adamjh3
Forum Culinary Powerhouse
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Called to an adolescent psych screening facility last night, AOS at approx 2030 to find a 14yo F, 5'4 approx 140lbs laying in bed responsive only to pain. There's a small puddle of vomit on the floor next to the bed.
Info from the Nurse states she was BIB CVPD on a 5585 hold (72hr psych eval for minors). Facility was advised that Pt was found by her mother passed out drunk at a park. Mother got her in the car and took her immediately to the police department. The only solid time we (the EMS crew) were able to get was 1855, when the 5585 hold was written by PD. Pt states she's "depressed about her parents divorce" and feels she shouldn't be alive.
Facility states Pt has vommited twice since her arrival, most recent being 5 minutes prior to our arrival.
We're able to get out of her that she was with a group of people and was in a fight, physical exam shows a bruise approx 3cm in diameter left and superior to pt's left eye, dried blood on pt's L elbow with no associated wound or bruising. Chest and abd negative. Pt denies pain, states nausea, does not recall vommiting earlier.
We load the pt into the ambulance approx 7 minutes after arriving on scene
V/S as follows:
P: 112
R: 14, shallow but effective, 99% R/A
BP: 98/58
Eyes: PERL 6
Lungs: clearx4
A&ox2, person, place, unaware of date, time, claims minimal recollection of event, states LOC but cannot give a specific time
Skins pink, cool and dry. Ambient Temp of about 70 degrees farenheit, Pt. states she feels cold.
As far as treatment, Tx in POC, ASPT, Heater turned on and patient wrapped in blanket to keep warm.
ER we're Tx'ing to is directly across the street, 1 minute Tx, we get there and turnover care w/o change or incident.
Here's the part my partner is kicking herself over. She noticed her nylons were torn on the inside of the thigh and crotch area (Pt. was wearing a very short black dress) but didn't think anything of it until we were already back at station.
How badly did we screw up by not asking about sexual activity?
EDIT: Oh and, if we responded to this as ALS, would you run a fluid bolus and give some Zophran even though you're across the street from the hospital?
EDIT #2: forgot to mention, pt stated she drank two 4lokos and "a bunch" of shots of vodka
Info from the Nurse states she was BIB CVPD on a 5585 hold (72hr psych eval for minors). Facility was advised that Pt was found by her mother passed out drunk at a park. Mother got her in the car and took her immediately to the police department. The only solid time we (the EMS crew) were able to get was 1855, when the 5585 hold was written by PD. Pt states she's "depressed about her parents divorce" and feels she shouldn't be alive.
Facility states Pt has vommited twice since her arrival, most recent being 5 minutes prior to our arrival.
We're able to get out of her that she was with a group of people and was in a fight, physical exam shows a bruise approx 3cm in diameter left and superior to pt's left eye, dried blood on pt's L elbow with no associated wound or bruising. Chest and abd negative. Pt denies pain, states nausea, does not recall vommiting earlier.
We load the pt into the ambulance approx 7 minutes after arriving on scene
V/S as follows:
P: 112
R: 14, shallow but effective, 99% R/A
BP: 98/58
Eyes: PERL 6
Lungs: clearx4
A&ox2, person, place, unaware of date, time, claims minimal recollection of event, states LOC but cannot give a specific time
Skins pink, cool and dry. Ambient Temp of about 70 degrees farenheit, Pt. states she feels cold.
As far as treatment, Tx in POC, ASPT, Heater turned on and patient wrapped in blanket to keep warm.
ER we're Tx'ing to is directly across the street, 1 minute Tx, we get there and turnover care w/o change or incident.
Here's the part my partner is kicking herself over. She noticed her nylons were torn on the inside of the thigh and crotch area (Pt. was wearing a very short black dress) but didn't think anything of it until we were already back at station.
How badly did we screw up by not asking about sexual activity?
EDIT: Oh and, if we responded to this as ALS, would you run a fluid bolus and give some Zophran even though you're across the street from the hospital?
EDIT #2: forgot to mention, pt stated she drank two 4lokos and "a bunch" of shots of vodka
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