RomeViking09 Posted September 10, 2007 Share Posted September 10, 2007 Scenario setting: Resident Overnight Scout Camp in the Blue Ridge Mountains in North GA Time: 1322 Local Time Call Info: A Scoutmaster with reaction to ant bites has stepped in a bed of red fire ants. at 1325 medic (you) are on scene with a BTLS Jump Bag and you have pulled 2 EpiPens from the Drug Lock Up. You know from the health form review that the PT carries EpiPens for ant bites, once on scene you find that the PT has given himself two .3ml EpiPens in the last 5 min "he did not feel the first one working" Baseline Vitals: A+O x4 (Destressed) RR 23/Regular/Labored HR 106/Regular/Bounding BP 145/P Pupils PERRL @6mm STCM Red/Hot/Damp Camp Ranger is Standing by to move the PT to the Camp Health Lodge. ALS has been called and will be on scene in 1 hour and 45 min the camp heath lodge is stocked with almost everything that would be on a BLS ambulance with access the the following Drugs: Acetaminophen Ibuprofen Naproxen Diphenhydramine HCL Pseudoephedrine HCL Epinephrine 1:1000 (5x 0.3ml EpiPen, 5x 0.15ml EpiPen) You team is yourself, The Camp Director (retired EMT-I/85), the Camp ranger (retired Fire Fighter/ EMT-P), 2nd Medic (in route to scene who is EMT-I/85) and Camp Health Officer (LPN with no Emergency Training works as a School Nurse and is not on Scene) Post how you would treat the PT while waiting for the ALS truck (you do have access to On-Line Direction from the ER and radio comm to the truck in route to the camp) Link to comment Share on other sites More sharing options...
Eydawn Posted September 11, 2007 Share Posted September 11, 2007 Well, per your last scenario's response I sure hope you restocked the nonrebreathers.... because that's the first thing I want on this guy. I also want to know his max epi dose and whether the 2nd one is helping much. Does he take benadryl ever for this? If so, as an adult he can choose to grab your benadryl bottle and take some.... does he have any other medical history or other medications? Have you removed him from the ant nest and ensured your own safety? Can you start an IV on him? Can you possibly ship him out with a BLS responding agency and have them rendezvous with ALS, to speed things up a touch? Give more epi if online med control or his maximum dose indicate that he can receive more, and if he doesn't show improvement from the prior doses. Possibly benadryl per online medical control or patient's normal routine, 12-15L via the nonrebreather, monitor vitals. Watch for airway compromise. Wait for ALS, or start him going with BLS if he's not improving... Wendy CO EMT-B Link to comment Share on other sites More sharing options...
Chief1C Posted September 11, 2007 Share Posted September 11, 2007 Pretend the ambulance is 2 hours away, and you're officially in the wilderness. Two hours from civilization. Maybe give some DPH, wait a few and give the epi a chance to work, unless it just isn't working, maybe then another epi, o2 is a given.. Take some ammonia or bleach and add water, and rub it on the bites, or some OTC cream. Hell with the ground ambo, wtf.. If you can call a ground ambo, you can most certainly request a medical helicopter. Any emergency in a true wilderness situation qualifies a person to be flown. Link to comment Share on other sites More sharing options...
spenac Posted September 11, 2007 Share Posted September 11, 2007 Pretend the ambulance is 2 hours away, and you're officially in the wilderness. Two hours from civilization. Maybe give some DPH, wait a few and give the epi a chance to work, unless it just isn't working, maybe then another epi, o2 is a given.. Take some ammonia or bleach and add water, and rub it on the bites, or some OTC cream. Hell with the ground ambo, wtf.. If you can call a ground ambo, you can most certainly request a medical helicopter. Any emergency in a true wilderness situation qualifies a person to be flown. May not have helicopter available. We can't get a helicopter down my neck of the woods. Nearest they will come is 60 miles away. Link to comment Share on other sites More sharing options...
RomeViking09 Posted September 11, 2007 Author Share Posted September 11, 2007 Helicopters are not going out to us for something unless the PT needs a Level 1 Trauma Center Link to comment Share on other sites More sharing options...
Dustdevil Posted September 11, 2007 Share Posted September 11, 2007 Give more epi if online med control or his maximum dose indicate that he can receive more, and if he doesn't show improvement from the prior doses. Whoa there, slow down! Take another look at the exam results and vitals. What kind of "improvement" are you looking for anyhow? What are you trying to correct? How old is this guy? What is his medical history? And what sort of reactions has he experienced to ant bites in the past? These must be Volunteer Fire Ants. All the professional Fire Ants are in Texas. Link to comment Share on other sites More sharing options...
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