chrissym6

The "white stuff" and pain meds tell me he was given propofol for the scope which if memory serves can, albeit rarely, cause tachycarida and tachypena. Looking at his med list I'm also starting to worry about possible drug intereactions especially if he was med compliant prior to the procedure, he hasn't taken them for at least two days at this point and I don't know how long they stay in the system but I know that ACE inhibitors can react with diuretics and thyroid hormone can react with iron supplements etc. The fact that he is dehydrated and hypoglycemic are just going to make any interactions that much worse. I would like to give him something for the hypoglycemia (oral glucose as a basic and D50W if I were a paramedic) to try and see what's being casued by that and what is being caused by something else. The zap he felt on the way home has me concerned as well, is his pacemaker malfunctioning or is there so much going on that the best it can do is bring his heart rate down to 120-140? What does his 12 lead look like?

Please bear with me when I repeat what others may have already mentioned but this is how I work though scenarios and will hopefully make it easier to see where I went wrong if I end up on the wrong track or missing something important. Based on the tachycardia and low diastolic pressure I too am leaning towards a bleed, whether it was caused by the colonoscopy or missed becasue it was occuring somewhere outside of the colon is not my main concern at the moment. I would like to know if there has been any improvement to his respiratory rate since he's been on the 15L or do I have to get ready to bag him? I'm not worried about his cough right now but I'm not ready to write of the paleness as dehydration just yet (although he is undoubtably dehydrated). I'm also curious as to why he hasn't been eating, drinking, or taking his meds since the colonoscopy-- I've had a few of those myself and normally the first thing I do when I wake up is get something to eat and have a nice drink of water or ginger ale. Was he not hungry/thirsty, at which point there is probably more than a bleed going on (inflammation in the small bowel comes to mind or he could have picked up a virus somewhere) or did he simply get confused and not realize he was allowed to go back to eating, drinking, and taking his meds following the procedure? As a basic I wouldn't be able to do much more than give him oxygen and transport but if I were a medic I'd like to get a line in him and given his cardiac history would put him on a monitor as well just as much to avoid any surprises as to keep an eye on whats going on in there. I'm not familar enough with ALS protocols to say definitivly that I would give him anything more than saline because not only do I not know exactly which medications I would have at my disposal I have no idea how they work or what the possible side effects are and am not comfortable giving someone something if I don't know exactly what it should (and shouldn't) do.

I'm not an EMT yet (my state practical is next Saturday) but I'd like to take a crack at this one if that's ok. Do we know what medications he is on and what, if anything he had been given for the colonoscopy?