truetiger
Forum Asst. Chief
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I'll throw in a scenario for fun, nothing tricky. You receive a third party 911 call for difficulty breathing. You arrive on the scene and find the fire department (bls) attending to an elderly woman in the front seat of a car. She appears unresponsive. They have started her on NRB and state her sats are at 90%.
Patient is responsive to pain only. GCS of 9. You note deep respirations of 20/min. No cyanosis present. Airway is clear. Strong radial pulse. Skin is pink/warm/dry. Pupils dilated bilaterally and sluggish. Husband states they just left a level 1 hospital about an hour and 20 mins ago and just pulled in the drive way. He went inside for a minute and came back to find her unresponsive. Only hx is a TIA a few years ago and lung cancer for which she was recently hospitalized for.
Patient is quickly moved to ambulance and an als assessment reveals:
HR 80's
BP120's/80's
Respirations still 20/deep
Oxygen sats are 94% on 15L
BGL is 206 no hx of diabetes
12 lead is non diagnostic.
Husband denies any pain meds or pain patches today. None found either. She was completely alert for the whole car ride home ( 1hr 20 mins). Patient is on blood thinners. No allergies given.
Your choices of hospitals are the local hospital which is about 20 mins away and or a level one about 35 mins away by helicopter. Time of day would put you in rush hour traffic going to the city.
Patient is responsive to pain only. GCS of 9. You note deep respirations of 20/min. No cyanosis present. Airway is clear. Strong radial pulse. Skin is pink/warm/dry. Pupils dilated bilaterally and sluggish. Husband states they just left a level 1 hospital about an hour and 20 mins ago and just pulled in the drive way. He went inside for a minute and came back to find her unresponsive. Only hx is a TIA a few years ago and lung cancer for which she was recently hospitalized for.
Patient is quickly moved to ambulance and an als assessment reveals:
HR 80's
BP120's/80's
Respirations still 20/deep
Oxygen sats are 94% on 15L
BGL is 206 no hx of diabetes
12 lead is non diagnostic.
Husband denies any pain meds or pain patches today. None found either. She was completely alert for the whole car ride home ( 1hr 20 mins). Patient is on blood thinners. No allergies given.
Your choices of hospitals are the local hospital which is about 20 mins away and or a level one about 35 mins away by helicopter. Time of day would put you in rush hour traffic going to the city.