Kiwiology Posted March 8, 2009 Posted March 8, 2009 You are dispatched to the home of a 60 yom who is looking after his 9yo grandson for the day. The grandson can't get grandpa up out of the recliner to play monopoly (my favorite game when I babysit my sister ) Grandpa is seated in his recliner in the lounge and complains of being "real tired"; he says that he does not want to cause any trouble and just needs to lay down for a bit BP 97/72 RR 22 shallow with equal rise and rales upon auscultation Pulse 110 and irregular GCS 12 SpO2 of 92% on RA (S) He is pale, cool, diaphoretic, confused and has that nasty grey sheen of death (A) None (M) Coumadin, nitro and a beta blocker (P) Had an MI about three years ago (L) Ate some eggs and toast for breakfast about three hours ago (E) Sat down to read the paper before playing with his grandson Now, the grandson really wants bust out the monoploy set and have you pack up and leave so .... whatcha gon' do?
FL_Medic Posted March 8, 2009 Posted March 8, 2009 Take a temperature & BG, apply supplemental O2, and treat his cardiogenic shock.
Kiwiology Posted March 8, 2009 Author Posted March 8, 2009 This is what your ECG shows You put gramps on some O2 and find temp 36.5°C and BGL of 4mmol/L (or whatever normal is how you measure) Having done that, the old boy promptly falls out the chair and collapses to the ground unconscious.
spenac Posted March 8, 2009 Posted March 8, 2009 My partner gave me the wrong pulse or he's deterioted quickly. I want bi lateral IV's Just saw that he now collapsed. Does he still have pulse? If not start CPR. Check rythym, is it shockable?
Katiebug Posted March 8, 2009 Posted March 8, 2009 2mg of versed IV & PACE!!!!!!!!! Agreed. Looks like a third degree AV block to me. Could try dopamine and epi, but I'd prolly pace em.
Richard B the EMT Posted March 8, 2009 Posted March 8, 2009 Not necessarily a medical thing, but either try to contact the child's parents, or get the LEOs there to put the child in some kind of temporary protective custody. Not the first priority, anyway. Grampa is.
FL_Medic Posted March 8, 2009 Posted March 8, 2009 Not necessarily a medical thing, but either try to contact the child's parents, or get the LEOs there to put the child in some kind of temporary protective custody. Not the first priority, anyway. Grampa is. Well you're thinking though. That situation would be a sucky one. Gotta wait for the pigs before we can leave I guess, or strap the kid in.
Kiwiology Posted March 8, 2009 Author Posted March 8, 2009 No pulse but an orginized rhythm on the monitor. You got two IVs
Recommended Posts