scubanurse Posted January 5, 2009 Share Posted January 5, 2009 You're dispatched around the corner from your station for the 22YOF with an altered mental status and difficulty breathing. You arrive to find a female in tripod position sitting in living room. Presents with 2-3 word dyspnea and apparent giddiness... patient is attempting to laugh at whatever you say. Breath sounds somewhat normal they just sound a little "rough", Heart sounds reveal a somewhat loud S2, sinus brady with unifocal pvc's ~ 3 a minute. NKDA, pt on BC, No past med history/history of abusing drugs/alcohol, no one know what pt was doing prior to symptoms. What could be wrong/ treatment... Link to comment Share on other sites More sharing options...
Arizonaffcep Posted January 5, 2009 Share Posted January 5, 2009 Other important question...does the Pt smoke? With the BC, my first thought would be a PE...would explain the giddiness (hypoxia) and SOB. Link to comment Share on other sites More sharing options...
scubanurse Posted January 5, 2009 Author Share Posted January 5, 2009 no evidence of the patient smoking... friends report she hates cigarettes and the smell. Link to comment Share on other sites More sharing options...
chbare Posted January 5, 2009 Share Posted January 5, 2009 Possibility of pregnancy? Possible PE? Allergies, Past Hx, Vital signs? JVD? What was she doing prior to this incident (HPI?) Take care, chbare. Link to comment Share on other sites More sharing options...
scubanurse Posted January 5, 2009 Author Share Posted January 5, 2009 always a possibility of pregnancy but friends deny bf or anything and she is on BC (no pills appear to be missing)... allergic to latex (no known exposure/no signs of allergic rcn) BP 168/97 P 42 RR 18 Skin is dry and warm Pupils perrl negative JVD friends say she was outside messing around and came in acting "weird" They don't know what she was doing nor did they go and look. Link to comment Share on other sites More sharing options...
TylerHastings Posted January 5, 2009 Share Posted January 5, 2009 Any evidence of recreational drugs...send another member of your crew to where the patient was outside and take a look around see if anything is out of the ordinary. What do the friends state that the patient was doing outside... Link to comment Share on other sites More sharing options...
scubanurse Posted January 5, 2009 Author Share Posted January 5, 2009 Friends have no clue... no evidence of recreational drug use... partner reports nothing found outside.... some posters she had been working on drying on the back porch. Link to comment Share on other sites More sharing options...
TylerHastings Posted January 5, 2009 Share Posted January 5, 2009 what kinda posters were they painted if so with what kind of paint... Link to comment Share on other sites More sharing options...
Timmy Posted January 5, 2009 Share Posted January 5, 2009 SP02? Using Accessory Muscles? Cynosis? Since we've been outside and come inside acting weird is there any trauma? Bit/punchure marks? Wounds ect evident? Resp rhythm and effort? Any sign of an airway obstruction? If things are still going down hill then: 02, pop in an IV, atropine, adrenaline, neb ipratropium and Salb. And if things are turning to crap maybe prepare for an RSI. Is it a possible that the patient has been exposed to something organophosphate'y? Link to comment Share on other sites More sharing options...
crotchitymedic1986 Posted January 5, 2009 Share Posted January 5, 2009 Good call on the paint -- i vote reaction to latex in the paint Link to comment Share on other sites More sharing options...
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