This episode focuses on EMS study tips for seizures and epilepsy. More key elements of exams and patient assessment. [Read more…]
This is part three of a recent episode where the panel talks about the patients story or how the story seems to change. Jim mentions some pet peeves he received via email and the one that stood out was how a patients gives you one story in the ambulance and then once at the ED does a switcheroo on you.
Take a listen to why we think this happens and some ideas on how to mitigate this from happening.
I sent this email to my members the other day about a possible stroke call I had.
Most of us expect that one sided droop, weakness, slurred speech or no speech deal.
What I get is a 78 y/o female completely alert who says she feels like her speech is slurred.
I do note some slurring. But no facial droop, negative Cinninatti Scores etc.
She also complains of headache that has been worsening over past 3 hours and numbness to her right hand for the past 20 mins, which is about the time she noticed her sleech issues.
When doing my history taking she can’t seem to recall details like why she takes a medication.
She says she feels “dopey” like she can’t formulate her thoughts as she usually can.
Her BP was 176/100, HR 88, RR 18, Sp02 98% on room air.
Here is what I did.
I called this in as a Code Stroke. Started an IV, gave 02 via NC and perfromed a 12 lead.
To me although she wasn’t presenting like a classic stroke patient, there where enough signs and symptoms to suspect that one may be occuring.
It may even have been a TIA.
But I felt better to up triage and treat as a CVA than blow it off and have her suddenly get worse enroute to the ED.
Plus I always worry that if I don’t point out my suspicsions she would end up in a ED room or hallway and not be seen for 10-15 mins or longer and suddenly a nurse will think “hey this may be a stroke” and now precious time has past where the alert talking patient is now unable to communicate or move her entire right side.
So, what would you do in this case? The same? Totally opposite?
I’d be interested to know if you think her complaints warranted a priority transport or not.
Leave your comments below with your thoughts and keep an eye out for a follow up on this in a few days.
If you want to be a better clinician and think about a bigger picture with your patients like the one above, Members of Turbo Medic do just that. Anyone can follow a protocol, real EMS professionals look at the whole patient presenation and treat/transport in the best interests of their patients. Join me at Turbo Medic and see what I mean – http://turbomedic.com/whytm/
EMS study guide on anatomy and physiology. This first installment in the A&P area focuses on the systems of the body and what is located within the various sections of the body.
This weeks episode talks about many of the mimics of a CVA/Stroke. Do you keep these differentials in mind when assessing your patient for neurological emergencies?
This episode focuses on a common element in EMS patient assessment. Giving a patients heart rate is great but do we consistently describe a patients pulse quality so that every healthcare professional understands what we mean?
This video will give you an easy and accepted method in pulse quality description.
Find this video helpful? Be sure to spread the social media vibes by Sharing or Liking below.
Patients with chest pain are common call types in EMS. While we may treat them as common that can lend itself to missing key points when assessing these patients. This weeks Monday Minutes focuses on the key points you should be thinking about when presented with the chest pain patient and potential myocardial infarction.
If you liked this video, please share it on FaceBook or your favorite social media site by clicking any of the buttons below.
This episode focuses on some key points when assessing your asthma patient. Part of a larger download over at Turbo Medic it gives some important elements when doing your EMS patient assessment on the asthmatic patient. It even talks how you can begin your assessment before you even get to the patients side.
This week I wanted to focus on the neck. When we do EMS patient assessment scenarios we often just look and verbalize things like tracheal deviation, midline blah blah blah. So here I just point out some key elements when assessing a patients neck for both medical and trauma. Yeah, it’s not rocket science but it’s not just looking for tracheal deviation either… what exactly is that anyway?