Eydawn Posted November 21, 2008 Share Posted November 21, 2008 Did I ask what ethnicity or race she is? Talking skin color, jeeze! As in cyanotic, pale, bright red... Also, if she's African American, might be thinking sickle cell as a confounding factor... but I didn't ask that, did I? (Sorry, the prednisone is making me uber cranky.) Wendy CO EMT-B Link to comment Share on other sites More sharing options...
spenac Posted November 21, 2008 Share Posted November 21, 2008 Did I ask what ethnicity or race she is? Talking skin color, jeeze! As in cyanotic, pale, bright red... Also, if she's African American, might be thinking sickle cell as a confounding factor... but I didn't ask that, did I? (Sorry, the prednisone is making me uber cranky.) Wendy CO EMT-B Dang calm down. I had the trouble maker smiley up didn't I? Yes I really figured you meant skin condition such as temp, pale, red, flushed, etc etc. Now I'll forgive you this one time as I hate them darn steriods to. Link to comment Share on other sites More sharing options...
spenac Posted November 21, 2008 Share Posted November 21, 2008 Zebra? Zithromax perhaps? I'm thinking of an illness/condition that a child might mistake the parents as saying zebra. OK Doc name that illness/condition. Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted November 21, 2008 Share Posted November 21, 2008 Well since she is 14 and has been to the doctor, she is either pregnant or was ill. Since she is not on any medications, most chronic ailments can probably be ruled out (Sickle Cell, Asthma, Congenital Heart Problems). Since the other kids are fine, can probably rule out CO poisoning. Regardless of cause, treatment is the same --- A-B-C- Immobilize, Intubate --- D-Stick, Narcan, 10-20 cc/kg fluid bolus (followed by Doapamine if no improvement -- not for cardiac, but because i believe she is severely septic). Best Guesses: 1. Infectious Illness / Sepsis / Menengitis 2. Pregnancy related issues 3. Drug OD / Poisoning 4. Brain illness or injury -- Spinal Trauma or other internal trauma Link to comment Share on other sites More sharing options...
Eydawn Posted November 21, 2008 Share Posted November 21, 2008 For the Basic who can't for the life of her figure out where you got septic from in that brief history and set of vitals, mind elaborating a tad? And how can you rule out other illnesses- you're going to trust a 5 year old on a medical history for someone? That's why I want to physically look for bottles, purse contents, etc. Finding bottles of narcotic pain meds would up my suspicion for OD or bad reaction... but I wouldn't necessarily give her narcan just because she's in the hood. *confused* Wendy CO EMT-B Link to comment Share on other sites More sharing options...
Richard B the EMT Posted November 21, 2008 Share Posted November 21, 2008 Whatever all else, the younger siblings are going with big sister to the ER, with dispatch center requested to have the LEOs meet you there (at the ER) to put the younger sibs into temporary protective custody, until the parents can be contacted. Obviously, we want to get the patient to definitive care, and also protect the younger siblings. Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted November 21, 2008 Share Posted November 21, 2008 No problem explaining at all: I would not trust a thing the little ones said, but is all you have to go on. The patient is hypotensive and tachycardic. Being 14, you can pretty much rule out a cardiac event, especially since the kid isnt on meds. The OP said no signs of trauma, so we know it is probably not a trauma event, but i immobilized anyway. The patient has been to the doctor recently and got a zebra, whatever that is to a 5 year old. Most kids in the hood only go to the doctor when they are sick -- they dont get wellness exams. So, why would a 14 year old with no history be at the doctor -- for an illness or a pregnancy in my humble opinion. When children in the hood get sick, sometimes they can not afford the expensive antibiotic or the follow-up visit, so the child could have worsened and became septic, or the more critical infectious diagnosis was missed by the doctor and the doctor thought he was treating a virus or an ear infection, when the child really had menengitis or a severe pneumonia. Narcan is part of the coma cocktail along with D50 that can/should be administered to anyone of altered LOC, when you do not know the cause (it wont hurt the patient -- I give it almost daily to altered nursing home patients who i suspect have been overmedicated to shut them up). This has nothing to do with the hood, lots of teenagers in the burbs are getting high on mommy's pain prescription. In all probability, this is probably an OD, because it was a fairly sudden onset. The child was fine earlier and is now near death. Yes anything is possible, she could have a SA or an undiagnosed heart condition, or even a AAA --- but that would be rare in an otherwise healthy pediatric patient. Link to comment Share on other sites More sharing options...
Richard B the EMT Posted November 21, 2008 Share Posted November 21, 2008 Being 14, you can pretty much rule out a cardiac event, especially since the kid isnt on meds. The child was fine earlier and is now near death. Yes anything is possible, she could have a SA or an undiagnosed heart condition, or even a AAA --- but that would be rare in an otherwise healthy pediatric patient. Glad you covered yourself. Never say never! Link to comment Share on other sites More sharing options...
spenac Posted November 21, 2008 Share Posted November 21, 2008 Narcan is part of the coma cocktail along with D50 that can/should be administered to anyone of altered LOC, when you do not know the cause (it wont hurt the patient -- I give it almost daily to altered nursing home patients who i suspect have been overmedicated to shut them up). . UMMMM. Perhaps you need to look at updating yourself. Coma cocktails are on the out, at least in the field. Link to comment Share on other sites More sharing options...
defib_wizard Posted November 21, 2008 Share Posted November 21, 2008 Another thing to think about is toxic shock syndrome. She is old enough to be going through puberty. A full secondary exam is in order. Link to comment Share on other sites More sharing options...
Recommended Posts