Acosell Posted April 10, 2007 Posted April 10, 2007 You have to keep in mind that the bystanders mentioned in this scenario are teachers that have been charged with the care and wellbeing of this ill child. Also, I don't think I've ever shook anybodies hand while at work, and I don't intend to. Just a friendly hello, I'm here to help or something along those lines will do. You don't have to go class to class shaking kids hands or anything. We can save that for EMS week.
hammerpcp Posted April 11, 2007 Author Posted April 11, 2007 Hmmm......If only life were that simple and we could just hand off all our pt's to someone else. For the sake of my education (and possibly yours), does any one else have any treatment suggestions? Assuming we have more then an oral airway, glucagon and a BVM at our disposal. 8)
Just Plain Ruff Posted April 11, 2007 Posted April 11, 2007 I'm gonna assume that this is more than a seizure. New onset of seizures calls for agressive treatment. I have a friends son who had a seizure which was caused by a brain bleed. Bad deal I'm going to have valium ready, Rapid sequence intubation kit ready I'm also going to get this kid going and going to bypass the local ER and go directly to a childrens teaching hospital and I more than likely if a helicopter will get this kid to that center faster than I can in my ambulance I'm gonna call a bird My cynical and negative nature makes me think this is gonna be a bad deal
Asysin2leads Posted April 11, 2007 Posted April 11, 2007 Hey! Hey! Hey! Over here, behind the firemonkeys, hello? Put down the EKG monitor and the Valium and the RSI kit and tell the firemonkeys to put the child down, slowly. Ummmm, you know, the biggest things otherwise healthy kids like to do is run around. Has this kid had a particularly rough time on the playground? Any signs of head injury? Given the risk of trauma in a pediatrics patient, even if there are no outward signs of injury, I still say full C-spine precautions on junior here. If its not trauma, the other biggest thing kids like to do is drink and take stuff they're not supposed to. Ask the parents if there are any medications missing from the cabinet, check the kid to see if he has any pills on him, and lets get him off to Mr. ER for a tox screen. Don't make me say BLS before ALS. I'll have to kill myself. In order of decreasing odds of probability, I'd say it would look something like this: 1. Fakin'. 2. Smack on the noggin. 3. Lack of child proof caps and Mr. Yuck stickers. 4. Mysterious sudden onset of hypoglycemia/seizures/brain tumor/Dr. Housemovieoftheweekitis/
Eydawn Posted April 11, 2007 Posted April 11, 2007 Haha! Asys cracked me up... Drhousemovieoftheweekitis.... I agree, I asked if there was any evidence of trauma... I'd also be considering boarding/C-spining this kid since I don't know what's causing all this and kids are A: clumsy and B: stupid (on occasion). Wendy CO EMT-B MI EMT-B
Just Plain Ruff Posted April 11, 2007 Posted April 11, 2007 well of course I'm gonna cover the ABC's I'm just remembering back to when my friends son had a similar incident prior to when he collapsed on the playground and the ambulance bypassed a non-peds specialty hospital and they took him to the childrens hospital. He is now a shell of his former self. He would have died had the ambulance crew not have taken him to the childrens hospital. but back to basics, of course we're gonna cover the bls but I'm gonna have that other stuff ready.
hammerpcp Posted April 19, 2007 Author Posted April 19, 2007 Sorry folks....I didn't intend to abandon this thread but I got busy. Anyhoo........I did not take spinal precautions. That seems a little ridiculous actually but whatever. The pt continued this sz activity. He actually deteriorated en route, losing his gag reflex and saliva began coming out of his mouth. My question to you all is would you intubate? You wouldn't need RSI at this point, but if you were going to administer pharmacologic therapy what and why and how much would you use?
Just Plain Ruff Posted April 19, 2007 Posted April 19, 2007 I told you all this was gonna be a bad one.
Asysin2leads Posted April 19, 2007 Posted April 19, 2007 I would pray to the gods of EMS that this was not some odd drug reaction that was going to have a synergistic effect with a benzo, and give the peds dose of diazepam for sedation, if necessary.
hammerpcp Posted May 1, 2007 Author Posted May 1, 2007 You give lorazepam and now he's apneic. The good news is the sz activity has stopped. What now? (Is this the worlds most long and drawn out scenario or what?)
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