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You are responding to a 21 year old female who is CONSCIOUS and BREATHING.

The scene is safe and there is no danger.

You are an ALS unit responding with a BLS unit.

The BLS unit is 5 minutes away from the scene. You are 20 minutes away.

The call is a "Echo Level, Confirmed Choking"...well...at least thats what Dispatch says. And we all know how dispatch is... :D

Call-Take Notes say that: "Your responding to a 21 year old female who has eating three tablespoons of cinnamon...and is now unable to breath...patient is drinking water".

Thats all you have.

Once you (The ALS) unit arrive on scene. You find a 21 year old female, who is pretty..and *oops*...nevermind...uhm...a 21 year old female who is concious and breathing. She is extremely nervous, and she is home alone. BLS units say she ate three tablespoons of pure cinnamon for "fun".

Vitals are:

BP: 150/80

HR: 140 Strong/Regular

RR: 30 shallow/and slightly labored

SPO2: 90% with a NRB

Breath Sounds (not that this is VS...but...just...but): equal on both sides

The patient is NOT coughing but is "huffin' and a puffin"...almost like...wheezing.

You have three EMT-Bs on scene and yourself (a EMT-P).

What would you do?

** The patient is in OBVIOUS respiratory distress, with a low o2 SAT of 90% even with NRB.

You are about 20 minutes away from the closest hospital non-emergency. You are about 10 minutes away from the hospital emergency. No allergies, no medications, no medical hx, last oral intake is UNK. The pt is very nervous.

How would you treat?

p.s. this is my first scenario...i know they're big mistakes here and there...just let me know what other info you want.

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Just an update: You are unable to contact OLMC due to "special circumstances"...and...

here is a good video of what she is expierencing: http://youtube.com/watch?v=PG8bSMDMKG0

Starting on the 28 second in the video is what she is expierincing...unfortunatley it contineus and drinking the water doesnt help.

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bone head moves,... ok first of all we have done this at the building and 3 people have been able to pull this off w/o issue. the problem is when you inhale it becomes the issue because of the properties of cinnamon it dries up everything it hits. so if one inhales this, it will clog up and clomplicate the airway, in the video she is moving air. commad will have to be called for special circumstances, but will need to be treated aggressivly, my guess is going to be either humidified o2, or possible albuterol tx. this ill have to consult with command, see if they have dealt with this.

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WOW, that is the dumbest $hit I have ever seen.

Anyhoo.. because the lung sounds are clear for now, I would fill a nebulizer with saline and set it at 6lpm. Make sure the ventolin is handy, I am not sure how the cinnamon is going to act once I pour the fluid at it.

I would also encourage coughing and spitting, and make sure there is no more cinnamon left in her mouth.

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I guess the big question in my mind is if she is experiencing anaphylaxis or not. A big heap of cinnamon could set off a reaction even in someone who had no previous incidents.

So her heart rate is up, and her saturation is down. If she aspirated, I would treat as any other aspiration pneumonia, High flow 02, monitor airway, transport.

Her behavior, heart rate, and Sat don't quite match. If she was tachying out in the 140's with a sat of 90, I think she'd be looking like crap at that point. Rule out possibility of drug use, search house, use bright lights and telephone book if necessary. Just kidding. The differential here for me would be aspiration vs. anaphylaxis. Other than she is just stupid and deserves to be stuck in the ER for a few hours with an IV in her arm. And if the the local FD needs some press they can feel free to dramatically rush her out the front door with an NRB on, and the local press could do a good scare the parents what YOUR teen is doing the latest craze thing on next.

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Adrenaline for upper airway obstruction (not) :D

Seriously, there’s not much we can do apart from what’s already been said. Just keep a tab on vitals and treat any deterioration.

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The call is a "Echo Level, Confirmed Choking"...well...at least thats what Dispatch says. And we all know how dispatch is... :D

Dude, how ould you know what dispatch would say?? Set your age to 14 where it should be, and im curious as to how you are going to judge people answer as an EMT P if your not even a basic?

Other than that, cinnamon!!! WTF!! :laughing6:

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Shouldn't this girl be featured on Stupid People Tricks with David Letterman?

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Darn I thought this was going to be a bash ECHOBURGER topic. :twisted: :twisted:

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