James_ffemt Posted September 20, 2006 Posted September 20, 2006 Ok. Got a call Monday night about 1am to help an 86y/o male back into bed after falling. Two basics working the truck. We get there and the wife meets us at the door. She says that he has been doing this on a regular basis. States that he seems to be getting up to go to the bathroom or is having bad dreams and gets up from that. ???? We find this guy propped up against the side of the bed. I say hello and he responds back with a hello. We do a quick assessment and make sure he hasn't hurt himself. Pt. is A & O x4. He can answer all of our questions and knows where he is. He is weak but can stand with some assistance. We get him back in bed and cover him up and I tell him to have sweet dreams. Back to the station we go. 2:30am We get woke back up to respond to the same address to help the guy back in bed. Again wife meets us at the door and she tells us that he has fallen again but something else is wrong. About this time we can hear him in the bedroom and it sounds like he his riding on the best roller coaster ever. Walk into the bedroom and he is lying on the floor with one hand above his head and is having a great time. I ask him what's going on and he does not answer. I again say his name and question him about what's goin on. He answer's in a slurred voice and say's yeaaaaaaaaaaaaaahhhhhhhhhhhh. I ask the wife if he hit his head when he fell and she stated that he did not. We decide he needs to go the the hospital for an evaluation. Also, he is rolling side to side as he is making his roller coaster ride noise. I am going to leave it here for now and see what everyone thinks it is. More info will make it to easy so see what ya think. James
nsmedic393 Posted September 20, 2006 Posted September 20, 2006 Stroke/Aneurism would be at the top of my list. Also perhaps dementia. Vitals? Physical findings?
GhostMedic28 Posted September 20, 2006 Posted September 20, 2006 Did you check a CBG on this patient. If so, what was the results? Any history of diabetes?
Just Plain Ruff Posted September 20, 2006 Posted September 20, 2006 my first thoughts are two items 1. CVA/Aneurism like previously stated 2. Vertigo - this can make you feel ike you are going side to side and up and down. The vertigo could have also caused him to fall. Could be caused by an inner ear infection. I'd choose number 2 over 1 though
James_ffemt Posted September 20, 2006 Author Posted September 20, 2006 Did you check a CBG on this patient. If so, what was the results? Any history of diabetes? Ding Ding Ding You Win the Prize. We are walking out the door with him and his wife tells us he is a insulin dependent diabetic. Get him in the back of the truck and I do a finger stick. Results......27. Holy Crap...Both of us just finished EMT-I school and are waiting to test so we call the ER and ask for the Dr. So we can start a line and push some D50. Dr. is asleep!!!??? So we just jumped in and drove like crazy to get him to the ER. At this point he was not responding well at all and felt like if he did go unresponsive that oral glucose might hinder us. Any way we get him to the ER and they finger stick him cause they don't believe me. It was 25. They got an IV established and pushed an amp of D50. He slowly came around. Also, I am not a paramedic but they put him on the monitor and he was ??? real wide and RN said it looked like A-Fib??? Anyway kinda scary....
JakeEMTP Posted September 20, 2006 Posted September 20, 2006 Why would the oral glucose hinder you? It is a basic medication and all that was available to you.
Just Plain Ruff Posted September 20, 2006 Posted September 20, 2006 maybe it was to counteract the way the patient was acting. If you drive like crazy it might counteract the roller coaster ride the pt. is going on. How far away from the ER were you? it was 2:30 am and you drove like crazy, what was traffic like? Honestly, I hate to be critical but there is never never never any reason for you to drive "Like Crazy". NEVER Hopefully that was a figure of speech. Why did you not call for ALS backup if he was so unstable that you had to drive like Crazy. Sometimes I just don't get it.
medic_ruth Posted September 20, 2006 Posted September 20, 2006 Hey James! You know, I stopped posting for a long time because of all the people around here who like to read waaaaaay too much into what your saying. (Just so you know, I used my common sense and figured out that "drive like crazy" meant "rapid transport") :roll: Anyway, I'm back and I loved your story. Had fun trying to figure it out. Take care and be safe!
Just Plain Ruff Posted September 20, 2006 Posted September 20, 2006 did I not state in my reply that I hoped that this was a figure of speech which I truly believe it was. But then again, we all know the types of drivers who think that driving emergency gives them full reign to do whatever they want in traffic. Again I will re-iterate I hope it was a figure of speech but if it wasn't....... I am glad the guy turned out ok and everyone made it safe.
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