ERDoc Posted August 24, 2008 Share Posted August 24, 2008 Here is another scenario for you (yes, it is a slow night in the ER). You are called to the residence of a 42 y/o male who is c/o sob. He was released from the hospital 5 days ago after having the lower and middle lobes of his right lung removed due to cancer. The surgery was 2 weeks ago and his postop course was relatively uneventful. He started feeling sob earlier in the day and has noted some bleed streaks in his sputum when he coughs tonight. What do you want to know? Link to comment Share on other sites More sharing options...
Mateo_1387 Posted August 24, 2008 Share Posted August 24, 2008 I'll start this one off... General impression? Is the patient in great distress breathing? Resp rate, volume, quality, breath sounds? Pulse rate, quality, location? Skin color/temp, mucus membrane color? Link to comment Share on other sites More sharing options...
ERDoc Posted August 25, 2008 Author Share Posted August 25, 2008 He does not appear to be in much discomfort. He is able to speak in full sentences. RR22 with sat 94% on room air. Lung sounds are clear on the left. The right has mininal sounds except in the upper area where you hear some rhonchi. HR 98, regular. Skin is warm and dry, no diaphoresis. Mucous membranes are pink. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted August 25, 2008 Share Posted August 25, 2008 He does not appear to be in much discomfort. He is able to speak in full sentences. RR22 with sat 94% on room air. Lung sounds are clear on the left. The right has mininal sounds except in the upper area where you hear some rhonchi. HR 98, regular. Skin is warm and dry, no diaphoresis. Mucous membranes are pink. nope nope nope you aren't gonna throw us with that red herring on his lung sounds, nope not gonna do it. Link to comment Share on other sites More sharing options...
zzyzx Posted August 25, 2008 Share Posted August 25, 2008 Do we have a 12-lead? Any recent illness? Chest pain? Complete medical Hx? Vital signs? Link to comment Share on other sites More sharing options...
ERDoc Posted August 25, 2008 Author Share Posted August 25, 2008 Do we have a 12-lead? Any recent illness? Chest pain? Complete medical Hx? Vital signs? 12-lead shows NSR with a rate of 94. No recent illness other than having his lung removed. Only history is the lung ca. No other surgeries. NKA. BP 142/90, other vitals as stated. Link to comment Share on other sites More sharing options...
ERDoc Posted August 25, 2008 Author Share Posted August 25, 2008 nope nope nope you aren't gonna throw us with that red herring on his lung sounds, nope not gonna do it. What could you possibly mean? :wink: Link to comment Share on other sites More sharing options...
zzyzx Posted August 25, 2008 Share Posted August 25, 2008 If I ran this call for real, I would probably put the blood streaks down to 1) his surgery 2) his cancer 3)pneumonia 4) pulmonary embolism (less likely). But of course I know ERDoc isn't going to make it so easy. For now I would just transport ALS, and I'll be sure to keep listening to his lung sounds in case something changes. Link to comment Share on other sites More sharing options...
Mateo_1387 Posted August 25, 2008 Share Posted August 25, 2008 Are we riding on the same ambulance with the tricorder? Link to comment Share on other sites More sharing options...
firedoc5 Posted August 25, 2008 Share Posted August 25, 2008 If I ran this call for real, I would probably put the blood streaks down to 1) his surgery 2) his cancer 3)pneumonia 4) pulmonary embolism (less likely). But of course I know ERDoc isn't going to make it so easy. For now I would just transport ALS, and I'll be sure to keep listening to his lung sounds in case something changes. Pretty much covered what I was going to say. :wink: Link to comment Share on other sites More sharing options...
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