rhan101277
Forum Deputy Chief
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Scenario:
You get a call that initially comes out as heart problems. A 27 y/o male with previous heart hx and a A.I.C.D. In route the call updates to a domestic violence and the scene is not safe. You stage two blocks down. About 15 seconds pass and someone stops and is hysterical, saying she is his sister and he is dying on the ground.
We ask what happened and she states he was found on the floor of the basement breathing rapidly and unable to talk. Is anyone arguing? I say. Nope she says, no weapons no nothing. Due to the nature of the call I make a split second decision to go to the scene without law enforcement. Before getting out of the truck I look over the scene, no weapons, knife's etc. No yelling. We approach and I am looking for weapons, I know this is dangerous but with the urgency in her voice, I wondered well what if he is dying.
Patient is on the floor breathing about 50 times/minute, HR 85 sinus rhythm. Only medical hx is seizures and panic attacks, neither have occurred recently. No meds, no allergies. The patient is pounding on his chest, he does have some wheezing but I can't tell if it patient created or new onset asthma. We get him to truck and 15L NRB and he sucks all air out of the bag. His pulse ox is 98%, pupils dilated, denies drug use. He is flailing around but it is not seizure activity, he can make purposeful movements and is breathing, he has not urinated on himself. He gets tired of breathing in route and RR slows, I try to put in a OPA and he is alert enough to try to spit it out. I start assist bagging and he is still at 98%.
IV 18ga left upper arm saline lock. I start to think excited delirium because he is hot to touch, but temp reads 98. I think panic attack, but all I have seen have tachy rates above 110.
I was not sure what was going on so I provided support. We got to ER and he got .5mg ativan to calm down and then they infused mag sulfate. The docs weren't really sure what was going on either.
Thoughts?
You get a call that initially comes out as heart problems. A 27 y/o male with previous heart hx and a A.I.C.D. In route the call updates to a domestic violence and the scene is not safe. You stage two blocks down. About 15 seconds pass and someone stops and is hysterical, saying she is his sister and he is dying on the ground.
We ask what happened and she states he was found on the floor of the basement breathing rapidly and unable to talk. Is anyone arguing? I say. Nope she says, no weapons no nothing. Due to the nature of the call I make a split second decision to go to the scene without law enforcement. Before getting out of the truck I look over the scene, no weapons, knife's etc. No yelling. We approach and I am looking for weapons, I know this is dangerous but with the urgency in her voice, I wondered well what if he is dying.
Patient is on the floor breathing about 50 times/minute, HR 85 sinus rhythm. Only medical hx is seizures and panic attacks, neither have occurred recently. No meds, no allergies. The patient is pounding on his chest, he does have some wheezing but I can't tell if it patient created or new onset asthma. We get him to truck and 15L NRB and he sucks all air out of the bag. His pulse ox is 98%, pupils dilated, denies drug use. He is flailing around but it is not seizure activity, he can make purposeful movements and is breathing, he has not urinated on himself. He gets tired of breathing in route and RR slows, I try to put in a OPA and he is alert enough to try to spit it out. I start assist bagging and he is still at 98%.
IV 18ga left upper arm saline lock. I start to think excited delirium because he is hot to touch, but temp reads 98. I think panic attack, but all I have seen have tachy rates above 110.
I was not sure what was going on so I provided support. We got to ER and he got .5mg ativan to calm down and then they infused mag sulfate. The docs weren't really sure what was going on either.
Thoughts?
I agree with coaching the pt as Aidey said.