RomeViking09 Posted September 11, 2007 Share Posted September 11, 2007 Scenario setting: Resident Overnight Scout Camp in the Blue Ridge Mountains in North GA Time: 1156 Local Time Call Info: Camper has been found near the lake he looks "loopy" and is being taken to the Health Lodge by an Adult Leader at 1159 the camper and leader walk up to the heath lodge you pull the camper's heath form and see no Hx, the camper says he has not had anything to eat since 0845. Baseline Vitals are: Camper Age 13 A+O x4 GCS 14/13 (problems with obey commands) HR 56/Strong/Reg RR 16/Reg/Unlabored BP 125/65 STCM Pale/Cool/Dry Pupils PERRL @ 5 mm Temp 99.2ºF Blood Sugar 75 mg/dL You give the kid a Gatorade and some water and let him rest for a while and then send him to lunch. @ 1732 The Kid is found again disoriented near his camp site he is taken to the health lodge and you take his vitals: A+O x3 GCS 13 HR 58/Strong/Reg RR 20/Reg/Unlabored BP 130/55 STCM Pale/Cool/Calmmy Pupils PERRL @ 6 mm Temp 102.6ºF Blood Sugar 141 mg/dL Kid says he has been drinking water all day but you get him to tell you that he dropped a pack of skittles into his water before drinking it and that he has been doing this all week (makes the water taste better). ALS can 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, you can only provided BLS Care and can provide non-emergency transport to a ER that is 45 min from camp. Post how you would treat the PT and if you would send him home, to the ER, or allow him to stay in camp. Link to comment Share on other sites More sharing options...
spenac Posted September 11, 2007 Share Posted September 11, 2007 He's running a fever, kick him out of camp in case it's contagious. How far away are the parents? Get them to meet you at the ER. If you can be at the ER in half the time it takes for ALS to reach you take him yourself. Should have taken him the first time, instead of letting him spread a deadly disease to the entire camp. To many possibilities. Unknown illness, unknown trauma, heat related illness. Link to comment Share on other sites More sharing options...
Chief1C Posted September 12, 2007 Share Posted September 12, 2007 I doubt the skittles have anything to do with the fever... Get rid of the lil bugger.. I'll go with spleenac Link to comment Share on other sites More sharing options...
dahlio Posted September 12, 2007 Share Posted September 12, 2007 ER Transport Non Emergency. Not much else ALS can do..plus waiting twice as long might warrant ALS, so it's worth getting him to the hospital. Have someone drive the car, and have him in the back, with someone monitoring vitals...if you believe he really needs to get there even faster, then see if you can get a cop to transport in the back of his car. Otherwise, a 45 minute trip should be fine. AOx4? What exactly is that? I was always thought AOx3 was a full mental state. Thanks for the info. Link to comment Share on other sites More sharing options...
RomeViking09 Posted September 12, 2007 Author Share Posted September 12, 2007 A+O x4 = Alert & Oriented to Self (1) Place (2) Time (3) Events (4)* *Event Leading to MOI or HPI Link to comment Share on other sites More sharing options...
RomeViking09 Posted September 12, 2007 Author Share Posted September 12, 2007 I doubt the skittles have anything to do with the fever... Get rid of the lil bugger.. I'll go with spleenac In the end the Skittles in the Water the ER doc found he had been making his own Glucose by adding Candy to Water (turns out he was diabetic and family doc had missed it) Link to comment Share on other sites More sharing options...
Chief1C Posted September 12, 2007 Share Posted September 12, 2007 Link to comment Share on other sites More sharing options...
Dustdevil Posted September 12, 2007 Share Posted September 12, 2007 AOx4? What exactly is that? I was always thought AOx3 was a full mental state. Yeah, that's way old school. Full orientation requires that the patient be aware of his current situation. If you know who you are, where you are, and what day it is, but don't know why you are laying naked in the street, surrounded by firemonkeys, then obviously there is a serious deficit in your orientation, no? The qualifications of any instructor who does not teach this to his/her students are to be doubted. In the end the Skittles in the Water the ER doc found he had been making his own Glucose by adding Candy to Water (turns out he was diabetic and family doc had missed it) I hope that's not all he found, because that isn't what is causing his fever. And, neither of those BGLs would normally have a profound effect on the kid's mentation. Something else is going on here. Did anybody find it? Link to comment Share on other sites More sharing options...
RomeViking09 Posted September 12, 2007 Author Share Posted September 12, 2007 Yeah, that's way old school. Full orientation requires that the patient be aware of his current situation. If you know who you are, where you are, and what day it is, but don't know why you are laying naked in the street, surrounded by firemonkeys, then obviously there is a serious deficit in your orientation, no? The qualifications of any instructor who does not teach this to his/her students are to be doubted. I hope that's not all he found, because that isn't what is causing his fever. And, neither of those BGLs would normally have a profound effect on the kid's mentation. Something else is going on here. Did anybody find it? Fever was written off to environment (outside temp was 102º + that day) and lack of proper hydration combined with poor adult supervision, it was expected that the kid's undiagnosed diabetes lead to the AMS and after a few hours in the ER they kid returned home and went to see the family doc about the diabetes. Link to comment Share on other sites More sharing options...
p3medic Posted September 12, 2007 Share Posted September 12, 2007 I guess I am confused as to how the diagnoses of diabetes was made here.. :roll: Link to comment Share on other sites More sharing options...
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