• Scene – 12 lead. IV, VS, CBG
• En route – TT, VS
• Hospital – unk
• Pt responded with lower BP en route with TLC and calm demeanor.
• No meds were given en route.
• Mark Shelton Paramedic Woodburn Ambulance
• David M. Spiro, MD, MPH Professor of Pediatrics University of Arkansas Medical Center
• Diarrhea
• Malaise
• Emesis
• Hypertension
• Electrolyte abnormality (hypokalemia)
• Dehydration
• Hypertensive crisis
• Myocardial infarction
• Hyperthyroidism
• Peptic ulcer disease
• Patient states – she has had diarrhea for 3 days with some relief from immodium AD. She has vomited twice over the same 3 days.
• States that her cognitive perception is not normal when this happens.
• She has had low potassium in the past.
• She gets a fever only at night of @ 100 F
• Today is the last day for her clonidine.
• BP – on scene 216/95, en route 137/74
• GCS -15
• EKG – NSR on 4 lead and 12 lead
• CBG – 147
The patient presents with non specific symptoms. The patient’s significant hypertension should be noted and compared to known baseline. The patient’s mental status seems intact. There is a student video of an IV insertion and a supplemental file.
-Dr. David Spiro
• Gender: Female • Age: 64 year • Height: Not Available • Weight: Not Available
• Temperature: 98.3 F/36.8 C • Blood Pressure: 216/95 • Heart Rate: 68 • Respiratory Rate: 16 • Pulse Oximetry: 99% RA
3d diarrhea, vomiting, low-grade fever.
• PMH: HTN, factor 5 • Allergies: codeine,vicodin • Dispatch info: weakness and diarrhea
• Lives alone in an apartment, has friends checking on her daily.
• Ranitidine, nitro stat, simvastatin, thyroid meds, coumadin, clonidine
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