brock8024 Posted November 29, 2006 Posted November 29, 2006 You respond to 1921 E. Main street for a 48 year old male with a new history of SZ. Scene is safe with fire there. Pt is in the living room floor and appears to be embarrassed. Pt is A&O X 4 Lets see if you guys can figure this one out fast. Most of my scenarios you guys get pretty fast, so I can up with this one to see how fast it takes you guys. I made this one more challenging.
Shelbmedic Posted November 29, 2006 Posted November 29, 2006 Ok you have a 48y/o M. post sz who is on the floor CAO x 4. S/S of any trauma? A- any allergies? M- what medications does he take? P- past medical history? any sz history? is he a diabetic? any heart problems? any B/P problems high or low? any respiratory problems? asthma, COPD. emphysema, any recent surgeries? any recent trauma in the last 72hrs? L- last meal? last time to the doctor? and what for? E O/E what do you see? any trauma ? any s/s of sz activity? How long did the pt. sz for. Any s/s of street drugs being used? What are his vitals, Blood sugar? pupils are the e/r and what size? hand grips are they strong and equal? whats the monitor showing in lead II / ?12 lead if lead II shows anything? whats the pt/ LOC?
brock8024 Posted November 29, 2006 Author Posted November 29, 2006 Ok you have a 48y/o M. post sz who is on the floor CAO x 4. S/S of any trauma? A- any allergies? M- what medications does he take? P- past medical history? any sz history? is he a diabetic? any heart problems? any B/P problems high or low? any respiratory problems? asthma, COPD. emphysema, any recent surgeries? any recent trauma in the last 72hrs? L- last meal? last time to the doctor? and what for? E O/E what do you see? any trauma ? any s/s of sz activity? How long did the pt. sz for. Any s/s of street drugs being used? What are his vitals, Blood sugar? pupils are the e/r and what size? hand grips are they strong and equal? whats the monitor showing in lead II / ?12 lead if lead II shows anything? whats the pt/ LOC? No s/s of trauma NKDA phenytoin, bactrium Started having SZ about 3 months ago. Until then never went to the doctor. He ate this evening with his wife Went to the doctor about a week ago for a sores on his hands Pt has sores on his hands, and complains of some small blisters in his mouth. When you lift his shirt for the 12 lead you notice a few rash looking areas. Monitor is NSR and 12 shows no changes. FSBS is 92 pupils pearl grips equal Pt A&O x 4
ERDoc Posted November 29, 2006 Posted November 29, 2006 What kind of workup has been done for the seizures? Let's hear a little more about the sores on his hands. Are they on his palms? Describe the rash on his chest. Any joint pains, fevers, penile discharge? What happened before the seizure?
Just Plain Ruff Posted November 29, 2006 Posted November 29, 2006 one of two things I'm thinking Meningitis that hasn't gotten bad yet Strep throat which can cause the rash and the sores in his mouth. Sores on his hands I'm at a loss for.
brock8024 Posted November 29, 2006 Author Posted November 29, 2006 What kind of workup has been done for the seizures? Let's hear a little more about the sores on his hands. Are they on his palms? Describe the rash on his chest. Any joint pains, fevers, penile discharge? What happened before the seizure? He had a seizure at work and then wen to a neuro doctor and had a EEG. The doctor put him on his meds and has been adjusting them. The sores on his hands are open blisters. The rash on his chest is different colors in spots. There are a few blistered areas that are open on his back and chest. He has some sores around his mouth. No joint pain, fever of 99.0 to 100 degrees. No penile discharge. Pt was sitting on couch and had a seizure per wife. The doctor told them this might happen til they get the dose of the med right. And he has had the sores on his hands for about 7 days. Went to PCP and was told it was just some type of staph infection and to take the bactrium. The rash has started a few days ago and then the blisters started yesterday. They must have ruptured during his seizure. He has a appointment with his PCP in the am per wife.
Just Plain Ruff Posted November 29, 2006 Posted November 29, 2006 multicolored rash and blisters on hands. Fever and seizures, this doesn't sound good for this guy.
brock8024 Posted November 29, 2006 Author Posted November 29, 2006 What do you think is going on with him. Anything eles you want to know?
brock8024 Posted November 29, 2006 Author Posted November 29, 2006 is the rash more petechiae or purpura Purpuric in nature
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