The tones at your station sound while you and your partner are checking out your vehicle in the morning. As you come up on the air and go en-route, dispatch provides the following update: “Rescue 74, I show you en route Priority 2 to 786 West Maine Ave. You’ll be responding on a 16-year-old female complaining of headache, nausea, vomiting and dizziness.
Patient assessment
You are met at the front door by a woman who identifies herself as the patient’s mother. The woman states that her daughter woke up this morning not feeling well. She reports that the patient has been “under the weather” for several days but is much worse this morning.
The patient has been reporting headache, neck pain, fever, sensitivity to light and nausea. The patient has a history of migraines, but her mother states that these symptoms are different.
The patient’s mother leads you to her daughter’s room. She looks over when you walk through the door and is sluggish and slow to respond. You turn a light on low in the room and see that the patient is pale and sweaty. You also notice a rash consisting of small pinpoint marks on her chest and arms.
At this point think about the following questions:
- What are some potential diagnoses for this patient?
- What about a “must not miss” diagnosis?
- Are there any concerns you have moving forward with the care of this patient?
- What are your next steps?
Post your answers below in the comments
