Chest issues?

[DragonClaw]

Was assist with my partner all day for a flycar CCT medic. Calls got more interesting as time went on. This last call we had a hypotensive, hypovolemic pt.

Pt was on a trach and vent. Pt had norepinephrine abs prbc running. Pt was cold, going hypothermic. His ribs an chest area was super well defined by then the rest of his torso and lower extremities looked sunken in.

He has a foot IV too. That was weird.

What might this be? Does barrel chest look like this? We took an hour to get him ready for transport and it was busy all the time so I didn't have time to ask.

He could not speak because his speech filter thing was gone. What do you call it? He could mouth words.

 

[NPO]

This could be barrel chesting. It's hard to tell what you're describing.

 

[Capital]

A passy muir valve is probably what you're referring to as his 'speech filter thing'.

 

[VFlutter]

Cachexia? Typical malnourished, non-mobile, chronically ill appearance

Surprised he didn't have a port or PICC but you get access anywhere you can on chronic patients with poor access. Foot and Saphenous veins are good targets.

You could put a 14g in my Sapheanous.

 

[E tank]

COPD, kyphosis or some spine thing or he could have once been a bad a** dude that worked out a lot but now has become badly deconditioned.

 

[DragonClaw]

Cachexia? Typical malnourished, non-mobile, chronically ill appearance

Surprised he didn't have a port or PICC but you get access anywhere you can on chronic patients with poor access. Foot and Saphenous veins are good targets.

You could put a 14g in my Sapheanous.

He did. He had a chest port and AC IVs and other lines. Dude was so sick

 

[DragonClaw]

His chest skin was also really tight and smooth.

 

[DragonClaw]

A lot of people overlook those who can't speak because it's easier. I tried to figure out what he was saying but usually could not and it was a bunch of guessing.

But when we moved from the hospital vent to the portable one, he started mouthing "I can't breathe".

Medic was on the other side of him and couldn't see his face well. I'm glad I was paying attention.

Medic has to do something with the vent. It happened again.

Turns out the vent malfunctioned and couldn't keep pressure or something. We had to get a different one.