Eydawn Posted September 25, 2006 Share Posted September 25, 2006 I might have tried a little oral glucose sublingually (not enough to obstruct the airway) before he conked out.. might be able a little bit at a time to raise the sugar level just enough to wake him up so that you could administer a full oral glucose dose. I have a question, which maybe someone can answer... you can absorb glucose through mucous membranes.. so why, since some basics cannot initiate IV's and thus are precluded from administering D-50, don't we have a glucose suppository of some sort? Seems to me you can't cause a life threat with that and it might be beneficial especially in rural settings where your ALS intercept or transport time might be longer than desired. Any thoughts? Wendy NREMT-B Link to comment Share on other sites More sharing options...
Cookie Posted September 25, 2006 Share Posted September 25, 2006 My first thought on this is if you had done a SAMPLE HISTORY on your first visit, wouldn't you have found that the pt. was insulin dependent? Just a thought and part of the patient assessment, might have saved the second run. Link to comment Share on other sites More sharing options...
Quicksilver Posted November 9, 2006 Share Posted November 9, 2006 Why would you drive "like crazy?" Link to comment Share on other sites More sharing options...
Shelbmedic Posted November 9, 2006 Share Posted November 9, 2006 I have a question for you. May be your guide lines are different than ours in Canada. But you say you had a male who slipped and fell at home and you and your partner did not transport. I understand his wife stated that he has been falling down a lot lately. This would make me think that may be his HR is dropping and he becomes weak and falls to floor or vertigo, maybe his B/P Bottoms out. My Question is did you do vitals on this pt chem strip ,12 lead to R/O his heart. I would asked if he had hit his head in the last while since family stated that he has been fallen alot more. Did you do neuro exam?Did you ask about past medical history, did you ask what medication he was on did you check the meds to make sure he was taken them as he should. had the pt been eating and drinking proper amounts? Not picking on you just wondering what you did in your first exam besides pick the pt of the floor and put him to bed? Link to comment Share on other sites More sharing options...
Dustdevil Posted November 9, 2006 Share Posted November 9, 2006 And if your Medical Director did not call you in and ask for answers to those very same questions after this run, your system sucks. Link to comment Share on other sites More sharing options...
JohnnyEMT Posted November 9, 2006 Share Posted November 9, 2006 So let me know if I get this straight. You already had been to the residence earlier that night (an hour and a half earlier as you had stated) and had you obtained your SAMPLE history, you would have realized that he was a diabetic and realized that chances were his condition was probably associated with this even though he was A and O x 4/4. Is this something that you did? I know that with myself, my level can go below 2 mmoL (normal range is between 4 - 8) and I am still A and O x 4/4, and I present with a slight headache. Now, with this being said, you could have taken his BGL (blood glucose level) on the first call and seen if this was within his normal range and find out what meds he was on and the last time he had eaten. This would have helped you immensely on your second call with him. If you would have taken his BGL on the first call and realized that it was below his normal range, then you could have given him the oral glucose. Here, the EMT use D50W and can also hang a line of D5W to help prevent his sugar levels from spiking then falling below his normal range again. Link to comment Share on other sites More sharing options...
Shelbmedic Posted November 9, 2006 Share Posted November 9, 2006 Dust I agree with you if their medical director didn't haul them into the office. There is something wrong with their system! Link to comment Share on other sites More sharing options...
EMSm0nster Posted January 26, 2007 Share Posted January 26, 2007 Basics can establish IVs? Where are you located? Link to comment Share on other sites More sharing options...
mobey Posted January 26, 2007 Share Posted January 26, 2007 We carry the IM shots and they are excellent for the slightly combative hypoglycemics(when they work). Oral glucose is in our protocol for unCx hypo pts. Squirt it in the buccal membrane and have the suction handy, ya the guy isn't gonna jump out of bed like he just had a dose of D50 but you can only do good with it. And we work in different countries and maybe there are some SOPs or politics I don't know about, but anyone who repeatedly falls out of bed is getting a full work up from me and the doc. A-Fib? so I assume you found an irregular pulse - did it match the meds (Digoxin, coumadin etc..) If not that COULD explain some vertigo, or pre syncope, either way off we go!! You should put some more thought into your first call, I am not calling you wrong but you should make sure you did the right thing chosing not to transport, in case you get the same call @ a different address. Link to comment Share on other sites More sharing options...
anon311 Posted March 25, 2007 Share Posted March 25, 2007 What's A/O x 4? I thought there were only 3 - person/place/time. Link to comment Share on other sites More sharing options...
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