Help! His passed out in the toilet!

[Chief1C]

ETOH?

[Kaisu]

Dehydration, vagaled down on the toilet. Give him IV fluid - our protocols say 250ml and reassess.. a young healthy kid can take a liter.. fix the BGL - D50 making DAMN sure you have a patent IV - stick him on a heart monitor - take him to the hospital.

[rock_shoes]

Fresh set of vitals. If the sugar is still low after the glucose given by the FR put some dextrose through the IV and bring it into the acceptable range (Don't forget the Thiamine). Whats the patient's GCS with the his sugar brought back up?

[defib_wizard]

IV with fluid bolus of 500-1000cc + 25gm dextrose 50% ivp . What does the monitor show for a rhyhm. If after the D50 no change in loc and he still has an opa. Intubate him and continue to assist with a bag valve. start transport to hospital.

[rock_shoes]

IV with fluid bolus of 500-1000cc + 25gm dextrose 50% ivp . What does the monitor show for a rhyhm. If after the D50 no change in loc and he still has an opa. Intubate him and continue to assist with a bag valve. start transport to hospital.

Why so much fluid so fast? I'd want to start with 500mL NS, re-auscultate and get another BP before giving any more than that. Did we get a rhythm strip? Also let's get another BGL before sticking a tube down the kids throat on the off chance his sugars are still low (I realize this is unlikely with that amount of D50). Also did we check the kids pupils yet? (I mean since the arrival of ALS)

[Arizonaffcep]

You can...but with the hypotension and dehydration, he's young and "healthy" until now...you could probably infuse several liters before you would need to worry much. Based on the vitals, I would say he could be in stage 4 shock (ALMOST brady with hypotension). But it feels wrong. I'm thinking possible opioid OD when you couple all the vitals together. I'd give 2mg narcan (post D50 with a second or even third d-stick). Go from there. Of course skills wise, IV, O2, Monitor .

[Timmy]

You give glucagon and push fluids. ECG shows a dysthrythmia (I cant remember what it was but one that will 'fix it self' once his been re hydrated) vitals are improving and BGL is coming up. The kid is now responding to your voice but is still quiet disorientated but able to answer some questions. He is Australian.

[rock_shoes]

You give glucagon and push fluids. ECG shows a dysthrythmia (I cant remember what it was but one that will 'fix it self' once his been re hydrated) vitals are improving and BGL is coming up. The kid is now responding to your voice but is still quiet disorientated but able to answer some questions. He is Australian.

Well let's go with ringers lactate if we have the option then. I take it his being Australian is somehow pertinent? All the usual questions. Allergies/meds, events prior, any medical conditions, last ins and outs. We should be in the midst of a L/S return by now. What were his pupils like? I'd be considering narcan but would be hesitant without at least some pupillary indication. Getting on the horn with med-control ASAP since I don't have a clear idea of everything that's going on with this patient at the moment.

[Timmy]

In Australia we like to stabilize on scene if we can, his improving with your treatment so there’s no hurry. We have no med control, just guidelines, so do what you like. After talking with him you find out his been at a party, has not had any sleep/eaten/had any fluids apart from alcohol in the last 48 hours. He states his had around 1250mls (around 5 cans) of Red Bull and a ‘no doze’ tablet this morning as a pick me up.

[scott33]

You give glucagon and push fluids. ECG shows a dysthrythmia (I cant remember what it was but one that will 'fix it self' once his been re hydrated)

Rehydrated with what? Amiodarone?

He is Australian.

Rapid infusion of Fosters Lager PO. Treat and release, job done!