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EMS challenge

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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

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