chbare Posted October 4, 2008 Posted October 4, 2008 You are called to a local soccer field for a 14 year old male who collapsed. Take it away. Take care, chbare.
mobey Posted October 4, 2008 Posted October 4, 2008 How do I view this neighborhood (ghetto?) What is the temperature and what time of day is it? Approach the patient: Airway? Breathing? Circulation? Skin condition and temp? Pupils? Medic alert bracelet, or shoe tag? Any swelling of the face? Does he respond to verbal, or pain? If so what is his responce? Start gathering info from bystanders while my partner obtains BGL, From bystanders: Past medical history? What was he doing prior to collapse? Anyone know if he has ever done this before? Any seizure activity? Drug or alcohol use?
firedoc5 Posted October 4, 2008 Posted October 4, 2008 How do I view this neighborhood (ghetto?) What is the temperature and what time of day is it? Approach the patient: Airway? Breathing? Circulation? Skin condition and temp? Pupils? Medic alert bracelet, or shoe tag? Any swelling of the face? Does he respond to verbal, or pain? If so what is his responce? Start gathering info from bystanders while my partner obtains BGL, From bystanders: Past medical history? What was he doing prior to collapse? Anyone know if he has ever done this before? Any seizure activity? Drug or alcohol use? Whew All that and, was he handling the ball or on another part of the field? Just prior to collapse, did he seem sluggish? Was he known to be a "charlie hustle" kind of player? Any difference in his play that day? Was there a gunshot heard? (Just kidding) Vitals, what is his LOC? If still unconscious, O2 12L per NRM and check O2 sat. (before & after). IV NS TKO. Any cyanosis? If he had been hot and sweaty, notice how quickly he stops sweating.
Richard B the EMT Posted October 4, 2008 Posted October 4, 2008 Was there a gunshot heard? (Just kidding) Actually, and regrettably, don't discount the possibility. In my service district, the gang-bangers seem to miss their targets, and hit an innocent person down the street, or across the park, more times than not.
chbare Posted October 5, 2008 Author Posted October 5, 2008 He is unresponsive and two adults are performing CPR. No history, healthy kid per the parents." Just collapsed after running into a fellow team mate." Take care, chbare.
mobey Posted October 5, 2008 Posted October 5, 2008 He is unresponsive and two adults are performing CPR. No history, healthy kid per the parents." Just collapsed after running into a fellow team mate." Take care, chbare. Running into... how hard? what area of the kids body, head, chest, etc... consider spinal precautions based on answers Hook up the AED or leads if manual what do we see? OPA, BVM (for now) compliance? IV establishment. Rapid head to toe for obvious trauma (gunshot) Oh, is there a parent around for a medical history?
Eydawn Posted October 5, 2008 Posted October 5, 2008 I'll bet he's a tall skinny white boy and that wreck into a fellow player caused a nice pneumo. What was the time elapsed between the collision and the collapse? That, or he got hit *just right* to throw his cardiac rhythm off- I've seen that happen before. It's scary as hell, but usually can be fixed. Look to see if he's got any sign of a blow to his chest. Or it could be the random brain aneurism type deal... that actually happened in the high school class before mine. Kid died during class change- just collapsed in the hall. If this kid's BP was up slightly, a weakened vessel could have easily given way. If I were a paramedic, I'd intubate him, get a cardiac monitor on him and see what we can find out, and definitely put him on the backboard. Wendy CO EMT-B
chbare Posted October 5, 2008 Author Posted October 5, 2008 History per prior post. Noting different or unusual in game play, behavior, or attitude. No known history of substance abuse and or use. He collapsed immediately following the collision. You place two nasal airways and an oral airway and begin bag valve mask ventilations. Good chest compliance, rise and fall, and symmetry is noted with ventilations. No carotid pulse is noted. CPR is continued while your partner places the fast patches. You note the following via quick look through the patches: Approximate down time is three minutes. Take care, chbare.
Eydawn Posted October 5, 2008 Posted October 5, 2008 Not having had my EKG class yet... is that a coarse V-fib rhythm? That's shockable, no? Wendy CO EMT-B
mobey Posted October 5, 2008 Posted October 5, 2008 History per prior post. Noting different or unusual in game play, behavior, or attitude. No known history of substance abuse and or use. He collapsed immediately following the collision. You place two nasal airways and an oral airway and begin bag valve mask ventilations. Good chest compliance, rise and fall, and symmetry is noted with ventilations. No carotid pulse is noted. CPR is continued while your partner places the fast patches. You note the following via quick look through the patches: Approximate down time is three minutes. Take care, chbare. Sounds good to me, three min down with CPR, V-Fib, lets light him up and see what happends. Initial thoughts Congenital defect (may need a internal defib) Acc pathway Myo/endocarditis (since we have no history.... ok it's a far stretch... in fact I change my mind) Blunt force trauma causing a rythm disturbance (Damn, can't remember the medical term) Cardiomyopathy Large PE
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