What is going on?

91W · Post by **91W** » August 13th, 2007, 2:24 pm

Dispatched to a party that is busted by law enforcement. On arrival find a 20 year old female in the fetal position with a GCS of 3. Pulled her out of the closet and laid down on the floor. Just to be sure I did a sternal rub that would have woke the dead with no response. Pulse is tachy at 150 resps at 14 and adequate, skin flushed and hot. Pupils constricted. I cut her shirt off to apply the monitor and she all of a sudden had a GCS 15.

She denied drinking. PBT was .112. She denied drug use. Pupils still constricted and skin same. Walked her to the truck and transported. Monitor showed Sinus tach, bp 158/90, pulse and resps same. Blood glucose was 158.

Urine Tox screen showed nothing in ER. Blood showed alcohol.

I was thinking amphetamines at first but with a negative urine tox I have no clue what was on board. Could X do this?

Just wondering what the other Medics and PA's and Doc's think.

DJB · Post by **DJB** » August 13th, 2007, 6:52 pm

Sounds like Anticholinergic syndrome, she may have OD on benadryl or Dramamine.

Sleepy Doc · Post by **Sleepy Doc** » August 13th, 2007, 9:44 pm

Bad heat stroke can present similarly. How was she mental status? You say GCS-15 but was she lethargic? Did she remember what happened? Did you try breaking her heart rate? IV's?

Really, as long as you have control of the ball when you cross the plane.. it counts as a score, right?

medicchick · Post by **medicchick** » August 13th, 2007, 10:12 pm

Any PVCs or just straight sinus tach?

Flesh Thorn · Post by **Flesh Thorn** » August 14th, 2007, 6:21 am

You lost me when you cut her shirt off.

RangerX · Post by **RangerX** » August 14th, 2007, 8:25 am

Flesh Thorn wrote:You lost me when you cut her shirt off.

This thread is worthless without pics.

42L5V · Post by **42L5V** » August 14th, 2007, 8:31 am

I don't know shit from shinola about advanced medical treatment, but pulling her out of the closet sounds kinda strange... The only people I've known in closets at a party are LSD users having a bad one, but constricted pupils disposes that theory...

Rock Island Ranger · August 14th, 2007, 9:11 am

After you got her shirt off.....was she hot?

RTO · Post by **RTO** » August 14th, 2007, 9:25 am

Abell9 wrote:After you got her shirt off.....was she hot?

And if she was, this thread is worthless without.......

Sleepy Doc · Post by **Sleepy Doc** » August 14th, 2007, 10:37 am

Shit, If I ONLY had a camera and could take pics of some of the shit I've seen.... We take some Hot-ass drunks to the ER on the weekends.. (but more are not so hot..) :(

Fishboy · Post by **Fishboy** » August 14th, 2007, 10:40 am

RTO wrote:
Abell9 wrote:After you got her shirt off.....was she hot?
And if she was, this thread is worthless without.......

have yall no shame!

Hijacking this thread...................

but seriously,
did you get pics?

Flesh Thorn · Post by **Flesh Thorn** » August 14th, 2007, 10:46 am

A sternum rub ? :? There are some intoxicants out there that are not main stream. I don't know about the increase in BP, but a heavy dose of something like Salvia could put a person into a "trip" for up to 15 minutes with a rapid return to reality and would not show up on a tox screen. Of course coming out of a hallucinogenic state with a paramedic "rubbing your sternum" could account for an increased BP. :D

Rock Island Ranger · August 14th, 2007, 11:03 am

Flesh Thorn wrote:A sternum rub ? :? There are some intoxicants out there that are not main stream. I don't know about the increase in BP, but a heavy dose of something like Salvia could put a person into a "trip" for up to 15 minutes with a rapid return to reality and would not show up on a tox screen. Of course coming out of a hallucinogenic state with a paramedic "rubbing your sternum" could account for an increased BP. :D

Yea, medically speaking. Of course, an injection of hot heat seeking moisture missile lubricant will do the same thing especially shot up the nose and throat..........

91W · Post by **91W** » August 15th, 2007, 5:24 pm

Ranger Bustedkidney

That one did not even cross my mind. I did not get an impression that she would be suicidal but accidental could be a possibility.

Ranger Sleepy Doc,

She was A@O X3. She had no recolition to the events. There was no indication to break the heart rate she was stable and all indications were pointing to normal perfusion at the time. Yes she got my normal IV 18ga in the hand. I ran the fluids at WO due to the fact of the elevated blood glucose. Our transport times are generally under 10 min in town so only about 250ml infused.

Medicchick,

No PVC's at all. That rules out most Cocain type drugs for me.

Ranger Fish,

That thought crossed my mind. The only time I have seen it the pt. did not due a complete turnaround that fast.

Ranger Flesh Thorn,

That is the problem she did not stir during the sternal rub. If she was faking she has an extremely high pain tolerance.

All other Rangers. I will keep my mouth shut due to what I think is the ethical thing to do. (and due to the fact of no camera)