Well, work has been pretty calm. I had a few days to think about my last few serious calls. I am constantly reminded that I do know what I am doing, although I don't always feel like it. I had an interesting OD call the other day that I wasn't really sure if I did the appropriate thing. Although I have been working in PA for over a year I still sometime revert to the protocols that were engrained in my mind originally (which would be WV...which limit a provider). I was dispatched for a male in his 30s who took an unknown amount of Seroquel. Upon my assessment my pt states he took several different kind of pills, at least 3 different colored pills. The EMTs had gathered pill bottles for me before rendevousing with me and all the bottle they had were Seroquel, all stating the pills were either white or yellow. The pt reported taking several large pink pills as well, the wife stated maybe some Lamictal.
Pt was initially A&Ox4 and stated he felt high, loopy, and nauseated. He attempted to induce vomiting before calling 911, no luck. In PA ALS providers do not carry or administer charcoal, some BLS units do and can give it with approval of medical command. BLS put pt on oxygen and called for ALS. Throughout tx pt became slower to respond to questions and began to get sleepy. Pt could be aroused by a gantle shake to the shoulder but was unable to stay awake for long periods of time and when he talked his speech became more and more slurred, his oxygen saturations also began to decrease as did his respirations. I ended up giving 1 mg Narcan, just to see if it might help, his oxygen saturations came up but he still remained with slurre speech and sleepiness.
When I got back I talked to one of my medic partners who has been a round for a while and she said she wouldnt have even given the 1 mg in case he became violent...
What do you all think?
Monday, December 14, 2009
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