Pablo the Pirate
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I thought this call was pretty interesting, just wanted some other opinions on it. We were paged out for child that fell.
We arrive on scene to find 10yom laying couch. FR had applied C-collar and O2 nrb 12lpm. Kid c/o headache, states no neck or back pain. However, the kid fell out of the rafters in his garage (about 10 feet) and landed on his head. C-collar stays on and since he is only 60lbs we put him on pediboard. Pt complains extensively about being on spine board says he's fine just wants to go to sleep and to leave him alone. Father stated pt never really lost consiousness but his eyes were rolled in the back of his head and he didnt know where he was or what happened right after he fell. Upon our arrival A&Ox3, GCS 15 but lethargic, bp right around 100/60 and stayed that way, resp about 18 and pulse around 60. we load and go put him on HM just to take a look. its NSR and i saw 1 PAC blip by. no big deal right? then my partner checks pulse on other side right before i check his BP and he goes "his pulse is irregular" i'm like what...ok so then i check, yep irregular look at HM more PAC's and like every 5 or 6 beats. so i ask dad if kid has cardiac history and dad says no and not irregular normally that he knows of. Now i'm like oh :censored: :censored: cuz the kid was already flirting with Sinus brady and now his HR is irregular. i start thinkin :censored: :censored: :censored: this kids gonna take a crap in the back of my truck. so i check his bp and he has this run of sinus tach, check his pulse, its regular.(this is why irregularity not noted before hand and also cuz we were looking at HR on pulse ox) then he goes back to irregular and having PAC's. After that everytime we checked his BP we noticed a run of sinus tach. It served as a reminder to me that you should not just rely on your equipment to give you all your vitals all the time...check them to make sure they are what your equipment says they are. i'm usually really good at this but was feeling distracted that day. we got him to ER without any incident. i think we were lucky. update on this kid came back as basilar skull fracture monitered in PICU overnight and sent home the next morning, just peachy. good for us. i had some ?s about his rhythm tho. ER staff didnt seem to care so much about irregularity and what not. just wondering what you would have thought about it and why they didnt seem to care. is this not as signigicant as i felt is was? let me know what you think.
sorry that got so long.
We arrive on scene to find 10yom laying couch. FR had applied C-collar and O2 nrb 12lpm. Kid c/o headache, states no neck or back pain. However, the kid fell out of the rafters in his garage (about 10 feet) and landed on his head. C-collar stays on and since he is only 60lbs we put him on pediboard. Pt complains extensively about being on spine board says he's fine just wants to go to sleep and to leave him alone. Father stated pt never really lost consiousness but his eyes were rolled in the back of his head and he didnt know where he was or what happened right after he fell. Upon our arrival A&Ox3, GCS 15 but lethargic, bp right around 100/60 and stayed that way, resp about 18 and pulse around 60. we load and go put him on HM just to take a look. its NSR and i saw 1 PAC blip by. no big deal right? then my partner checks pulse on other side right before i check his BP and he goes "his pulse is irregular" i'm like what...ok so then i check, yep irregular look at HM more PAC's and like every 5 or 6 beats. so i ask dad if kid has cardiac history and dad says no and not irregular normally that he knows of. Now i'm like oh :censored: :censored: cuz the kid was already flirting with Sinus brady and now his HR is irregular. i start thinkin :censored: :censored: :censored: this kids gonna take a crap in the back of my truck. so i check his bp and he has this run of sinus tach, check his pulse, its regular.(this is why irregularity not noted before hand and also cuz we were looking at HR on pulse ox) then he goes back to irregular and having PAC's. After that everytime we checked his BP we noticed a run of sinus tach. It served as a reminder to me that you should not just rely on your equipment to give you all your vitals all the time...check them to make sure they are what your equipment says they are. i'm usually really good at this but was feeling distracted that day. we got him to ER without any incident. i think we were lucky. update on this kid came back as basilar skull fracture monitered in PICU overnight and sent home the next morning, just peachy. good for us. i had some ?s about his rhythm tho. ER staff didnt seem to care so much about irregularity and what not. just wondering what you would have thought about it and why they didnt seem to care. is this not as signigicant as i felt is was? let me know what you think.
sorry that got so long.
