DwayneEMTP Posted October 2, 2011 Posted October 2, 2011 I'd not thought of the pseudo seizures until Mobey mentioned it. I've treated them, and the first time I medicated, and medicated, and medicated, each time only breaking the seizure for a minute or two...Got into the ER and the Doc yelled, "HEY! STOP THAT NOW!" and they did...grin. I told him, "hell, I'd never thought of trying to shout a seizure away before." He sent me to do some research on pseudo seizures and it was truly amazing to learn about. Benzos aren't breaking the seizure...did you try putting ice in their pants? Time to load and head in. How long is the transport? I can't think of anything else I'd like to ask the mother. But I do want to yell at him to make sure that it's not a pseudo seizure. Any reaction when you placed the IV? Dwayne
MedicNorth Posted October 2, 2011 Posted October 2, 2011 Mom sais he has been sick lately - what KIND of sick? - Duration, Symptoms, Medications, possible diagnosis.... Epilepsy is only one cause for seizures.
FireEMT2009 Posted October 2, 2011 Posted October 2, 2011 Well since he isnt seeming to be a psuedoseizure as of this point, I am now looking for possible factors that are treatable in the field. What ist he patient's temperature? If you have an I Stat what does his blood chemistry come back as, pH, electrolytes, etc. skin turgor, JVD, any other abnormal sign. Lets also get a 12 lead and get him exposed and see what we find. After that we will contenplate whether to load and go or stay and play for a little bit longer. I know we have 2 level I trauma centers within 20 minutes but what other resources do we have? Does he have a neurologist? If so can we get him on the line and get some better history of his epilepsy and contact our med control. Also while we are doing that go ahead and administer another 5mg of diazepam, seems like we are getting a little response in the severity and violence in the seizures with the administration. What do lung and heart sounds sound like? Trying to get all bases cleared here. And what did the doctors give him this morning to stop his seizure? How much?
Just Plain Ruff Posted October 3, 2011 Posted October 3, 2011 Does he have a fever? could be meningitis or encephalitis During his first seizure any chance he cracked his noggin when he fell? could be a nasty head injury.
DwayneEMTP Posted October 4, 2011 Posted October 4, 2011 FE2, how did you come to the conclusion that this is not a pseudoseizure? Dwayne
ERDoc Posted October 4, 2011 Posted October 4, 2011 (edited) Have we done all of the standard "faking-it" tests? If so, we need to maximize this guys benzos. I would like to know his electrolytes. What electrolyte abnormalities can lead to seizures? Any recreational drug use or evidence of it? If all else fails, paralyze, sedate, pentobarb coma. Edit: To add another thought. Edited October 4, 2011 by ERDoc
Just Plain Ruff Posted October 4, 2011 Posted October 4, 2011 Have we done all of the standard "faking-it" tests? If so, we need to maximize this guys benzos. I would like to know his electrolytes. What electrolyte abnormalities can lead to seizures? Any recreational drug use or evidence of it? If all else fails, paralyze, sedate, pentobarb coma. Edit: To add another thought. Or you could just give 2 nitro's and put a c-collar on him! 1
ERDoc Posted October 4, 2011 Posted October 4, 2011 Or you could just give 2 nitro's and put a c-collar on him! Crap. I forgot about that study.
Just Plain Ruff Posted October 4, 2011 Posted October 4, 2011 Crap. I forgot about that study. it's the I dispatch myself to the car wreck with the major chest trauma and give 2 nitros(cause i can) and put a c-collar on him study. It was reported in all the major medical journals and even on TV.
ERDoc Posted October 4, 2011 Posted October 4, 2011 it's the I dispatch myself to the car wreck with the major chest trauma and give 2 nitros(cause i can) and put a c-collar on him study. It was reported in all the major medical journals and even on TV. Wasn't it first reported on Rescue Me? Or was it Turd Watch?
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