JPINFV Posted February 5, 2008 Share Posted February 5, 2008 20y/o male complaining of sudden onset paralysis to right arm. Go. Edit: note: The EMT-City Super Ambulance is not in play, yet. Link to comment Share on other sites More sharing options...
Fluffpaw38 Posted February 5, 2008 Share Posted February 5, 2008 I arrive on scene what do u see? Any help? Any additional info from dispatch? Paint a picture of the scene, and my general impression of the patient/skin, posture, obvious bleeding? Link to comment Share on other sites More sharing options...
JPINFV Posted February 5, 2008 Author Share Posted February 5, 2008 You and your partner are ALS. You find the patient sitting in a chair. His eyes are reactive, even if a tad sluggish, and bloodshot. A slight whiff of alcohol reaches you, but it's not strong. He appears on the outside to be in good health by having a normal build with no noticeable skin lesions. You do notice, though, that there is a decent splotch of half dried vomit behind the chair. His friend, the one who called 911, states that when he woke up he wasn't able to move his right arm below the elbow. "I'm not sure whats wrong, but I didn't wanna *hic* risk driving him to the hospital." Link to comment Share on other sites More sharing options...
ERDoc Posted February 5, 2008 Share Posted February 5, 2008 Good case JP. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted February 5, 2008 Share Posted February 5, 2008 neuro check and circulation check in area distal and proximal to the elbow. What color is the hand? Any history of a fall prior to going to sleep? I'm gonna suspect nerve involvment or a injury to the elbow causing impingement to the nerve bundle in the elbow. Is the elbow swollen? Link to comment Share on other sites More sharing options...
AnthonyM83 Posted February 5, 2008 Share Posted February 5, 2008 FD: Hey, stop screwing around like a baby! You can move your arm. Do you want to go or not? No? You're going, anyway, we're here. -Guys, just load him up, BLS. We're going with general malaise. Link to comment Share on other sites More sharing options...
Fluffpaw38 Posted February 5, 2008 Share Posted February 5, 2008 So we check PMS in the arm, adema? contusions? Skin color, temp of arm? What was he doing before he felt like this? Any pain in the elbow joint or any where else? Vitals? Did he do anything to try and fix the arm himself? take advil or something? Link to comment Share on other sites More sharing options...
JPINFV Posted February 5, 2008 Author Share Posted February 5, 2008 The hand is warm with a strong pulse of 90 beats/min[blood pressure is 130/76 mm/Hg with resperations at 20 ]. He's complains that he can't feel anything in the back of his hand and forearm. While he can move his arm, he can't seem to get his wrist to move. With significant effort, though, he is able to weakly extend his fingers. He doesn't really have a clear memory about what happened before he went to sleep, but he doesn't have any noticable bruising, tenderness, or deformaties. There is some reddness in the right axillary region. He denies taking any medication since waking up. Link to comment Share on other sites More sharing options...
mobey Posted February 5, 2008 Share Posted February 5, 2008 If I try move it does it hurt? Link to comment Share on other sites More sharing options...
mobey Posted February 5, 2008 Share Posted February 5, 2008 Sluuuurred speach? Muscle twitching? has he noticed any other deficits such as trouble chewing? Was this sudden onset or progressive weakness over the last few days? Link to comment Share on other sites More sharing options...
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