Timmy Posted March 22, 2009 Share Posted March 22, 2009 Your at a local high school, everyone knows your involved with the local hospital/EMS and your asked to look in on a girl who the school RN is looking after. You have a 17 year old female who is having intermittent, spontaneous, tonic clonic seizures. The girl has a history of these seizures, the school RN states these seizures are psychosocial and no epileptic in nature, they think certain stresses may be the trigger (lol). Seizures started E/C appendix post 7 months with some sort of complication peri surgery. The RN informs you that an ambulance is not to be called on the parents orders, as this issue has been raised before. You call the family who advice you also not to call an ambulance. The girl is under the care of a consulting neruo doctor in a major paediatric hospital and has instructed the family not to call an ambulance, just to take the girl home and rest. The patient is not on any medication or current treatment as the seizures are not epileptic and there unsure of the cause. The girl has around 9 seizures a day, on this particular day she has a seizure, stops then goes back into one, this continues for about an hour. The parents arrive at the school, thank you very much for your assistance and carry her (still having a seizure) to the car. The girl returns to school the next day only to face the same problem. This situation is a daily/normal occurrence. You cant get any vitals apart from the patient is maintaining some sort of airway and has a pulse... Apart from the obvious fact of why they keep sending her back to school, what can you do? Just follow the advice of the people in the know? Link to comment Share on other sites More sharing options...
DartmouthDave Posted March 22, 2009 Share Posted March 22, 2009 Hello, "Seizures started E/C appendix post 7 months with some sort of complication peri surgery." Just a quick question. What dose 'E/C' mean? Is 'peri surgery'? Endoscopic surgery? Difficult situation for EMS. Did the nurse have any patient records from the consulted hospital that may help illuminate the situation? Cheers, D Link to comment Share on other sites More sharing options...
Timmy Posted March 22, 2009 Author Share Posted March 22, 2009 Hello, "Seizures started E/C appendix post 7 months with some sort of complication peri surgery." Just a quick question. What dose 'E/C' mean? Is 'peri surgery'? Endoscopic surgery? Difficult situation for EMS. Did the nurse have any patient records from the consulted hospital that may help illuminate the situation? Cheers, D E/C means removal of and per surgery meaning sometime during the surgery they experinenced a complication. Link to comment Share on other sites More sharing options...
Emtgirl101 Posted March 22, 2009 Share Posted March 22, 2009 i have a seizure problem myself and i have been dealing with it for years it is very hard to deal with somtimes, especially now that i work, i have to stay on medications and can never mis doses. Link to comment Share on other sites More sharing options...
fiznat Posted March 22, 2009 Share Posted March 22, 2009 (edited) If these are actually seizures (there seems to be some doubt?): call an ambulance. To hell with what the family wants or what the patients says when she is conscious. This is tacit consent and seizures (especially status seizures as what you described) are pathological. The nurse (maybe not you) has a responsibility to this patient and you can't simply sit there and watch her seize for an hour because someone told you on the phone that its all fine. If she his having 9 "seizures" PER DAY she needs to get it handled properly before she comes back to school. Edited March 22, 2009 by fiznat Link to comment Share on other sites More sharing options...
FireMedic65 Posted March 22, 2009 Share Posted March 22, 2009 Sounds like very poor health care to me. Parents won't let you call an ambulance, DR says don't call one. Puts her on no medication even though these are chronic? If she is actively seizing and I am there, I am calling an ambulance to have her taken to see a real doctor. Sounds like very poor health care to me. Parents won't let you call an ambulance, DR says don't call one. Puts her on no medication even though these are chronic? If she is actively seizing and I am there, I am calling an ambulance to have her taken to see a real doctor. Link to comment Share on other sites More sharing options...
DartmouthDave Posted March 22, 2009 Share Posted March 22, 2009 Hello, I agree as well. This sounds like an odd situation that could lead to a big problem for the RN as well as the Paramedics. Not to get off topic too much. E/C <-----Is that short hand for ectomy? I have nver seen it used before. Cheers Link to comment Share on other sites More sharing options...
AnthonyM83 Posted March 22, 2009 Share Posted March 22, 2009 What meds is she taking to try and curb these? Obviously not working well enough with 9 a day and one lasting an hour. Even if they're common, an hour long sz is just asking for some sort of airway problem. Yeah, everything's fine until she aspirates and dies in the bathroom where no one notices or can position her right. Link to comment Share on other sites More sharing options...
p3medic Posted March 22, 2009 Share Posted March 22, 2009 If she is in the care of the RN, unless you have been called by her, or have a higher level of medical license than she does you should probably stay out of it. It isn't your kid, you aren't employed by the school, and have less knowledge about this kids condition than the nurse does. Just my opinion. Link to comment Share on other sites More sharing options...
fiznat Posted March 22, 2009 Share Posted March 22, 2009 If she is in the care of the RN, unless you have been called by her, or have a higher level of medical license than she does you should probably stay out of it. It isn't your kid, you aren't employed by the school, and have less knowledge about this kids condition than the nurse does. Just my opinion. Yeah this is definitely a good point. This sounds like a problematic situation to begin with. I see no reason to get yourself tangled up in it. Link to comment Share on other sites More sharing options...
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