chbare Posted October 15, 2007 Posted October 15, 2007 You are called to the residence of a 56 year old male complaining of chest pain. Take it from here. Take care, chbare.
DwayneEMTP Posted October 15, 2007 Posted October 15, 2007 LOC? General appearance? Breathing rate, quality? Quality of pain?
chbare Posted October 15, 2007 Author Posted October 15, 2007 -He is awake and responsive; however, his ability to speak and articulate in sentences greater than a few words long is quite limited. He does respond appropriately to questions to the best of his abilities given his respiratory status. -He is sitting in a chair and appears acutely ill. He is pale, diaphoretic, and appears to be having allot of difficulty breathing. -His respiratory rate is around 32 and shallow, he is working hard to breath, and spitting up frothy sputum. -His chief complaint is actually difficulty breathing. Take care, chbare.
DwayneEMTP Posted October 15, 2007 Posted October 15, 2007 Syphilis Next. If you're right, what's the point? If you're wrong, what's the point? See what I mean? We can use some good scenarios... If you're not in the mood to contribute, why the need to pollute it for the rest...? Be back in a bit chbare...thanks for taking the time to do this! Dwayne
dahlio Posted October 15, 2007 Posted October 15, 2007 Right away slap (not literally) a NRB at 12lpm on him, make sure you brought the BVM in, call ALS. What is this chest pain like? Crushing, Dull, Constant? Does it radiate anywhere? Lets do a quick stroke test (arm drift, squeezing fingers), is he leaning to one particular side? While partner gets vitals, does he have a medical history, was he doing anything strenuous? AO times ?
chbare Posted October 15, 2007 Author Posted October 15, 2007 Not a problem, glad to contribute something. -NRB is placed. You gather that he may be experiencing a little chest pressure, but he continues to state with strained effort, "I cannot breath." -He has strong movement of all extremities and you do not appreciate any facial droop. his is sitting up in a tripod like stance in a chair. -Vital signs: R-32, P-128, B/P- 128/94, Pulse Oximetry-88% -His past history is significant for NIDDM and he takes metformin 500 mg PO BID. -He was washing dishes when his signs and symptoms began suddenly. -He is awake, alert, oriented to person, place, time, situation, and appears to be answering questions appropriately and to the best of his ability. Take care, chbare.
akroeze Posted October 15, 2007 Posted October 15, 2007 If you're right, what's the point? If you're wrong, what's the point? See what I mean? We can use some good scenarios... If you're not in the mood to contribute, why the need to pollute it for the rest...? Be back in a bit chbare...thanks for taking the time to do this! Dwayne Apparently tongue-in-cheek humour is not appreciated. I shall try to remember that. Anyway, from what I'm seeing so far I want to immediately get this guy on a high FiO2. I would have my partner attempt to assist his respirations (if possible) while I auscultate the chest, get a full set of V/S (BP, Pulse, Resp, GCS, Saturation) and a rhythm strip.
akroeze Posted October 15, 2007 Posted October 15, 2007 Not a problem, glad to contribute something. -NRB is placed. You gather that he may be experiencing a little chest pressure, but he continues to state with strained effort, "I cannot breath." -He has strong movement of all extremities and you do not appreciate any facial droop. his is sitting up in a tripod like stance in a chair. -Vital signs: R-32, P-128, B/P- 128/94, Pulse Oximetry-88% -His past history is significant for NIDDM and he takes metformin 500 mg PO BID. -He was washing dishes when his signs and symptoms began suddenly. -He is awake, alert, oriented to person, place, time, situation, and appears to be answering questions appropriately and to the best of his ability. Take care, chbare. Implement Tx as I noted above. Once I have a rhythm strip I want to get an IV line on this guy. Also, lung sounds?
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