By: Kate Pula, Captain, 2013-2014
As EMTs we do not provide official diagnoses for our patients but in EMS care it is important to differentiate between call types. In this spirit, each month I’ll present a short scenario and either ask you to provide a treatment plan or tell me what’s wrong. So, without further ado…
You receive a dispatch on a Friday evening for a semiconscious 19 year old male patient. When you arrive on scene you find your patient awake, but confused on the floor of his room. Bystanders report that they came in and found the patient asleep on the floor. Your patient originally started out confused and stated “it’s hard to concentrate right now”, but is now answering questions slowly. He reports while he feels a little sleepy, he is starting to feel better. Your patient does not report any nausea or vomiting (nor is there any present on scene). Your patient is having trouble remembering, but believes after going out tonight he had only a two beers, which is below his usual limit. The bystanders cannot confirm prior events because they were not with the patient earlier tonight.
Your patient is allergic to dust mites and reports taking no medications. You take vitals and everything is normal, except breathing is fast at 20 breaths/min and he is hypertensive with a blood pressure of 140/90. You again ask how your patient is feeling, “it’s still hard to think” and he reports a slight migraine. He also reports it’s still hard to remember tonight’s details. However, he is feeling more awake and is answering questions faster. There is no trauma present and your patient reports he doesn’t feel any pain besides the migraine.
The events and symptoms of your patient don’t seem to add up. You ask a few more questions about your patient’s past medical history and he does mention some past injuries (concussions) from playing soccer, one of which happened quite recently. You think you have your patient’s problem figured out and ask one more question about your patient’s family medical history, and decide immediately that he should go to the hospital.
What was wrong with your patient? Send your thoughts to firstname.lastname@example.org.