End of Shift Report; Paramedicine
I will do my best to keep all HIPPA laws in check. Which basically means I cannot give any info that would identify anyone in any way possible. I also cannot talk about high profile cases. I think I have done a good job of not violating these rules but please notify me if I have somehow.
All photos are taken from the internet randomly.
Case study purpose only
Male in his early 50s is altered; meaning they are very confused and cannot answer the following questions:
- Person; what is your name?
- Place; where are you right now?
- Time; what year is it?
- Event; why am I here right now?
This particular pt is AOx0; alert and oriented x 0 meaning he cannot answer any of those questions.
Wife states she witnessed a seizure while in bed; full body movement; lasting 5 minutes.
Wife states he normally recovers very fast within 5-10min but she waited 30 minutes and he is still confused.
Pt is carried by the FIRE department due to inability to walk.
Pt is very postictal; phase of confusion following a seizure.
Blood sugar is 110; afebrile (no fever); pupils are pinpoint.
I ask about drug/alcohol use; "denies." Painkillers; "Sometimes."
High flow O2 via Non Rebreather mask should shorten recovery phase; he removes it saying he cannot breathe.
Then tries to undue seatbelts and run out the back door while the ambulance is moving.
Pulled over; restrained with soft 4 point restraints for the patients safety. If he recovers to normal I will remove them immediately. Oxygen is continued once again and an IV is started.
18 guage in the left AC attached to a saline lock.
Pt recovers to AOx2 unable to tell me the time and event; then gets the time correct by hospital arrival.
Pt had no sign of trauma; no oral trauma and no incontinence.
Denies headache, nausea, CP and SOB
I was thinking of giving Narcan just to see if there was an issue with opiates because the pupils were pinpoint.
But it really wasn't an underlying problem in my opinion. Id really be doing it to see if he reacted or not; because if he didn't then id be more concerned about a brain bleed.
Hx of Hypertension Seizures Diabetes
All images are taken from bing.com under keywords mentioned above
If I am doing anything that violates hippa or if you have any concerns - please voice them because I would be happy to hear or take down this post. I thought it would be kind of cool to have a medical discussion; people can learn or even I could learn by someone else sharing knowledge. This is only 1 out of 5 calls I had but this one was the best medical.
