MedicRN

over a roaring

Lone Star, she

of doing the

vodka and tequilla

What is going on here?

Could be about anything from a horrible migraine to a cerebral aneurysm to brain masses.

Why do you think that?

Given her hx of smoking and taking BCPs, she's at high risk for blood clots. HPV can cause brains and encephalopathy. She's showing severe migraine-like symptoms (which appear to be refractory to her prescribed meds) which incidentally are also general s/s of increased ICP.

What else would you like to know?

Is the BCPs and Imitrex the only meds she takes? Any antivirals? Illicit drug use? Pregnant again?

What are your assessment ?'s.

Onset? Symptom progression? Thorough neuro exam - any deficits? (other than the scatoma (shit for brains)?? - or is it scotoma (diminished vision)?), Anisocoria? Gaze deviation? Sided weakness? CPSS or LAPSS score (if applicable)? Vitals (especially BP and HR)?

Whats your clinical impression?

See above

Do you triage down, and clear, or ALS the patient, and why?

Unless the hospital was a 5 minute transport, I feel I'd have to make this an ALS call. Something about this girl just doesn't feel right. Call it gut instinct.

What do you do for this patient and why?

I would make her as comfortable as possible (duh!) and do what I can to relieve the pain and nausea. However, I doubt med control would approve of morphine (or nubain) or phenergan due to the potential of skewing the neuro exam. If she were to become obtunded, obviously assess her ability to maintain her airway and intervene as necessary. These are in addition to IV with NS TKO (or better yet, locked) and O2. Transport to a facility with neuro/stroke care (neurologist staffed as well as CT and MRI available in-house) capabilities is extremely preferred.

blog that only allows members to access your blog. This hopefully will alleviate the problem from recurring.

I did this some time ago after spam started appearing in my shout out box. It has seemed to fix the problem.

Connie = interesting

Trench = NUTZ

Kountess = flirty

Wow...

We don't quit.

I need a life.

THAT'S WHAT I'VE BEEN TRYING TO TELL YOU!!!!!!!!!!!!!!!! :banghead: :violent1: :roll:

sweet

My turn.............

sneaks in while everyone is asleep............................................... :-$ :-$ :-$ :-$

Hey now...... no fair!!!! I've been out of town. You're not supposed to continue games when I'm gone!!

So............. I'm on top!!!!!!!!!!1

Eric = hmmmm

What kind of questions/frustrations do you have? Some one here is bound to have an answer.

If you are going to argue about it then I'll be on top!![/font:f25efd6c44]

Generally it can take many, many hours. Usually longer then EMS will ever have their hands on the patient.

Gotcha!!!!! Now it's me!!!!!

All you can really do is monitor pedal pulses and vital signs. Depending on the level of the SCI/paraplegia, you might see some autonomic dysreflexia due to the body's altered response to pain.

:queen: :tongue: :tongue: :pottytrain1: :pottytrain1:

I don't think there has ever been a thread that has gone 100+ pages in less than 2 days..........................

I still say ya'll need to get a life.................

Blame Terri, Jeni, and Ron and maybe a few other.