Post your assessment in the comment section below, and the person with the best answer will receive one of our exclusive EMS1 Challenge Coins!
After clearing the hospital following a transfer, you are advised by dispatch to respond Priority 1 to the local university campus for a report of a male who was found unresponsive in the library.
While you are en route, the first responders provide the following update on the radio: “The patient is on the ground floor, seated in a chair, with slow, shallow respirations and a weak radial pulse. We have an OPA in place and are assisting ventilations.”
Patient assessment
Upon your arrival, you see that the fire department has moved the patient to the floor. The company officer advises you that the patient was studying with friends when he excused himself to go to the bathroom.
When he did not return for 30 minutes, a friend went looking for him and found him slumped over with snoring respirations in a chair near the exit of the bathroom.
The firefighter providing ventilations reports that he is getting good compliance with the BVM and that the patient has not rejected the OPA. A brief head-to-toe exam reveals no apparent trauma.
The patient does not have a medical alert bracelet and his friends state they are not aware of any medical history other than bruised ribs during a soccer game two weeks ago.
You confirm that the patient’s pulse oximetry is remaining in the high 90s with assistance from the BVM. His skin is clammy and his vital signs are 80/56, pulse of 76 and respirations of eight without the BVM. His blood glucose is 115.
The patient’s lung sounds are clear and equal and his pupils are equal and sluggish to respond. Your ALS intercept vehicle is approximately 15 minutes away.
As you proceed with the call think about the following questions:
- What are some potential diagnoses for this patient?
- What is a “must not miss” diagnosis?
- What are your next steps?
Post your answers below in the comments.
