Trouble in the kitchen

[Chief1C]

provide pt care until mom or dad gets their to sign RMA or to bring pt to hospital

I believe it's a staff member, in the kitchen of the preschool. If it were a child, they would be required to have an emergency care/contact permission sheet. i.e. in an emergency, the facility could initiate treatment, and send the pt. away in an ambulance, without the child's legal guardian being present. This would be filled out by the parent/etc, prior to the child attending school. At least that's how schools work around here.

[Gypsy]

I believe it's a staff member, in the kitchen of the preschool. If it were a child, they would be required to have an emergency care/contact permission sheet. i.e. in an emergency, the facility could initiate treatment, and send the pt. away in an ambulance, without the child's legal guardian being present. This would be filled out by the parent/etc, prior to the child attending school. At least that's how schools work around here.

Here we would have one person calling parents while the other calls 911 if this was a child. This was a teacher who also works in the kitchen.

[wrmedic82]

If we are still on the basic level. There is nothing more basic about a good diesel bolus. Unless you drive like someone in a demolition derby.

[cosgrojo]

You get a call to go to a local preschool. The director meets you outfront and takes you into the downstairs kitchen for the school. You see your patient sitting in a stool drinking water looking like she's been hit by a mac truck. Her assissant is standing next to her. The assissant explains she's the one that called because the patient was not acting or thinking straight. It had gotten to the point she was scared and worried that "Karen's" sugar might be dangeriously high. She does know the patient has a history of diabeties but doesn't know any more than that.

Take it away boys and girls. Please keep it more or less at a basic level. Name was replaced to protect the patient's identity.

The blood sugar being in the 220's is not very worrisome... as others have pointed out, everyone is different, so note it.

Is the Patient having any chest pain? Any back pain? Any pain in her arms? Anything that might give further evidence toward some sort of cardiac compromise? Her presentation is one that generally ends up being cardiac or cerebral in nature.

Headache? Any hemi-paresis or weakening of one side of body? Facial droop, PEARLA, arm drift, slurred speech, CSM's positive and equal?

What is the pt's temperature, is she diaphoretic? I know it is hot in the kitchen... has she had a cold lately? Dehydration or sepsis possible.

Med list... has she mistakingly taken too much of a particular drug? Does she have a hx of taking recreational drugs?

Abdominal pain, nausea/vomiting, dizziness, blurred vision? Any obvious signs of trauma?

You have a middle aged female presenting with Altered Mental Status from unknown etiology, most likely cardiac in nature... even if it is not cardiac... ALS should be called. A solid BLS assessment like one outlined above will, however, start the medics out on the right path and give them some valuable information that will help get the patient the best care possible.