vivibonita Posted March 14, 2007 Posted March 14, 2007 Does he have any head injuries? What's the BP? Is he febrile? POx?
JPINFV Posted March 15, 2007 Posted March 15, 2007 Any medical history that he can tell us, especially cancer or neurological? Has he traveled outside of the country at all, either recently or not so recently?
ERDoc Posted March 15, 2007 Author Posted March 15, 2007 You said yes/no questions didn't you, I am paying attention. I would get some paper and a pen and ask him if he feel if he could write down answers for me. Q1) Do you feel okay? Q2) Do you have any allergies? if nodding yes can you write them down for me... Q3)Are you taking any meds again please write them down and when you last took them Q4)Did you have anything to eat while at them bar? more writing.. Q5) Did/do you have a headache? Q1 Yes Q2 No Q3 Yes Q4 Yes Q5 No
ERDoc Posted March 15, 2007 Author Posted March 15, 2007 What happened prior to his paralysis? Was he actually drinking, or is this just a case of wrong place wrong time? (Could have been picking a buddy up but doubtful lol) Any history of trauma? Any medical history? Meds (legal or illegal)? related syncope? incontinence? history of sickness? Let's get some vitals and get some O2 on this guy, considering him a priority transport is probably not a bad idea, IV and monitor as well... Oh also...any family history of stroke, seizure or any other good stuff? (Diabetes, heart problems, any other neuro disorders?) No history of trauma. Yes, he was drinking. Yes he has a medical problem. No illegal meds. Yes he is on a legal med. He answers no to syncope, yes to incontinence, no to sickness. No to family history.
ERDoc Posted March 15, 2007 Author Posted March 15, 2007 Exactly. I understand the call came in anonymous but that does not mean there is not someone in the immediate vicinity that can tell us a bit more about the situation. If PD is still present and/or the scene appears to be managed appropriately I would like someone to step into that bar/surrounding businesses/question bystanders to see if there is any more info available to us. If I am the lone first responder then obviously this won't happen but if I am here with a crew then let's make use of them. We have a patient that may or may not be an accurate/helpful historian and although there is no real way to verify the original caller's claims the issue was originally reported as an unconscious male on the sidewalk. Maybe this patient has had a recent change in level of consciousness...or maybe not. I have some exam/intervention things I'd like to do but in keeping with ERDoc's request I'll stick it mostly to history right now save for one. I'm interested to hear this patient's responses to Quicksilver's questions. While we are asking these questions hows abouts we slip a shoe off of the affected side and give a little upstroke with the trauma shears against the sole of the foot. Is there any response to this stimulus? -Trevor Your astute partner, thinking ahead as always, goes into the bar and finds a bunch of guys wearing shirts from the same fraternity. They said he was acting a little funny when they last saw him and assumed he was either in the bathroom or had left with a girl he was buying drinks for. A girl walks up to you and asks if you are the cops. When you say no, she tells you that she is the anonymous caller. She is underage, so she didn't want to get in trouble. She tells you that she was the one he was buying drinks for. They were having a good time, but he started talking funny and telling her he was seeing spots. He then got up from the bar. She assumed that he was just drunk and heading for the bathroom. She just happened to wander outside and found him laying on the floor, incoherent with a small trickle of blood coming from the corner of his mouth. Your Babinkski on the affected side is equivocal.
ERDoc Posted March 15, 2007 Author Posted March 15, 2007 Can you smell AOB or he merely appears intoxicated by behavior and speech? You can smell alcohol.
ERDoc Posted March 15, 2007 Author Posted March 15, 2007 Does he have any head injuries? What's the BP? Is he febrile? POx? No obvious head injuries 126/74 Tympanic temp is 96.5 100% on RA
ERDoc Posted March 15, 2007 Author Posted March 15, 2007 Any medical history that he can tell us, especially cancer or neurological? Has he traveled outside of the country at all, either recently or not so recently? He answers no to cancer and yes to neurological. His speech is becoming more clear and he says seizure. He also says, "Scared...can't move." He denies any travel out of the country.
Eydawn Posted March 15, 2007 Posted March 15, 2007 This is a shot in the dark. Are fungal infections associated with being febrile? If not... frat houses breed NASTY fungal strains that can cause REALLY strange problems. Yes? No? Maybe so? Seizures- does he have a wallet card or any medical ID on him? How 'bout meds in the jacket pocket? Do his buddies know any more about his condition? Do they have his mother's number by any chance or some other contact info that could give you the clue here? Is he complaining of any respiratory distress or obviously displaying such? Wendy CO EMT-B MI EMT-B
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