• Scene – vital signs, EKG, assessment, Hx from parents
• En route – 12 lead, IV, BG, assessment
• Hospital – unknown
• Response to treatment – using Wong Baker scale, pt looks to be at a two. We did not give any NTG or ASA. 12 lead showed NSR.
• Disposition – unknown
Authors:
• Elliot Williams, Paramedic Woodburn Ambulance
Editors:
• David M. Spiro, MD, MPH Professor of Pediatrics University of Arkansas Medical Center
• Myocardial infarction
• Chest contusion
• Psychogenic pain
• Arrhythmia
• GERD
• Asthma exacerbation
• Patient states – pt would answer questions with a yes or two most of the time, but when asked where his pain was, he would point to chest. Not able to give a number on pain scale.
• Caregiver states – Mom was helping pt out of the shower when he suddenly grabbed his chest and became pale and appeared short of breath. Episode lasted about 3 minutes. Mom states that pt does not complain very often. He loves to talk about sports and is normally very happy.
• No trauma noted, but pt did have slight redness on shoulders. We surmised that he may have turned the water temperature in his shower up too high, and possibly been burned.
• GCS – 15
• EKG – sinus
• CBG – 108
When interviewing children with special health care needs, it is key to interview the caregiver/parent to obtain an accurate history and sense of baseline status. This patient seems conversant with the paramedic, which is reassuring, although the vital signs reveal tachycardia and hypertension. Children with Koolen-de-Vries syndrome could have cardiac abnormalities – this needs to be evaluated in the history.
-Dr. David Spiro
• Gender: Male
• Age: 14 years
• Height: Not Available
• Weight: Not Available
• Temperature: 98.4 F/36.9 C
• Blood Pressure: 130/91
• Heart Rate: 114
• Respiratory Rate: 20
• Pulse Oximetry: 98% RA
Signs and Symptoms
Chest pain; shortness of breath
• PMH: Asthma, Autism, Koolen-de-Vries syndrome.
• Alleriges: Penicillin
• Dispatch info: Chest pain and difficulty breathing.
• Lives with parents and sibling Medications
• Singulair, albuterol
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