Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 Gene you forget even smart people can't be educated if the close thier mind. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > Well, no matter what one's certification level is, there is > something to be learned from scenarios. For example, if one is a > Basic EMT, it would seem to be of great interest that a patient had > no obtainable blood pressures in either arm but a heart rate of only > 72. If I were an EMT-B, I would be asking, WHY and trying to learn > something. As a paramedic I'm reviewing all the causes I can think > of right now and attempting to eliminate all except the right one. > > A low or unobtainable BP " should " trigger an increase in heart rate > through catecholamine release (WHAT? Basics don't know that? They > should). So why is that not happening here? > > Also, a Basic EMT ought to be able to spot signs of a CVA or TIA > when they're as plain as in the scenario. > > There's a great deal for Basic EMTs to learn from this scenario. If > you can't get a BP in either arm, then where else can you try? What > conditions can lead to absent palpable blood pressures or different > BPs in the arms? > > This scenario happens to be a real puzzler, which should at least > tempt one to do some Googling, unless one is perfectly satisfied > with one's current level of knowledge. > > If the Doc doesn't have it yet, it's probably a pretty good learning > scenario. > > Just sayin. > > With malice to none. > > Gene G. > > Re: EMS challenge > > > > > > > > > > > > > > > > Your scene is a fairly normal office building. Blood sugar is > > 128 mg/ > > > > dL. > > > > Pupils unequal. Obvious weakness left side when you check a > stroke > > > > scale. > > > > No medical alert tag. No obvious signs of trauma. The only > > medicine > > > > you find on scene is a box containing a drug called Enbrel. > > > > > > > > -Wes > > > > > > > > > > > > In a message dated 6/10/2010 6:29:32 P.M. Central Daylight Time, > > > > _lrichardson@... > %40ci.duncanville.tx.us> _ > > (mailto:lrichardson@... > %40ci.duncanville.tx.us> ) %40ci.duncanville.tx.us>; > > > > > > > > %40ci.duncanville.tx.us> writes: > > > > > > > > Ok Professor Wes! > > > > > > > > Some clues please! scene findings? other VS's? Blood Sugar? > Stroke > > > > Scale? Pupils? Obvious trauma? medical alert tags? meds on > scene? > > > > ________________________________ > > > > From: _texasems-l > %40yahoogroups.com> _ (mailto:texasems-l > > ; ) > > ; > > > > texasems-l > > > > %40yahoogroups.com> > > [_texasems-l ; > > _ (mailto:texasems-l > %40yahoogroups.com> ) > > ; %40yahoogroups.com> > > > > > > %40yahoogroups.com>] On Behalf Of > > > > _ExLngHrn@... ; _ (mailto:ExLngHrn@... > > ; ) > > ; > > %2540aol.com>>; > > > > > > > [_ExLngHrn@... ; _ (mailto:ExLngHrn@... > > ; ) > > ; > > %2540aol.com>>;] > > > > > > > Sent: Thursday, June 10, 2010 6:14 PM > > > > To: _Paramedicine > %40yahoogroups.com> _ > > (mailto:Paramedicine > %40yahoogroups.com> ) ; > > > > > > > > %40yahoogroups.com>; > > _texasems-l %40yahoogroups.com>; _ > > (mailto:texasems-l > %40yahoogroups.com> ) > > ; Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 chuckle....no, Kuru is a prion disease associated with New Guinea's cannibals. Moyamoya is an interesting chronic disease that starts much earlier in life than we are given information about. The treatment for it involves burr holes in the skull and one of several different techniques to bypass the blocked internal carotid circulation with blood flow from the external carotids. The more common disease that I was thinking about, which involves the tender temples, is often associated with oddball visual problems due to both mini strokes and direct damage to the retinas. While a rare complication, it can cause reduced pulses in the distal circulation, but not to the extent that Wes portrayed. It does respond to chronic steroid treatment. The disease that Wes is portraying is quite rare among non Asiatic females, but has been found world wide- a MedLine search shows that there was a significant case of the problem in the Mideast. It's one of those zebras that medical school professors so love, because it has such interesting and blatant symptoms and signs....but is so rare as to be almost impossible to see a case in a lifetime of practice in the Western world. One point on this disease is that the first manifestations normally occur in the second and third decades (teens and twenties) of life, as opposed to the more common problems with athereosclerosis, which don't normally show up until the fifth decade (forties) or later. This disease does respond to steroids as well. Hopefully, between the hints that Gene and I have dropped, more folks will be persuaded to do further reading as well. ck In a message dated 6/12/2010 04:38:08 Central Daylight Time, bradsattler@... writes: Wes, I did the research and found the zebra. It was not kuru, sadly. Methylprednisolone via med control permission would be my treatment (another clue). I can't find the tie-in to stroke, is there a corroboration I'm missing? -Brad Sent via BlackBerry, the office that follows you. EMS challenge > > > > > > > > Since it's been a while since Professor Gandy offered a > challenge > > > > (and the > > > > prize-winner's trip to Ladonia), I present the following brain- > > > > teaser for > > > > all of y'all. Alas, there are no prizes since the half-star > hotel > > > > resort > > > > in Ladonia is closed for fumigation. > > > > > > > > On to the challenge...... you are dispatched to an altered > mental > > > > status > > > > call. Upon arrival, you find a middle-aged female laying on the > > > > floor of an > > > > office. She is semi-coherent and semi-combative, with slurred > > > > speech. Her > > > > co-workers know that she has an extensive medical history, but > > they > > > > can't > > > > remember what it is. > > > > > > > > Oddly, while the patient is breathing and speaking (although > > > > abnormally), > > > > you cannot obtain a radial pulse or a blood pressure. You do > > find a > > > > palpable carotid pulse at 72 bpm. > > > > > > > > What is happening to the patient and what is the underlying > > etiology? > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > -Attorney at Law/Licensed Paramedic > > > > -Austin, Texas > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 chuckle....no, Kuru is a prion disease associated with New Guinea's cannibals. Moyamoya is an interesting chronic disease that starts much earlier in life than we are given information about. The treatment for it involves burr holes in the skull and one of several different techniques to bypass the blocked internal carotid circulation with blood flow from the external carotids. The more common disease that I was thinking about, which involves the tender temples, is often associated with oddball visual problems due to both mini strokes and direct damage to the retinas. While a rare complication, it can cause reduced pulses in the distal circulation, but not to the extent that Wes portrayed. It does respond to chronic steroid treatment. The disease that Wes is portraying is quite rare among non Asiatic females, but has been found world wide- a MedLine search shows that there was a significant case of the problem in the Mideast. It's one of those zebras that medical school professors so love, because it has such interesting and blatant symptoms and signs....but is so rare as to be almost impossible to see a case in a lifetime of practice in the Western world. One point on this disease is that the first manifestations normally occur in the second and third decades (teens and twenties) of life, as opposed to the more common problems with athereosclerosis, which don't normally show up until the fifth decade (forties) or later. This disease does respond to steroids as well. Hopefully, between the hints that Gene and I have dropped, more folks will be persuaded to do further reading as well. ck In a message dated 6/12/2010 04:38:08 Central Daylight Time, bradsattler@... writes: Wes, I did the research and found the zebra. It was not kuru, sadly. Methylprednisolone via med control permission would be my treatment (another clue). I can't find the tie-in to stroke, is there a corroboration I'm missing? -Brad Sent via BlackBerry, the office that follows you. EMS challenge > > > > > > > > Since it's been a while since Professor Gandy offered a > challenge > > > > (and the > > > > prize-winner's trip to Ladonia), I present the following brain- > > > > teaser for > > > > all of y'all. Alas, there are no prizes since the half-star > hotel > > > > resort > > > > in Ladonia is closed for fumigation. > > > > > > > > On to the challenge...... you are dispatched to an altered > mental > > > > status > > > > call. Upon arrival, you find a middle-aged female laying on the > > > > floor of an > > > > office. She is semi-coherent and semi-combative, with slurred > > > > speech. Her > > > > co-workers know that she has an extensive medical history, but > > they > > > > can't > > > > remember what it is. > > > > > > > > Oddly, while the patient is breathing and speaking (although > > > > abnormally), > > > > you cannot obtain a radial pulse or a blood pressure. You do > > find a > > > > palpable carotid pulse at 72 bpm. > > > > > > > > What is happening to the patient and what is the underlying > > etiology? > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > -Attorney at Law/Licensed Paramedic > > > > -Austin, Texas > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 Takayasu arteritis. Sent from the itty bitty keyboard on my iPhone > chuckle....no, Kuru is a prion disease associated with New Guinea's > cannibals. > > Moyamoya is an interesting chronic disease that starts much earlier > in life > than we are given information about. The treatment for it involves > burr > holes in the skull and one of several different techniques to bypass > the > blocked internal carotid circulation with blood flow from the > external carotids. > > The more common disease that I was thinking about, which involves the > tender temples, is often associated with oddball visual problems due > to both > mini strokes and direct damage to the retinas. While a rare > complication, it > can cause reduced pulses in the distal circulation, but not to the > extent > that Wes portrayed. It does respond to chronic steroid treatment. > > The disease that Wes is portraying is quite rare among non Asiatic > females, > but has been found world wide- a MedLine search shows that there was a > significant case of the problem in the Mideast. It's one of those > zebras that > medical school professors so love, because it has such interesting and > blatant symptoms and signs....but is so rare as to be almost > impossible to see > a case in a lifetime of practice in the Western world. One point on > this > disease is that the first manifestations normally occur in the > second and > third decades (teens and twenties) of life, as opposed to the more > common > problems with athereosclerosis, which don't normally show up until > the fifth > decade (forties) or later. This disease does respond to steroids as > well. > > Hopefully, between the hints that Gene and I have dropped, more > folks will > be persuaded to do further reading as well. > > ck > > > In a message dated 6/12/2010 04:38:08 Central Daylight Time, > bradsattler@... writes: > > Wes, > > I did the research and found the zebra. It was not kuru, sadly. > > Methylprednisolone via med control permission would be my treatment > (another clue). > > I can't find the tie-in to stroke, is there a corroboration I'm > missing? > > -Brad > > Sent via BlackBerry, the office that follows you. > > EMS challenge > > > > > > > > > > Since it's been a while since Professor Gandy offered a > > challenge > > > > > (and the > > > > > prize-winner's trip to Ladonia), I present the following > brain- > > > > > teaser for > > > > > all of y'all. Alas, there are no prizes since the half-star > > hotel > > > > > resort > > > > > in Ladonia is closed for fumigation. > > > > > > > > > > On to the challenge...... you are dispatched to an altered > > mental > > > > > status > > > > > call. Upon arrival, you find a middle-aged female laying on > the > > > > > floor of an > > > > > office. She is semi-coherent and semi-combative, with slurred > > > > > speech. Her > > > > > co-workers know that she has an extensive medical history, but > > > they > > > > > can't > > > > > remember what it is. > > > > > > > > > > Oddly, while the patient is breathing and speaking (although > > > > > abnormally), > > > > > you cannot obtain a radial pulse or a blood pressure. You do > > > find a > > > > > palpable carotid pulse at 72 bpm. > > > > > > > > > > What is happening to the patient and what is the underlying > > > etiology? > > > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > > -Attorney at Law/Licensed Paramedic > > > > > -Austin, Texas > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 A bit of a better explanation of my theory - Takayasu Arteritis. It's a disease which is 8 to 9 times more common in females, and typically affects Asians. It's most common in females of childbearing age, and usually presents before 40. It's relatively rare. It has an unknown cause, but is an inflammatory disease, and so can be treated with steroids. It is also referred to as " pulseless disease " because subjects can have different pulses between left and right arms or even entirely lose the pulses in both arms (though it should be noted that pulses are lost in the upper extremities, so a pedal pulse should still be present). Subjects may also present with anemia, increased sedimentation rate in the blood, and generalized fatigue, and commonly present with Raynaud's Phenomenon. (So, you should look for discoloration of the fingertips, toes, or unexplained (non-bruised) blue spots caused by hypoxia.) It can also cause an aneurysm, which, if in the brain, can lead to a subarachnoid hemorrhage (SAH) or intracranial hematoma (ICH), which constitutes a stroke. Takayasu Arteritis has two main ways of presenting - half of patients develop only late stages, without any initial illness, and the other half have an initial, systematic illness, followed by a chronic stage. Since she has the Enbrel there, we can assume she falls into the second, " chronic " category, SO... She has Takayasu Arteritis. She is being treated for it. She has no pulses, and no obtainable BP as a result of narrowing of the arteries and blood vessels in the upper extremities, and has developed an aneurysm in her brain which I'm guessing was not detected until this point - the point at which she has the stroke, and EMS becomes involved. Close? Alyssa Woods, FF/NREMT-B > chuckle....no, Kuru is a prion disease associated with New Guinea's > cannibals. > > Moyamoya is an interesting chronic disease that starts much earlier > in life > than we are given information about. The treatment for it involves > burr > holes in the skull and one of several different techniques to bypass > the > blocked internal carotid circulation with blood flow from the > external carotids. > > The more common disease that I was thinking about, which involves the > tender temples, is often associated with oddball visual problems due > to both > mini strokes and direct damage to the retinas. While a rare > complication, it > can cause reduced pulses in the distal circulation, but not to the > extent > that Wes portrayed. It does respond to chronic steroid treatment. > > The disease that Wes is portraying is quite rare among non Asiatic > females, > but has been found world wide- a MedLine search shows that there was a > significant case of the problem in the Mideast. It's one of those > zebras that > medical school professors so love, because it has such interesting and > blatant symptoms and signs....but is so rare as to be almost > impossible to see > a case in a lifetime of practice in the Western world. One point on > this > disease is that the first manifestations normally occur in the > second and > third decades (teens and twenties) of life, as opposed to the more > common > problems with athereosclerosis, which don't normally show up until > the fifth > decade (forties) or later. This disease does respond to steroids as > well. > > Hopefully, between the hints that Gene and I have dropped, more > folks will > be persuaded to do further reading as well. > > ck > > > In a message dated 6/12/2010 04:38:08 Central Daylight Time, > bradsattler@... writes: > > Wes, > > I did the research and found the zebra. It was not kuru, sadly. > > Methylprednisolone via med control permission would be my treatment > (another clue). > > I can't find the tie-in to stroke, is there a corroboration I'm > missing? > > -Brad > > Sent via BlackBerry, the office that follows you. > > EMS challenge > > > > > > > > > > Since it's been a while since Professor Gandy offered a > > challenge > > > > > (and the > > > > > prize-winner's trip to Ladonia), I present the following > brain- > > > > > teaser for > > > > > all of y'all. Alas, there are no prizes since the half-star > > hotel > > > > > resort > > > > > in Ladonia is closed for fumigation. > > > > > > > > > > On to the challenge...... you are dispatched to an altered > > mental > > > > > status > > > > > call. Upon arrival, you find a middle-aged female laying on > the > > > > > floor of an > > > > > office. She is semi-coherent and semi-combative, with slurred > > > > > speech. Her > > > > > co-workers know that she has an extensive medical history, but > > > they > > > > > can't > > > > > remember what it is. > > > > > > > > > > Oddly, while the patient is breathing and speaking (although > > > > > abnormally), > > > > > you cannot obtain a radial pulse or a blood pressure. You do > > > find a > > > > > palpable carotid pulse at 72 bpm. > > > > > > > > > > What is happening to the patient and what is the underlying > > > etiology? > > > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > > -Attorney at Law/Licensed Paramedic > > > > > -Austin, Texas > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 Winner! Nice work! Wes Ogilvie Sent from my iPad > Takayasu arteritis. > > Sent from the itty bitty keyboard on my iPhone > > > > > chuckle....no, Kuru is a prion disease associated with New Guinea's > > cannibals. > > > > Moyamoya is an interesting chronic disease that starts much earlier > > in life > > than we are given information about. The treatment for it involves > > burr > > holes in the skull and one of several different techniques to bypass > > the > > blocked internal carotid circulation with blood flow from the > > external carotids. > > > > The more common disease that I was thinking about, which involves the > > tender temples, is often associated with oddball visual problems due > > to both > > mini strokes and direct damage to the retinas. While a rare > > complication, it > > can cause reduced pulses in the distal circulation, but not to the > > extent > > that Wes portrayed. It does respond to chronic steroid treatment. > > > > The disease that Wes is portraying is quite rare among non Asiatic > > females, > > but has been found world wide- a MedLine search shows that there was a > > significant case of the problem in the Mideast. It's one of those > > zebras that > > medical school professors so love, because it has such interesting and > > blatant symptoms and signs....but is so rare as to be almost > > impossible to see > > a case in a lifetime of practice in the Western world. One point on > > this > > disease is that the first manifestations normally occur in the > > second and > > third decades (teens and twenties) of life, as opposed to the more > > common > > problems with athereosclerosis, which don't normally show up until > > the fifth > > decade (forties) or later. This disease does respond to steroids as > > well. > > > > Hopefully, between the hints that Gene and I have dropped, more > > folks will > > be persuaded to do further reading as well. > > > > ck > > > > > > In a message dated 6/12/2010 04:38:08 Central Daylight Time, > > bradsattler@... writes: > > > > Wes, > > > > I did the research and found the zebra. It was not kuru, sadly. > > > > Methylprednisolone via med control permission would be my treatment > > (another clue). > > > > I can't find the tie-in to stroke, is there a corroboration I'm > > missing? > > > > -Brad > > > > Sent via BlackBerry, the office that follows you. > > > > EMS challenge > > > > > > > > > > > > Since it's been a while since Professor Gandy offered a > > > challenge > > > > > > (and the > > > > > > prize-winner's trip to Ladonia), I present the following > > brain- > > > > > > teaser for > > > > > > all of y'all. Alas, there are no prizes since the half-star > > > hotel > > > > > > resort > > > > > > in Ladonia is closed for fumigation. > > > > > > > > > > > > On to the challenge...... you are dispatched to an altered > > > mental > > > > > > status > > > > > > call. Upon arrival, you find a middle-aged female laying on > > the > > > > > > floor of an > > > > > > office. She is semi-coherent and semi-combative, with slurred > > > > > > speech. Her > > > > > > co-workers know that she has an extensive medical history, but > > > > they > > > > > > can't > > > > > > remember what it is. > > > > > > > > > > > > Oddly, while the patient is breathing and speaking (although > > > > > > abnormally), > > > > > > you cannot obtain a radial pulse or a blood pressure. You do > > > > find a > > > > > > palpable carotid pulse at 72 bpm. > > > > > > > > > > > > What is happening to the patient and what is the underlying > > > > etiology? > > > > > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > > > -Attorney at Law/Licensed Paramedic > > > > > > -Austin, Texas > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 Beyond phenomenal, Alyssa!! You get the only prize better than a trip to Ladonia -- not being made to go to Ladonia! Wes Ogilvie Sent from my iPad > A bit of a better explanation of my theory - Takayasu Arteritis. > > It's a disease which is 8 to 9 times more common in females, and > typically affects Asians. It's most common in females of childbearing > age, and usually presents before 40. It's relatively rare. It has an > unknown cause, but is an inflammatory disease, and so can be treated > with steroids. It is also referred to as " pulseless disease " because > subjects can have different pulses between left and right arms or even > entirely lose the pulses in both arms (though it should be noted that > pulses are lost in the upper extremities, so a pedal pulse should > still be present). Subjects may also present with anemia, increased > sedimentation rate in the blood, and generalized fatigue, and commonly > present with Raynaud's Phenomenon. (So, you should look for > discoloration of the fingertips, toes, or unexplained (non-bruised) > blue spots caused by hypoxia.) It can also cause an aneurysm, which, > if in the brain, can lead to a subarachnoid hemorrhage (SAH) or > intracranial hematoma (ICH), which constitutes a stroke. Takayasu > Arteritis has two main ways of presenting - half of patients develop > only late stages, without any initial illness, and the other half have > an initial, systematic illness, followed by a chronic stage. Since she > has the Enbrel there, we can assume she falls into the second, > " chronic " category, SO... > > She has Takayasu Arteritis. She is being treated for it. She has no > pulses, and no obtainable BP as a result of narrowing of the arteries > and blood vessels in the upper extremities, and has developed an > aneurysm in her brain which I'm guessing was not detected until this > point - the point at which she has the stroke, and EMS becomes involved. > > Close? > > Alyssa Woods, FF/NREMT-B > > > > > chuckle....no, Kuru is a prion disease associated with New Guinea's > > cannibals. > > > > Moyamoya is an interesting chronic disease that starts much earlier > > in life > > than we are given information about. The treatment for it involves > > burr > > holes in the skull and one of several different techniques to bypass > > the > > blocked internal carotid circulation with blood flow from the > > external carotids. > > > > The more common disease that I was thinking about, which involves the > > tender temples, is often associated with oddball visual problems due > > to both > > mini strokes and direct damage to the retinas. While a rare > > complication, it > > can cause reduced pulses in the distal circulation, but not to the > > extent > > that Wes portrayed. It does respond to chronic steroid treatment. > > > > The disease that Wes is portraying is quite rare among non Asiatic > > females, > > but has been found world wide- a MedLine search shows that there was a > > significant case of the problem in the Mideast. It's one of those > > zebras that > > medical school professors so love, because it has such interesting and > > blatant symptoms and signs....but is so rare as to be almost > > impossible to see > > a case in a lifetime of practice in the Western world. One point on > > this > > disease is that the first manifestations normally occur in the > > second and > > third decades (teens and twenties) of life, as opposed to the more > > common > > problems with athereosclerosis, which don't normally show up until > > the fifth > > decade (forties) or later. This disease does respond to steroids as > > well. > > > > Hopefully, between the hints that Gene and I have dropped, more > > folks will > > be persuaded to do further reading as well. > > > > ck > > > > > > In a message dated 6/12/2010 04:38:08 Central Daylight Time, > > bradsattler@... writes: > > > > Wes, > > > > I did the research and found the zebra. It was not kuru, sadly. > > > > Methylprednisolone via med control permission would be my treatment > > (another clue). > > > > I can't find the tie-in to stroke, is there a corroboration I'm > > missing? > > > > -Brad > > > > Sent via BlackBerry, the office that follows you. > > > > EMS challenge > > > > > > > > > > > > Since it's been a while since Professor Gandy offered a > > > challenge > > > > > > (and the > > > > > > prize-winner's trip to Ladonia), I present the following > > brain- > > > > > > teaser for > > > > > > all of y'all. Alas, there are no prizes since the half-star > > > hotel > > > > > > resort > > > > > > in Ladonia is closed for fumigation. > > > > > > > > > > > > On to the challenge...... you are dispatched to an altered > > > mental > > > > > > status > > > > > > call. Upon arrival, you find a middle-aged female laying on > > the > > > > > > floor of an > > > > > > office. She is semi-coherent and semi-combative, with slurred > > > > > > speech. Her > > > > > > co-workers know that she has an extensive medical history, but > > > > they > > > > > > can't > > > > > > remember what it is. > > > > > > > > > > > > Oddly, while the patient is breathing and speaking (although > > > > > > abnormally), > > > > > > you cannot obtain a radial pulse or a blood pressure. You do > > > > find a > > > > > > palpable carotid pulse at 72 bpm. > > > > > > > > > > > > What is happening to the patient and what is the underlying > > > > etiology? > > > > > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > > > -Attorney at Law/Licensed Paramedic > > > > > > -Austin, Texas > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 Thank you! Couldn't have done it without all of the clues. Alyssa Woods, FF/NREMT-B Sent from the itty bitty keyboard on my iPhone > Winner! Nice work! > > Wes Ogilvie > > Sent from my iPad > > > > > Takayasu arteritis. > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > > > > chuckle....no, Kuru is a prion disease associated with New > Guinea's > > > cannibals. > > > > > > Moyamoya is an interesting chronic disease that starts much > earlier > > > in life > > > than we are given information about. The treatment for it involves > > > burr > > > holes in the skull and one of several different techniques to > bypass > > > the > > > blocked internal carotid circulation with blood flow from the > > > external carotids. > > > > > > The more common disease that I was thinking about, which > involves the > > > tender temples, is often associated with oddball visual problems > due > > > to both > > > mini strokes and direct damage to the retinas. While a rare > > > complication, it > > > can cause reduced pulses in the distal circulation, but not to the > > > extent > > > that Wes portrayed. It does respond to chronic steroid treatment. > > > > > > The disease that Wes is portraying is quite rare among non Asiatic > > > females, > > > but has been found world wide- a MedLine search shows that there > was a > > > significant case of the problem in the Mideast. It's one of those > > > zebras that > > > medical school professors so love, because it has such > interesting and > > > blatant symptoms and signs....but is so rare as to be almost > > > impossible to see > > > a case in a lifetime of practice in the Western world. One point > on > > > this > > > disease is that the first manifestations normally occur in the > > > second and > > > third decades (teens and twenties) of life, as opposed to the more > > > common > > > problems with athereosclerosis, which don't normally show up until > > > the fifth > > > decade (forties) or later. This disease does respond to steroids > as > > > well. > > > > > > Hopefully, between the hints that Gene and I have dropped, more > > > folks will > > > be persuaded to do further reading as well. > > > > > > ck > > > > > > > > > In a message dated 6/12/2010 04:38:08 Central Daylight Time, > > > bradsattler@... writes: > > > > > > Wes, > > > > > > I did the research and found the zebra. It was not kuru, sadly. > > > > > > Methylprednisolone via med control permission would be my > treatment > > > (another clue). > > > > > > I can't find the tie-in to stroke, is there a corroboration I'm > > > missing? > > > > > > -Brad > > > > > > Sent via BlackBerry, the office that follows you. > > > > > > EMS challenge > > > > > > > > > > > > > > Since it's been a while since Professor Gandy offered a > > > > challenge > > > > > > > (and the > > > > > > > prize-winner's trip to Ladonia), I present the following > > > brain- > > > > > > > teaser for > > > > > > > all of y'all. Alas, there are no prizes since the half- > star > > > > hotel > > > > > > > resort > > > > > > > in Ladonia is closed for fumigation. > > > > > > > > > > > > > > On to the challenge...... you are dispatched to an altered > > > > mental > > > > > > > status > > > > > > > call. Upon arrival, you find a middle-aged female laying > on > > > the > > > > > > > floor of an > > > > > > > office. She is semi-coherent and semi-combative, with > slurred > > > > > > > speech. Her > > > > > > > co-workers know that she has an extensive medical > history, but > > > > > they > > > > > > > can't > > > > > > > remember what it is. > > > > > > > > > > > > > > Oddly, while the patient is breathing and speaking > (although > > > > > > > abnormally), > > > > > > > you cannot obtain a radial pulse or a blood pressure. > You do > > > > > find a > > > > > > > palpable carotid pulse at 72 bpm. > > > > > > > > > > > > > > What is happening to the patient and what is the > underlying > > > > > etiology? > > > > > > > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > > > > -Attorney at Law/Licensed Paramedic > > > > > > > -Austin, Texas > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 On Saturday, June 12, 2010 14:53, krin135@... said: > The disease that Wes is portraying is quite rare among non Asiatic females... I have to admit that my first instinct, upon hearing this qualifier, was that she had suffered a CHI in an MVA. After all, aren't Asian females prone to that? Congrats, Alyssa! Rob Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 Congratulations, Alyssa! Most impressive. Isn't this fun? Gene Gandy EMS challenge > > > > > > > > > > > > > > Since it's been a while since Professor Gandy offered a > > > > challenge > > > > > > > (and the > > > > > > > prize-winner's trip to Ladonia), I present the following > > > brain- > > > > > > > teaser for > > > > > > > all of y'all. Alas, there are no prizes since the half- > star > > > > hotel > > > > > > > resort > > > > > > > in Ladonia is closed for fumigation. > > > > > > > > > > > > > > On to the challenge...... you are dispatched to an altered > > > > mental > > > > > > > status > > > > > > > call. Upon arrival, you find a middle-aged female laying > on > > > the > > > > > > > floor of an > > > > > > > office. She is semi-coherent and semi-combative, with > slurred > > > > > > > speech. Her > > > > > > > co-workers know that she has an extensive medical > history, but > > > > > they > > > > > > > can't > > > > > > > remember what it is. > > > > > > > > > > > > > > Oddly, while the patient is breathing and speaking > (although > > > > > > > abnormally), > > > > > > > you cannot obtain a radial pulse or a blood pressure. > You do > > > > > find a > > > > > > > palpable carotid pulse at 72 bpm. > > > > > > > > > > > > > > What is happening to the patient and what is the > underlying > > > > > etiology? > > > > > > > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > > > > -Attorney at Law/Licensed Paramedic > > > > > > > -Austin, Texas > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 Always! That's why I love to play the game. I just got a little discouraged after I kept getting chewed out for it. Alyssa Woods, FF/NREMT-B > > Congratulations, Alyssa! Most impressive. > > Isn't this fun? > > Gene Gandy > > EMS challenge > > > > > > > > > > > > > > > > Since it's been a while since Professor Gandy offered a > > > > > challenge > > > > > > > > (and the > > > > > > > > prize-winner's trip to Ladonia), I present the following > > > > brain- > > > > > > > > teaser for > > > > > > > > all of y'all. Alas, there are no prizes since the half- > > star > > > > > hotel > > > > > > > > resort > > > > > > > > in Ladonia is closed for fumigation. > > > > > > > > > > > > > > > > On to the challenge...... you are dispatched to an > altered > > > > > mental > > > > > > > > status > > > > > > > > call. Upon arrival, you find a middle-aged female laying > > on > > > > the > > > > > > > > floor of an > > > > > > > > office. She is semi-coherent and semi-combative, with > > slurred > > > > > > > > speech. Her > > > > > > > > co-workers know that she has an extensive medical > > history, but > > > > > > they > > > > > > > > can't > > > > > > > > remember what it is. > > > > > > > > > > > > > > > > Oddly, while the patient is breathing and speaking > > (although > > > > > > > > abnormally), > > > > > > > > you cannot obtain a radial pulse or a blood pressure. > > You do > > > > > > find a > > > > > > > > palpable carotid pulse at 72 bpm. > > > > > > > > > > > > > > > > What is happening to the patient and what is the > > underlying > > > > > > etiology? > > > > > > > > > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > > > > > -Attorney at Law/Licensed Paramedic > > > > > > > > -Austin, Texas > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2010 Report Share Posted June 12, 2010 Alyssa. Never loose your passion as it is what counts nothing nor anyone else. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > Always! That's why I love to play the game. I just got a little > discouraged after I kept getting chewed out for it. > > Alyssa Woods, FF/NREMT-B > > > > > > > Congratulations, Alyssa! Most impressive. > > > > Isn't this fun? > > > > Gene Gandy > > > > EMS challenge > > > > > > > > > > > > > > > > > > Since it's been a while since Professor Gandy > offered a > > > > > > challenge > > > > > > > > > (and the > > > > > > > > > prize-winner's trip to Ladonia), I present the > following > > > > > brain- > > > > > > > > > teaser for > > > > > > > > > all of y'all. Alas, there are no prizes since the > half- > > > star > > > > > > hotel > > > > > > > > > resort > > > > > > > > > in Ladonia is closed for fumigation. > > > > > > > > > > > > > > > > > > On to the challenge...... you are dispatched to an > > altered > > > > > > mental > > > > > > > > > status > > > > > > > > > call. Upon arrival, you find a middle-aged female > laying > > > on > > > > > the > > > > > > > > > floor of an > > > > > > > > > office. She is semi-coherent and semi-combative, with > > > slurred > > > > > > > > > speech. Her > > > > > > > > > co-workers know that she has an extensive medical > > > history, but > > > > > > > they > > > > > > > > > can't > > > > > > > > > remember what it is. > > > > > > > > > > > > > > > > > > Oddly, while the patient is breathing and speaking > > > (although > > > > > > > > > abnormally), > > > > > > > > > you cannot obtain a radial pulse or a blood pressure. > > > You do > > > > > > > find a > > > > > > > > > palpable carotid pulse at 72 bpm. > > > > > > > > > > > > > > > > > > What is happening to the patient and what is the > > > underlying > > > > > > > etiology? > > > > > > > > > > > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > > > > > > -Attorney at Law/Licensed Paramedic > > > > > > > > > -Austin, Texas > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 13, 2010 Report Share Posted June 13, 2010 I disagree. Everyone needs someone. No man is an island. Etc, etc. Alyssa Woods, FF/NREMT-B Sent from the itty bitty keyboard on my iPhone On Jun 13, 2010, at 12:24 AM, " Louis N. Molino, Sr. " lnmolino@...> wrote: > > Alyssa. > > Never loose your passion as it is what counts nothing nor anyone else. > Louis N. Molino, Sr. CET > FF/NREMT/FSI/EMSI > Typed by my fingers on my iPhone. > Please excuse any typos. > (Cell) > LNMolino@... > > > > > Always! That's why I love to play the game. I just got a little > > discouraged after I kept getting chewed out for it. > > > > Alyssa Woods, FF/NREMT-B > > > > > > > > > > > > Congratulations, Alyssa! Most impressive. > > > > > > Isn't this fun? > > > > > > Gene Gandy > > > > > > EMS challenge > > > > > > > > > > > > > > > > > > > > Since it's been a while since Professor Gandy > > offered a > > > > > > > challenge > > > > > > > > > > (and the > > > > > > > > > > prize-winner's trip to Ladonia), I present the > > following > > > > > > brain- > > > > > > > > > > teaser for > > > > > > > > > > all of y'all. Alas, there are no prizes since the > > half- > > > > star > > > > > > > hotel > > > > > > > > > > resort > > > > > > > > > > in Ladonia is closed for fumigation. > > > > > > > > > > > > > > > > > > > > On to the challenge...... you are dispatched to an > > > altered > > > > > > > mental > > > > > > > > > > status > > > > > > > > > > call. Upon arrival, you find a middle-aged female > > laying > > > > on > > > > > > the > > > > > > > > > > floor of an > > > > > > > > > > office. She is semi-coherent and semi-combative, > with > > > > slurred > > > > > > > > > > speech. Her > > > > > > > > > > co-workers know that she has an extensive medical > > > > history, but > > > > > > > > they > > > > > > > > > > can't > > > > > > > > > > remember what it is. > > > > > > > > > > > > > > > > > > > > Oddly, while the patient is breathing and speaking > > > > (although > > > > > > > > > > abnormally), > > > > > > > > > > you cannot obtain a radial pulse or a blood > pressure. > > > > You do > > > > > > > > find a > > > > > > > > > > palpable carotid pulse at 72 bpm. > > > > > > > > > > > > > > > > > > > > What is happening to the patient and what is the > > > > underlying > > > > > > > > etiology? > > > > > > > > > > > > > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > > > > > > > -Attorney at Law/Licensed Paramedic > > > > > > > > > > -Austin, Texas > > > > > > > > > > > > > > > > > > > > [Non-text portions of this message have been > removed] > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 13, 2010 Report Share Posted June 13, 2010 At an intimate level yes but outside that passion and heart carry you. Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > I disagree. > > Everyone needs someone. No man is an island. Etc, etc. > > Alyssa Woods, FF/NREMT-B > > Sent from the itty bitty keyboard on my iPhone > > On Jun 13, 2010, at 12:24 AM, " Louis N. Molino, Sr. " > lnmolino@...> wrote: > > > > > Alyssa. > > > > Never loose your passion as it is what counts nothing nor anyone > else. > > Louis N. Molino, Sr. CET > > FF/NREMT/FSI/EMSI > > Typed by my fingers on my iPhone. > > Please excuse any typos. > > (Cell) > > LNMolino@... > > > > On Jun 12, 2010, at 22:49, Alyssa Woods amwoods8644@...> > wrote: > > > > > Always! That's why I love to play the game. I just got a little > > > discouraged after I kept getting chewed out for it. > > > > > > Alyssa Woods, FF/NREMT-B > > > > > > > > > > > > > > > > > Congratulations, Alyssa! Most impressive. > > > > > > > > Isn't this fun? > > > > > > > > Gene Gandy > > > > > > > > EMS challenge > > > > > > > > > > > > > > > > > > > > > > Since it's been a while since Professor Gandy > > > offered a > > > > > > > > challenge > > > > > > > > > > > (and the > > > > > > > > > > > prize-winner's trip to Ladonia), I present the > > > following > > > > > > > brain- > > > > > > > > > > > teaser for > > > > > > > > > > > all of y'all. Alas, there are no prizes since the > > > half- > > > > > star > > > > > > > > hotel > > > > > > > > > > > resort > > > > > > > > > > > in Ladonia is closed for fumigation. > > > > > > > > > > > > > > > > > > > > > > On to the challenge...... you are dispatched to an > > > > altered > > > > > > > > mental > > > > > > > > > > > status > > > > > > > > > > > call. Upon arrival, you find a middle-aged female > > > laying > > > > > on > > > > > > > the > > > > > > > > > > > floor of an > > > > > > > > > > > office. She is semi-coherent and semi-combative, > > with > > > > > slurred > > > > > > > > > > > speech. Her > > > > > > > > > > > co-workers know that she has an extensive medical > > > > > history, but > > > > > > > > > they > > > > > > > > > > > can't > > > > > > > > > > > remember what it is. > > > > > > > > > > > > > > > > > > > > > > Oddly, while the patient is breathing and speaking > > > > > (although > > > > > > > > > > > abnormally), > > > > > > > > > > > you cannot obtain a radial pulse or a blood > > pressure. > > > > > You do > > > > > > > > > find a > > > > > > > > > > > palpable carotid pulse at 72 bpm. > > > > > > > > > > > > > > > > > > > > > > What is happening to the patient and what is the > > > > > underlying > > > > > > > > > etiology? > > > > > > > > > > > > > > > > > > > > > > -Wes Ogilvie, MPA, JD, NREMT-P/Lic.P. > > > > > > > > > > > -Attorney at Law/Licensed Paramedic > > > > > > > > > > > -Austin, Texas > > > > > > > > > > > > > > > > > > > > > > [Non-text portions of this message have been > > removed] > > > > > > > > > > > > > > > > > > > > > > ------------------------------------ > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 having delivered more than a few babies to teen moms, generally the girls who deny being pg are NOT high class athletes.... that being said, the youngest mom I delivered a baby to is now about 35....and the oldest mom I delivered is about 75. ck In a message dated 01/06/11 13:50:48 Central Standard Time, lnmolino@... writes: So was the 15 year old we had in Gloucester City as she was crowning. That kid is about 15 herself now. Yes, history can repeat itself b Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > She is very adamant about not being pregnant. > > Alyssa Woods, NREMT-B > CPR Instructor > > > > > >> Is she worried about the next 9 months? Or what comes at the end of same? >> >> Louis N. Molino, Sr. CET >> FF/NREMT/FSI/EMSI >> Typed by my fingers on my iPhone. >> Please excuse any typos. >> (979) 412-0890 (Cell) >> LNMolino@... >> >> On Jan 6, 2011, at 13:29, Alyssa Woods amwoods8644@...> wrote: >> >>> What, cute athletes can't be gay? Gee, thanks! >>> >>> Kidding! >>> >>> She has had the same boyfriend since she was 14. >>> >>> Alyssa Woods, NREMT-B >>> CPR Instructor >>> >>> >>> >>> >>> >>>> Not that I'm cynical, but does she have a history of boyfriend over the last 9 months? >>>> >>>> - Brad Sattler >>>> >>>> >>>> >>>>> >>>>> Subject: EMS Challenge >>>>> To: texasems-l >>>>> Date: Thursday, January 6, 2011, 1:16 PM >>>>> I think we're about due for another >>>>> challenge, if anyone is up for it. >>>>> >>>>> You're dispatched to an 18 year old woman experiencing >>>>> seizures. Upon arrival, you find a young woman who appears >>>>> to be having a panic attack, and states that she experienced >>>>> a few " shocks " . She's diaphoretic and tachycardic at a rate >>>>> of 140 resting, with a blood pressure of 142/98, and a >>>>> respiratory rate of 26. She has notable tremor. She reports >>>>> no medical history, no medications, and no allergies, and >>>>> her parents state that she's perfectly healthy, and couldn't >>>>> be on drugs, as she's active in high school sports and is >>>>> drug tested routinely. >>>>> >>>>> The patient states that she doesn't think that she's >>>>> experiencing an emergency, and insists that her parents are >>>>> overreacting and she simply wants to go back to bed. >>>>> >>>>> >>>>> >>>>> Alyssa Woods, NREMT-B >>>>> CPR Instructor >>>>> >>>>> >>>>> >>>>> >>>>> >>>>> ------------------------------------ >>>>> >>>>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 Not that I'm cynical, but does she have a history of boyfriend over the last 9 months? - Brad Sattler > > Subject: EMS Challenge > To: texasems-l > Date: Thursday, January 6, 2011, 1:16 PM > I think we're about due for another > challenge, if anyone is up for it. > > You're dispatched to an 18 year old woman experiencing > seizures. Upon arrival, you find a young woman who appears > to be having a panic attack, and states that she experienced > a few " shocks " . She's diaphoretic and tachycardic at a rate > of 140 resting, with a blood pressure of 142/98, and a > respiratory rate of 26. She has notable tremor. She reports > no medical history, no medications, and no allergies, and > her parents state that she's perfectly healthy, and couldn't > be on drugs, as she's active in high school sports and is > drug tested routinely. > > The patient states that she doesn't think that she's > experiencing an emergency, and insists that her parents are > overreacting and she simply wants to go back to bed. > > > > Alyssa Woods, NREMT-B > CPR Instructor > > > > > > ------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 Not that I'm cynical, but does she have a history of boyfriend over the last 9 months? - Brad Sattler > > Subject: EMS Challenge > To: texasems-l > Date: Thursday, January 6, 2011, 1:16 PM > I think we're about due for another > challenge, if anyone is up for it. > > You're dispatched to an 18 year old woman experiencing > seizures. Upon arrival, you find a young woman who appears > to be having a panic attack, and states that she experienced > a few " shocks " . She's diaphoretic and tachycardic at a rate > of 140 resting, with a blood pressure of 142/98, and a > respiratory rate of 26. She has notable tremor. She reports > no medical history, no medications, and no allergies, and > her parents state that she's perfectly healthy, and couldn't > be on drugs, as she's active in high school sports and is > drug tested routinely. > > The patient states that she doesn't think that she's > experiencing an emergency, and insists that her parents are > overreacting and she simply wants to go back to bed. > > > > Alyssa Woods, NREMT-B > CPR Instructor > > > > > > ------------------------------------ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 What, cute athletes can't be gay? Gee, thanks! Kidding! She has had the same boyfriend since she was 14. Alyssa Woods, NREMT-B CPR Instructor > Not that I'm cynical, but does she have a history of boyfriend over the last 9 months? > > - Brad Sattler > > > > > > > Subject: EMS Challenge > > To: texasems-l > > Date: Thursday, January 6, 2011, 1:16 PM > > I think we're about due for another > > challenge, if anyone is up for it. > > > > You're dispatched to an 18 year old woman experiencing > > seizures. Upon arrival, you find a young woman who appears > > to be having a panic attack, and states that she experienced > > a few " shocks " . She's diaphoretic and tachycardic at a rate > > of 140 resting, with a blood pressure of 142/98, and a > > respiratory rate of 26. She has notable tremor. She reports > > no medical history, no medications, and no allergies, and > > her parents state that she's perfectly healthy, and couldn't > > be on drugs, as she's active in high school sports and is > > drug tested routinely. > > > > The patient states that she doesn't think that she's > > experiencing an emergency, and insists that her parents are > > overreacting and she simply wants to go back to bed. > > > > > > > > Alyssa Woods, NREMT-B > > CPR Instructor > > > > > > > > > > > > ------------------------------------ > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 What, cute athletes can't be gay? Gee, thanks! Kidding! She has had the same boyfriend since she was 14. Alyssa Woods, NREMT-B CPR Instructor > Not that I'm cynical, but does she have a history of boyfriend over the last 9 months? > > - Brad Sattler > > > > > > > Subject: EMS Challenge > > To: texasems-l > > Date: Thursday, January 6, 2011, 1:16 PM > > I think we're about due for another > > challenge, if anyone is up for it. > > > > You're dispatched to an 18 year old woman experiencing > > seizures. Upon arrival, you find a young woman who appears > > to be having a panic attack, and states that she experienced > > a few " shocks " . She's diaphoretic and tachycardic at a rate > > of 140 resting, with a blood pressure of 142/98, and a > > respiratory rate of 26. She has notable tremor. She reports > > no medical history, no medications, and no allergies, and > > her parents state that she's perfectly healthy, and couldn't > > be on drugs, as she's active in high school sports and is > > drug tested routinely. > > > > The patient states that she doesn't think that she's > > experiencing an emergency, and insists that her parents are > > overreacting and she simply wants to go back to bed. > > > > > > > > Alyssa Woods, NREMT-B > > CPR Instructor > > > > > > > > > > > > ------------------------------------ > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 Diagnosis= Teenager........ Also Kidding (I can just hear the bad medic comments) Events leading up to ? Where is she at right now? Has she had this before? Been Sick in the past few weeks? > What, cute athletes can't be gay? Gee, thanks! > > Kidding! > > She has had the same boyfriend since she was 14. > > Alyssa Woods, NREMT-B > CPR Instructor > > > > > >> Not that I'm cynical, but does she have a history of boyfriend over the last 9 months? >> >> - Brad Sattler >> >> >> >>> >>> Subject: EMS Challenge >>> To: texasems-l >>> Date: Thursday, January 6, 2011, 1:16 PM >>> I think we're about due for another >>> challenge, if anyone is up for it. >>> >>> You're dispatched to an 18 year old woman experiencing >>> seizures. Upon arrival, you find a young woman who appears >>> to be having a panic attack, and states that she experienced >>> a few " shocks " . She's diaphoretic and tachycardic at a rate >>> of 140 resting, with a blood pressure of 142/98, and a >>> respiratory rate of 26. She has notable tremor. She reports >>> no medical history, no medications, and no allergies, and >>> her parents state that she's perfectly healthy, and couldn't >>> be on drugs, as she's active in high school sports and is >>> drug tested routinely. >>> >>> The patient states that she doesn't think that she's >>> experiencing an emergency, and insists that her parents are >>> overreacting and she simply wants to go back to bed. >>> >>> >>> >>> Alyssa Woods, NREMT-B >>> CPR Instructor >>> >>> >>> >>> >>> >>> ------------------------------------ >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 Is she worried about the next 9 months? Or what comes at the end of same? Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > What, cute athletes can't be gay? Gee, thanks! > > Kidding! > > She has had the same boyfriend since she was 14. > > Alyssa Woods, NREMT-B > CPR Instructor > > > > > >> Not that I'm cynical, but does she have a history of boyfriend over the last 9 months? >> >> - Brad Sattler >> >> >> >>> >>> Subject: EMS Challenge >>> To: texasems-l >>> Date: Thursday, January 6, 2011, 1:16 PM >>> I think we're about due for another >>> challenge, if anyone is up for it. >>> >>> You're dispatched to an 18 year old woman experiencing >>> seizures. Upon arrival, you find a young woman who appears >>> to be having a panic attack, and states that she experienced >>> a few " shocks " . She's diaphoretic and tachycardic at a rate >>> of 140 resting, with a blood pressure of 142/98, and a >>> respiratory rate of 26. She has notable tremor. She reports >>> no medical history, no medications, and no allergies, and >>> her parents state that she's perfectly healthy, and couldn't >>> be on drugs, as she's active in high school sports and is >>> drug tested routinely. >>> >>> The patient states that she doesn't think that she's >>> experiencing an emergency, and insists that her parents are >>> overreacting and she simply wants to go back to bed. >>> >>> >>> >>> Alyssa Woods, NREMT-B >>> CPR Instructor >>> >>> >>> >>> >>> >>> ------------------------------------ >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 Is she worried about the next 9 months? Or what comes at the end of same? Louis N. Molino, Sr. CET FF/NREMT/FSI/EMSI Typed by my fingers on my iPhone. Please excuse any typos. (Cell) LNMolino@... > What, cute athletes can't be gay? Gee, thanks! > > Kidding! > > She has had the same boyfriend since she was 14. > > Alyssa Woods, NREMT-B > CPR Instructor > > > > > >> Not that I'm cynical, but does she have a history of boyfriend over the last 9 months? >> >> - Brad Sattler >> >> >> >>> >>> Subject: EMS Challenge >>> To: texasems-l >>> Date: Thursday, January 6, 2011, 1:16 PM >>> I think we're about due for another >>> challenge, if anyone is up for it. >>> >>> You're dispatched to an 18 year old woman experiencing >>> seizures. Upon arrival, you find a young woman who appears >>> to be having a panic attack, and states that she experienced >>> a few " shocks " . She's diaphoretic and tachycardic at a rate >>> of 140 resting, with a blood pressure of 142/98, and a >>> respiratory rate of 26. She has notable tremor. She reports >>> no medical history, no medications, and no allergies, and >>> her parents state that she's perfectly healthy, and couldn't >>> be on drugs, as she's active in high school sports and is >>> drug tested routinely. >>> >>> The patient states that she doesn't think that she's >>> experiencing an emergency, and insists that her parents are >>> overreacting and she simply wants to go back to bed. >>> >>> >>> >>> Alyssa Woods, NREMT-B >>> CPR Instructor >>> >>> >>> >>> >>> >>> ------------------------------------ >>> >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 Or worried about what hasn't come for the last 36-40 weeks? > >> > >>> > >>> Subject: EMS Challenge > >>> To: texasems-l > >>> Date: Thursday, January 6, 2011, 1:16 PM > >>> I think we're about due for another > >>> challenge, if anyone is up for it. > >>> > >>> You're dispatched to an 18 year old woman > experiencing > >>> seizures. Upon arrival, you find a young woman > who appears > >>> to be having a panic attack, and states that > she experienced > >>> a few " shocks " . She's diaphoretic and > tachycardic at a rate > >>> of 140 resting, with a blood pressure of > 142/98, and a > >>> respiratory rate of 26. She has notable > tremor. She reports > >>> no medical history, no medications, and no > allergies, and > >>> her parents state that she's perfectly > healthy, and couldn't > >>> be on drugs, as she's active in high school > sports and is > >>> drug tested routinely. > >>> > >>> The patient states that she doesn't think that > she's > >>> experiencing an emergency, and insists that > her parents are > >>> overreacting and she simply wants to go back > to bed. > >>> > >>> > >>> > >>> Alyssa Woods, NREMT-B > >>> CPR Instructor > >>> > >>> > >>> > >>> > >>> > >>> ------------------------------------ > >>> > >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 Or worried about what hasn't come for the last 36-40 weeks? > >> > >>> > >>> Subject: EMS Challenge > >>> To: texasems-l > >>> Date: Thursday, January 6, 2011, 1:16 PM > >>> I think we're about due for another > >>> challenge, if anyone is up for it. > >>> > >>> You're dispatched to an 18 year old woman > experiencing > >>> seizures. Upon arrival, you find a young woman > who appears > >>> to be having a panic attack, and states that > she experienced > >>> a few " shocks " . She's diaphoretic and > tachycardic at a rate > >>> of 140 resting, with a blood pressure of > 142/98, and a > >>> respiratory rate of 26. She has notable > tremor. She reports > >>> no medical history, no medications, and no > allergies, and > >>> her parents state that she's perfectly > healthy, and couldn't > >>> be on drugs, as she's active in high school > sports and is > >>> drug tested routinely. > >>> > >>> The patient states that she doesn't think that > she's > >>> experiencing an emergency, and insists that > her parents are > >>> overreacting and she simply wants to go back > to bed. > >>> > >>> > >>> > >>> Alyssa Woods, NREMT-B > >>> CPR Instructor > >>> > >>> > >>> > >>> > >>> > >>> ------------------------------------ > >>> > >>> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 She is very adamant about not being pregnant. Alyssa Woods, NREMT-B CPR Instructor > Is she worried about the next 9 months? Or what comes at the end of same? > > Louis N. Molino, Sr. CET > FF/NREMT/FSI/EMSI > Typed by my fingers on my iPhone. > Please excuse any typos. > (Cell) > LNMolino@... > > > > > What, cute athletes can't be gay? Gee, thanks! > > > > Kidding! > > > > She has had the same boyfriend since she was 14. > > > > Alyssa Woods, NREMT-B > > CPR Instructor > > > > > > > > > > > >> Not that I'm cynical, but does she have a history of boyfriend over the last 9 months? > >> > >> - Brad Sattler > >> > >> > >> > >>> > >>> Subject: EMS Challenge > >>> To: texasems-l > >>> Date: Thursday, January 6, 2011, 1:16 PM > >>> I think we're about due for another > >>> challenge, if anyone is up for it. > >>> > >>> You're dispatched to an 18 year old woman experiencing > >>> seizures. Upon arrival, you find a young woman who appears > >>> to be having a panic attack, and states that she experienced > >>> a few " shocks " . She's diaphoretic and tachycardic at a rate > >>> of 140 resting, with a blood pressure of 142/98, and a > >>> respiratory rate of 26. She has notable tremor. She reports > >>> no medical history, no medications, and no allergies, and > >>> her parents state that she's perfectly healthy, and couldn't > >>> be on drugs, as she's active in high school sports and is > >>> drug tested routinely. > >>> > >>> The patient states that she doesn't think that she's > >>> experiencing an emergency, and insists that her parents are > >>> overreacting and she simply wants to go back to bed. > >>> > >>> > >>> > >>> Alyssa Woods, NREMT-B > >>> CPR Instructor > >>> > >>> > >>> > >>> > >>> > >>> ------------------------------------ > >>> > >>> Quote Link to comment Share on other sites More sharing options...
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