Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 LMP? Gravida/para? Describe the shocks. Was she drying her hair standing in water? (sorry had to ask) > > > > > >>>>>> > > > > > >>>>>>> > > > > > >>>>>>> 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 does she mean by " shocks " ? pain? numbness? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 No altercation. Nothing out of the norm. She's an A student, all set for college, top 5% of her class, graduates in a month. There was nothing out of the ordinary that day. Nausea, no vomiting, no diarrhea. I think you're moving in the right direction, though. Alyssa Woods, NREMT-B CPR Instructor Sent from the itty bitty keyboard on my iPhone > I may have missed it, but what were the events leading up to the “attackâ€. > > You said she was getting ready for bed, but was there any altercation with anyone…parent(s), friend, herself? > > How is school? Exams passed or upcoming? Report cards? > > What took place that day? > > Any nausea/vomiting/diarrhea? > > From: texasems-l [mailto:texasems-l ] On Behalf Of Alyssa Woods > Sent: Thursday, January 06, 2011 3:56 PM > To: texasems-l > Subject: Re: EMS Challenge > > Patient reports no recent trauma. > > Alyssa Woods, NREMT-B > CPR Instructor > > > My itty bitty iPhone keyboard makes me jealous of your iPad. Forgive any spelling errors or Freudian gits. > > On Jan 6, 2011, at 3:50 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > Any recent trauma? > > > > Wes > > > > Sent from my iPad > > > > On Jan 6, 2011, at 15:44, Alyssa Woods amwoods8644@... > wrote: > > > > > Apart from inverted t waves, the EKG is normal. No apparent LVH. > > > > > > And no drugs - she hadn't so much as had the flu since she was six. > > > > > > Alyssa Woods, NREMT-B > > > CPR Instructor > > > > > > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > On Jan 6, 2011, at 3:41 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > > > No drugs at all for the patient? > > > > > > > > With her being an athlete, is it possible that the inverted t waves come from left ventricular hypertrophy? > > > > > > > > Wes Ogilvie > > > > > > > > Sent from my iPad > > > > > > > > On Jan 6, 2011, at 15:07, Alyssa Woods amwoods8644@... > wrote: > > > > > > > > > She reports drinking approximately 64 oz of fluid throughout the day. > > > > > > > > > > Alyssa Woods, NREMT-B > > > > > CPR Instructor > > > > > > > > > > > > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > > > > > On Jan 6, 2011, at 2:59 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > > > > > > > Define plenty? > > > > > > > > > > > > Sent from my iPhone > > > > > > > > > > > > On Jan 6, 2011, at 14:46, Alyssa Woods amwoods8644@... > wrote: > > > > > > > > > > > > > Nothing out of the ordinary. > > > > > > > She's drank plenty of fluids - half gatorade, half water. > > > > > > > Cap refill is normal. She's warm, pink, and diaphoretic. > > > > > > > > > > > > > > Blood glucose is 109. > > > > > > > Capnography is 32. > > > > > > > EKG is normal except for inverted t-wiaves. > > > > > > > > > > > > > > > > > > > > > > > > > > > > Alyssa Woods, NREMT-B > > > > > > > CPR Instructor > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >> any athletics today? > > > > > > >> drink plenty of fluids? > > > > > > >> skin conditions upon assessment other than what initially noted? > > > > > > >> > > > > > > >> > > > > > > >> > > > > > > >>> She was preparing for bed. She's in her residence. She's never experienced this before, and she hasn't been ill in the last few weeks (and she has the trophies to prove it). > > > > > > >>> > > > > > > >>> Alyssa Woods, NREMT-B > > > > > > >>> CPR Instructor > > > > > > >>> > > > > > > >>> > > > > > > >>> > > > > > > >>> > > > > > > >>> > > > > > > >>>> 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 > > > > > > >>>>>> > > > > > > >>>>>> > > > > > > >>>>>> > > > > > > >>>>>>> From: Alyssa Woods amwoods8644@... > > > > > > > >>>>>>> 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 You keep saying that nothing happened out of the ordinary or out of the norm. But what did happen? Was she getting ready for school and all of a sudden she started shaking…out of the blue? How long ago did this start? What time is it now? If nothing is out of the ordinary, why is she drinking 50/50? When was the last time she ate? What is her sport? Did she “perform†today? You also say warm and pink. Temp? From: texasems-l [mailto:texasems-l ] On Behalf Of Alyssa Woods Sent: Thursday, January 06, 2011 4:36 PM To: texasems-l Subject: Re: EMS Challenge No altercation. Nothing out of the norm. She's an A student, all set for college, top 5% of her class, graduates in a month. There was nothing out of the ordinary that day. Nausea, no vomiting, no diarrhea. I think you're moving in the right direction, though. Alyssa Woods, NREMT-B CPR Instructor Sent from the itty bitty keyboard on my iPhone On Jan 6, 2011, at 4:03 PM, " Toni Crippen " toni_crippen@... > wrote: > I may have missed it, but what were the events leading up to the “attackâ€. > > You said she was getting ready for bed, but was there any altercation with anyone…parent(s), friend, herself? > > How is school? Exams passed or upcoming? Report cards? > > What took place that day? > > Any nausea/vomiting/diarrhea? > > From: texasems-l [mailto:texasems-l ] On Behalf Of Alyssa Woods > Sent: Thursday, January 06, 2011 3:56 PM > To: texasems-l > Subject: Re: EMS Challenge > > Patient reports no recent trauma. > > Alyssa Woods, NREMT-B > CPR Instructor > > > My itty bitty iPhone keyboard makes me jealous of your iPad. Forgive any spelling errors or Freudian gits. > > On Jan 6, 2011, at 3:50 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > Any recent trauma? > > > > Wes > > > > Sent from my iPad > > > > On Jan 6, 2011, at 15:44, Alyssa Woods amwoods8644@... > wrote: > > > > > Apart from inverted t waves, the EKG is normal. No apparent LVH. > > > > > > And no drugs - she hadn't so much as had the flu since she was six. > > > > > > Alyssa Woods, NREMT-B > > > CPR Instructor > > > > > > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > On Jan 6, 2011, at 3:41 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > > > No drugs at all for the patient? > > > > > > > > With her being an athlete, is it possible that the inverted t waves come from left ventricular hypertrophy? > > > > > > > > Wes Ogilvie > > > > > > > > Sent from my iPad > > > > > > > > On Jan 6, 2011, at 15:07, Alyssa Woods amwoods8644@... > wrote: > > > > > > > > > She reports drinking approximately 64 oz of fluid throughout the day. > > > > > > > > > > Alyssa Woods, NREMT-B > > > > > CPR Instructor > > > > > > > > > > > > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > > > > > On Jan 6, 2011, at 2:59 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > > > > > > > Define plenty? > > > > > > > > > > > > Sent from my iPhone > > > > > > > > > > > > On Jan 6, 2011, at 14:46, Alyssa Woods amwoods8644@... > wrote: > > > > > > > > > > > > > Nothing out of the ordinary. > > > > > > > She's drank plenty of fluids - half gatorade, half water. > > > > > > > Cap refill is normal. She's warm, pink, and diaphoretic. > > > > > > > > > > > > > > Blood glucose is 109. > > > > > > > Capnography is 32. > > > > > > > EKG is normal except for inverted t-wiaves. > > > > > > > > > > > > > > > > > > > > > > > > > > > > Alyssa Woods, NREMT-B > > > > > > > CPR Instructor > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >> any athletics today? > > > > > > >> drink plenty of fluids? > > > > > > >> skin conditions upon assessment other than what initially noted? > > > > > > >> > > > > > > >> > > > > > > >> > > > > > > >>> She was preparing for bed. She's in her residence. She's never experienced this before, and she hasn't been ill in the last few weeks (and she has the trophies to prove it). > > > > > > >>> > > > > > > >>> Alyssa Woods, NREMT-B > > > > > > >>> CPR Instructor > > > > > > >>> > > > > > > >>> > > > > > > >>> > > > > > > >>> > > > > > > >>> > > > > > > >>>> 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 > > > > > > >>>>>> > > > > > > >>>>>> > > > > > > >>>>>> > > > > > > >>>>>>> From: Alyssa Woods amwoods8644@... > > > > > > > >>>>>>> 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 Correction…not school, but rather bed. From: texasems-l [mailto:texasems-l ] On Behalf Of Toni Crippen Sent: Thursday, January 06, 2011 4:55 PM To: texasems-l Subject: RE: EMS Challenge You keep saying that nothing happened out of the ordinary or out of the norm. But what did happen? Was she getting ready for school and all of a sudden she started shaking…out of the blue? How long ago did this start? What time is it now? If nothing is out of the ordinary, why is she drinking 50/50? When was the last time she ate? What is her sport? Did she “perform†today? You also say warm and pink. Temp? From: texasems-l [mailto:texasems-l ] On Behalf Of Alyssa Woods Sent: Thursday, January 06, 2011 4:36 PM To: texasems-l Subject: Re: EMS Challenge No altercation. Nothing out of the norm. She's an A student, all set for college, top 5% of her class, graduates in a month. There was nothing out of the ordinary that day. Nausea, no vomiting, no diarrhea. I think you're moving in the right direction, though. Alyssa Woods, NREMT-B CPR Instructor Sent from the itty bitty keyboard on my iPhone On Jan 6, 2011, at 4:03 PM, " Toni Crippen " toni_crippen@... > wrote: > I may have missed it, but what were the events leading up to the “attackâ€. > > You said she was getting ready for bed, but was there any altercation with anyone…parent(s), friend, herself? > > How is school? Exams passed or upcoming? Report cards? > > What took place that day? > > Any nausea/vomiting/diarrhea? > > From: texasems-l [mailto:texasems-l ] On Behalf Of Alyssa Woods > Sent: Thursday, January 06, 2011 3:56 PM > To: texasems-l > Subject: Re: EMS Challenge > > Patient reports no recent trauma. > > Alyssa Woods, NREMT-B > CPR Instructor > > > My itty bitty iPhone keyboard makes me jealous of your iPad. Forgive any spelling errors or Freudian gits. > > On Jan 6, 2011, at 3:50 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > Any recent trauma? > > > > Wes > > > > Sent from my iPad > > > > On Jan 6, 2011, at 15:44, Alyssa Woods amwoods8644@... > wrote: > > > > > Apart from inverted t waves, the EKG is normal. No apparent LVH. > > > > > > And no drugs - she hadn't so much as had the flu since she was six. > > > > > > Alyssa Woods, NREMT-B > > > CPR Instructor > > > > > > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > On Jan 6, 2011, at 3:41 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > > > No drugs at all for the patient? > > > > > > > > With her being an athlete, is it possible that the inverted t waves come from left ventricular hypertrophy? > > > > > > > > Wes Ogilvie > > > > > > > > Sent from my iPad > > > > > > > > On Jan 6, 2011, at 15:07, Alyssa Woods amwoods8644@... > wrote: > > > > > > > > > She reports drinking approximately 64 oz of fluid throughout the day. > > > > > > > > > > Alyssa Woods, NREMT-B > > > > > CPR Instructor > > > > > > > > > > > > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > > > > > On Jan 6, 2011, at 2:59 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > > > > > > > Define plenty? > > > > > > > > > > > > Sent from my iPhone > > > > > > > > > > > > On Jan 6, 2011, at 14:46, Alyssa Woods amwoods8644@... > wrote: > > > > > > > > > > > > > Nothing out of the ordinary. > > > > > > > She's drank plenty of fluids - half gatorade, half water. > > > > > > > Cap refill is normal. She's warm, pink, and diaphoretic. > > > > > > > > > > > > > > Blood glucose is 109. > > > > > > > Capnography is 32. > > > > > > > EKG is normal except for inverted t-wiaves. > > > > > > > > > > > > > > > > > > > > > > > > > > > > Alyssa Woods, NREMT-B > > > > > > > CPR Instructor > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >> any athletics today? > > > > > > >> drink plenty of fluids? > > > > > > >> skin conditions upon assessment other than what initially noted? > > > > > > >> > > > > > > >> > > > > > > >> > > > > > > >>> She was preparing for bed. She's in her residence. She's never experienced this before, and she hasn't been ill in the last few weeks (and she has the trophies to prove it). > > > > > > >>> > > > > > > >>> Alyssa Woods, NREMT-B > > > > > > >>> CPR Instructor > > > > > > >>> > > > > > > >>> > > > > > > >>> > > > > > > >>> > > > > > > >>> > > > > > > >>>> 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 > > > > > > >>>>>> > > > > > > >>>>>> > > > > > > >>>>>> > > > > > > >>>>>>> From: Alyssa Woods amwoods8644@... > > > > > > > >>>>>>> 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 not pregnant and has not ever been pregnant. She wasn't doing anything with electricity. She just feels like she's getting shocked every now and then. She can't remember when the shaking started. Her parents say that they don't remember it before today, but she says it's been going on for a while, it's just gotten worse today. She, however, also does not know when it started - " A month ago, maybe? " It's about 10 o'clock at night. She exercised today, but she exercises every day. She plays basketball and runs track. She used to do volleyball but skipped it this year. Temp is 98.9 F. No over the counter pills - definitely no diet pills. She has enough trouble gaining weight, what with all of the exercise. Alyssa Woods, NREMT-B CPR Instructor > Correction…not school, but rather bed. > > From: texasems-l [mailto:texasems-l ] On Behalf Of Toni Crippen > Sent: Thursday, January 06, 2011 4:55 PM > To: texasems-l > Subject: RE: EMS Challenge > > You keep saying that nothing happened out of the ordinary or out of the norm. But what did happen? > > Was she getting ready for school and all of a sudden she started shaking…out of the blue? How long ago did this start? > > What time is it now? > > If nothing is out of the ordinary, why is she drinking 50/50? When was the last time she ate? What is her sport? Did she “perform” today? > > You also say warm and pink. Temp? > > From: texasems-l [mailto:texasems-l ] On Behalf Of Alyssa Woods > Sent: Thursday, January 06, 2011 4:36 PM > To: texasems-l > Subject: Re: EMS Challenge > > No altercation. Nothing out of the norm. > > She's an A student, all set for college, top 5% of her class, graduates in a month. > > There was nothing out of the ordinary that day. > > Nausea, no vomiting, no diarrhea. > > I think you're moving in the right direction, though. > > Alyssa Woods, NREMT-B > CPR Instructor > > > Sent from the itty bitty keyboard on my iPhone > > On Jan 6, 2011, at 4:03 PM, " Toni Crippen " toni_crippen@... > wrote: > > > I may have missed it, but what were the events leading up to the “attack”. > > > > You said she was getting ready for bed, but was there any altercation with anyone…parent(s), friend, herself? > > > > How is school? Exams passed or upcoming? Report cards? > > > > What took place that day? > > > > Any nausea/vomiting/diarrhea? > > > > From: texasems-l [mailto:texasems-l ] On Behalf Of Alyssa Woods > > Sent: Thursday, January 06, 2011 3:56 PM > > To: texasems-l > > Subject: Re: EMS Challenge > > > > Patient reports no recent trauma. > > > > Alyssa Woods, NREMT-B > > CPR Instructor > > > > > > My itty bitty iPhone keyboard makes me jealous of your iPad. Forgive any spelling errors or Freudian gits. > > > > On Jan 6, 2011, at 3:50 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > Any recent trauma? > > > > > > Wes > > > > > > Sent from my iPad > > > > > > On Jan 6, 2011, at 15:44, Alyssa Woods amwoods8644@... > wrote: > > > > > > > Apart from inverted t waves, the EKG is normal. No apparent LVH. > > > > > > > > And no drugs - she hadn't so much as had the flu since she was six. > > > > > > > > Alyssa Woods, NREMT-B > > > > CPR Instructor > > > > > > > > > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > > > On Jan 6, 2011, at 3:41 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > > > > > No drugs at all for the patient? > > > > > > > > > > With her being an athlete, is it possible that the inverted t waves come from left ventricular hypertrophy? > > > > > > > > > > Wes Ogilvie > > > > > > > > > > Sent from my iPad > > > > > > > > > > On Jan 6, 2011, at 15:07, Alyssa Woods amwoods8644@... > wrote: > > > > > > > > > > > She reports drinking approximately 64 oz of fluid throughout the day. > > > > > > > > > > > > Alyssa Woods, NREMT-B > > > > > > CPR Instructor > > > > > > > > > > > > > > > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > > > > > > > On Jan 6, 2011, at 2:59 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > > > > > > > > > Define plenty? > > > > > > > > > > > > > > Sent from my iPhone > > > > > > > > > > > > > > On Jan 6, 2011, at 14:46, Alyssa Woods amwoods8644@... > wrote: > > > > > > > > > > > > > > > Nothing out of the ordinary. > > > > > > > > She's drank plenty of fluids - half gatorade, half water. > > > > > > > > Cap refill is normal. She's warm, pink, and diaphoretic. > > > > > > > > > > > > > > > > Blood glucose is 109. > > > > > > > > Capnography is 32. > > > > > > > > EKG is normal except for inverted t-wiaves. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Alyssa Woods, NREMT-B > > > > > > > > CPR Instructor > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >> any athletics today? > > > > > > > >> drink plenty of fluids? > > > > > > > >> skin conditions upon assessment other than what initially noted? > > > > > > > >> > > > > > > > >> > > > > > > > >> > > > > > > > >>> She was preparing for bed. She's in her residence. She's never experienced this before, and she hasn't been ill in the last few weeks (and she has the trophies to prove it). > > > > > > > >>> > > > > > > > >>> Alyssa Woods, NREMT-B > > > > > > > >>> CPR Instructor > > > > > > > >>> > > > > > > > >>> > > > > > > > >>> > > > > > > > >>> > > > > > > > >>> > > > > > > > >>>> 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 > > > > > > > >>>>>> > > > > > > > >>>>>> > > > > > > > >>>>>> > > > > > > > >>>>>>> From: Alyssa Woods amwoods8644@... > > > > > > > > >>>>>>> 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 not pregnant and has not ever been pregnant. She wasn't doing anything with electricity. She just feels like she's getting shocked every now and then. She can't remember when the shaking started. Her parents say that they don't remember it before today, but she says it's been going on for a while, it's just gotten worse today. She, however, also does not know when it started - " A month ago, maybe? " It's about 10 o'clock at night. She exercised today, but she exercises every day. She plays basketball and runs track. She used to do volleyball but skipped it this year. Temp is 98.9 F. No over the counter pills - definitely no diet pills. She has enough trouble gaining weight, what with all of the exercise. Alyssa Woods, NREMT-B CPR Instructor > Correction…not school, but rather bed. > > From: texasems-l [mailto:texasems-l ] On Behalf Of Toni Crippen > Sent: Thursday, January 06, 2011 4:55 PM > To: texasems-l > Subject: RE: EMS Challenge > > You keep saying that nothing happened out of the ordinary or out of the norm. But what did happen? > > Was she getting ready for school and all of a sudden she started shaking…out of the blue? How long ago did this start? > > What time is it now? > > If nothing is out of the ordinary, why is she drinking 50/50? When was the last time she ate? What is her sport? Did she “perform” today? > > You also say warm and pink. Temp? > > From: texasems-l [mailto:texasems-l ] On Behalf Of Alyssa Woods > Sent: Thursday, January 06, 2011 4:36 PM > To: texasems-l > Subject: Re: EMS Challenge > > No altercation. Nothing out of the norm. > > She's an A student, all set for college, top 5% of her class, graduates in a month. > > There was nothing out of the ordinary that day. > > Nausea, no vomiting, no diarrhea. > > I think you're moving in the right direction, though. > > Alyssa Woods, NREMT-B > CPR Instructor > > > Sent from the itty bitty keyboard on my iPhone > > On Jan 6, 2011, at 4:03 PM, " Toni Crippen " toni_crippen@... > wrote: > > > I may have missed it, but what were the events leading up to the “attack”. > > > > You said she was getting ready for bed, but was there any altercation with anyone…parent(s), friend, herself? > > > > How is school? Exams passed or upcoming? Report cards? > > > > What took place that day? > > > > Any nausea/vomiting/diarrhea? > > > > From: texasems-l [mailto:texasems-l ] On Behalf Of Alyssa Woods > > Sent: Thursday, January 06, 2011 3:56 PM > > To: texasems-l > > Subject: Re: EMS Challenge > > > > Patient reports no recent trauma. > > > > Alyssa Woods, NREMT-B > > CPR Instructor > > > > > > My itty bitty iPhone keyboard makes me jealous of your iPad. Forgive any spelling errors or Freudian gits. > > > > On Jan 6, 2011, at 3:50 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > Any recent trauma? > > > > > > Wes > > > > > > Sent from my iPad > > > > > > On Jan 6, 2011, at 15:44, Alyssa Woods amwoods8644@... > wrote: > > > > > > > Apart from inverted t waves, the EKG is normal. No apparent LVH. > > > > > > > > And no drugs - she hadn't so much as had the flu since she was six. > > > > > > > > Alyssa Woods, NREMT-B > > > > CPR Instructor > > > > > > > > > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > > > On Jan 6, 2011, at 3:41 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > > > > > No drugs at all for the patient? > > > > > > > > > > With her being an athlete, is it possible that the inverted t waves come from left ventricular hypertrophy? > > > > > > > > > > Wes Ogilvie > > > > > > > > > > Sent from my iPad > > > > > > > > > > On Jan 6, 2011, at 15:07, Alyssa Woods amwoods8644@... > wrote: > > > > > > > > > > > She reports drinking approximately 64 oz of fluid throughout the day. > > > > > > > > > > > > Alyssa Woods, NREMT-B > > > > > > CPR Instructor > > > > > > > > > > > > > > > > > > Sent from the itty bitty keyboard on my iPhone > > > > > > > > > > > > On Jan 6, 2011, at 2:59 PM, Wes Ogilvie wes.ogilvie@... > wrote: > > > > > > > > > > > > > Define plenty? > > > > > > > > > > > > > > Sent from my iPhone > > > > > > > > > > > > > > On Jan 6, 2011, at 14:46, Alyssa Woods amwoods8644@... > wrote: > > > > > > > > > > > > > > > Nothing out of the ordinary. > > > > > > > > She's drank plenty of fluids - half gatorade, half water. > > > > > > > > Cap refill is normal. She's warm, pink, and diaphoretic. > > > > > > > > > > > > > > > > Blood glucose is 109. > > > > > > > > Capnography is 32. > > > > > > > > EKG is normal except for inverted t-wiaves. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Alyssa Woods, NREMT-B > > > > > > > > CPR Instructor > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >> any athletics today? > > > > > > > >> drink plenty of fluids? > > > > > > > >> skin conditions upon assessment other than what initially noted? > > > > > > > >> > > > > > > > >> > > > > > > > >> > > > > > > > >>> She was preparing for bed. She's in her residence. She's never experienced this before, and she hasn't been ill in the last few weeks (and she has the trophies to prove it). > > > > > > > >>> > > > > > > > >>> Alyssa Woods, NREMT-B > > > > > > > >>> CPR Instructor > > > > > > > >>> > > > > > > > >>> > > > > > > > >>> > > > > > > > >>> > > > > > > > >>> > > > > > > > >>>> 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 > > > > > > > >>>>>> > > > > > > > >>>>>> > > > > > > > >>>>>> > > > > > > > >>>>>>> From: Alyssa Woods amwoods8644@... > > > > > > > > >>>>>>> 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 Ok, I'll bite, on a strictly EMT-B level First, she is 18, if she refuses to go get checked out, you try to talk her into it, but if it fails, Get a signed refusal. Notify the parents to keep an eye on her, and call back if things get worse, If she's 18 y.o. and refusing medical treatment, there is really not much you can do about it, unless she passes out, then you have " Implied " consent. MAKE SURE to get the refusal signed by her before leaving. Chances are, you'll be back. The only other way to forcibly treat this patient would be to have Law Enforcement on scene, that is willing to place her under temporary arrest, known as " protective custody " an it would need to be documented, documented, documented. Otherwise, you cant even take a B/P without her permission. Coug. I'll keep my Guns, my Freedom and my MONEY, You can keep the " CHANGE. " Subject: EMS Challenge To: texasems-l Date: Thursday, January 6, 2011, 1:16 PM Â 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 I had one whose father continued to deny that she was pregnant even after the baby was shown to him. To which the L&D nurse said, " Call the media. I think we have another blessed event. " GG 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 I had one whose father continued to deny that she was pregnant even after the baby was shown to him. To which the L&D nurse said, " Call the media. I think we have another blessed event. " GG 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 When you say " EKG is normal " what does that mean? Was it a 12-lead? Were the following considered? Delta waves? What leads were T waves inverted in? What is T-wave conformation? What is axis? What is the QRS configuration? What is Q-T interval? What is PR interval? Is transition normal? What is P wave conformation? What is T wave height compared with R wave? What is ST segment configuration? Are U waves present? Also, what is her skin condition and body temp? Gene 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 Hm. I used to work on a college campus where we had cases of young females having sudden runs of tachycardia. In most of these cases they were athletic, small healthy females. The U-waves could be a sign of the cardiac stress prior to her self-conversion. I'd like to know if she has any diaphoresis associated and I think probably we should put some O2 on her. Am I close? -Brad Sattler > > > > > > > > >>>>>> > > > > > > > > > > >>>>>>> From: Alyssa Woods amwoods8644@... > > > > > > > > > > > > > >>>>>>> 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 Some differentials: Onset of multiple sclerosis ingestion of " energy drinks " thyroid problems. anxiety reaction cardiac anomaly PAT adrenal tumor anemia or other blood dyscrasia When you say the EKG is " normal " are you sure her tacycardia is sinus rather than SVT? GG EMS Challenge 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 Very good differential, though you're wrong. One of them is kind of close, but still incorrect. I'm sure it's sinus tachycardia, and not SVT. Both your partner and your little EKG machine agrees with you, and the little machine gives you a t-axis of - 75 . Alyssa Woods, NREMT-B CPR Instructor > Some differentials: > > Onset of multiple sclerosis > ingestion of " energy drinks " > thyroid problems. > anxiety reaction > cardiac anomaly > PAT > adrenal tumor > anemia or other blood dyscrasia > > When you say the EKG is " normal " are you sure her tacycardia is sinus rather than SVT? > > GG > > EMS Challenge > > 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 Can you describe her " shocks " in greater detail? Where do they start and what path do they follow? How frequently? Any relation between activities and the shocks? What does your detailed physical examination show? HEENT? CHEST? ABDOMEN? LOWER EXTREMITIES? UPPER EXTREMITIES? BACK? Are her reflexes normal or abnormal? GG EMS Challenge > > 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 Can you describe her " shocks " in greater detail? Where do they start and what path do they follow? How frequently? Any relation between activities and the shocks? What does your detailed physical examination show? HEENT? CHEST? ABDOMEN? LOWER EXTREMITIES? UPPER EXTREMITIES? BACK? Are her reflexes normal or abnormal? GG EMS Challenge > > 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 Can you describe her " shocks " in greater detail? Where do they start and what path do they follow? How frequently? Any relation between activities and the shocks? What does your detailed physical examination show? HEENT? CHEST? ABDOMEN? LOWER EXTREMITIES? UPPER EXTREMITIES? BACK? Are her reflexes normal or abnormal? GG EMS Challenge > > 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 No Delta waves. Inverted T-waves are across all leads. T-waves are symmetrical, as far as you can tell. The axis is normal. QRS configuration is normal. Q-T interval is normal. PR interval is .20. Transition is normal. P waves are normal. T to R ratio is 1:2. ST segments are normal. No U waves. Alyssa Woods, NREMT-B HazMat Specialist CPR Instructor > When you say " EKG is normal " what does that mean? > > Was it a 12-lead? Were the following considered? > > Delta waves? > What leads were T waves inverted in? > What is T-wave conformation? > What is axis? > What is the QRS configuration? > What is Q-T interval? > What is PR interval? > Is transition normal? > What is P wave conformation? > What is T wave height compared with R wave? > What is ST segment configuration? > Are U waves present? > > Also, what is her skin condition and body temp? > > Gene > > 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 I was letting everyone go with the assumption that she was allowing you to check her out to humor her parents, and reassure them that she's okay. She seems entirely sure that she's fine, on the other hand. I like the direction you're going. Never forget the basics. When you question her further, she is quick to dismiss the shocks as " nothing " , " just a weird feeling in my head " , and then flat-out says she's just having headaches. If you're really paying attention, you will notice a relation between shocks and activity, - she claims that she's not having them anymore, though every few minutes you notice her tense abruptly. Detailed physical is normal, except for mild dizziness, fatigue, tremor, and nausea. Reflexes are on the low end of normal, and she seems to be experiencing some mild ataxia. Her parents are growing increasingly distressed, and believe thoroughly that this is not normal for her. Lots of symptoms, few signs... Alyssa Woods, NREMT-B CPR Instructor > Ok, I'll bite, on a strictly EMT-B level > > First, she is 18, if she refuses to go get checked out, you try to talk her into it, but if it fails, Get a signed refusal. > > Notify the parents to keep an eye on her, and call back if things get worse, > > If she's 18 y.o. and refusing medical treatment, there is really not much you can do about it, unless she passes out, then you have " Implied " consent. > > MAKE SURE to get the refusal signed by her before leaving. > > Chances are, you'll be back. > > The only other way to forcibly treat this patient would be to have Law Enforcement on scene, that is willing to place her under temporary arrest, known as " protective custody " an it would need to be documented, documented, documented. > > Otherwise, you cant even take a B/P without her permission. > > Coug. > > I'll keep my Guns, my Freedom and my MONEY, > You can keep the " CHANGE. " > > > > > 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 Paracarditis? Sent from my iPhone I was letting everyone go with the assumption that she was allowing you to check her out to humor her parents, and reassure them that she's okay. She seems entirely sure that she's fine, on the other hand. I like the direction you're going. Never forget the basics. When you question her further, she is quick to dismiss the shocks as " nothing " , " just a weird feeling in my head " , and then flat-out says she's just having headaches. If you're really paying attention, you will notice a relation between shocks and activity, - she claims that she's not having them anymore, though every few minutes you notice her tense abruptly. Detailed physical is normal, except for mild dizziness, fatigue, tremor, and nausea. Reflexes are on the low end of normal, and she seems to be experiencing some mild ataxia. Her parents are growing increasingly distressed, and believe thoroughly that this is not normal for her. Lots of symptoms, few signs... Alyssa Woods, NREMT-B CPR Instructor Ok, I'll bite, on a strictly EMT-B level First, she is 18, if she refuses to go get checked out, you try to talk her into it, but if it fails, Get a signed refusal. Notify the parents to keep an eye on her, and call back if things get worse, If she's 18 y.o. and refusing medical treatment, there is really not much you can do about it, unless she passes out, then you have " Implied " consent. MAKE SURE to get the refusal signed by her before leaving. Chances are, you'll be back. The only other way to forcibly treat this patient would be to have Law Enforcement on scene, that is willing to place her under temporary arrest, known as " protective custody " an it would need to be documented, documented, documented. Otherwise, you cant even take a B/P without her permission. Coug. I'll keep my Guns, my Freedom and my MONEY, You can keep the " CHANGE. " 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 Paracarditis? Sent from my iPhone I was letting everyone go with the assumption that she was allowing you to check her out to humor her parents, and reassure them that she's okay. She seems entirely sure that she's fine, on the other hand. I like the direction you're going. Never forget the basics. When you question her further, she is quick to dismiss the shocks as " nothing " , " just a weird feeling in my head " , and then flat-out says she's just having headaches. If you're really paying attention, you will notice a relation between shocks and activity, - she claims that she's not having them anymore, though every few minutes you notice her tense abruptly. Detailed physical is normal, except for mild dizziness, fatigue, tremor, and nausea. Reflexes are on the low end of normal, and she seems to be experiencing some mild ataxia. Her parents are growing increasingly distressed, and believe thoroughly that this is not normal for her. Lots of symptoms, few signs... Alyssa Woods, NREMT-B CPR Instructor Ok, I'll bite, on a strictly EMT-B level First, she is 18, if she refuses to go get checked out, you try to talk her into it, but if it fails, Get a signed refusal. Notify the parents to keep an eye on her, and call back if things get worse, If she's 18 y.o. and refusing medical treatment, there is really not much you can do about it, unless she passes out, then you have " Implied " consent. MAKE SURE to get the refusal signed by her before leaving. Chances are, you'll be back. The only other way to forcibly treat this patient would be to have Law Enforcement on scene, that is willing to place her under temporary arrest, known as " protective custody " an it would need to be documented, documented, documented. Otherwise, you cant even take a B/P without her permission. Coug. I'll keep my Guns, my Freedom and my MONEY, You can keep the " CHANGE. " 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 I would like to know if there was ANY traumatic event in the past 2 weeks. Sent from my iPhone > I was letting everyone go with the assumption that she was allowing you to check her out to humor her parents, and reassure them that she's okay. > > She seems entirely sure that she's fine, on the other hand. > > I like the direction you're going. Never forget the basics. > > When you question her further, she is quick to dismiss the shocks as " nothing " , " just a weird feeling in my head " , and then flat-out says she's just having headaches. If you're really paying attention, you will notice a relation between shocks and activity, - she claims that she's not having them anymore, though every few minutes you notice her tense abruptly. > > Detailed physical is normal, except for mild dizziness, fatigue, tremor, and nausea. Reflexes are on the low end of normal, and she seems to be experiencing some mild ataxia. > > Her parents are growing increasingly distressed, and believe thoroughly that this is not normal for her. > > Lots of symptoms, few signs... > > > > Alyssa Woods, NREMT-B > CPR Instructor > > > > > >> Ok, I'll bite, on a strictly EMT-B level >> >> First, she is 18, if she refuses to go get checked out, you try to talk her into it, but if it fails, Get a signed refusal. >> >> Notify the parents to keep an eye on her, and call back if things get worse, >> >> If she's 18 y.o. and refusing medical treatment, there is really not much you can do about it, unless she passes out, then you have " Implied " consent. >> >> MAKE SURE to get the refusal signed by her before leaving. >> >> Chances are, you'll be back. >> >> The only other way to forcibly treat this patient would be to have Law Enforcement on scene, that is willing to place her under temporary arrest, known as " protective custody " an it would need to be documented, documented, documented. >> >> Otherwise, you cant even take a B/P without her permission. >> >> Coug. >> >> I'll keep my Guns, my Freedom and my MONEY, >> You can keep the " CHANGE. " >> >> >> >> >> 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 I would like to know if there was ANY traumatic event in the past 2 weeks. Sent from my iPhone > I was letting everyone go with the assumption that she was allowing you to check her out to humor her parents, and reassure them that she's okay. > > She seems entirely sure that she's fine, on the other hand. > > I like the direction you're going. Never forget the basics. > > When you question her further, she is quick to dismiss the shocks as " nothing " , " just a weird feeling in my head " , and then flat-out says she's just having headaches. If you're really paying attention, you will notice a relation between shocks and activity, - she claims that she's not having them anymore, though every few minutes you notice her tense abruptly. > > Detailed physical is normal, except for mild dizziness, fatigue, tremor, and nausea. Reflexes are on the low end of normal, and she seems to be experiencing some mild ataxia. > > Her parents are growing increasingly distressed, and believe thoroughly that this is not normal for her. > > Lots of symptoms, few signs... > > > > Alyssa Woods, NREMT-B > CPR Instructor > > > > > >> Ok, I'll bite, on a strictly EMT-B level >> >> First, she is 18, if she refuses to go get checked out, you try to talk her into it, but if it fails, Get a signed refusal. >> >> Notify the parents to keep an eye on her, and call back if things get worse, >> >> If she's 18 y.o. and refusing medical treatment, there is really not much you can do about it, unless she passes out, then you have " Implied " consent. >> >> MAKE SURE to get the refusal signed by her before leaving. >> >> Chances are, you'll be back. >> >> The only other way to forcibly treat this patient would be to have Law Enforcement on scene, that is willing to place her under temporary arrest, known as " protective custody " an it would need to be documented, documented, documented. >> >> Otherwise, you cant even take a B/P without her permission. >> >> Coug. >> >> I'll keep my Guns, my Freedom and my MONEY, >> You can keep the " CHANGE. " >> >> >> >> >> 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 Nothing special, though you do note that her eyes are dilated slightly. Alyssa Woods, NREMT-B CPR Instructor > what do her eyeballs do when she tenses up? > > ck > > > In a message dated 01/06/11 20:14:47 Central Standard Time, > amwoods8644@... writes: > > When you question her further, she is quick to dismiss the shocks as > " nothing " , " just a weird feeling in my head " , and then flat-out says she's just > having headaches. If you're really paying attention, you will notice a > relation between shocks and activity, - she claims that she's not having them > anymore, though every few minutes you notice her tense abruptly. > > Detailed physical is normal, except for mild dizziness, fatigue, tremor, > and nausea. Reflexes are on the low end of normal, and she seems to be > experiencing some mild ataxia. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 6, 2011 Report Share Posted January 6, 2011 Nothing special, though you do note that her eyes are dilated slightly. Alyssa Woods, NREMT-B CPR Instructor > what do her eyeballs do when she tenses up? > > ck > > > In a message dated 01/06/11 20:14:47 Central Standard Time, > amwoods8644@... writes: > > When you question her further, she is quick to dismiss the shocks as > " nothing " , " just a weird feeling in my head " , and then flat-out says she's just > having headaches. If you're really paying attention, you will notice a > relation between shocks and activity, - she claims that she's not having them > anymore, though every few minutes you notice her tense abruptly. > > Detailed physical is normal, except for mild dizziness, fatigue, tremor, > and nausea. Reflexes are on the low end of normal, and she seems to be > experiencing some mild ataxia. > > Quote Link to comment Share on other sites More sharing options...
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