ERDoc Posted October 10, 2007 Share Posted October 10, 2007 You are called to the local elementary school for a 9 year old female who has been vomiting. The school nurse tells you they have been having a rash of kids with the stomach flu who have presented with vomiting and diarrhea. This particular girl looked more dehydrated than the others have and she was unable to get in touch with the kids parents so she decided to call and get her a ride to the ER. What else do you want to know? Link to comment Share on other sites More sharing options...
vs-eh? Posted October 10, 2007 Share Posted October 10, 2007 Cool....I'lll assess this patient... General impression of the patient - Hello... - What's going on today? - How's your breathing? Auscultate prn- Any pain/discomfort/funny feeling? prn (points to head chest adbo) - palpatate prn - "OPQRST" prn "AMP" prn vitals - Witness my awesome... Link to comment Share on other sites More sharing options...
ERDoc Posted October 10, 2007 Author Share Posted October 10, 2007 Cool....I'lll assess this patient... General impression of the patient - Hello... - What's going on today? - How's your breathing? Auscultate prn- Any pain/discomfort/funny feeling? prn (points to head chest adbo) - palpatate prn - "OPQRST" prn "AMP" prn vitals - Witness my awesome... "I'm fine. I've been puking since I got to school. My tummy hurts a little. The nurse says its the flume. No, I'm not having any trouble breathing." LS clear b/l Abd has mild diffuse tenderness with no rebound. She has hyperactive bowel sounds. The pain started earlier today about the same time as the vomiting. She can only describe the pain as "My tummy hurts." It seems to be constant. Nothing makes it better or worse. No allergies, PMH, PSH or meds. HR 120 RR 24 BP 84/33 Pulse ox 99% on RA Link to comment Share on other sites More sharing options...
Scaramedic Posted October 10, 2007 Share Posted October 10, 2007 Skin color/pallor? Temp? Has this patient had diarrhea in last 24? (hyperactive BT, probably will soon) How many other students affected? When? School cafeteria, or do they bring their own lunches? Peace, Marty Link to comment Share on other sites More sharing options...
ERDoc Posted October 10, 2007 Author Share Posted October 10, 2007 Skin color/pallor? Temp? Has this patient had diarrhea in last 24? (hyperactive BT, probably will soon) How many other students affected? When? School cafeteria, or do they bring their own lunches? Peace, Marty Skin is cool, dry and slightly pale. Temp is 36.8. No diarrhea. The nurse says that there are a large number. Some getting sick in school and some getting sick at home. It has been a mix of people who brought lunch and those that have eaten in the cafeteria. The nurse says, "It's funny. Most of the kids have diarrhea and crampy pain. It is definitely different from hers. They all have also had a fever but she doesn't." Link to comment Share on other sites More sharing options...
vs-eh? Posted October 10, 2007 Share Posted October 10, 2007 Transport to the hospital with maybe a mask. Link to comment Share on other sites More sharing options...
ERDoc Posted October 10, 2007 Author Share Posted October 10, 2007 Transport to the hospital with maybe a mask. You don't really think I'm going to post something that lame do you? Link to comment Share on other sites More sharing options...
Scaramedic Posted October 10, 2007 Share Posted October 10, 2007 I think I know where your going with this. So she probably has the same issue as the other children, she is just exhibiting early symptoms. Have dispatch attempt one more contact with parents, if unable to contact initiate care. 1. Child is dehydrated, vomiting and hypotensive for her age. IV access would be the most appropriate intervention. Fluids would be NS (in my system) fluid bolus of 250cc's and re-asses. Monitor, HR is elevated for age. 2. I would hold off on O2, no dyspnea and she is probably stoked up enough. 3. Transport in POC. Give mandatory Teddy Bear ( or other provided comfort toy). 4. Continue assessment, was there guarding on palp of abdomen. 5. Transport to Pediatric Hospital, alert M.D. of multiple cases at this school. 6. Wash hands with acetone, burn uniform and rinse mouth with Listerene. Peace, Marty :sith: Link to comment Share on other sites More sharing options...
AnthonyM83 Posted October 10, 2007 Share Posted October 10, 2007 Transport to the hospital with maybe a mask.Realistically, that'd probably be it here...except probably no mask. BLS. Link to comment Share on other sites More sharing options...
ERDoc Posted October 10, 2007 Author Share Posted October 10, 2007 You begin to package the pt to go. As you put the straps on her she asks you to stop because, "I need to pee again. I've been going so much the past few days that I have been really thirsty. Can I get a drink before we go too?" Link to comment Share on other sites More sharing options...
Recommended Posts