brock8024 Posted November 4, 2007 Author Posted November 4, 2007 Mom states that he has had NVD for the last few days and stayed home alone today. Does not think he has eaten anything.
brock8024 Posted November 4, 2007 Author Posted November 4, 2007 As you go to load him up he starts to have a seizure. His mom is now yelling at you to help her son and stop playing around.
hammerpcp Posted November 5, 2007 Posted November 5, 2007 Continue fluid bolus, 5mg valium IV, cont to assist vents with BVM and prepare to intubate. Find out more about 'strange' behaviour. Was he confused/irritable/irrational? What OTC meds has he been taking? Did he have pain in his abdomen at any point? Has there been any blood in his stools? Is he still vomiting even with the decreased food/fluid intake? What about urination? Any neuro deficits in extremities? Nucal rigidity?
brock8024 Posted November 5, 2007 Author Posted November 5, 2007 Continue fluid bolus, 5mg valium IV, cont to assist vents with BVM and prepare to intubate. Find out more about 'strange' behaviour. Was he confused/irritable/irrational? What OTC meds has he been taking? Did he have pain in his abdomen at any point? Has there been any blood in his stools? Is he still vomiting even with the decreased food/fluid intake? What about urination? Any neuro deficits in extremities? Nucal rigidity? He was just acting irritable. His mom states that he was taking tylenol/motrin for his fever. They do not think he took anything else.He told his mom that he tummy was hurting more than normal the night before. His last vomiting was last pm. Decreased urine and no nucal rigidity. What size ETT are you going to use.
hammerpcp Posted November 5, 2007 Posted November 5, 2007 Alrighty then. So we are thinking either infection/sepsis/SIRS, or a toxidrome of some sort. Are there any medications in the house? It isn't your run of the mill anticholinergic or cholinergic OD in any case. Tube size for a 12 y/o 60lb child. Probably a 6.0. 60lbs is a pretty small guy.
brock8024 Posted November 5, 2007 Author Posted November 5, 2007 Alrighty then. So we are thinking either infection/sepsis/SIRS, or a toxidrome of some sort. Are there any medications in the house? It isn't your run of the mill anticholinergic or cholinergic OD in any case. Tube size for a 12 y/o 60lb child. Probably a 6.0. 60lbs is a pretty small guy. Tube passes easy, everything is good. Parents just have normal OTC meds in their bathroom.
hammerpcp Posted November 5, 2007 Posted November 5, 2007 Well......I am pretty much done at this point. I will transport and continue to monitor VS etc. Unless any changes enroute? Now for the bloodwork!
brock8024 Posted November 5, 2007 Author Posted November 5, 2007 well as far as transport you pt has one other seizure enroute. What labs do you want.
irme Posted November 5, 2007 Posted November 5, 2007 I'm not all done, I want to go back to some more basics here, Why did he seizure, that is the question - > Was it hypoxic? We have not yet grasped his Sats, does he look cyanosed? Did the temp cause it? What is causing this lack of perfusion -> low BP or is it some kind of anemia, chuck him on Capnography, BSL, skin tenting? Hx of seizures? Obviously you cant answer all these, so in an easyier format, Sats BSL Capnography Clothes off, cool the pt Raise those legs for some cerebral perfusion Lets try get to the bottom of what the cause of the problem (seizure) is!
brock8024 Posted November 5, 2007 Author Posted November 5, 2007 I'm not all done, I want to go back to some more basics here, Why did he seizure, that is the question - > Was it hypoxic? We have not yet grasped his Sats, does he look cyanosed? Did the temp cause it? What is causing this lack of perfusion -> low BP or is it some kind of anemia, chuck him on Capnography, BSL, skin tenting? Hx of seizures? Obviously you cant answer all these, so in an easyier format, Sats BSL Capnography Clothes off, cool the pt Raise those legs for some cerebral perfusion Lets try get to the bottom of what the cause of the problem (seizure) is! 88% before intubating 98% after 38mmhg FSBS as before What do you think caused the seizure???? What labs do you want
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