Clinical scenario: Patient complaining of weakness

You are dispatched to a report of an elderly male found down on the floor

Rescue 7, first respond to 7866 E14th St. The caller reports she arrived home to find her father on the ground in the living room. Caller reports the patient is not responding normally.

You pull up to a well-kept house in an older residential neighborhood. The woman who meets you at the sidewalk identifies herself as the caller. She states she was performing a daily check on her father who is 86-years-old and still lives alone when she found him lying on the floor in front of his recliner. The caller says she spoke with her father last night when he had already moved into bed.

Upon entering the house, you note the house is tidy. You reach the living room and are introduced to Mr. Stephenson. His daughter states he has only been able to groan in response to her questions. The patient has a history of high blood pressure, coronary artery disease and diabetes. Your paramedic partner begins his assessment while you obtain a set of vital signs. You note Mr. Stephenson’s skin is cold to the touch while you check a pulse. The vital signs you record are:

  • BP: 160/94
  • HR: 110
  • RR: 10
  • SpO2: 56 percent RA

Your partner asks you to take a temperature and – using the temporal thermometer from the rescue – you get 88.7F (31.5C). When putting Mr. Stephenson on the cardiac monitor, however, you find that his core feels warm to the touch.

Your partner has started an IV and hands you the catheter, asking you to measure a blood glucose from the sample of venous blood in the flash chamber. When you report the vital signs, your partner is extremely concerned with Mr. Stephenson’s pulse oximetry reading and asks you to begin assisting his ventilations with a bag valve mask.

How is the call going so far? Consider the following questions:

  • Which of Mr. Stephenson’s assessment findings above are accurate?
  • Which findings are potentially inaccurate?
  • What are some pitfalls which may affect the accuracy of the patient assessment?

Post your answers in the comments and view the solution for this scenario.

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