Jim37F
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We're a BLS ambulance dispatched to a private residence for shortness of breath. Arrive on scene to find the local FD Paramedic Rescue squad on scene already, beginning their assessment.
PT is a 62 yo male found sitting high fowlers in a chair in his living room. PT is conscious, alert and orientated times 4, GCS 15 with a chief complaint of difficulty breathing. PT is a bigger gentleman at 276lbs.
Medics state his lungs are clear, but the Pt has audible rhonchi. PT does state the problem is in his throat, not chest or lungs. Tidal Volume is normal, with a respiration rate of 26-30. SpO2 96% room air. Skin is pale w/ normal cap refill. BP is 140/palp, pulse 100, eyes PEARRL. 12 lead shows NSR, Blood Sugar 130.
PT states the breathing problems were progressively getting worse over the last 2-3 days, was planning on seeing his doctor the next day until it got bad enough to call 911. Exertion made the breathing worse. PT described it as a sore throat and fever times 1 day, felt like he had trouble swallowing. No real pain associated w/ the symptoms, rated 0 out of 10.
Negative chest pain, negative JVD, positive 3 word dyspnea.
Prior medical history of hypertension, gout, acid reflux, thyroid issues, and kidney stones. No known allergies. Unknown medications.
PT was ambulatory with assistance, helped into the gurney and placed high fowlers. PT given O2 @15LPM via NRB. On scene time of 12 minutes, 20g lock established in left AC by medic enroute, pt transported Code 3 (lights and sirens) with medic on board to hospital, 4 min transport time.
PT stated to oxygen helped him breathe, but once we got to the ED asked us to take the mask off because he now felt it was easier to breathe without it. PT ambulated w/ assistance into hospital bed and I start my paperwork.
NOW here comes the crazy part. While I'm still doing my paperwork, within just a few minutes he just crashes. Is just white and starting to turn blue, ED MDs begin intubating and at that point I'm just in the way and get out of there as it becomes a beehive of activity.
My question is why did he deteriorate so rapidly? He seemed (relatively) stable with us, even said he was starting to breathe easier by the time we got there, what would've caused such a sudden and drastic change?
PT is a 62 yo male found sitting high fowlers in a chair in his living room. PT is conscious, alert and orientated times 4, GCS 15 with a chief complaint of difficulty breathing. PT is a bigger gentleman at 276lbs.
Medics state his lungs are clear, but the Pt has audible rhonchi. PT does state the problem is in his throat, not chest or lungs. Tidal Volume is normal, with a respiration rate of 26-30. SpO2 96% room air. Skin is pale w/ normal cap refill. BP is 140/palp, pulse 100, eyes PEARRL. 12 lead shows NSR, Blood Sugar 130.
PT states the breathing problems were progressively getting worse over the last 2-3 days, was planning on seeing his doctor the next day until it got bad enough to call 911. Exertion made the breathing worse. PT described it as a sore throat and fever times 1 day, felt like he had trouble swallowing. No real pain associated w/ the symptoms, rated 0 out of 10.
Negative chest pain, negative JVD, positive 3 word dyspnea.
Prior medical history of hypertension, gout, acid reflux, thyroid issues, and kidney stones. No known allergies. Unknown medications.
PT was ambulatory with assistance, helped into the gurney and placed high fowlers. PT given O2 @15LPM via NRB. On scene time of 12 minutes, 20g lock established in left AC by medic enroute, pt transported Code 3 (lights and sirens) with medic on board to hospital, 4 min transport time.
PT stated to oxygen helped him breathe, but once we got to the ED asked us to take the mask off because he now felt it was easier to breathe without it. PT ambulated w/ assistance into hospital bed and I start my paperwork.
NOW here comes the crazy part. While I'm still doing my paperwork, within just a few minutes he just crashes. Is just white and starting to turn blue, ED MDs begin intubating and at that point I'm just in the way and get out of there as it becomes a beehive of activity.
My question is why did he deteriorate so rapidly? He seemed (relatively) stable with us, even said he was starting to breathe easier by the time we got there, what would've caused such a sudden and drastic change?
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