itku2er Posted January 7, 2010 Share Posted January 7, 2010 You are called to the house of 45 yo female on hospice for cervical Cancer. CC: Pain BP 190/90 HR:64 Resp 12 O2 sat 75 RA How do you treat this patient? NKDA Pain rated at 20 on a scale of 1-10 Alert and responsive Link to comment Share on other sites More sharing options...
joesph Posted January 8, 2010 Share Posted January 8, 2010 ok abc,s appear to be OK how is air way, questions location of pain, started when, quality,radiating so on, meds list alergies, events leading up to this, last oral intake, expand current medical history, breath sounds what is patents general appearance and skin color. Actions o2 15 lpm on nrb and may examine abdomen or pain area if pertinent and productive. 1 Link to comment Share on other sites More sharing options...
itku2er Posted January 8, 2010 Author Share Posted January 8, 2010 ok abc,s appear to be OK how is air way, questions location of pain, started when, quality,radiating so on, meds list alergies, events leading up to this, last oral intake, expand current medical history, breath sounds what is patents general appearance and skin color. Actions o2 15 lpm on nrb and may examine abdomen or pain area if pertinent and productive. Pain in lower abd, started about 10 min prior to calling ems. NKDA current meds: PCA pump with Morphine 2mg/hr continous with a extra dose of 1mg Q15 min. xanax for anxiety Zofran for the N/V Skin warm dry ashened color. Link to comment Share on other sites More sharing options...
letmesleep Posted January 8, 2010 Share Posted January 8, 2010 Given the information noted above, I have 1 question for the pt and family........Do you want transport to the hospital? Link to comment Share on other sites More sharing options...
Chief1C Posted January 8, 2010 Share Posted January 8, 2010 How do you respond? ...with an ambulance. 2 Link to comment Share on other sites More sharing options...
fireflymedic Posted January 8, 2010 Share Posted January 8, 2010 (edited) Given the information noted above, I have 1 question for the pt and family........Do you want transport to the hospital? That would be my question exactly. If so, ask the person what they want done and ask for copy of DNR (and EMS DNR if required by your state). Treat with comfort measures, and don't get aggressive. However, I wouldn't withold oxygen and things - Do not resucitate does not mean do not treat ! Provide pain control, oxygen, what you can without exceeding the person's wishes. Do I feel the need to rush to the hospital? Probably not - I would go without L/S unless company protocol dictated otherwise. All that being said, it may be related to something completely different, and if it is something that you can correct, by all means do so ! Edited January 8, 2010 by fireflymedic Link to comment Share on other sites More sharing options...
letmesleep Posted January 8, 2010 Share Posted January 8, 2010 That would be my question exactly. If so, ask the person what they want done and ask for copy of DNR (and EMS DNR if required by your state). Treat with comfort measures, and don't get aggressive. However, I wouldn't withold oxygen and things - Do not resucitate does not mean do not treat ! Provide pain control, oxygen, what you can without exceeding the person's wishes. Do I feel the need to rush to the hospital? Probably not - I would go without L/S unless company protocol dictated otherwise. All that being said, it may be related to something completely different, and if it is something that you can correct, by all means do so ! My thoughts exactly, a little comfort and compassion will go a long way! Link to comment Share on other sites More sharing options...
Medic2945 Posted January 8, 2010 Share Posted January 8, 2010 over ride her pump and allow her to pass peacefully and pain free. Link to comment Share on other sites More sharing options...
P_Instructor Posted January 8, 2010 Share Posted January 8, 2010 Question......If this patient is already on pain meds with booster, isn't anyone thinking about why all of a sudden the pain has increased in such a short time span? Is this an exacerbation of existing problem, or is there something else going on? The belly has got a bunch of things in it people! Gee, sounds like the other post......do we palpate the abdomen? Let us know what the outcome was. Link to comment Share on other sites More sharing options...
Timmy Posted January 8, 2010 Share Posted January 8, 2010 over ride her pump and allow her to pass peacefully and pain free. 1 Link to comment Share on other sites More sharing options...
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