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Post by blueeighty8 on Mar 12, 2005 23:13:15 GMT -5
I'm bored, so I searched the net for these. Plus I want to get up to 100 posts. Unit 10 respond to the senior citizen living cetner on MLK St. for a pt in having difficulty breathing." When you arrive you top for a moment at the doorway and notice the that the hallway is messy. The pt is a 67 y/o male sitting upright in his chair with rapid respirations and wheezing. You ask why he has called MES and he respnds in short sentences, twelling you that he has trouble catching his breath and may be having an asthma attack. Your partner tells him that she wants to put him on O2. While an NBR is being set up you begin the intial asessment. Pt has a patent airway and R32 with wheezing upon exhalation. The additional V/S taken by your partner are P110 BP 160/100 skin is moist and pupils are normal and reactive. You aks him about his medications and he askes you to speak up and you do w/o shouting. S - labored respirations and wheezing on exhalation A - no known allergies M - Has shoebox of medications including two inhalers. Last medication dosage was this morning at 0700 for asthma P - has had previous asthma attacks, becoming more frequent. L - ate breakfast at 0800 E - Pt was sitting in recliner and began having SOB. No pain was indicated by the pt. Ok here are the questions 1. Based on the assessment would you expect this pts condition to worsen? If so, how would you be prepared? 2. What additional assessments need to be taken enroute? How often should the V/S be taken? 3. What information about the pt. living condition should you share with ER nurse??
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Post by Medic13 on Mar 13, 2005 6:09:47 GMT -5
1) Yep. Load 'n go situation. Expedite ALS. Get the BVM ready. 2) Did pt use inhalers?, Cyanosis?, 02 Sat, onset, change in mental status, check vitals every 5min (unstable pt). If resp is still over 24 and inadequate, assist with BVM. 3) Messy living conditions = dust and junk, which could easily be responsible for the onset of the attack.
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9Wacker1
Full Member
Wacker - and proud of it!
Posts: 54
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Post by 9Wacker1 on Mar 14, 2005 9:31:24 GMT -5
I would have to agree: 1) Load and go and get the BVM ready 2) Definitely a 5min vitals check but I would add to all that provocation - what was he doing before he was sitting in the recliner? 3) I would tell the nurse if there was noticable dust and such - but messy doesn't have to mean dirty. Just my slant on the situation.
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Post by GVEMS11 on Mar 15, 2005 18:09:57 GMT -5
While we are loading and going and my partner is preparing the NRB, I would look through the patient's "shoebox of medications" and see what his two inhalers are. If he has a prescribed short-acting rapid-onset beta-2 antagonist inhaler (Albuterol or a brand name thereof), I would assist him in the administration of 1 prescribed dose, as his condition is associated with respiratory distress and wheezing. This is assuming that he has not used the inhaler within the last 20 minutes. I doubt very highly that the patient will tolerate any attempts with a BVM (until he exhausts himself, anyway).
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Post by 911wacker on Mar 16, 2005 23:55:46 GMT -5
L.S.P.O.R.Long Skinny Pedal On the Right Of course this would be after I started a NRB, give the patient a hit on the inhaler and prayed that he made it until advanced care arrived.
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