Scenario

[rocket]

PMHX, Meds, ALL, V/S's,complete head to toe assessment, and Events preceeding, v/s's including bilat B/P's pulse ox, 12-lead, and pert + and - cardio-respritory exam findings.

Thanks,

ACE844

What he said, most especially the bilat B/Ps (help to r/o AAA). The other DDx on my mind was appencitis so I'd like to ask about rebound tenderness just to get a better picture.

She could be tachy/palpy from anxiety or it could be something more. Since I am on a BLS rig it's time to get packaged and moving...let's get her into a comfortable position (if possible) and do the vitals, PE and history. I'll defer on my option to call for ALS until I hear the vitals and findings of the exam.

-Trevor

[FL_Medic]

ok, when you isolate the kid from the parent, any further tox related information coem out? Is the pt a smoker? supplement user? Any signs of Drug abuse-use?What activities was she partaking in prior to coming home, running exertional, etc...? Next, since you didnt mention it, Breath sounds, what are the other B/P's, etc...? Any murmurs?

Good catch I recall my last post.

when you remove the pt. you get a better Hx.

Cocain

Last menstration was 10 weeks ago.

[FL_Medic]

What he said, most especially the bilat B/Ps (help to r/o AAA). The other DDx on my mind was appencitis so I'd like to ask about rebound tenderness just to get a better picture.

She could be tachy/palpy from anxiety or it could be something more. Since I am on a BLS rig it's time to get packaged and moving...let's get her into a comfortable position (if possible) and do the vitals, PE and history. I'll defer on my option to call for ALS until I hear the vitals and findings of the exam.

-Trevor

no this became ALS a while ago, palpitations, HR -160, hypotensive... fallow Ace's lead.

[Ace844]

Pt. denies using any drugs, or ingesting anything toxic.

what does reciprocial mean?

Reciprocal changes occur on a 12-lead in 'opposite' leads. So if there is elevation in a few leads, there will be depression in the 'opposite' leads. As far as the scene, i thought soemone had asked that, but in case not, add that to the list, and as well whatever other bystander, partmner, PD, etc.. info you can get or see.

[FL_Medic]

Reciprocal changes occur on a 12-lead in 'opposite' leads. So if there is elevation in a few leads, there will be depression in the 'opposite' leads. As far as the scene, i thought soemone had asked that, but in case not, add that to the list, and as well whatever other bystander, partmner, PD, etc.. info you can get or see.

Oh, watch your spelling, no just looks like ischemia.. probably do to the rythm.

[FL_Medic]

not to say I am a good speller I just didn't make out the word.

[rocket]

no this became ALS a while ago, palpitations, HR -160, hypotensive... fallow Ace's lead.

Yup. With those numbers I'd agree. I'll be following along and learning now :wink:

-Trevor

[FL_Medic]

Im on shift and have to go prepare dinner so I will be back in a few, start your Tx and I will get back.

[Ace844]

OK, the short quick immediate answers are as follows...2+ large bore IV's, labs, 325 ASA PO {Barring contraindications} Low flow o2, as already started, a follow up 12-lead in a few minutes, and BENZO'S until anxiolysis-symptomtology reduction is achieved..extriacte to the ambulance and transport, as care is supportive mostly in this case.

[chbare]

Agree with ACE 844. I would consider a fluid challenge as long as the lungs are clear and there are no indications of heart failure. Nitroglycerin may be considered if we can maintain a stable systolic blood pressure. Lets see if the rate comes down with fluids. Stay away from beta blockers.

Take care,

chbare.