MariB Posted September 24, 2013 Posted September 24, 2013 Well let's open that airway and put in an opa. I want all vitals, including my bgl. Breath sounds?
uglyEMT Posted September 24, 2013 Posted September 24, 2013 (edited) I'll drop an NPA. The snoring resperations sounds like he may still have a gag reflex and I don't want to deal with asperation at this point. Want to start getting my vitals going. Collapsed, twitched around Im thinking seizure and is presenting post dictal. Lung problem? Are we talking chronic lung problem (emphiasema, lung cancer) or acute (pneumonia, infection). What meds are around? This could help us if the bystanders can't. Whats his temp? Could we be looking at a high grade fever induced seizure? If so start breaking those cold packs out. Edited September 24, 2013 by uglyEMT
chbare Posted September 25, 2013 Author Posted September 25, 2013 Vital Signs: P-118, B/P- 150/102, SPO2-97% on a partial rebreather mask, T-38.2 Celsius, RR- 22 snoring resolves with that placement of a nasal airway and airway positioning (Patient does not accept an oral airway), BGL 7 mmol/L. Bystanders and not sure of the exact pulmonary history. The patient has several pill bottles in his bathroom. You see the following; rifampin, isoniazid, ethambutol and pyrazinamide. The patient begins to develop tonic/clonic activity...
MariB Posted September 25, 2013 Posted September 25, 2013 When were pills prescribed? How many are left?
DartmouthDave Posted September 25, 2013 Posted September 25, 2013 (edited) Hello, Isoniazid can cause seizures. Looks like TB medications to me. The temperature is worrying as well. Dose he have abnormal muscle tone? Cheers Edited September 25, 2013 by DartmouthDave
scubanurse Posted September 25, 2013 Posted September 25, 2013 N-95 masks on... Something no bueno is brewing here. Start 2 lines...as large as I can get em and start some fluids (LR/NS). Hook up the monitor. I'm thinking a call to the health department will be in order after this call for everyone exposed to TB.
chbare Posted September 25, 2013 Author Posted September 25, 2013 The patient continues to have tonic-clonic activity.
scubanurse Posted September 25, 2013 Posted September 25, 2013 Benzodiazepine of your choice, suction, O2
chbare Posted September 25, 2013 Author Posted September 25, 2013 What do you want, how are you giving it and what dose are you going to administer?
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