on room air.
BP: 126/58
Eyes PERRL @ 3
Skins are pink cool and dry.
Contact with your base hospital (the aforementioned hospital 15 minutes away) to activate a stroke code ends up with them requesting you transport l&s but go directly to an ED room. No stroke code is activated.
My thinking with calling a stroke code was a clot could moved into the brain during the declotting of the fistula. The ED staff seemed unworried and pretty much brushed us off.
Offload was about ten minutes shy of three hours from the onset of symptoms.
Your thoughts?
Sent from my DROID X2 using Tapatalk
You arrive on scene at 1432 to find an 81 yo M sitting upright in a wheelchair, unresponsive but breathing. Story from the nurses and correlating paperwork states he came in at approximately 1200 for a declotting of his fistula. You are unable to obtain a history on the patient other than he's normally a&oX1 but always alert.
At about 1230 s/p scheduled procedure the patient goes unresponsive. Facility nurses then recorded a bgl of 45 and administered 2 amps of D50 via IV. bgl rechecked at 1345 and is recorded at 234, pt remains unresponsive. Facility calls pts son to authorize bls transport to a hospital 15 minutes away.
Pts vitals are as follows
P:110 with a fib/flutter on the facilities monitor. Palpated pulse correlates and is strong at the radial site
R:12 full and effective w/clear lungs W/spO2 @98% on room air.
BP: 126/58
Eyes PERRL @ 3
Skins are pink cool and dry.
Contact with your base hospital (the aforementioned hospital 15 minutes away) to activate a stroke code ends up with them requesting you transport l&s but go directly to an ED room. No stroke code is activated.
My thinking with calling a stroke code was a clot could moved into the brain during the declotting of the fistula. The ED staff seemed unworried and pretty much brushed us off.
Offload was about ten minutes shy of three hours from the onset of symptoms.
Your thoughts?
Sent from my DROID X2 using Tapatalk