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EMS clinical scenario: 22-year-old male after a syncopal episode

You are asked to respond to the football practice field of a local college

“Rescue 45, respond with Medic 17 to the field house on University Way for a report of a football player who passed out during practice.”

You are met at the entrance to the indoor practice facility by an athletic trainer who walks with you to the sideline of the field. You are introduced to Will, a football player. Will is lying supine on the ground and appears responsive. He is able to answer your questions in full sentences and does not appear to be in obvious distress.

According to Will, he was lining up for drills when he began to feel dizzy. He has been feeling weak for the past two days, but the dizziness is new. Will denies medical history and any recent illness. While running drills, Will was witnessed by the athletic trainer leaning over and when he tried to stand up, he collapsed to the ground. Will’s loss of consciousness lasted approximately 15 seconds. An AED was brought over but the AED pads were not applied. Will’s only complaint at this time is left, upper quadrant abdominal pain.

Will’s vital signs are:

  • BP: 110/68
  • HR: 98
  • RR: 16
  • SpO2: 98 percent room air

The transport unit brings over the stretcher and when you ask Will to sit up he reports that his dizziness has returned.

Think about these questions as you consider what to do next:

  • What are some potential concerns about Will’s presentation?
  • What other assessments would you perform?
  • What is your working diagnosis?

Post your answers below in the comments and view the clinical solution for this patient.

An EMS practitioner for nearly 15 years, Patrick Lickiss is currently located in Grand Rapids, MI. He is interested in education and research and hopes to further the expansion of evidence-based practice in EMS. He is also an avid homebrewer and runner.