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Posted

You are called to the residence of an 88y/o woman c/o left eye pain. When you arrive on scene you find a very friendly little old lady with a gauze eye patch. After you think of all of the possible pirate jokes you can think of, what do you want to know?

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Posted

What were the events leading up to the injury? Was she having a cup of tea just prior to a sudden onset of pain? You gotta watch them spoon injuries they can be serious. Seriously I've seen it happen, patient got distracted while making tea and got poked in the eye by the spoon he used to stir the tea when he forgot to remove it from the cup.

Posted

She tells you that she had a sharp, throbbing pain for the last 3 days that is gone now. The daughter noticed that the eye was red and swollen since yest. Today the pt noted she could not see out of the eye. She said her vision was "milky" for the last 3 days. There is no history of dinnerware induced trauma.

Posted

My take:

Do you want to go to the hospital?

Yes?

Good. Get in.

Done.

Posted

Was she doing any cleaning, or other things that involve chemicals, which could possibly cause this eye injury? Did she use any eye drops or such?

Posted
Was she doing any cleaning, or other things that involve chemicals, which could possibly cause this eye injury? Did she use any eye drops or such?

"I'm 82. I'm lucky I can walk, much less bend over to clean." No eye drops use.

Posted

What are her VS? Any neuro deficits? How do her eyes appear to the EMS provider?

More questions later when I wake up.

Posted

What are the vital signs? Nuero exam? Is she oriented? What medical history and medications does she have?

Posted

I'll echo the other's with a request for an initial assessment. Let's see what she was doing when this whole thing started? What change prompted her to call for the ambulance today? What is her medical history? Meds? Allergies? Has this ever happened to her before? Vital signs including skin color/temp? Has she ever seen her physician for something similar in the past? Any pain anywhere? While we're checking her pupils, how is her occular motor function? Can she control her eye without trouble? Or with a rull range of motion?

Shane

NREMT-P

Posted

On top of VS, Allergies, Meds...

How do both her eyes look to you? Intact?

How well can she track with her eyes?

PEEARL?

How is the other eye?

Is the eye with the gauze the one she called you about?

Hx of diabetes, HTN, other eye or vision problems?

Recent trauma, change in meds, visiting new environment?

Difficulty breathing? Other signs of allergic reaction?

Any swelling other places?


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