At ILS my shift, we were called to a rural area. A man of 70 years, unconsciousness and have periods of seizures. When we arrive, he was in recovery position, and his daughter was with him, very agitated.
Physical assessment and vital signs:
- pupils are dilated and have a small response to light
- GCS: 11
- RR: 15
- HR: 68
- BP: 140/95
- Temp: 36 ºC / 96,8 ºF
- SpO2: 95 on room air
- 3 and 12 lead ECG shows normal sinus rythm
He have no signs of CVA or TIA
My nurse-partner inserted an naso tube, O2, and IV line, while I got his medical history.
He has hypertension and takes everyday captopril and indapamide.
In the last months, he has felt severe headaches, but his family physician depreciated his symptoms, prescribing Codeine + acetaminophen. He ate 2 hours ago.
When we load him to the ambulance, suddenly he has another tonic-clonic seizure, and the nurse gave 5 mg of diazepam, slow IV push. We transport him to nearest central ER, with neuro service.
In the E.R., he did some diagnostic tests:
- Blood tests
- MRI
- CT scan
My nurse-partner could have access to CT scan, which is attached.
What are your guesses?
Play, and have fun !
Physical assessment and vital signs:
- pupils are dilated and have a small response to light
- GCS: 11
- RR: 15
- HR: 68
- BP: 140/95
- Temp: 36 ºC / 96,8 ºF
- SpO2: 95 on room air
- 3 and 12 lead ECG shows normal sinus rythm
He have no signs of CVA or TIA
My nurse-partner inserted an naso tube, O2, and IV line, while I got his medical history.
He has hypertension and takes everyday captopril and indapamide.
In the last months, he has felt severe headaches, but his family physician depreciated his symptoms, prescribing Codeine + acetaminophen. He ate 2 hours ago.
When we load him to the ambulance, suddenly he has another tonic-clonic seizure, and the nurse gave 5 mg of diazepam, slow IV push. We transport him to nearest central ER, with neuro service.
In the E.R., he did some diagnostic tests:
- Blood tests
- MRI
- CT scan
My nurse-partner could have access to CT scan, which is attached.
What are your guesses?
Play, and have fun !