Arizonaffcep Posted December 3, 2008 Posted December 3, 2008 Ok...here's a scenario that was presented to me today during a CE: You are dispatched to a 55 yom, C/C of CP. Location is at a local Flying J Restaurant. Questions?
Eydawn Posted December 3, 2008 Posted December 3, 2008 What's he look like, what was he eating, is he a truck driver... medical history please? Meds? BP, P R? Lung sounds? Recent illness/surgery? Wendy CO EMT-B
Arizonaffcep Posted December 3, 2008 Author Posted December 3, 2008 Appearance: Pale, cool, diaphoretic. Last meal: Country Fried Steak, mashed potatoes, lots of gravy, coffee. Pertinent HX: Previous MI, 2 yrs ago, HTN, high cholesterol, NIDDM Meds: Glyburide, Crestor, ASA, Atenolol BP: 160/100 Pulse: 98, regular Resp: 18 LS: Clear = bilat Recent Illness/Surgery: None Occupation: Truck Driver
island emt Posted December 3, 2008 Posted December 3, 2008 I don't get whats so special about this call Fat truck driver with HTN niddm & past MI hx that just choked down a truck stop 6000 calorie chicken fried steak bomb dinner with a quart of blood thicking sludge poured over it. Time to start ordering a casket fat man. :roll:
pacman Posted December 3, 2008 Posted December 3, 2008 Truck driver makes me think that he has been sitting for a long time. Is he on anticoagulants? Is he compliant with his medication? Is the chest pain worse when he breaths? How are the lung sounds? Does he have leg pain? Hows that EKG looking....surely some signs of old infarcts from that MI, but anything active? What makes the pain worse? Movement, breathing, palpation, exertion? Is that pain sharp, constant, or dull? Where and how severe is the chest pain? Sorry for the random, unorganized questions, but I feel like I need to know so much more about this case.
Arizonaffcep Posted December 3, 2008 Author Posted December 3, 2008 Truck driver makes me think that he has been sitting for a long time. Is he on anticoagulants? Is he compliant with his medication? Is the chest pain worse when he breaths? How are the lung sounds? Does he have leg pain? Hows that EKG looking....surely some signs of old infarcts from that MI, but anything active? Meds are as listed previously. Pt states he sometimes forgets his Atenolol. No change in pain with respiration. LS as stated previously. No leg pain. EKG shows sinus neg. ectopy (AKA NSR). What makes the pain worse? Movement, breathing, palpation, exertion? Is that pain sharp, constant, or dull? Where and how severe is the chest pain? Nothing changes the pain. Pt states "pain is intense!" Pain is center in chest. Sorry for the random, unorganized questions, but I feel like I need to know so much more about this case. No prob. Just ask.
pacman Posted December 3, 2008 Posted December 3, 2008 Any abdominal pain and/or tenderness? I hate to simplify this, but maybe it a bad case of GERD. He might just needs a GI cocktail with some good old Pepcid, Donnatal, Maalox, Viscous Lidocaine......... that meal he was eating could have triggered it. Yeah, half the info I asked for before was already answered by you; I should pay more attention.
Arizonaffcep Posted December 3, 2008 Author Posted December 3, 2008 Any abdominal pain and/or tenderness? I hate to simplify this, but maybe it a bad case of GERD. He might just needs a GI cocktail with some good old Pepcid, Donnatal, Maalox, Viscous Lidocaine......... that meal he was eating could have triggered it. No abd pain...for R/O purposes, you have given a GI cocktail. No change in pain. Yeah, half the info I asked for before was already answered by you; I should pay more attention. No prob! Everyone's human. :wink:
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