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Pediatric: Lethargic


EMS_Cadet

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You are dispatched to an upscale neighborhood for a "DIABETIC EMERGENCY". Dispatch advises that your patient is a 15 year old male, known IDDM, with a chief complaint of "dizziness".

You arrive on scene. Scene is secure.

The mother lets you in the house and directs you upstairs to her child's bedroom. As you climb the stairs, you obtain that the child was fine this morning (it's about 1pm now), but was playing in the backyard with friends when he came in and started complaining of "pain all over his body". Mom assumed this was some type of neurological disturbance due to the diabetes. She checked his BS and it came back @ 156. She gave him some Motrin and sent him to bed. About 4pm, she went in and checked on him. He is now pale and cool. He is unable to move to due being extremely lethargic.

Go for it.

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Start with the basics. General Impression, pt. looks like crap and is sick. He's sick, load, go, get vitals on the way. O2 via NRB. SAMPLE. Is he Alert/Orientated? Is the patient complaining of anything?

Doesn't seem that his blood sugar is low, but the Glucometer could be misreading and/or uncalibrated. Long shot here, does the backyard have tall grass? Might as well check patient on the way to the hospital for bug bites ticks and etc., seeing theres not much else from a BLS perspective without further info, so can't hurt if you're wrong. I'm sure I missed something, but someone will catch it.

Merry Christmas!

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S - Nausea/vomiting (new symptoms), "pain all over", dizziness, "faint feeling"

A - NKDA

M - Insulin

P - IDDM

L - Lunch (it's now 4pm)

E - See original post.

Vitals: Pulse @ 62, BP 92/68, Pulse ox @ 89%, Temp @ 98.7F. His skin is very pale, cool, and somewhat diaphoretic.

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Is there a possibility he was exposed to, inhaled, or ingested a poison or drug? What does he remember immediately preceding his symptoms? Is he telling you the truth about everything?

Double check BGL. Enlist ALS if available.

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Is there a possibility he was exposed to, inhaled, or ingested a poison or drug? What does he remember immediately preceding his symptoms? Is he telling you the truth about everything?

Double check BGL. Enlist ALS if available.

No toxic exposure or overdose. He remembers running around trying to catch his friend when pain started in his left arm and started moving down into his chest.

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