strippel Posted February 20, 2006 Share Posted February 20, 2006 I would follow the MI or CVA protocol. It would depend on how his chest pain presented, and if you wanted to give him nitro and ASA. I think it is TNT. (as in nobody has more drama in the daytime than TNT) Link to comment Share on other sites More sharing options...
Asysin2leads Posted February 20, 2006 Share Posted February 20, 2006 It was bullshit. I wish I had a fake plastic Oscar in my tech bag to give to people when they were doing their routine. Look at his vitals. Right on point for someone who was agitated and upset but physiologically ok. I mean, sure maybe he was having some sort of weird off the wall House M.D. episode TIA where he had a sudden onset of hemiparesis, but I really doubt it, more like he was some schmuck looking for attention. I really hope his parents were well insured, its always heart breaking when you see someone like that sattle their poor family with hospital bills because they need a little attention. I've noticed in my career that people of lower economic class tend to have a lower incidence of paroxysmal idiopathic syncope, with one notable exception. In certain parts of the city, there is a certain ethnic group who shall remain nameless, who are occasionally stricken with a related syncopal disorder known colloquially as the "Ai-yai-yais." This usually occurs when a young woman and a young man get into a heated discussion following some Coronas, words get exchanged back and forth and back and forth until, finally, the man has enough and CRACK! smacks her across the face. In our culture, this is spousal abuse. In their culture, apparently, it is legitimate means to end an arguement. After that, its all over, suddenly the woman is on the floor, passed out, not moving, and the family is around her DESPERATELY trying to wake her up (hence the term, 'ai-yai-yais') and throw water on her and pray and light candles (I'm not exaggerating, this is really what happens) and call 911, for the ambulance to come and revive her. This leads the poor, inexperienced, bewildered EMS crew dispatched to an unconscious secondary to trauma, and given the chaotic scene, can really look very bad, after all, you really can get very hurt if someone hits you hard enough in the face. But usually, almost always, its not neurogenic shock secondary to cervical trauma, its just a case of the ai-yai-yais. Arouse her gently, start making like you're about to start an IV, and you'll get a miraculous recovery and even walk away with an RMA, plus a few new friends. Really, you could probably go back later off duty and have a few Coronas at the party, you'll be the star of the scene, and let me tell ya, being a hero in front of a few of the girls from Telemundo is not the worst place you can find yourself. Yes, that was sexist and innappropriate and I don't care. Suck it up. Note: The comorbidity of the families presentation, charactized by hypertension, tachycardia and tachypnea, is known collectively as 'status hispanicus'. Link to comment Share on other sites More sharing options...
ERDoc Posted February 20, 2006 Share Posted February 20, 2006 It was bullshit. I wish I had a fake plastic Oscar in my tech bag to give to people when they were doing their routine. Look at his vitals. Right on point for someone who was agitated and upset but physiologically ok. I mean, sure maybe he was having some sort of weird off the wall House M.D. episode TIA where he had a sudden onset of hemiparesis, but I really doubt it, more like he was some schmuck looking for attention. I really hope his parents were well insured, its always heart breaking when you see someone like that sattle their poor family with hospital bills because they need a little attention. I've noticed in my career that people of lower economic class tend to have a lower incidence of paroxysmal idiopathic syncope, with one notable exception. In certain parts of the city, there is a certain ethnic group who shall remain nameless, who are occasionally stricken with a related syncopal disorder known colloquially as the "Ai-yai-yais." This usually occurs when a young woman and a young man get into a heated discussion following some Coronas, words get exchanged back and forth and back and forth until, finally, the man has enough and CRACK! smacks her across the face. In our culture, this is spousal abuse. In their culture, apparently, it is legitimate means to end an arguement. After that, its all over, suddenly the woman is on the floor, passed out, not moving, and the family is around her DESPERATELY trying to wake her up (hence the term, 'ai-yai-yais') and throw water on her and pray and light candles (I'm not exaggerating, this is really what happens) and call 911, for the ambulance to come and revive her. This leads the poor, inexperienced, bewildered EMS crew dispatched to an unconscious secondary to trauma, and given the chaotic scene, can really look very bad, after all, you really can get very hurt if someone hits you hard enough in the face. But usually, almost always, its not neurogenic shock secondary to cervical trauma, its just a case of the ai-yai-yais. Arouse her gently, start making like you're about to start an IV, and you'll get a miraculous recovery and even walk away with an RMA, plus a few new friends. Really, you could probably go back later off duty and have a few Coronas at the party, you'll be the star of the scene, and let me tell ya, being a hero in front of a few of the girls from Telemundo is not the worst place you can find yourself. Yes, that was sexist and innappropriate and I don't care. Suck it up. Note: The comorbidity of the families presentation, charactized by hypertension, tachycardia and tachypnea, is known collectively as 'status hispanicus'. Not to be politically incorrect either, but in some circles the syndrome you have referred to is called Aye-tach, very unsimilar to v-tach (which is life threatening). My guess in this case is conversion disorder vs. malingering. What feild of work is the pt in? Link to comment Share on other sites More sharing options...
strippel Posted February 20, 2006 Share Posted February 20, 2006 As Asysin2leads states, it is very prevalent in cities of any size. Having a patient acting unresponsive is not uncommon after a fight or any good/bad family event. Many times, they are drenched in water. Sometimes with ice cubes, sometimes they are stuffed in their undies. I have also seen salt water used. It is wonderful when you slosh when you walk. I have been in houses with over 1 inch of water on the floor, which is a PITA when you attempt to check on your patient. There is another ethnic group who acts very similar, except they yell "oy oy oy", and cover their "unconscious" people head to toe in Tiger-Balm. Link to comment Share on other sites More sharing options...
Guest Posted February 20, 2006 Share Posted February 20, 2006 Yah Yah Yah: but was he from nebraska? Any one have some spare Gravol? :pukeright: Link to comment Share on other sites More sharing options...
vcfd35s Posted February 20, 2006 Share Posted February 20, 2006 With the little field experience that I have....im going to take a stab. Looking at all the other posts and looking at the vitals.....my guess would be that the argument that he had with his parents caused him to have chest pain...tightning of the chest....maybe an asthma attack....now im just guessing... :roll: But, it doesnt look like anything serious and I dont think he was going for attention. As an EMT running that call I would just get vitals, 02 with a NRB, asses and have the nitro ready for the medic. Who knows....but I would love to hear what the dx was. Link to comment Share on other sites More sharing options...
xselerate Posted February 20, 2006 Share Posted February 20, 2006 It was bullshit. I wish I had a fake plastic Oscar in my tech bag to give to people when they were doing their routine. Look at his vitals. Right on point for someone who was agitated and upset but physiologically ok. Hey... that makes a lot of sense. Link to comment Share on other sites More sharing options...
medik8 Posted February 20, 2006 Author Share Posted February 20, 2006 LMAO....I've considered all this...PRPG and I had a discussion last night about Fake, vs...??? I plan on making a follow up call today. I'm SO curious..... Will fill you in when I know... Link to comment Share on other sites More sharing options...
medik8 Posted February 20, 2006 Author Share Posted February 20, 2006 My guess in this case is conversion disorder vs. malingering. What feild of work is the pt in? Patient only works at a part time job, is mostly a student from what I gather. And no, North...he wasn't from Nebraska...lmao... :wink: *8* Link to comment Share on other sites More sharing options...
mamamo899 Posted February 20, 2006 Share Posted February 20, 2006 Okay, first thought MI, then possible CVA, BUT I think in the end I would go for playing it up. Nothing really makes sense as a whole. Where I worked prior to this, we had a patient who would fake seizures all the time but never seem to be incontinent. Another of my (stupid) coworkers informed him that if he were really having a seizure, we would be incontinent. Guess what? Next time I picked him up, he WAS incontinent. It never fails to surprise me what some people will go through for attention. I would be very interested to find out what was actually wrong w/him. I liked the reference to House w/all the weird presentations.... Link to comment Share on other sites More sharing options...
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