En RouteA paramedic is dispatched to a residence for a welfare check on an 85-year-old patient. The time of the call is 0900 on a clear summer morning with a temperature of 84oF (29oC). The region is a medium-sized city with moderate traffic. Response time is approximately 6 minutes. A stand-alone ED is approximately 8 minutes away, a regional trauma center is 25 minutes away, and an ICU-capable medical center is 15 minutes away with normal traffic.The paramedic is partnered with an EMT in a standard-equipped ALS ambulance.The dispatch notes state the family has been unable to contact the patient who lives alone. They are en route and about 20 minutes away. A local fire engine and law enforcement agency is also responding. On Scene Upon arrival at the scene, law enforcement officers state there was no answer when they knocked on the door, and that they are about to gain access to the residence by force. Once inside, the patient is found lying on his right side on the floor of the living room. The patient has a palpable radial pulse and is breathing 20 times a minute. The patient’s skin is cool and clammy. Rapid exam is pertinent for a small hematoma on his right temple. When the patient is rolled onto their back, the respirations become sonorous. The patient does not respond to verbal or painful stimuli. Vital signs are BP 142/80, P 77, RR 14, SpO2 96%. Lung sounds are clear bilaterally.The patient’s history is unknown but the following medications were found on the counter: Aspirin, Humulin kwikpen, hydrochlorothiazide, Percocet, simvastatin, and metoprolol. Post Scene The paramedic is unable to obtain IV access and opted to administer IM glucagon. The patient was packaged up and transport initiated. Family was notified to meet the patient at the hospital. While en route to the hospital, repeat vital signs are BP 130/78, P 68, RR 10, SpO2 92%. Capillary blood glucose is 40 ten minutes after glucagon administration. Pupils are unchanged and there are no other injuries noted on exam.
An 18 year old patient complains of diffuse periumbilical pa…
An 18 year old patient complains of diffuse periumbilical pain that is increasing and moving towards their lower right quadrant. They present with a low fever and nausea. You should:
A child with altered mental status has a history of diabetes…
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What is the order of a rescue operation?
After initiating transcutaneous pacing and obtaining electri…
After initiating transcutaneous pacing and obtaining electrical capture on the ECG monitor, paramedics should next:
During intubation, the tip of the curved blade:
During intubation, the tip of the curved blade:
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Because of the changes in the patient’s condition, what is t…
Because of the changes in the patient’s condition, what is the paramedics next step?
Based upon the above mechanism of injury, the paramedic shou…
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