JPINFV Posted November 5, 2007 Share Posted November 5, 2007 ^ Damn, you might be on to something. Did they give him any aspirin? /learned about Reye's Syndrome in biochem recently Link to comment Share on other sites More sharing options...
hammerpcp Posted November 6, 2007 Share Posted November 6, 2007 So to recap: 4am called to residence for 12 y/o male, 60lbs, altered LOC, laboured resps, febrile w/ NVD x 3 days. Pt found supine on bed, hot, dry flushed. Moderate respiratory distress. Opens eyes and withdraws from painful stimulus and is verbalizing innapropriate/incomp. words. Pt has had a "stomach flu" times 3 days with NVD, diffuse abdo pain increasing on palp, hyperactive bowel sounds, decreased food intake, fever, and decreased urine output. Pt had soup for dinner and was lethargic and irritable prior to going to bed. Side note: Why is mom trying to rouse pt at 4 am? previously healthy, no allergies, no meds. Initial VS: pulse 148 weak RR 28 laboured BP 90/40 Sats 88% Temp 103.2 f BG normal (? I think) Pupils equal and reactive but sluggish LS? Pt has been self administering tylenol since onset of symptoms. NOT: CO poisoning trauma drugs/alcohol Prescription drugs menningitis Pt now having sz activity autonomic hyperdysreflexia. 8) Link to comment Share on other sites More sharing options...
hammerpcp Posted November 6, 2007 Share Posted November 6, 2007 Did we ask if his abdomen is distended at all? is there any rigidity or masses? Link to comment Share on other sites More sharing options...
ERDoc Posted November 6, 2007 Share Posted November 6, 2007 Looking at Hammers recap, I have a few questions: 1. Does this kid has some unknown metabolic disorder? A 60 pound 12 year old, things that make you go hmmmmmm. 2. What meds was he taking and who was giving them to him? 3. Is anyone else at home or at school sick? Hammer, why can't this be meningitis? A kid with fever, possible sepsis and mental status changes could definitely have meningitis. Link to comment Share on other sites More sharing options...
hammerpcp Posted November 6, 2007 Share Posted November 6, 2007 I am going with my original diagnoses of peritonitis. Sz caused by all or one or a combination of the following: hypotension, hypoxia, toxins in blood from ruptured intestine, fever. Lets get the docs to look at his abdomen. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted November 6, 2007 Share Posted November 6, 2007 I just can't get used to these newfangled acronyms. I sat here for a good five minutes thinking, "sample of what?" :? In LA, we use HAM (Hx, Allergies, Meds) for everything. When medics come on scene they always ask "Did you get a HAM yet" Link to comment Share on other sites More sharing options...
JPINFV Posted November 6, 2007 Share Posted November 6, 2007 I remember being told about HAM during EMT class [LA Co medic taught the course]. I always figured that if you needed something to remind you about asking about medical history, allergies, and medications then EMS might not be the place for you. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted November 6, 2007 Share Posted November 6, 2007 So, far all I can think of is some kind if -itis in the abd or meningities (but don't think I got my photosensitivity questions answered...Brudzinski's and Kernig's signs?...can't do all nerve tests b/c not following instructions...any muscle stiffness per parents?) or some kind of exposure (can we get more hx on what he did that day he stayed home alone). Maybe stool check ISN'T a bad idea....I volunteer Dust for this mission since he's more qualified. Umm...WBC count? Link to comment Share on other sites More sharing options...
njmedic1485 Posted November 6, 2007 Share Posted November 6, 2007 I may have missed it, but what is the lads blood sugar. Is this a new onset diabetic perhaps? Link to comment Share on other sites More sharing options...
njmedic1485 Posted November 6, 2007 Share Posted November 6, 2007 I should read more carefully before posting, BG is 82/o much for the easy answer :oops: Link to comment Share on other sites More sharing options...
Recommended Posts