Altered LOC

[island emt]

Thats why I said consider it. Might still give a little d-50 to bring her up 120 +/-. Urban outdoorsmen are not known for good diet and nutrition. BG of 90 could be low for her norm.

What are her neuro responses to sharp/soft at extremities? normal reflexes? retractions? decorticate posturing?

GCS is around 5=6 as I see it at this point.

edit for spelling

Edited July 13, 2013 by island emt

[scubanurse]

Thats why I said consider it. Might still give a little d-50 to bring her up 120 +/-. Urban outdoorsmen are not known for good diet and nutrition. BG of 90 could be low for her norm. I could see hanging some or something along those lines...

What are her neuro responses to sharp/soft at extremities? normal reflexes? retractions? decorticate posturing? Minimal reactions, 1+ reflexes x 4, no posturing

GCS is around 5=6 as I see it at this point.

edit for spelling

That's all I'm going to do for tonight...hopefully more people come along tomorrow and we can brainstorm the differential for this gal

[island emt]

I'm good with that. I have some pretty good ideas and was hoping for more form Mari & others

[scubanurse]

You can always PM me if you just can't wait

[MariB]

Hmmmm, how does her face look? Any signs of stroke?

Beginning to lead to neuro

Where are my medics!

I'd be worried about like a brain infection, tumor etc

[BushyFromOz]

I would withold the narcan, its hard to tell across a couple of pages of text but i dont get the respiratory depressed of a narcotic OD from this, in any case, if im wrong and the IC guys decide to RSI her they would be able to maintain sedation post tube

I will howevere reposition her head with a folded towel beneath her occiput and get her in a sniffing position and stop her snoring

Alcholism and empty whisky bottles but no smell of alcohol, depressed CNS, im thinking maybe methanol / ethanol / glycol ingestion or something similar?

Whats her resp rate, rhythm, effort/accessory muscle use, auscultation?

Edited July 13, 2013 by BushyFromOz

[1EMT-P]

Does your patient have a medic alert? Do you have any PMHX? Does she have an meds with her? What's her Pulse Ox on room air? I agree with the c-collar, long spine board, IV of NS & Oxygen. I would also like to know about her lung sounds. I would also like to know what her labs were like, including ABG if she had one.

[scubanurse]

Hmmmm, how does her face look? Any signs of stroke? No s/s stroke

Beginning to lead to neuro You would be correct but neuro is vague...which disease process?

Where are my medics!

I'd be worried about like a brain infection, tumor etc

I would withold the narcan, its hard to tell across a couple of pages of text but i dont get the respiratory depressed of a narcotic OD from this, in any case, if im wrong and the IC guys decide to RSI her they would be able to maintain sedation post tube

I'm good with that.

I will howevere reposition her head with a folded towel beneath her occiput and get her in a sniffing position and stop her snoring

Sounds perfect.

Alcholism and empty whisky bottles but no smell of alcohol, depressed CNS, im thinking maybe methanol / ethanol / glycol ingestion or something similar?

Possible... no evidence of that though.

Whats her resp rate, rhythm, effort/accessory muscle use, auscultation?

RR 12, even, little effort, lungs clear

Does your patient have a medic alert? no

Do you have any PMHX? none in the system

Does she have an meds with her? an empty 30mL cup of something red and sticky but no name on it

What's her Pulse Ox on room air? 92% (this is Colorado and that's generally acceptable)

I agree with the c-collar, long spine board, IV of NS & Oxygen.

I would also like to know about her lung sounds. Clear

I would also like to know what her labs were like, including ABG if she had one. pH 7.48 HCO3 17 PaCO2 25 K: 3.2 Na 132 CL 89 Hgb 9 Hct 32

Any lab in particular you are looking for?

[BushyFromOz]

Alcholism and empty whisky bottles but no smell of alcohol, depressed CNS, im thinking maybe methanol / ethanol / glycol ingestion or something similar?

Possible... no evidence of that though.

Yeah, would have been too easy

[Chief1C]

Blame the weather and turf her off to the nearest sprinkler.