Not another patient with seizures.

[AnthonyM83]

I enjoyed it, thanks.

[Dustdevil]

I hate to let this topic end this way, because it is very misleading.

As it stands, we have made this look like a rare and complicated ALS scenario in which there is very little a BLS provider can do, and therefore should not be particularly interested in or concerned about. Wrong!

The reason I said to work this scenario out logically is because, at the EMS level, it really doesn't matter what diagnostic label you put on the condition, the treatment should be glaringly obvious to providers of all levels. Short and sweet bottom line:

ABC's. Rapid cooling. Fluids. Rapid transport.

• Anybody who wants to call themselves a healthcare professional should absolutely be familiar with what the condition actually is, the pathophysiology involved, and the goals of the treatment regimen. But even a basic Emergency Monkey Technician should immediately recognise the fever as being the primary problem facing them, as well as how to treat the patient. It's not rocket surgery.

And if your service isn't carrying thermometers, your service sucks!

[chbare]

Dustdevil, you are correct. You could call NMS a chemical induced type of heat stroke. Securing the ABC's and rapid cooling is paramount married with rapid transport. In addition, I wanted to give the ALS providers something to work with, so the scenario I gave was a very severe case of NMS. In addition, I wanted everybody to see some of the complications of this syndrome and how it would have been managed after the patient left the care of the EMS crew. This case was nearly identical to a case that I saw in nursing school, of course the hospital had an ICU and the patient was simply transported to the unit, RSI'd and managed on site. You bring out a good point that good BLS could have sustained this patient. Not all cases of NMS are this severe and I would bet a few cases fall through the cracks as simply being called viral syndrome or seizure disorder. So, good assessment skills and an understanding of pathophysiology of your patient, their condition, and medications could actually help make the correct diagnosis. I wanted to wait a while before placing this post, so a few more people would see the scenario. And yes, if you service does not have a thermometer that can check rectal temps, they need to do a system check.

Take care,

chbare.