Unresponsive

[NomadicMedic]

Arrive on scene at 1640 to find a 41 year old female, unconscious. Found in bed by her ex husband after daughter called him and said she couldn't wake up mommy. PT has no significant PMHX, NKDA as takes no meds. No indication of alcohol or drug use.


Vitals on arrival:

Hr: 88 and irregular
Respirs: 24 and shallow
BP: 142/118
ETCO2: 48, non obstructive waveform
Glucose: "lo" (<10)
Skin: cool, dry and ashen.
GCS: 6. E1,V1,M4
Dried saliva around the mouth. No obvious emesis.

BLS had just arrived and put the patient on 15 LPN of o2 via NRB.

... And go.

 

[abckidsmom]

Oh, she's sick.

Pupils? Any incontinence? Risk factors for DVT? Signs of DVT? Gag reflex? Protecting her own airway? Lung sounds?

 

[NomadicMedic]

Pupils 3mm and sluggish. No incontinence. Positive gag and she is protecting her own airway, lungs clear bilat. No recent surgeries, not bed confined. Unknown about BC or smoking history. Is normally active and was last seen this morning.

 

[Aidey]

How about we give the woman some sugar?

 

[JMorin95]

Is she diabetic? Low sugar is probably playing a large role here.

 

[NomadicMedic]

Multiple IV attempts are unsuccessful. The crew gave 1mg IM glucagon.

This patient is not a diabetic. No history of any hypoglycemic events.

 

[abckidsmom]

How about we give the woman some sugar?

I was just getting some information while I started the IV.

 

[abckidsmom]

Multiple IV attempts are unsuccessful. The crew gave 1mg IM glucagon.

That's going to do nothing, I bet. I give it precisely 5 minutes, then I drill her.

 

[NomadicMedic]

What else would you like...?

 

[abckidsmom]

Multiple IV attempts are unsuccessful. The crew gave 1mg IM glucagon.

This patient is not a diabetic. No history of any hypoglycemic events.

Anyone in the family a diabetic?

 

[JMorin95]

Events leading up to? Possibly could gain this from the daughter.

 

[NomadicMedic]

Anyone in the family a diabetic?

Ex husband doesn't know family history and daughter was at school. She came home and "mom wouldn't wake up"

 

[abckidsmom]

Ex husband doesn't know family history and daughter was at school. She came home and "mom wouldn't wake up"

I mean like anyone living in the house who is a diabetic. Access to insulin or oral hypoglycemic agents? Possibility she's pregnant?

 

[JMorin95]

Any clues around the house as to what could be happening? I.e. pill bottles, alcohol bottles, illegal substances?

 

[Aidey]

How old is the kid?

 

[NomadicMedic]

Initial rhythm.

 

[NomadicMedic]

I mean like anyone living in the house who is a diabetic. Access to insulin or oral hypoglycemic agents? Possibility she's pregnant?

Nope. Nothing in the house. No idea if she's preg. The kid is 12.

 

[NomadicMedic]

Any clues around the house as to what could be happening? I.e. pill bottles, alcohol bottles, illegal substances?

Nothing found.

 

[Wheel]

What does her skin look like?

 

[abckidsmom]

Those are some peaked T waves, huh?

Can we get another pressure? I don't like that first one. It's 5 minutes now, too. Did the glucagon work?