crotchitymedic1986 Posted December 29, 2008 Share Posted December 29, 2008 It's approximately 17:30 hours, and you respond to "unresponsive child". Upon arrival at the scene, you find an 8 year old girl, unconscious, unresponsive, and diaphoretic. She got off the school bus at grandma's house around 16:30, and was feeling fine. She told grandma that she had fallen on the playground at school earlier that date, and asked grandma if she could have a band-aid, then went out into the backyard to play. Vitals: Pt unconscious/unresponisve on ground in back yard. No radials - B/P 50 palp Monitor - Sinus Tach at 140 - no ectopy D-Stick - 112 RR 18, pulse ox 94%, lungs clear Skin pale and diaphoretic No hx, no meds, no allergies -- perfectly healthy child. There is no evidence of trauma, fall, insect sting, or overdose --- playmates state she just passed out. Go for it ...................................... Link to comment Share on other sites More sharing options...
Kaisu Posted December 29, 2008 Share Posted December 29, 2008 O2 high flow with NRB, immediate IV access, I/O if you cant get an IV, start with 20ml/kg fluid bolus- - recheck BP. Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted December 29, 2008 Author Share Posted December 29, 2008 Good treatment so far, but if that didnt work or atleast improve the situation, what would be your next course of treatment ? What are your thoughts as to why the patient is in this condition ? Link to comment Share on other sites More sharing options...
Kaisu Posted December 29, 2008 Share Posted December 29, 2008 check lung sounds... pneumo? Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted December 29, 2008 Author Share Posted December 29, 2008 Lung sounds are clear and equal -- respirations are shallow, most likely due to current condition. If all you did was the treatment that you first stated kaisu, you would probably improve the patient's condition, but would be embarrased upon arrival at the ER. Keep thinking about the cause. It is not obvious, but this was a real call, and could happen again very easily. Link to comment Share on other sites More sharing options...
scubanurse Posted December 29, 2008 Share Posted December 29, 2008 What are pupils like... Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted December 29, 2008 Author Share Posted December 29, 2008 pupils are normal and equal, a bit sluggish to light. Link to comment Share on other sites More sharing options...
scubanurse Posted December 29, 2008 Share Posted December 29, 2008 What part of the body is the band-aid on? Just throwing this out there but it could be some kind of emboli.... Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted December 29, 2008 Author Share Posted December 29, 2008 scuba is getting warm. it is on her right knee, but you cant see it because it is under her pants leg. Link to comment Share on other sites More sharing options...
scubanurse Posted December 29, 2008 Share Posted December 29, 2008 So let's expose and check out the coloring of the legs.... Cut both pant legs and do a full assesment looking for eccymosis and the like.... Link to comment Share on other sites More sharing options...
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