NYCEMS Posted April 19, 2009 Share Posted April 19, 2009 you find a 56 yr old male supine in bed unresponsive. no obvious signs of injuries. b/p 122/76 rr 16 pulse 84 pupils constricted. sugar at 144 family sts pt never goes to doctor and therefore they have no medical history for him. they do state pt alcoholic and last seen a & o was night before. Also that pt doesn't use any drugs. Link to comment Share on other sites More sharing options...
FireMedic65 Posted April 19, 2009 Share Posted April 19, 2009 you find a 56 yr old male supine in bed unresponsive. no obvious signs of injuries. b/p 122/76 rr 16 pulse 84 pupils constricted. sugar at 144 family sts pt never goes to doctor and therefore they have no medical history for him. they do state pt alcoholic and last seen a & o was night before. Also that pt doesn't use any drugs. do you want us to figure it out or are you going to tell us? This section is for discussion of EMS stuff. If you want to discuss what happened, go ahead. If you want us to figure out what is going on with the patient, please move it to the scenario section. Link to comment Share on other sites More sharing options...
mobey Posted April 19, 2009 Share Posted April 19, 2009 you find a 56 yr old male supine in bed unresponsive. no obvious signs of injuries. b/p 122/76 rr 16 pulse 84 pupils constricted. sugar at 144 family sts pt never goes to doctor and therefore they have no medical history for him. they do state pt alcoholic and last seen a & o was night before. Also that pt doesn't use any drugs. 4 questions to start What's a "rule out"? Is the sugar normal ( we use mmol in Canada... sorry)? Temp? Signs of drug use? Link to comment Share on other sites More sharing options...
NYCEMS Posted April 19, 2009 Author Share Posted April 19, 2009 do you want us to figure it out or are you going to tell us? This section is for discussion of EMS stuff. If you want to discuss what happened, go ahead. If you want us to figure out what is going on with the patient, please move it to the scenario section. ok didn't know there was a section for senario's only. I use that in the future. 4 questions to start What's a "rule out"? Is the sugar normal ( we use mmol in Canada... sorry)? Temp? Signs of drug use? rule out means what do you think the pt may have. we don't check temp at my job but pt was warm to touch no signs of drug use wa have 120 to 200 as normal glucose level Link to comment Share on other sites More sharing options...
FireMedic65 Posted April 19, 2009 Share Posted April 19, 2009 144 mg/dl = 8 mmol/l and normal BGL is is roughly 70-120mg/dl according to text books. Link to comment Share on other sites More sharing options...
mobey Posted April 19, 2009 Share Posted April 19, 2009 So rule out = Differential Diagnosis. Gotchya Any history of current illness from family? Is the patient responsive to pain? Loss of continence? 12 - lead? SpO2/skin coulor and condition? Have partner do a search of the house for medications (or empty bottles that should contain them) Link to comment Share on other sites More sharing options...
FireMedic65 Posted April 19, 2009 Share Posted April 19, 2009 (edited) when was his last drink? I'm willing to bet it's alcohol related. Seizure from not having a drink for awhile. Edited April 19, 2009 by FireEMT177959 Link to comment Share on other sites More sharing options...
NYCEMS Posted April 19, 2009 Author Share Posted April 19, 2009 So rule out = Differential Diagnosis. Gotchya Any history of current illness from family? Is the patient responsive to pain? Loss of continence? 12 - lead? SpO2/skin coulor and condition? Have partner do a search of the house for medications (or empty bottles that should contain them) Als advised normal 12 lead, pt is incontinent ( sorry left that out) Skin warm dry and unremarked. Pt not on any medications as family sts pt doesn't go to doctor. pt unresponsive to pain when was his last drink? I'm willing to bet it's alcohol related. Seizure from not having a drink for awhile. late seen alert and drinking alcohol the night before do you want us to figure it out or are you going to tell us? This section is for discussion of EMS stuff. If you want to discuss what happened, go ahead. If you want us to figure out what is going on with the patient, please move it to the scenario section. I do know the outcome of the pt if you'd like me to fill you in now say so. Link to comment Share on other sites More sharing options...
FireMedic65 Posted April 19, 2009 Share Posted April 19, 2009 I do know the outcome of the pt if you'd like me to fill you in now say so. no, I was just confused because of where you posted the topic that's all. Link to comment Share on other sites More sharing options...
NYCEMS Posted April 19, 2009 Author Share Posted April 19, 2009 no, I was just confused because of where you posted the topic that's all. so since I know the outcome I should say it then making this ems discussion??? Link to comment Share on other sites More sharing options...
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