chbare Posted March 25, 2007 Posted March 25, 2007 You are called to the scene of a 21 month old. Dispatch reports a complaint of "not acting normally." What would you like to know? Take care, chbare.
AZCEP Posted March 25, 2007 Posted March 25, 2007 What is "not normal"? How does the kiddo look? How long have they been this way?
chbare Posted March 25, 2007 Author Posted March 25, 2007 You arrive on scene and observe a 21 month old male in his mothers arms. The patient appears pale and is very lethargic. He only responds to painful stimuli. The parents are crying and the patients 8 year old brother is in a corner looking guilty about something. Take care, chbare.
AZCEP Posted March 25, 2007 Posted March 25, 2007 This scenario is already not my favorite. Respiratory effort? Signs of trauma? What do the parents know about what happened?
chbare Posted March 25, 2007 Author Posted March 25, 2007 No signs of trauma. Patient has slow snoring respirations at a rate of ten. Parents speak little english; however, you gather that the patient may have taken something. Take care, chbare.
AZCEP Posted March 25, 2007 Posted March 25, 2007 Can we find anything to support the toxicology assumption? Pupillary response? Pulse rate/quality? ECG? Will he accept an OPA? If not, manual airway maneuver and apply some oxygen as we move out of the house.
DwayneEMTP Posted March 25, 2007 Posted March 25, 2007 Hey chbare! Pretty cool you're taking the time do do a scenario! 8 year old brother, regardless of first language almost certainly speaks english..can/will he shed any light on this? List of meds parents may be taking. Any obvious OTC/home toxin (under the sink)/alcohol containers? Other than upset, other family members acting normally? Dwayne
chbare Posted March 25, 2007 Author Posted March 25, 2007 The patient still has an intact gag reflex and does not accept an OPA. Airway positioning, suction, and high flow O2 is applied. The snoring resolves with positioning, and the respiratory rate remains ten breaths per minute. Pupils are equal, round, and slightly sluggish to react bilat. He has a carotid heart rate of 50, and it feels slightly irregular. The monitor shows sinus bradycardia with a first degree AV block and an occasional unifocal PVC. No toxins or medications in the house. The brother is able to tell you that the patient took some pills when they visited grandma about an hour ago. The parents seem frightened and genuinely fearful for their son. Take care, chbare.
medic001918 Posted March 25, 2007 Posted March 25, 2007 Pills from Grandma's house? And a symtomatic bradycardia? My guess might be a beta blocker overdose. I would try to have a family member call Grandma and see what pills she's on. Otherwise, call medical control and see if you can get an order for some IV Glucagon. While all of this is going on, we'll be doing the basics such as supporting the patient's airway, oxygen administration, etc. Shane NREMT-P
chbare Posted March 25, 2007 Author Posted March 25, 2007 Grandma is not home; however, you gather it is some kind of cough or cold medication from the older brother's comments. The patient suddenly begins to seize. You note generalized tonic clonic activity. Take care, chbare.
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