DartmouthDave Posted September 18, 2013 Share Posted September 18, 2013 (edited) Hello, You are staffing an ALS ambulance in a rural farming area. There is a local community hospital with an ED. The main medical centre is 45 minutes away. You are dispatched for an 'unwell person'. A 31 year-old female was at a u-pick when she started to feel weak. En route the call is upgraded to 'cardiac arrest' and the local volunteer FD has been dispatched as well. You arrive at the farm and the FD is on scene. The MFR are doing CPR on a women in the middle of a raspberry field. It looks safe other than a few shady looking chickens roaming about. Cheers Edited September 18, 2013 by DartmouthDave Link to comment Share on other sites More sharing options...
island emt Posted September 18, 2013 Share Posted September 18, 2013 (edited) Is she alone except for the shady chickens? Does she have a patent airway? Signs of Ananphalaxis uticaria, swelling of the face / lips Was she eating raspberries ? & she's allergic to them? Any obvious injury site? Is she in V-fib / V-tach? Do we have her on an AED or monitor? How long has she been down? Given the topic header she's going to get aggressive tx with epi Edited September 18, 2013 by island emt Link to comment Share on other sites More sharing options...
triemal04 Posted September 18, 2013 Share Posted September 18, 2013 Holy hell! Immediately back away from the patient and take cover. Request code 3 cover from the police and be ready to defend yourself it you get attacked. Shady looking chickens are no joke...dangerous little beasts... Link to comment Share on other sites More sharing options...
DartmouthDave Posted September 18, 2013 Author Share Posted September 18, 2013 (edited) Hello, She is there with her boyfriend. They came to the farm to pick berries to make jam. There are 4 FD First Responders and a few others milling about. She is allergic to bees. She was stung by one and started to panic and scream. He boyfriend injected her in the arm with her EpiPen immediately. Then her colour got bad and she collapsed. Her face is not swollen and there seems to be no signs of an allergic reaction. Her airway is open. The First Responders have an OPA in and are bagging her without difficulty. CPR is ongoing. Bystanders did effective CPR before the Fire Department arrived. The AED has not been attached yet. The chickens have cleared out but they have been replaced by angry and aggressive honey bees. Bzzzzzzzzzzzzzzzz!! Cheers Edited September 18, 2013 by DartmouthDave Link to comment Share on other sites More sharing options...
scubanurse Posted September 18, 2013 Share Posted September 18, 2013 Get the hose monkeys on scene to grab their extinguishers and clear a path to load her up into the ambulance. No signs of anaphylaxis? Hook her up to the monitor and try to figure out the underlying rhythm? I have a hard time believing one epi pen IM could cause a cardiac arrest but I suppose it is possible? Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted September 18, 2013 Share Posted September 18, 2013 was it an epi pen for sure? Could the epi pen have been a pharmaceutical mistake and a different drug be in the pen? Could the epi pen have caused her heart to run so fast that she arrested, maybe a underlying heart condition that causes her to go into arrest? Link to comment Share on other sites More sharing options...
island emt Posted September 19, 2013 Share Posted September 19, 2013 Not likely , but a possibilty. did the epipen in the arm go into a vein.??? Epi for anaphylaxis is 1:1000 Epi for Cardiac IV is 1:10000 Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted September 19, 2013 Share Posted September 19, 2013 Don't raspberry bushes have thorns? Are we sure she was stung by a bee and not stung by a thorn? Link to comment Share on other sites More sharing options...
DartmouthDave Posted September 19, 2013 Author Share Posted September 19, 2013 Hello, No, the epi pen was used correctly. You get her on the monitor and skillfully pop in an IV while CPR is done. The monitor show VT. She feels cool and looks gray. Her airway is still clear and she is easy to ventilate with a BVM and OPA. Cheers Link to comment Share on other sites More sharing options...
island emt Posted September 19, 2013 Share Posted September 19, 2013 Electrical therapy at 360 joules. Does she convert? Link to comment Share on other sites More sharing options...
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