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Posted
Is he complient with his meds? Did he take them all today? Any pain?

Currently not on meds DM is controlled with diet. He can't tell you if he is having pain.

pupils? skin?

Pupils are round a little sluggish

Skin is warm cynosis is noted at the hands and feet

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Posted (edited)
anterior wall fascicular block small Q in lead 1 and possible prolonged qrs ??

left axis deviation -40 to - 80

Can you just explain how you found that, and its clinical significance. I can't see any of what you are saying.

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Did we get lung sounds?

Edited by scott33
Posted (edited)

I'm still thinking it's hemorrhagic stroke. Can I assume it's been five minutes and get a repeat on vitals, including bp, hr, rr, pupils, and skin?

edit- also assuming we're already in the truck and gone, btw

Edited by Jeepluv77
Posted
Can you just explain how you found that, and its clinical significance. I can't see any of what you are saying.

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Did we get lung sounds?

BBS are clear but you do have an occassional Wheeze

Posted
JVD? pedal edema? acites? Heart sounds if you do them? Right sided-EKG?

Slight JVD +2 pitting edema. no right sided ekg no heart sounds done.

Posted
anterior wall fascicular block small Q in lead 1 and possible prolonged qrs ??

left axis deviation (-40 to -90)

I have the axis as normal??? Dont tell me I have been doing it wrong all these years!

Cant see the Q wave either, but if it is there its certainley not big enough to be pathological!

Have dispersed clots travelled to his brain and heart?? Im going with AMI (inferior) - lets go with a V4R, )

Posted
I have the axis as normal??? Dont tell me I have been doing it wrong all these years!

Cant see the Q wave either, but if it is there its certainley not big enough to be pathological!

Have dispersed clots travelled to his brain and heart?? Im going with AMI (inferior) - lets go with a V4R, )

you are on the right track there itxme.

Posted

I'm thinking this guy needs a head CT ASAP. I'm calling it neurological until proven otherwise and treating it as such. His PMH of a DVT makes me suspicious of a cerebral vascular event of some type- aneurysm, bleed, AVM, clot, etc. Could be cardiac based which led to head problems- he's on Coumadin, so maybe threw a clot...

Curious to see the outcome, here.


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