ERDoc Posted October 19, 2006 Author Share Posted October 19, 2006 Great to see your back on duty was following this one ERDOC, your senarios are good fun. squint pushes rookie on car out of the way, I will take it frome here and suggests get his/her chariot needs checking out...just kidding. Ok back to busniess: - grips + reflexes.... any unusual findings? the history may be suggestive of cluster type HA. - beta blocked.... hmm.... is she compliant with meds? and when was this treatment initiated? - When was she DX HTN...any complaints of leg pains, drowsyiness, unusual dreams or dizzyness when she first awakens? - Has she taken any OTCs to relieve her pain, or any herbal remedies? - Since we got to the call, has the pain changed in any way and have her describe what she is feeling if any changes. - Pulse 66 you say, ECG done yet? NSR? or any blockes? - Chestsounds...any adventicia? any SOB? - Any problem with urine production? (just no way to make that sound good) cheers, as typical your senarious start out benign, then..........??? Grips are 5/5 b/l, reflexes 2+ throughout. No leg pains, drowsiness, dreams or dizziness. She has tried some Motrin with minimal relief. The pain is about the same. EKG NRS no blocks. Chest wnl "Now that you mention it, I do need to use the potty. Can you wait two minutes for me to go?" Otherwise no interesting facts about her urine. Link to comment Share on other sites More sharing options...
ERDoc Posted October 19, 2006 Author Share Posted October 19, 2006 Edit At this point, becksdad sneaks off to the bedroom while his partner does the work. He is later found by PD snooping through her lingerie collection edit but does look very attractive in the blue teddie, and the those high heals...whoo hoo. TMI, please keep your disturbing fantacies to yourself. Link to comment Share on other sites More sharing options...
becksdad Posted October 19, 2006 Share Posted October 19, 2006 :shock: Link to comment Share on other sites More sharing options...
8151 Posted October 19, 2006 Share Posted October 19, 2006 Attached garage? carbon monoxide from letting vehicle warm up? Link to comment Share on other sites More sharing options...
tniuqs Posted October 19, 2006 Share Posted October 19, 2006 oops.....its been awhile....sorry. Ok have we got a line in? Perhaps a touch of benzo for aniety, s/l, i/m or iv? We should do the transport thing soon we have been on scene since 08:00 hrs.... :roll: Well thats....if we can get becksdad out of the closet. late entry...is she menstrating? Link to comment Share on other sites More sharing options...
ERDoc Posted October 19, 2006 Author Share Posted October 19, 2006 No garage, driveway only. Really good thought though. Line is in. You start to take the pt out to the ambulance with one of the police officers. Suddenly over the officers radio you hear the one inside call for backup. Apparently he needs help getting becksdad out of the closet (in more ways than one) since becksdad has now found the pts leather collection and has taken to trying the samples on. Link to comment Share on other sites More sharing options...
becksdad Posted October 19, 2006 Share Posted October 19, 2006 Ok, at this point, these are the differentials I'm thinking of: cluster headache, possible reaction to food (such as wine or cheese), pressure on nerves and/or vasculature from sleep posture, psychosomatic. Nothing seems to point specifically to lesions of ear,sinus, oral cavity, so I toss that for now. Maybe some problem w/ medication (her BP is a good bit higher now than previously w/ tx). The only serious thing I can think of would be some lesion/mass in brain, but it would probably progressively get worse (I think). For any of this, though, there's not much I can do in the field, so I'm gonna stop wasting time on scene, take off the teddy and heels, and transport. Keep her comfortable, monitor V/S, throw in a lock just in case. Why do I feel like she's about to crash cause I missed something? Link to comment Share on other sites More sharing options...
tniuqs Posted October 19, 2006 Share Posted October 19, 2006 Ok, at this point, these are the differentials I'm thinking of: cluster headache, possible reaction to food (such as wine or cheese), pressure on nerves and/or vasculature from sleep posture, psychosomatic. Nothing seems to point specifically to lesions of ear,sinus, oral cavity, so I toss that for now. Maybe some problem w/ medication (her BP is a good bit higher now than previously w/ tx). The only serious thing I can think of would be some lesion/mass in brain, but it would probably progressively get worse (I think). For any of this, though, there's not much I can do in the field, so I'm gonna stop wasting time on scene, take off the teddy and heels, and transport. Keep her comfortable, monitor V/S, throw in a lock just in case. Why do I feel like she's about to crash cause I missed something? Good thinking...but where have you been? Lets transport 30 degree head up, and run quiet. I think we should talk after. Link to comment Share on other sites More sharing options...
chaser Posted October 19, 2006 Share Posted October 19, 2006 transport for a CT and psych eval Link to comment Share on other sites More sharing options...
MrSpykes Posted October 19, 2006 Share Posted October 19, 2006 I am thinking may be something positional in the way she sleeps, maybe she is pinching a nerve or something. Does the headache get better or go away after she gets up and out of bed, like after an hour or so. Does her headache improve after a hot shower? Does she have any congested sinuses. Is her nose runny or is she stuffy? Maybe they are sinus headaches. Or maybe she is building a tolerance to the Atenolol and needs her dosage up'ed. I don't even know if you can build a tolerance to Atenolol but I figured its worth a shot. Are her pulses and blood pressures equal in both arms? Upon palpation of the ABD do you find anything? Do we know how high her BP was before the Meds and for how long? I am thinking it could be a dissecting aortic aneurysm? Link to comment Share on other sites More sharing options...
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