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Posted

Hello,

You are an ALS crew in a city of 300,000. There is a large teaching hospital and two smaller community hospitals. You are dispatched for a 58 year-old male with a complaint of a boils and SOB.

Once on scene your are greeted by the patient`s wife. She is quite anxious but holding things together. Her husband did not want an ambulance called be she vetoed him. She says he has a horrible rash on his face, arms and inside his mouth. It started three days ago and has been getting worse. Much worse. He also has had trouble breathing and has cough up some bright red blood for the past four hours.

She usher you into an upstairs bedroom. The patient is sitting in bed with three large pillows behind his back. He looks tired and quite toxic. He has no shirt on and his face, upper chest, and lips and tongue are covered red lesions of which quite a few have the skin sloughing off. His face looks puffy as well.

His wife said that he had pneumonia and a sore throat a two week ago and was Zythromax and also started some medication for gout. Other than she has been very healthy.

Cheers....

Posted

steven johnson syndrome

Posted

steven johnson syndrome

Wow...Google really is your friend.

Care to expound instead of just queering this interesting thread?

Dwayne

Posted

Wow...Google really is your friend.

Care to expound instead of just queering this interesting thread?

Dwayne

What are you implying dude?

Posted

Wow...Google really is your friend.

Care to expound instead of just queering this interesting thread?

Dwayne

Manute Bol recently died. It was all over the news that he had SJS. I knew what this case was right away also because I read up on it when Manute passed.

Posted (edited)

Manute Bol recently died. It was all over the news that he had SJS. I knew what this case was right away also because I read up on it when Manute passed.

Dunno who Manute Bol is bro, but yeah, i recognised it when i read the OP too

Edited by BushyFromOz
Posted (edited)

Hello,

Nice.

Yes, he has SJS. Good show. I have heard about it. But, I have never seen it until last week when a fellow came in to the ED with it. I figured it would be a good case study.

I have never heard about Manute Bol. But, I Googled it and it seems he was a NBA player that died of SJS. I don't follow the NBA at all. LOL! I thought I was clever....guess not! =)

So, now what? =)

Cheers...

Edited by DartmouthDave
Posted

Hello,

Nice.

Yes, he has SJS. Good show. I have heard about it. But, I have never seen it until last week when a fellow came in to the ED with it. I figured it would be a good case study.

I have never heard about Manute Bol. But, I Googled it and it seems he was a NBA player that died of SJS. I don't follow the NBA at all. LOL! I thought I was clever....guess not! =)

So, now what? =)

Cheers...

Call the funeral home?

Seriosly though:

ABC's

Condition of house

What does the patient look like other than posted

Any foreign substances in the room such as cleaning supplies or strange smells?

This disease also has a 1970's ring to it. Remember the reports of kids and young women with Toxic Shock Syndrome?

This is a very very bad disease. Without intensive care unit help as well as Infectious disease consults and treatment he's gonna die.

I took care of a 18 year old with Toxic Shock about 5 years ago. She died. She was one of the sickest people I've ever taken care of.

This guy needs a University level hospital with all the bells and whistles.

I do not wish this disease on anyone.

RIP Manute (sic)

Posted (edited)

Wow...Google really is your friend.

Care to expound instead of just queering this interesting thread?

Dwayne

Dwayne, not everybody here googles things. I believe this illness has been in the news quite a bit over the past week or so. Even I heard it mentioned and I rarely read the news paper nor do I rarely watch the news.

Some of us here know things when they are presented and for some things we don't need google, for other things, we do need google.

Edited by Ruffems
Posted (edited)

One of my first calls as a medic was SJS... horrible condition with a terrible prognosis. Fortunately it is relatively rare. Some of the identifying factors that I noted was a history of asthma (or some type of auto-immune issue) and treatment with one of 5 or 6 different antibiotics that trigger the syndrome. I think with the increased use of antibiotics, we will unfortunately see more of this.

Prehospital treatment is primarily supportive with pain control. The skin condition is similiar to burns. Unfortunately, it can hit internal organs too.

Thats about what I know about it.

edited to delete the second posting.. my click finger is too impatient

Dwayne, not everybody here googles things. I believe this illness has been in the news quite a bit over the past week or so. Even I heard it mentioned and I rarely read the news paper nor do I rarely watch the news.

Some of us here know things when they are presented and for some things we don't need google, for other things, we do need google.

Would you two take your p***ing contest to PM please ?

Edited by CrapMagnet
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