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Cerebral Amyloid angiopathy....

or AV malformation....

Christie Hale

---- Alyssa Woods amwoods8644@...> wrote:

> No, but you're definitely on the right track. Keep thinking along vasculature

lines.

>

> What do we do to dialysis patients?

>

> Alyssa Woods, NREMT-B

>

>

>

>

>

>

> > Cerebral Aneurysms?

> >

> > Barry Sharp, MSHP, MCHES

> > Tobacco Prevention & Control Program Coordinator

> > Substance Abuse Services Unit

> > Mental Health and Substance Abuse Division

> >

> >

> >

> > Re: Mystery Diagnosis

> > > >>>>>>>

> > > >>>>>>> By which you mean metastatic cancer? No, but you're the

> > closest

> > > >> one so far.

> > > >>>>>>> You're thinking along the right lines -- chronic, medical, and

> > > >> focal.

> > > >>>>>>>

> > > >>>>>>> Alyssa Woods, NREMT-B

> > > >>>>>>> (21) 842-6428

> > > >>>>>>>

> > > >>>>>>>

> > > >>>>>>>

> > > >>>>>>>> Could be mets ca? Just a thought..

> > > >>>>>>>>

> > > >>>>>>>> Excuse any errors.

> > > >>>>>>>> Sent from my iPhone

> > > >>>>>>>>

> > > >>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

> > > >> amwoods8644@...> wrote:

> > > >>>>>>>>

> > > >>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

> > > >> swollen lymph node

> > > >>>>>>> and one minor abrasion on her chin.

> > > >>>>>>>>>

> > > >>>>>>>>> Alyssa Woods, NREMT-B

> > > >>>>>>>>>

> > > >>>>>>>>>

> > > >>>>>>>>> Sent from the itty bitty keyboard on my iPhone

> > > >>>>>>>>>

> > > >>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

> > > >> jeremydriver@...> wrote:

> > > >>>>>>>>>

> > > >>>>>>>>>> Cat-scratch encephalopathy?

> > > >>>>>>>>>>

> > > >>>>>>>>>> Sent from my iPhone

> > > >>>>>>>>>>

> > > >>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

> > > >> bradsattler@...> wrote:

> > > >>>>>>>>>>

> > > >>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

> > > >> anyway)?

> > > >>>>>>>>>>

> > > >>>>>>>>>> -Brad

> > > >>>>>>>>>>

> > > >>>>>>>>>> Sent from my iPhone

> > > >>>>>>>>>>

> > > >>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

> > > >> amwoods8644@...> wrote:

> > > >>>>>>>>>>

> > > >>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

> > > >> duration of the

> > > >>>>>>> drip only, the node is visibly swollen. You don't see or feel

> > any

> > > >> other swollen

> > > >>>>>>> lymph nodes. No s/s of anemia.

> > > >>>>>>>>>>>

> > > >>>>>>>>>>> Alyssa Woods, NREMT-B

> > > >>>>>>>>>>>

> > > >>>>>>>>>>>

> > > >>>>>>>>>>>

> > > >>>>>>>>>>>

> > > >>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

> > the

> > > >> node?

> > > >>>>>>> Reasesses paying attention for nodules?

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> Sent from my iPhone

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

> > > >> amwoods8644@...>

> > > >>>>>>> wrote:

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

> > stop

> > > >> her seizures

> > > >>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> Alyssa Woods, NREMT-B

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

> > normal

> > > >> treatment

> > > >>>>>>> for siezure until you know more.

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> Henry

> > > >>>>>>>>>>>> Mystery Diagnosis

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

> > > >> the yard,

> > > >>>>>>> when she suddenly had a seizure. When you arrive on scene her

> > > >> parents instantly

> > > >>>>>>> calm down and tell you she has no history, no medications, and

> > no

> > > >> known

> > > >>>>>>> allergies. Your patient is having a grand mal seizure which

> > has

> > > >> been going on

> > > >>>>>>> for at least 5 minutes.

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> What's your treatment and what's happening to her?

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> Alyssa Woods, NREMT-B

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>>

> > ----------------------------------------------------------

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> No virus found in this incoming message.

> > > >>>>>>>>>>>> Checked by AVG - www.avg.com

> > > >>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

> > > >> Date:

> > > >>>>>>> 07/11/11 18:35:00

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> ----------

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>> No virus found in this outgoing message.

> > > >>>>>>>>>>>> Checked by AVG - www.avg.com

> > > >>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

> > > >> Date:

> > > >>>>>>> 07/11/11 18:35:00

> > > >>>>>>>>>>>>

> > > >>>>>>>>>>>>

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Guest guest

Shapiro syndrome?

Sent from myTouch 4G

----- Reply message -----

To: texasems-l >

Subject: Mystery Diagnosis

Date: Wed, Jul 13, 2011 11:13

Uuummm... dialyze them? ;)

Are you suggesting an AV malformation or fistula of some sort, that can

be corrected with surgery?

> No, but you're definitely on the right track. Keep thinking along vasculature

lines.

>

> What do we do to dialysis patients?

>

> Alyssa Woods, NREMT-B

>

>

>

>

>

>

>> Cerebral Aneurysms?

>>

>> Barry Sharp, MSHP, MCHES

>> Tobacco Prevention& Control Program Coordinator

>> Substance Abuse Services Unit

>> Mental Health and Substance Abuse Division

>>

>>

>>

>> Re: Mystery Diagnosis

>>>>>>>>>>

>>>>>>>>>> By which you mean metastatic cancer? No, but you're the

>> closest

>>>>> one so far.

>>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

>>>>> focal.

>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>> (21) 842-6428

>>>>>>>>>>

>>>>>>>>>>

>>>>>>>>>>

>>>>>>>>>>> Could be mets ca? Just a thought..

>>>>>>>>>>>

>>>>>>>>>>> Excuse any errors.

>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>

>>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

>>>>> swollen lymph node

>>>>>>>>>> and one minor abrasion on her chin.

>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

>>>>>>>>>>>>

>>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

>>>>> jeremydriver@...> wrote:

>>>>>>>>>>>>> Cat-scratch encephalopathy?

>>>>>>>>>>>>>

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

>>>>> bradsattler@...> wrote:

>>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

>>>>> anyway)?

>>>>>>>>>>>>> -Brad

>>>>>>>>>>>>>

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

>>>>> duration of the

>>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

>> any

>>>>> other swollen

>>>>>>>>>> lymph nodes. No s/s of anemia.

>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

>> the

>>>>> node?

>>>>>>>>>> Reasesses paying attention for nodules?

>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

>>>>> amwoods8644@...>

>>>>>>>>>> wrote:

>>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

>> stop

>>>>> her seizures

>>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

>> normal

>>>>> treatment

>>>>>>>>>> for siezure until you know more.

>>>>>>>>>>>>>>> Henry

>>>>>>>>>>>>>>> Mystery Diagnosis

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

>>>>> the yard,

>>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

>>>>> parents instantly

>>>>>>>>>> calm down and tell you she has no history, no medications, and

>> no

>>>>> known

>>>>>>>>>> allergies. Your patient is having a grand mal seizure which

>> has

>>>>> been going on

>>>>>>>>>> for at least 5 minutes.

>>>>>>>>>>>>>>> What's your treatment and what's happening to her?

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>> ----------------------------------------------------------

>>>>>>>>>>>>>>> No virus found in this incoming message.

>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>> Date:

>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>> ----------

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> No virus found in this outgoing message.

>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>> Date:

>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>

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Guest guest

Shapiro syndrome?

Sent from myTouch 4G

----- Reply message -----

To: texasems-l >

Subject: Mystery Diagnosis

Date: Wed, Jul 13, 2011 11:13

Uuummm... dialyze them? ;)

Are you suggesting an AV malformation or fistula of some sort, that can

be corrected with surgery?

> No, but you're definitely on the right track. Keep thinking along vasculature

lines.

>

> What do we do to dialysis patients?

>

> Alyssa Woods, NREMT-B

>

>

>

>

>

>

>> Cerebral Aneurysms?

>>

>> Barry Sharp, MSHP, MCHES

>> Tobacco Prevention& Control Program Coordinator

>> Substance Abuse Services Unit

>> Mental Health and Substance Abuse Division

>>

>>

>>

>> Re: Mystery Diagnosis

>>>>>>>>>>

>>>>>>>>>> By which you mean metastatic cancer? No, but you're the

>> closest

>>>>> one so far.

>>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

>>>>> focal.

>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>> (21) 842-6428

>>>>>>>>>>

>>>>>>>>>>

>>>>>>>>>>

>>>>>>>>>>> Could be mets ca? Just a thought..

>>>>>>>>>>>

>>>>>>>>>>> Excuse any errors.

>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>

>>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

>>>>> swollen lymph node

>>>>>>>>>> and one minor abrasion on her chin.

>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

>>>>>>>>>>>>

>>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

>>>>> jeremydriver@...> wrote:

>>>>>>>>>>>>> Cat-scratch encephalopathy?

>>>>>>>>>>>>>

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

>>>>> bradsattler@...> wrote:

>>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

>>>>> anyway)?

>>>>>>>>>>>>> -Brad

>>>>>>>>>>>>>

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

>>>>> duration of the

>>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

>> any

>>>>> other swollen

>>>>>>>>>> lymph nodes. No s/s of anemia.

>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

>> the

>>>>> node?

>>>>>>>>>> Reasesses paying attention for nodules?

>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

>>>>> amwoods8644@...>

>>>>>>>>>> wrote:

>>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

>> stop

>>>>> her seizures

>>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

>> normal

>>>>> treatment

>>>>>>>>>> for siezure until you know more.

>>>>>>>>>>>>>>> Henry

>>>>>>>>>>>>>>> Mystery Diagnosis

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

>>>>> the yard,

>>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

>>>>> parents instantly

>>>>>>>>>> calm down and tell you she has no history, no medications, and

>> no

>>>>> known

>>>>>>>>>> allergies. Your patient is having a grand mal seizure which

>> has

>>>>> been going on

>>>>>>>>>> for at least 5 minutes.

>>>>>>>>>>>>>>> What's your treatment and what's happening to her?

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>> ----------------------------------------------------------

>>>>>>>>>>>>>>> No virus found in this incoming message.

>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>> Date:

>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>> ----------

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> No virus found in this outgoing message.

>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>> Date:

>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>

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Guest guest

Congratulations, !

She had an Cerebral AV Malformation -- her arteries and veins had grown together

to the point where it created an ischemic area in her brain (hence why I

would've accepted ischemic stroke or CVA -- something I would expect in older

patients). For some reason, it was this day that she became symptomatic.

In actuality, she was taken to the closest facility, and immediately transported

out (via ground ambulance, as air ambulances were unavailable), to a facility

with pediatric neurosurgery capabilities.

Way to go, ! You win the only thing better than getting a prize from me --

NOT getting a prize from me!

Alyssa Woods, NREMT-B

> Uuummm... dialyze them? ;)

>

> Are you suggesting an AV malformation or fistula of some sort, that can

> be corrected with surgery?

>

>

> > No, but you're definitely on the right track. Keep thinking along

vasculature lines.

> >

> > What do we do to dialysis patients?

> >

> > Alyssa Woods, NREMT-B

> >

> >

> >

> >

> >

> >

> >> Cerebral Aneurysms?

> >>

> >> Barry Sharp, MSHP, MCHES

> >> Tobacco Prevention& Control Program Coordinator

> >> Substance Abuse Services Unit

> >> Mental Health and Substance Abuse Division

> >>

> >>

> >>

> >> Re: Mystery Diagnosis

> >>>>>>>>>>

> >>>>>>>>>> By which you mean metastatic cancer? No, but you're the

> >> closest

> >>>>> one so far.

> >>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

> >>>>> focal.

> >>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>> (21) 842-6428

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>> Could be mets ca? Just a thought..

> >>>>>>>>>>>

> >>>>>>>>>>> Excuse any errors.

> >>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>

> >>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

> >>>>> swollen lymph node

> >>>>>>>>>> and one minor abrasion on her chin.

> >>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>

> >>>>>>>>>>>>

> >>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

> >>>>>>>>>>>>

> >>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

> >>>>> jeremydriver@...> wrote:

> >>>>>>>>>>>>> Cat-scratch encephalopathy?

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

> >>>>> bradsattler@...> wrote:

> >>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

> >>>>> anyway)?

> >>>>>>>>>>>>> -Brad

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

> >>>>> duration of the

> >>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

> >> any

> >>>>> other swollen

> >>>>>>>>>> lymph nodes. No s/s of anemia.

> >>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

> >> the

> >>>>> node?

> >>>>>>>>>> Reasesses paying attention for nodules?

> >>>>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

> >>>>> amwoods8644@...>

> >>>>>>>>>> wrote:

> >>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

> >> stop

> >>>>> her seizures

> >>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

> >> normal

> >>>>> treatment

> >>>>>>>>>> for siezure until you know more.

> >>>>>>>>>>>>>>> Henry

> >>>>>>>>>>>>>>> Mystery Diagnosis

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

> >>>>> the yard,

> >>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

> >>>>> parents instantly

> >>>>>>>>>> calm down and tell you she has no history, no medications, and

> >> no

> >>>>> known

> >>>>>>>>>> allergies. Your patient is having a grand mal seizure which

> >> has

> >>>>> been going on

> >>>>>>>>>> for at least 5 minutes.

> >>>>>>>>>>>>>>> What's your treatment and what's happening to her?

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >> ----------------------------------------------------------

> >>>>>>>>>>>>>>> No virus found in this incoming message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>> ----------

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> No virus found in this outgoing message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>>

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Guest guest

Congratulations, !

She had an Cerebral AV Malformation -- her arteries and veins had grown together

to the point where it created an ischemic area in her brain (hence why I

would've accepted ischemic stroke or CVA -- something I would expect in older

patients). For some reason, it was this day that she became symptomatic.

In actuality, she was taken to the closest facility, and immediately transported

out (via ground ambulance, as air ambulances were unavailable), to a facility

with pediatric neurosurgery capabilities.

Way to go, ! You win the only thing better than getting a prize from me --

NOT getting a prize from me!

Alyssa Woods, NREMT-B

> Uuummm... dialyze them? ;)

>

> Are you suggesting an AV malformation or fistula of some sort, that can

> be corrected with surgery?

>

>

> > No, but you're definitely on the right track. Keep thinking along

vasculature lines.

> >

> > What do we do to dialysis patients?

> >

> > Alyssa Woods, NREMT-B

> >

> >

> >

> >

> >

> >

> >> Cerebral Aneurysms?

> >>

> >> Barry Sharp, MSHP, MCHES

> >> Tobacco Prevention& Control Program Coordinator

> >> Substance Abuse Services Unit

> >> Mental Health and Substance Abuse Division

> >>

> >>

> >>

> >> Re: Mystery Diagnosis

> >>>>>>>>>>

> >>>>>>>>>> By which you mean metastatic cancer? No, but you're the

> >> closest

> >>>>> one so far.

> >>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

> >>>>> focal.

> >>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>> (21) 842-6428

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>> Could be mets ca? Just a thought..

> >>>>>>>>>>>

> >>>>>>>>>>> Excuse any errors.

> >>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>

> >>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

> >>>>> swollen lymph node

> >>>>>>>>>> and one minor abrasion on her chin.

> >>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>

> >>>>>>>>>>>>

> >>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

> >>>>>>>>>>>>

> >>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

> >>>>> jeremydriver@...> wrote:

> >>>>>>>>>>>>> Cat-scratch encephalopathy?

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

> >>>>> bradsattler@...> wrote:

> >>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

> >>>>> anyway)?

> >>>>>>>>>>>>> -Brad

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

> >>>>> duration of the

> >>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

> >> any

> >>>>> other swollen

> >>>>>>>>>> lymph nodes. No s/s of anemia.

> >>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

> >> the

> >>>>> node?

> >>>>>>>>>> Reasesses paying attention for nodules?

> >>>>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

> >>>>> amwoods8644@...>

> >>>>>>>>>> wrote:

> >>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

> >> stop

> >>>>> her seizures

> >>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

> >> normal

> >>>>> treatment

> >>>>>>>>>> for siezure until you know more.

> >>>>>>>>>>>>>>> Henry

> >>>>>>>>>>>>>>> Mystery Diagnosis

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

> >>>>> the yard,

> >>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

> >>>>> parents instantly

> >>>>>>>>>> calm down and tell you she has no history, no medications, and

> >> no

> >>>>> known

> >>>>>>>>>> allergies. Your patient is having a grand mal seizure which

> >> has

> >>>>> been going on

> >>>>>>>>>> for at least 5 minutes.

> >>>>>>>>>>>>>>> What's your treatment and what's happening to her?

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >> ----------------------------------------------------------

> >>>>>>>>>>>>>>> No virus found in this incoming message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>> ----------

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> No virus found in this outgoing message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>>

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Guest guest

Congratulations, !

She had an Cerebral AV Malformation -- her arteries and veins had grown together

to the point where it created an ischemic area in her brain (hence why I

would've accepted ischemic stroke or CVA -- something I would expect in older

patients). For some reason, it was this day that she became symptomatic.

In actuality, she was taken to the closest facility, and immediately transported

out (via ground ambulance, as air ambulances were unavailable), to a facility

with pediatric neurosurgery capabilities.

Way to go, ! You win the only thing better than getting a prize from me --

NOT getting a prize from me!

Alyssa Woods, NREMT-B

> Uuummm... dialyze them? ;)

>

> Are you suggesting an AV malformation or fistula of some sort, that can

> be corrected with surgery?

>

>

> > No, but you're definitely on the right track. Keep thinking along

vasculature lines.

> >

> > What do we do to dialysis patients?

> >

> > Alyssa Woods, NREMT-B

> >

> >

> >

> >

> >

> >

> >> Cerebral Aneurysms?

> >>

> >> Barry Sharp, MSHP, MCHES

> >> Tobacco Prevention& Control Program Coordinator

> >> Substance Abuse Services Unit

> >> Mental Health and Substance Abuse Division

> >>

> >>

> >>

> >> Re: Mystery Diagnosis

> >>>>>>>>>>

> >>>>>>>>>> By which you mean metastatic cancer? No, but you're the

> >> closest

> >>>>> one so far.

> >>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

> >>>>> focal.

> >>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>> (21) 842-6428

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>> Could be mets ca? Just a thought..

> >>>>>>>>>>>

> >>>>>>>>>>> Excuse any errors.

> >>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>

> >>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

> >>>>> swollen lymph node

> >>>>>>>>>> and one minor abrasion on her chin.

> >>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>

> >>>>>>>>>>>>

> >>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

> >>>>>>>>>>>>

> >>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

> >>>>> jeremydriver@...> wrote:

> >>>>>>>>>>>>> Cat-scratch encephalopathy?

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

> >>>>> bradsattler@...> wrote:

> >>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

> >>>>> anyway)?

> >>>>>>>>>>>>> -Brad

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

> >>>>> duration of the

> >>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

> >> any

> >>>>> other swollen

> >>>>>>>>>> lymph nodes. No s/s of anemia.

> >>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

> >> the

> >>>>> node?

> >>>>>>>>>> Reasesses paying attention for nodules?

> >>>>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

> >>>>> amwoods8644@...>

> >>>>>>>>>> wrote:

> >>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

> >> stop

> >>>>> her seizures

> >>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

> >> normal

> >>>>> treatment

> >>>>>>>>>> for siezure until you know more.

> >>>>>>>>>>>>>>> Henry

> >>>>>>>>>>>>>>> Mystery Diagnosis

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

> >>>>> the yard,

> >>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

> >>>>> parents instantly

> >>>>>>>>>> calm down and tell you she has no history, no medications, and

> >> no

> >>>>> known

> >>>>>>>>>> allergies. Your patient is having a grand mal seizure which

> >> has

> >>>>> been going on

> >>>>>>>>>> for at least 5 minutes.

> >>>>>>>>>>>>>>> What's your treatment and what's happening to her?

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >> ----------------------------------------------------------

> >>>>>>>>>>>>>>> No virus found in this incoming message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>> ----------

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> No virus found in this outgoing message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>>

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Guest guest

Darn good diagnosis challenge to the group Alyssa. Thanks for giving us

something to scratch our heads about while trying to figure out what was

going on in your patient's head.

Barry

Barry Sharp, MSHP, MCHES

Tobacco Prevention & Control Program Coordinator

Substance Abuse Services Unit

Mental Health and Substance Abuse Division

Re: Mystery Diagnosis

> >>>>>>>>>>

> >>>>>>>>>> By which you mean metastatic cancer? No, but you're the

> >> closest

> >>>>> one so far.

> >>>>>>>>>> You're thinking along the right lines -- chronic, medical,

and

> >>>>> focal.

> >>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>> (21) 842-6428

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>> Could be mets ca? Just a thought..

> >>>>>>>>>>>

> >>>>>>>>>>> Excuse any errors.

> >>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>

> >>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

> >>>>> swollen lymph node

> >>>>>>>>>> and one minor abrasion on her chin.

> >>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>

> >>>>>>>>>>>>

> >>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

> >>>>>>>>>>>>

> >>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

> >>>>> jeremydriver@...> wrote:

> >>>>>>>>>>>>> Cat-scratch encephalopathy?

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

> >>>>> bradsattler@...> wrote:

> >>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

> >>>>> anyway)?

> >>>>>>>>>>>>> -Brad

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

> >>>>> duration of the

> >>>>>>>>>> drip only, the node is visibly swollen. You don't see or

feel

> >> any

> >>>>> other swollen

> >>>>>>>>>> lymph nodes. No s/s of anemia.

> >>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big

is

> >> the

> >>>>> node?

> >>>>>>>>>> Reasesses paying attention for nodules?

> >>>>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

> >>>>> amwoods8644@...>

> >>>>>>>>>> wrote:

> >>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

> >> stop

> >>>>> her seizures

> >>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

> >> normal

> >>>>> treatment

> >>>>>>>>>> for siezure until you know more.

> >>>>>>>>>>>>>>> Henry

> >>>>>>>>>>>>>>> Mystery Diagnosis

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing

in

> >>>>> the yard,

> >>>>>>>>>> when she suddenly had a seizure. When you arrive on scene

her

> >>>>> parents instantly

> >>>>>>>>>> calm down and tell you she has no history, no medications,

and

> >> no

> >>>>> known

> >>>>>>>>>> allergies. Your patient is having a grand mal seizure which

> >> has

> >>>>> been going on

> >>>>>>>>>> for at least 5 minutes.

> >>>>>>>>>>>>>>> What's your treatment and what's happening to her?

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >> ----------------------------------------------------------

> >>>>>>>>>>>>>>> No virus found in this incoming message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 -

Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>> ----------

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> No virus found in this outgoing message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 -

Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>>

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Guest guest

Darn good diagnosis challenge to the group Alyssa. Thanks for giving us

something to scratch our heads about while trying to figure out what was

going on in your patient's head.

Barry

Barry Sharp, MSHP, MCHES

Tobacco Prevention & Control Program Coordinator

Substance Abuse Services Unit

Mental Health and Substance Abuse Division

Re: Mystery Diagnosis

> >>>>>>>>>>

> >>>>>>>>>> By which you mean metastatic cancer? No, but you're the

> >> closest

> >>>>> one so far.

> >>>>>>>>>> You're thinking along the right lines -- chronic, medical,

and

> >>>>> focal.

> >>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>> (21) 842-6428

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>> Could be mets ca? Just a thought..

> >>>>>>>>>>>

> >>>>>>>>>>> Excuse any errors.

> >>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>

> >>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

> >>>>> swollen lymph node

> >>>>>>>>>> and one minor abrasion on her chin.

> >>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>

> >>>>>>>>>>>>

> >>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

> >>>>>>>>>>>>

> >>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

> >>>>> jeremydriver@...> wrote:

> >>>>>>>>>>>>> Cat-scratch encephalopathy?

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

> >>>>> bradsattler@...> wrote:

> >>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

> >>>>> anyway)?

> >>>>>>>>>>>>> -Brad

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

> >>>>> duration of the

> >>>>>>>>>> drip only, the node is visibly swollen. You don't see or

feel

> >> any

> >>>>> other swollen

> >>>>>>>>>> lymph nodes. No s/s of anemia.

> >>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big

is

> >> the

> >>>>> node?

> >>>>>>>>>> Reasesses paying attention for nodules?

> >>>>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

> >>>>> amwoods8644@...>

> >>>>>>>>>> wrote:

> >>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

> >> stop

> >>>>> her seizures

> >>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

> >> normal

> >>>>> treatment

> >>>>>>>>>> for siezure until you know more.

> >>>>>>>>>>>>>>> Henry

> >>>>>>>>>>>>>>> Mystery Diagnosis

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing

in

> >>>>> the yard,

> >>>>>>>>>> when she suddenly had a seizure. When you arrive on scene

her

> >>>>> parents instantly

> >>>>>>>>>> calm down and tell you she has no history, no medications,

and

> >> no

> >>>>> known

> >>>>>>>>>> allergies. Your patient is having a grand mal seizure which

> >> has

> >>>>> been going on

> >>>>>>>>>> for at least 5 minutes.

> >>>>>>>>>>>>>>> What's your treatment and what's happening to her?

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >> ----------------------------------------------------------

> >>>>>>>>>>>>>>> No virus found in this incoming message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 -

Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>> ----------

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> No virus found in this outgoing message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 -

Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>>

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Guest guest

Wait until everyone else has guessed wrong and you've provided several

hints, and then swoop in and take the prize.

Yep, that's me. ;)

> Congratulations, !

>

> She had an Cerebral AV Malformation -- her arteries and veins had grown

together to the point where it created an ischemic area in her brain (hence why

I would've accepted ischemic stroke or CVA -- something I would expect in older

patients). For some reason, it was this day that she became symptomatic.

>

> In actuality, she was taken to the closest facility, and immediately

transported out (via ground ambulance, as air ambulances were unavailable), to a

facility with pediatric neurosurgery capabilities.

>

>

> Way to go, ! You win the only thing better than getting a prize from me

-- NOT getting a prize from me!

>

>

>

> Alyssa Woods, NREMT-B

>

>

>

>

>

>> Uuummm... dialyze them? ;)

>>

>> Are you suggesting an AV malformation or fistula of some sort, that can

>> be corrected with surgery?

>>

>>

>>> No, but you're definitely on the right track. Keep thinking along

vasculature lines.

>>>

>>> What do we do to dialysis patients?

>>>

>>> Alyssa Woods, NREMT-B

>>>

>>>

>>>

>>>

>>>

>>>

>>>> Cerebral Aneurysms?

>>>>

>>>> Barry Sharp, MSHP, MCHES

>>>> Tobacco Prevention& Control Program Coordinator

>>>> Substance Abuse Services Unit

>>>> Mental Health and Substance Abuse Division

>>>>

>>>>

>>>>

>>>> Re: Mystery Diagnosis

>>>>>>>>>>>>

>>>>>>>>>>>> By which you mean metastatic cancer? No, but you're the

>>>> closest

>>>>>>> one so far.

>>>>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

>>>>>>> focal.

>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>> (21) 842-6428

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>>> Could be mets ca? Just a thought..

>>>>>>>>>>>>>

>>>>>>>>>>>>> Excuse any errors.

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

>>>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

>>>>>>> swollen lymph node

>>>>>>>>>>>> and one minor abrasion on her chin.

>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

>>>>>>>>>>>>>>

>>>>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

>>>>>>> jeremydriver@...> wrote:

>>>>>>>>>>>>>>> Cat-scratch encephalopathy?

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

>>>>>>> bradsattler@...> wrote:

>>>>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

>>>>>>> anyway)?

>>>>>>>>>>>>>>> -Brad

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

>>>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

>>>>>>> duration of the

>>>>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

>>>> any

>>>>>>> other swollen

>>>>>>>>>>>> lymph nodes. No s/s of anemia.

>>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

>>>> the

>>>>>>> node?

>>>>>>>>>>>> Reasesses paying attention for nodules?

>>>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

>>>>>>> amwoods8644@...>

>>>>>>>>>>>> wrote:

>>>>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

>>>> stop

>>>>>>> her seizures

>>>>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

>>>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

>>>> normal

>>>>>>> treatment

>>>>>>>>>>>> for siezure until you know more.

>>>>>>>>>>>>>>>>> Henry

>>>>>>>>>>>>>>>>> Mystery Diagnosis

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

>>>>>>> the yard,

>>>>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

>>>>>>> parents instantly

>>>>>>>>>>>> calm down and tell you she has no history, no medications, and

>>>> no

>>>>>>> known

>>>>>>>>>>>> allergies. Your patient is having a grand mal seizure which

>>>> has

>>>>>>> been going on

>>>>>>>>>>>> for at least 5 minutes.

>>>>>>>>>>>>>>>>> What's your treatment and what's happening to her?

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>>

>>>> ----------------------------------------------------------

>>>>>>>>>>>>>>>>> No virus found in this incoming message.

>>>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>>>> Date:

>>>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>>> ----------

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> No virus found in this outgoing message.

>>>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>>>> Date:

>>>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>>>

Link to comment
Share on other sites

Guest guest

Wait until everyone else has guessed wrong and you've provided several

hints, and then swoop in and take the prize.

Yep, that's me. ;)

> Congratulations, !

>

> She had an Cerebral AV Malformation -- her arteries and veins had grown

together to the point where it created an ischemic area in her brain (hence why

I would've accepted ischemic stroke or CVA -- something I would expect in older

patients). For some reason, it was this day that she became symptomatic.

>

> In actuality, she was taken to the closest facility, and immediately

transported out (via ground ambulance, as air ambulances were unavailable), to a

facility with pediatric neurosurgery capabilities.

>

>

> Way to go, ! You win the only thing better than getting a prize from me

-- NOT getting a prize from me!

>

>

>

> Alyssa Woods, NREMT-B

>

>

>

>

>

>> Uuummm... dialyze them? ;)

>>

>> Are you suggesting an AV malformation or fistula of some sort, that can

>> be corrected with surgery?

>>

>>

>>> No, but you're definitely on the right track. Keep thinking along

vasculature lines.

>>>

>>> What do we do to dialysis patients?

>>>

>>> Alyssa Woods, NREMT-B

>>>

>>>

>>>

>>>

>>>

>>>

>>>> Cerebral Aneurysms?

>>>>

>>>> Barry Sharp, MSHP, MCHES

>>>> Tobacco Prevention& Control Program Coordinator

>>>> Substance Abuse Services Unit

>>>> Mental Health and Substance Abuse Division

>>>>

>>>>

>>>>

>>>> Re: Mystery Diagnosis

>>>>>>>>>>>>

>>>>>>>>>>>> By which you mean metastatic cancer? No, but you're the

>>>> closest

>>>>>>> one so far.

>>>>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

>>>>>>> focal.

>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>> (21) 842-6428

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>>> Could be mets ca? Just a thought..

>>>>>>>>>>>>>

>>>>>>>>>>>>> Excuse any errors.

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

>>>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

>>>>>>> swollen lymph node

>>>>>>>>>>>> and one minor abrasion on her chin.

>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

>>>>>>>>>>>>>>

>>>>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

>>>>>>> jeremydriver@...> wrote:

>>>>>>>>>>>>>>> Cat-scratch encephalopathy?

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

>>>>>>> bradsattler@...> wrote:

>>>>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

>>>>>>> anyway)?

>>>>>>>>>>>>>>> -Brad

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

>>>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

>>>>>>> duration of the

>>>>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

>>>> any

>>>>>>> other swollen

>>>>>>>>>>>> lymph nodes. No s/s of anemia.

>>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

>>>> the

>>>>>>> node?

>>>>>>>>>>>> Reasesses paying attention for nodules?

>>>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

>>>>>>> amwoods8644@...>

>>>>>>>>>>>> wrote:

>>>>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

>>>> stop

>>>>>>> her seizures

>>>>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

>>>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

>>>> normal

>>>>>>> treatment

>>>>>>>>>>>> for siezure until you know more.

>>>>>>>>>>>>>>>>> Henry

>>>>>>>>>>>>>>>>> Mystery Diagnosis

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

>>>>>>> the yard,

>>>>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

>>>>>>> parents instantly

>>>>>>>>>>>> calm down and tell you she has no history, no medications, and

>>>> no

>>>>>>> known

>>>>>>>>>>>> allergies. Your patient is having a grand mal seizure which

>>>> has

>>>>>>> been going on

>>>>>>>>>>>> for at least 5 minutes.

>>>>>>>>>>>>>>>>> What's your treatment and what's happening to her?

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>>

>>>> ----------------------------------------------------------

>>>>>>>>>>>>>>>>> No virus found in this incoming message.

>>>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>>>> Date:

>>>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>>> ----------

>>>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>>> No virus found in this outgoing message.

>>>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>>>> Date:

>>>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>>>

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Share on other sites

Guest guest

Agreed!! Do another one. That was fun!

Christie Hale

---- " Sharp wrote:

> Darn good diagnosis challenge to the group Alyssa. Thanks for giving us

> something to scratch our heads about while trying to figure out what was

> going on in your patient's head.

>

> Barry

>

> Barry Sharp, MSHP, MCHES

> Tobacco Prevention & Control Program Coordinator

> Substance Abuse Services Unit

> Mental Health and Substance Abuse Division

>

>

>

> Re: Mystery Diagnosis

> > >>>>>>>>>>

> > >>>>>>>>>> By which you mean metastatic cancer? No, but you're the

> > >> closest

> > >>>>> one so far.

> > >>>>>>>>>> You're thinking along the right lines -- chronic, medical,

> and

> > >>>>> focal.

> > >>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>> (21) 842-6428

> > >>>>>>>>>>

> > >>>>>>>>>>

> > >>>>>>>>>>

> > >>>>>>>>>>> Could be mets ca? Just a thought..

> > >>>>>>>>>>>

> > >>>>>>>>>>> Excuse any errors.

> > >>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>

> > >>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

> > >>>>> amwoods8644@...> wrote:

> > >>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

> > >>>>> swollen lymph node

> > >>>>>>>>>> and one minor abrasion on her chin.

> > >>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>

> > >>>>>>>>>>>>

> > >>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

> > >>>>>>>>>>>>

> > >>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

> > >>>>> jeremydriver@...> wrote:

> > >>>>>>>>>>>>> Cat-scratch encephalopathy?

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

> > >>>>> bradsattler@...> wrote:

> > >>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

> > >>>>> anyway)?

> > >>>>>>>>>>>>> -Brad

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

> > >>>>> amwoods8644@...> wrote:

> > >>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

> > >>>>> duration of the

> > >>>>>>>>>> drip only, the node is visibly swollen. You don't see or

> feel

> > >> any

> > >>>>> other swollen

> > >>>>>>>>>> lymph nodes. No s/s of anemia.

> > >>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big

> is

> > >> the

> > >>>>> node?

> > >>>>>>>>>> Reasesses paying attention for nodules?

> > >>>>>>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

> > >>>>> amwoods8644@...>

> > >>>>>>>>>> wrote:

> > >>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

> > >> stop

> > >>>>> her seizures

> > >>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

> > >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

> > >> normal

> > >>>>> treatment

> > >>>>>>>>>> for siezure until you know more.

> > >>>>>>>>>>>>>>> Henry

> > >>>>>>>>>>>>>>> Mystery Diagnosis

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing

> in

> > >>>>> the yard,

> > >>>>>>>>>> when she suddenly had a seizure. When you arrive on scene

> her

> > >>>>> parents instantly

> > >>>>>>>>>> calm down and tell you she has no history, no medications,

> and

> > >> no

> > >>>>> known

> > >>>>>>>>>> allergies. Your patient is having a grand mal seizure which

> > >> has

> > >>>>> been going on

> > >>>>>>>>>> for at least 5 minutes.

> > >>>>>>>>>>>>>>> What's your treatment and what's happening to her?

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >> ----------------------------------------------------------

> > >>>>>>>>>>>>>>> No virus found in this incoming message.

> > >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> > >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 -

> Release

> > >>>>> Date:

> > >>>>>>>>>> 07/11/11 18:35:00

> > >>>>>>>>>>>>>>> ----------

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> No virus found in this outgoing message.

> > >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> > >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 -

> Release

> > >>>>> Date:

> > >>>>>>>>>> 07/11/11 18:35:00

> > >>>>>>>>>>>>>>>

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Guest guest

Agreed!! Do another one. That was fun!

Christie Hale

---- " Sharp wrote:

> Darn good diagnosis challenge to the group Alyssa. Thanks for giving us

> something to scratch our heads about while trying to figure out what was

> going on in your patient's head.

>

> Barry

>

> Barry Sharp, MSHP, MCHES

> Tobacco Prevention & Control Program Coordinator

> Substance Abuse Services Unit

> Mental Health and Substance Abuse Division

>

>

>

> Re: Mystery Diagnosis

> > >>>>>>>>>>

> > >>>>>>>>>> By which you mean metastatic cancer? No, but you're the

> > >> closest

> > >>>>> one so far.

> > >>>>>>>>>> You're thinking along the right lines -- chronic, medical,

> and

> > >>>>> focal.

> > >>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>> (21) 842-6428

> > >>>>>>>>>>

> > >>>>>>>>>>

> > >>>>>>>>>>

> > >>>>>>>>>>> Could be mets ca? Just a thought..

> > >>>>>>>>>>>

> > >>>>>>>>>>> Excuse any errors.

> > >>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>

> > >>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

> > >>>>> amwoods8644@...> wrote:

> > >>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

> > >>>>> swollen lymph node

> > >>>>>>>>>> and one minor abrasion on her chin.

> > >>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>

> > >>>>>>>>>>>>

> > >>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

> > >>>>>>>>>>>>

> > >>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

> > >>>>> jeremydriver@...> wrote:

> > >>>>>>>>>>>>> Cat-scratch encephalopathy?

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

> > >>>>> bradsattler@...> wrote:

> > >>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

> > >>>>> anyway)?

> > >>>>>>>>>>>>> -Brad

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

> > >>>>> amwoods8644@...> wrote:

> > >>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

> > >>>>> duration of the

> > >>>>>>>>>> drip only, the node is visibly swollen. You don't see or

> feel

> > >> any

> > >>>>> other swollen

> > >>>>>>>>>> lymph nodes. No s/s of anemia.

> > >>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big

> is

> > >> the

> > >>>>> node?

> > >>>>>>>>>> Reasesses paying attention for nodules?

> > >>>>>>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

> > >>>>> amwoods8644@...>

> > >>>>>>>>>> wrote:

> > >>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

> > >> stop

> > >>>>> her seizures

> > >>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

> > >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

> > >> normal

> > >>>>> treatment

> > >>>>>>>>>> for siezure until you know more.

> > >>>>>>>>>>>>>>> Henry

> > >>>>>>>>>>>>>>> Mystery Diagnosis

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing

> in

> > >>>>> the yard,

> > >>>>>>>>>> when she suddenly had a seizure. When you arrive on scene

> her

> > >>>>> parents instantly

> > >>>>>>>>>> calm down and tell you she has no history, no medications,

> and

> > >> no

> > >>>>> known

> > >>>>>>>>>> allergies. Your patient is having a grand mal seizure which

> > >> has

> > >>>>> been going on

> > >>>>>>>>>> for at least 5 minutes.

> > >>>>>>>>>>>>>>> What's your treatment and what's happening to her?

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >> ----------------------------------------------------------

> > >>>>>>>>>>>>>>> No virus found in this incoming message.

> > >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> > >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 -

> Release

> > >>>>> Date:

> > >>>>>>>>>> 07/11/11 18:35:00

> > >>>>>>>>>>>>>>> ----------

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> No virus found in this outgoing message.

> > >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> > >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 -

> Release

> > >>>>> Date:

> > >>>>>>>>>> 07/11/11 18:35:00

> > >>>>>>>>>>>>>>>

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Guest guest

Agreed!! Do another one. That was fun!

Christie Hale

---- " Sharp wrote:

> Darn good diagnosis challenge to the group Alyssa. Thanks for giving us

> something to scratch our heads about while trying to figure out what was

> going on in your patient's head.

>

> Barry

>

> Barry Sharp, MSHP, MCHES

> Tobacco Prevention & Control Program Coordinator

> Substance Abuse Services Unit

> Mental Health and Substance Abuse Division

>

>

>

> Re: Mystery Diagnosis

> > >>>>>>>>>>

> > >>>>>>>>>> By which you mean metastatic cancer? No, but you're the

> > >> closest

> > >>>>> one so far.

> > >>>>>>>>>> You're thinking along the right lines -- chronic, medical,

> and

> > >>>>> focal.

> > >>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>> (21) 842-6428

> > >>>>>>>>>>

> > >>>>>>>>>>

> > >>>>>>>>>>

> > >>>>>>>>>>> Could be mets ca? Just a thought..

> > >>>>>>>>>>>

> > >>>>>>>>>>> Excuse any errors.

> > >>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>

> > >>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

> > >>>>> amwoods8644@...> wrote:

> > >>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

> > >>>>> swollen lymph node

> > >>>>>>>>>> and one minor abrasion on her chin.

> > >>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>

> > >>>>>>>>>>>>

> > >>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

> > >>>>>>>>>>>>

> > >>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

> > >>>>> jeremydriver@...> wrote:

> > >>>>>>>>>>>>> Cat-scratch encephalopathy?

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

> > >>>>> bradsattler@...> wrote:

> > >>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

> > >>>>> anyway)?

> > >>>>>>>>>>>>> -Brad

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>>>

> > >>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

> > >>>>> amwoods8644@...> wrote:

> > >>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

> > >>>>> duration of the

> > >>>>>>>>>> drip only, the node is visibly swollen. You don't see or

> feel

> > >> any

> > >>>>> other swollen

> > >>>>>>>>>> lymph nodes. No s/s of anemia.

> > >>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big

> is

> > >> the

> > >>>>> node?

> > >>>>>>>>>> Reasesses paying attention for nodules?

> > >>>>>>>>>>>>>>> Sent from my iPhone

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

> > >>>>> amwoods8644@...>

> > >>>>>>>>>> wrote:

> > >>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

> > >> stop

> > >>>>> her seizures

> > >>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

> > >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

> > >> normal

> > >>>>> treatment

> > >>>>>>>>>> for siezure until you know more.

> > >>>>>>>>>>>>>>> Henry

> > >>>>>>>>>>>>>>> Mystery Diagnosis

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing

> in

> > >>>>> the yard,

> > >>>>>>>>>> when she suddenly had a seizure. When you arrive on scene

> her

> > >>>>> parents instantly

> > >>>>>>>>>> calm down and tell you she has no history, no medications,

> and

> > >> no

> > >>>>> known

> > >>>>>>>>>> allergies. Your patient is having a grand mal seizure which

> > >> has

> > >>>>> been going on

> > >>>>>>>>>> for at least 5 minutes.

> > >>>>>>>>>>>>>>> What's your treatment and what's happening to her?

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>>

> > >> ----------------------------------------------------------

> > >>>>>>>>>>>>>>> No virus found in this incoming message.

> > >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> > >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 -

> Release

> > >>>>> Date:

> > >>>>>>>>>> 07/11/11 18:35:00

> > >>>>>>>>>>>>>>> ----------

> > >>>>>>>>>>>>>>>

> > >>>>>>>>>>>>>>> No virus found in this outgoing message.

> > >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> > >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 -

> Release

> > >>>>> Date:

> > >>>>>>>>>> 07/11/11 18:35:00

> > >>>>>>>>>>>>>>>

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Guest guest

Henry:

generally those folks are a: older, and b: sicker to start with....I don't

think I've seen a decent peridontal abscess in a patient under age 15 in my

35 year career....even in the teens with a meth problem.

Since I was one of the few docs willing to work with the dentists to clear

kids with 'milk teeth' (multiple caries due to a combination of bottle

propping, poor diet and worse hygiene) for multiple extractions back when I was

in the clinic, I suspect I would have noticed something like that.

ck

In a message dated 07/13/11 13:29:03 Central Daylight Time,

hbarber@... writes:

Did we cover brain abcess do to bad tooth

henry

Mystery Diagnosis

>> > >>>>>>>>>

>> > >>>>>>>>> You're called out to a 5 year old girl who was playing in

>> the yard,

>> > >>>> when she suddenly had a seizure. When you arrive on scene her

>> parents instantly

>> > >>>> calm down and tell you she has no history, no medications, and no

>> known

>> > >>>> allergies. Your patient is having a grand mal seizure which has

>> been going on

>> > >>>> for at least 5 minutes.

>> > >>>>>>>>>

>> > >>>>>>>>> What's your treatment and what's happening to her?

>> > >>>>>>>>>

>> > >>>>>>>>> Alyssa Woods, NREMT-B

>> > >>>>>>>>>

>> > >>>>>>>>>

>> > >>>>>>>>> ----------------------------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this incoming message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> ----------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this outgoing message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> [Non-text portions of this message have been removed]

>> > >>>>>>>>>

>> > >>>>>>>>> [Non-text portions of this message have been removed]

>> > >>>>>>>>>

>> > >>>>>>>>> ------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>>

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Guest guest

Henry:

generally those folks are a: older, and b: sicker to start with....I don't

think I've seen a decent peridontal abscess in a patient under age 15 in my

35 year career....even in the teens with a meth problem.

Since I was one of the few docs willing to work with the dentists to clear

kids with 'milk teeth' (multiple caries due to a combination of bottle

propping, poor diet and worse hygiene) for multiple extractions back when I was

in the clinic, I suspect I would have noticed something like that.

ck

In a message dated 07/13/11 13:29:03 Central Daylight Time,

hbarber@... writes:

Did we cover brain abcess do to bad tooth

henry

Mystery Diagnosis

>> > >>>>>>>>>

>> > >>>>>>>>> You're called out to a 5 year old girl who was playing in

>> the yard,

>> > >>>> when she suddenly had a seizure. When you arrive on scene her

>> parents instantly

>> > >>>> calm down and tell you she has no history, no medications, and no

>> known

>> > >>>> allergies. Your patient is having a grand mal seizure which has

>> been going on

>> > >>>> for at least 5 minutes.

>> > >>>>>>>>>

>> > >>>>>>>>> What's your treatment and what's happening to her?

>> > >>>>>>>>>

>> > >>>>>>>>> Alyssa Woods, NREMT-B

>> > >>>>>>>>>

>> > >>>>>>>>>

>> > >>>>>>>>> ----------------------------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this incoming message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> ----------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this outgoing message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> [Non-text portions of this message have been removed]

>> > >>>>>>>>>

>> > >>>>>>>>> [Non-text portions of this message have been removed]

>> > >>>>>>>>>

>> > >>>>>>>>> ------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>>

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Guest guest

and in a patient over say, 15, it would have been a reasonable one.

One thing about most of the infectious causes for seizures that needs to be

brought out: those folks are generally sick *before* they seize. Same with

folks who are hypothermia from sepsis.

ck

In a message dated 07/13/11 16:03:35 Central Daylight Time,

hbarber@... writes:

I don't doubt you would have. I had no clue what the problem was so I

remembered a patient years ago that had unexplained siezures and they finally

found out he had an abcess. Shot in the dark on my part.

Thanks

Henry

Mystery Diagnosis

>> > >>>>>>>>>

>> > >>>>>>>>> You're called out to a 5 year old girl who was playing in

>> the yard,

>> > >>>> when she suddenly had a seizure. When you arrive on scene her

>> parents instantly

>> > >>>> calm down and tell you she has no history, no medications, and

no

>> known

>> > >>>> allergies. Your patient is having a grand mal seizure which has

>> been going on

>> > >>>> for at least 5 minutes.

>> > >>>>>>>>>

>> > >>>>>>>>> What's your treatment and what's happening to her?

>> > >>>>>>>>>

>> > >>>>>>>>> Alyssa Woods, NREMT-B

>> > >>>>>>>>>

>> > >>>>>>>>>

>> > >>>>>>>>> ----------------------------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this incoming message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> ----------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this outgoing message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> [Non-text portions of this message have been removed]

>> > >>>>>>>>>

>> > >>>>>>>>> [Non-text portions of this message have been removed]

>> > >>>>>>>>>

>> > >>>>>>>>> ------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>>

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Guest guest

and in a patient over say, 15, it would have been a reasonable one.

One thing about most of the infectious causes for seizures that needs to be

brought out: those folks are generally sick *before* they seize. Same with

folks who are hypothermia from sepsis.

ck

In a message dated 07/13/11 16:03:35 Central Daylight Time,

hbarber@... writes:

I don't doubt you would have. I had no clue what the problem was so I

remembered a patient years ago that had unexplained siezures and they finally

found out he had an abcess. Shot in the dark on my part.

Thanks

Henry

Mystery Diagnosis

>> > >>>>>>>>>

>> > >>>>>>>>> You're called out to a 5 year old girl who was playing in

>> the yard,

>> > >>>> when she suddenly had a seizure. When you arrive on scene her

>> parents instantly

>> > >>>> calm down and tell you she has no history, no medications, and

no

>> known

>> > >>>> allergies. Your patient is having a grand mal seizure which has

>> been going on

>> > >>>> for at least 5 minutes.

>> > >>>>>>>>>

>> > >>>>>>>>> What's your treatment and what's happening to her?

>> > >>>>>>>>>

>> > >>>>>>>>> Alyssa Woods, NREMT-B

>> > >>>>>>>>>

>> > >>>>>>>>>

>> > >>>>>>>>> ----------------------------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this incoming message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> ----------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this outgoing message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> [Non-text portions of this message have been removed]

>> > >>>>>>>>>

>> > >>>>>>>>> [Non-text portions of this message have been removed]

>> > >>>>>>>>>

>> > >>>>>>>>> ------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>>

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Guest guest

Congenital AV malformation?

Sent from my iPhone

> No, but you're definitely on the right track. Keep thinking along vasculature

lines.

>

> What do we do to dialysis patients?

>

> Alyssa Woods, NREMT-B

>

>

>

>

>

>

>> Cerebral Aneurysms?

>>

>> Barry Sharp, MSHP, MCHES

>> Tobacco Prevention & Control Program Coordinator

>> Substance Abuse Services Unit

>> Mental Health and Substance Abuse Division

>>

>>

>>

>> Re: Mystery Diagnosis

>>>>>>>>>>

>>>>>>>>>> By which you mean metastatic cancer? No, but you're the

>> closest

>>>>> one so far.

>>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

>>>>> focal.

>>>>>>>>>>

>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>> (21) 842-6428

>>>>>>>>>>

>>>>>>>>>>

>>>>>>>>>>

>>>>>>>>>>> Could be mets ca? Just a thought..

>>>>>>>>>>>

>>>>>>>>>>> Excuse any errors.

>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>

>>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>

>>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

>>>>> swollen lymph node

>>>>>>>>>> and one minor abrasion on her chin.

>>>>>>>>>>>>

>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

>>>>>>>>>>>>

>>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

>>>>> jeremydriver@...> wrote:

>>>>>>>>>>>>

>>>>>>>>>>>>> Cat-scratch encephalopathy?

>>>>>>>>>>>>>

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

>>>>> bradsattler@...> wrote:

>>>>>>>>>>>>>

>>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

>>>>> anyway)?

>>>>>>>>>>>>>

>>>>>>>>>>>>> -Brad

>>>>>>>>>>>>>

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>>>

>>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

>>>>> duration of the

>>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

>> any

>>>>> other swollen

>>>>>>>>>> lymph nodes. No s/s of anemia.

>>>>>>>>>>>>>>

>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

>> the

>>>>> node?

>>>>>>>>>> Reasesses paying attention for nodules?

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

>>>>> amwoods8644@...>

>>>>>>>>>> wrote:

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

>> stop

>>>>> her seizures

>>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

>> normal

>>>>> treatment

>>>>>>>>>> for siezure until you know more.

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Henry

>>>>>>>>>>>>>>> Mystery Diagnosis

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

>>>>> the yard,

>>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

>>>>> parents instantly

>>>>>>>>>> calm down and tell you she has no history, no medications, and

>> no

>>>>> known

>>>>>>>>>> allergies. Your patient is having a grand mal seizure which

>> has

>>>>> been going on

>>>>>>>>>> for at least 5 minutes.

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> What's your treatment and what's happening to her?

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>> ----------------------------------------------------------

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> No virus found in this incoming message.

>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>> Date:

>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> ----------

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> No virus found in this outgoing message.

>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>> Date:

>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

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Guest guest

Congenital AV malformation?

Sent from my iPhone

> No, but you're definitely on the right track. Keep thinking along vasculature

lines.

>

> What do we do to dialysis patients?

>

> Alyssa Woods, NREMT-B

>

>

>

>

>

>

>> Cerebral Aneurysms?

>>

>> Barry Sharp, MSHP, MCHES

>> Tobacco Prevention & Control Program Coordinator

>> Substance Abuse Services Unit

>> Mental Health and Substance Abuse Division

>>

>>

>>

>> Re: Mystery Diagnosis

>>>>>>>>>>

>>>>>>>>>> By which you mean metastatic cancer? No, but you're the

>> closest

>>>>> one so far.

>>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

>>>>> focal.

>>>>>>>>>>

>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>> (21) 842-6428

>>>>>>>>>>

>>>>>>>>>>

>>>>>>>>>>

>>>>>>>>>>> Could be mets ca? Just a thought..

>>>>>>>>>>>

>>>>>>>>>>> Excuse any errors.

>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>

>>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>

>>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

>>>>> swollen lymph node

>>>>>>>>>> and one minor abrasion on her chin.

>>>>>>>>>>>>

>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

>>>>>>>>>>>>

>>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

>>>>> jeremydriver@...> wrote:

>>>>>>>>>>>>

>>>>>>>>>>>>> Cat-scratch encephalopathy?

>>>>>>>>>>>>>

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

>>>>> bradsattler@...> wrote:

>>>>>>>>>>>>>

>>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

>>>>> anyway)?

>>>>>>>>>>>>>

>>>>>>>>>>>>> -Brad

>>>>>>>>>>>>>

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>>>

>>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

>>>>> duration of the

>>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

>> any

>>>>> other swollen

>>>>>>>>>> lymph nodes. No s/s of anemia.

>>>>>>>>>>>>>>

>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

>> the

>>>>> node?

>>>>>>>>>> Reasesses paying attention for nodules?

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

>>>>> amwoods8644@...>

>>>>>>>>>> wrote:

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

>> stop

>>>>> her seizures

>>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

>> normal

>>>>> treatment

>>>>>>>>>> for siezure until you know more.

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Henry

>>>>>>>>>>>>>>> Mystery Diagnosis

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

>>>>> the yard,

>>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

>>>>> parents instantly

>>>>>>>>>> calm down and tell you she has no history, no medications, and

>> no

>>>>> known

>>>>>>>>>> allergies. Your patient is having a grand mal seizure which

>> has

>>>>> been going on

>>>>>>>>>> for at least 5 minutes.

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> What's your treatment and what's happening to her?

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>> ----------------------------------------------------------

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> No virus found in this incoming message.

>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>> Date:

>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> ----------

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> No virus found in this outgoing message.

>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>> Date:

>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

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Guest guest

Congenital AV malformation?

Sent from my iPhone

> No, but you're definitely on the right track. Keep thinking along vasculature

lines.

>

> What do we do to dialysis patients?

>

> Alyssa Woods, NREMT-B

>

>

>

>

>

>

>> Cerebral Aneurysms?

>>

>> Barry Sharp, MSHP, MCHES

>> Tobacco Prevention & Control Program Coordinator

>> Substance Abuse Services Unit

>> Mental Health and Substance Abuse Division

>>

>>

>>

>> Re: Mystery Diagnosis

>>>>>>>>>>

>>>>>>>>>> By which you mean metastatic cancer? No, but you're the

>> closest

>>>>> one so far.

>>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

>>>>> focal.

>>>>>>>>>>

>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>> (21) 842-6428

>>>>>>>>>>

>>>>>>>>>>

>>>>>>>>>>

>>>>>>>>>>> Could be mets ca? Just a thought..

>>>>>>>>>>>

>>>>>>>>>>> Excuse any errors.

>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>

>>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>

>>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

>>>>> swollen lymph node

>>>>>>>>>> and one minor abrasion on her chin.

>>>>>>>>>>>>

>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

>>>>>>>>>>>>

>>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

>>>>> jeremydriver@...> wrote:

>>>>>>>>>>>>

>>>>>>>>>>>>> Cat-scratch encephalopathy?

>>>>>>>>>>>>>

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

>>>>> bradsattler@...> wrote:

>>>>>>>>>>>>>

>>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

>>>>> anyway)?

>>>>>>>>>>>>>

>>>>>>>>>>>>> -Brad

>>>>>>>>>>>>>

>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

>>>>> amwoods8644@...> wrote:

>>>>>>>>>>>>>

>>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

>>>>> duration of the

>>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

>> any

>>>>> other swollen

>>>>>>>>>> lymph nodes. No s/s of anemia.

>>>>>>>>>>>>>>

>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

>> the

>>>>> node?

>>>>>>>>>> Reasesses paying attention for nodules?

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Sent from my iPhone

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

>>>>> amwoods8644@...>

>>>>>>>>>> wrote:

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

>> stop

>>>>> her seizures

>>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

>> normal

>>>>> treatment

>>>>>>>>>> for siezure until you know more.

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Henry

>>>>>>>>>>>>>>> Mystery Diagnosis

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

>>>>> the yard,

>>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

>>>>> parents instantly

>>>>>>>>>> calm down and tell you she has no history, no medications, and

>> no

>>>>> known

>>>>>>>>>> allergies. Your patient is having a grand mal seizure which

>> has

>>>>> been going on

>>>>>>>>>> for at least 5 minutes.

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> What's your treatment and what's happening to her?

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

>> ----------------------------------------------------------

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> No virus found in this incoming message.

>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>> Date:

>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> ----------

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>> No virus found in this outgoing message.

>>>>>>>>>>>>>>> Checked by AVG - www.avg.com

>>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>>>>> Date:

>>>>>>>>>> 07/11/11 18:35:00

>>>>>>>>>>>>>>>

>>>>>>>>>>>>>>>

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Guest guest

Indeed; won it.

Alyssa Woods, NREMT-B

> Congenital AV malformation?

>

> Sent from my iPhone

>

>

>

> > No, but you're definitely on the right track. Keep thinking along

vasculature lines.

> >

> > What do we do to dialysis patients?

> >

> > Alyssa Woods, NREMT-B

> >

> >

> >

> >

> >

> >

> >> Cerebral Aneurysms?

> >>

> >> Barry Sharp, MSHP, MCHES

> >> Tobacco Prevention & Control Program Coordinator

> >> Substance Abuse Services Unit

> >> Mental Health and Substance Abuse Division

> >>

> >>

> >>

> >> Re: Mystery Diagnosis

> >>>>>>>>>>

> >>>>>>>>>> By which you mean metastatic cancer? No, but you're the

> >> closest

> >>>>> one so far.

> >>>>>>>>>> You're thinking along the right lines -- chronic, medical, and

> >>>>> focal.

> >>>>>>>>>>

> >>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>> (21) 842-6428

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>

> >>>>>>>>>>> Could be mets ca? Just a thought..

> >>>>>>>>>>>

> >>>>>>>>>>> Excuse any errors.

> >>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>

> >>>>>>>>>>> On Jul 12, 2011, at 1:39 PM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>

> >>>>>>>>>>>> No pets. No cat scratches. Pt is pristine except for one

> >>>>> swollen lymph node

> >>>>>>>>>> and one minor abrasion on her chin.

> >>>>>>>>>>>>

> >>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>

> >>>>>>>>>>>>

> >>>>>>>>>>>> Sent from the itty bitty keyboard on my iPhone

> >>>>>>>>>>>>

> >>>>>>>>>>>> On Jul 12, 2011, at 13:35, jeremydriver

> >>>>> jeremydriver@...> wrote:

> >>>>>>>>>>>>

> >>>>>>>>>>>>> Cat-scratch encephalopathy?

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 1:28 PM, Brad Sattler

> >>>>> bradsattler@...> wrote:

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Pupils/PMS/Cranial Nerve Responses (those you can check

> >>>>> anyway)?

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> -Brad

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>

> >>>>>>>>>>>>> On Jul 12, 2011, at 11:22 AM, Alyssa Woods

> >>>>> amwoods8644@...> wrote:

> >>>>>>>>>>>>>

> >>>>>>>>>>>>>> High-dose phenobarbital drip calms her seizures for the

> >>>>> duration of the

> >>>>>>>>>> drip only, the node is visibly swollen. You don't see or feel

> >> any

> >>>>> other swollen

> >>>>>>>>>> lymph nodes. No s/s of anemia.

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Phenobarbitol drip? Look for s/s of anemia... How big is

> >> the

> >>>>> node?

> >>>>>>>>>> Reasesses paying attention for nodules?

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Sent from my iPhone

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> On Jul 12, 2011, at 1:13 PM, Alyssa Woods

> >>>>> amwoods8644@...>

> >>>>>>>>>> wrote:

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> She did not ingest a plant. Benzo's and phenobarbital

> >> stop

> >>>>> her seizures

> >>>>>>>>>> for 30 seconds - 1 minute, paralytics for a few minutes.

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Find out what plant she possibly ingested. Begin your

> >> normal

> >>>>> treatment

> >>>>>>>>>> for siezure until you know more.

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Henry

> >>>>>>>>>>>>>>> Mystery Diagnosis

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in

> >>>>> the yard,

> >>>>>>>>>> when she suddenly had a seizure. When you arrive on scene her

> >>>>> parents instantly

> >>>>>>>>>> calm down and tell you she has no history, no medications, and

> >> no

> >>>>> known

> >>>>>>>>>> allergies. Your patient is having a grand mal seizure which

> >> has

> >>>>> been going on

> >>>>>>>>>> for at least 5 minutes.

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> What's your treatment and what's happening to her?

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> Alyssa Woods, NREMT-B

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

> >> ----------------------------------------------------------

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> No virus found in this incoming message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> ----------

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>> No virus found in this outgoing message.

> >>>>>>>>>>>>>>> Checked by AVG - www.avg.com

> >>>>>>>>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

> >>>>> Date:

> >>>>>>>>>> 07/11/11 18:35:00

> >>>>>>>>>>>>>>>

> >>>>>>>>>>>>>>>

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Guest guest

Did we cover brain abcess do to bad tooth

henry

Mystery Diagnosis

>> > >>>>>>>>>

>> > >>>>>>>>> You're called out to a 5 year old girl who was playing in

>> the yard,

>> > >>>> when she suddenly had a seizure. When you arrive on scene her

>> parents instantly

>> > >>>> calm down and tell you she has no history, no medications, and no

>> known

>> > >>>> allergies. Your patient is having a grand mal seizure which has

>> been going on

>> > >>>> for at least 5 minutes.

>> > >>>>>>>>>

>> > >>>>>>>>> What's your treatment and what's happening to her?

>> > >>>>>>>>>

>> > >>>>>>>>> Alyssa Woods, NREMT-B

>> > >>>>>>>>>

>> > >>>>>>>>>

>> > >>>>>>>>> ----------------------------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this incoming message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> ----------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this outgoing message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>>

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Guest guest

I don't doubt you would have. I had no clue what the problem was so I remembered

a patient years ago that had unexplained siezures and they finally found out he

had an abcess. Shot in the dark on my part.

Thanks

Henry

Mystery Diagnosis

>> > >>>>>>>>>

>> > >>>>>>>>> You're called out to a 5 year old girl who was playing in

>> the yard,

>> > >>>> when she suddenly had a seizure. When you arrive on scene her

>> parents instantly

>> > >>>> calm down and tell you she has no history, no medications, and no

>> known

>> > >>>> allergies. Your patient is having a grand mal seizure which has

>> been going on

>> > >>>> for at least 5 minutes.

>> > >>>>>>>>>

>> > >>>>>>>>> What's your treatment and what's happening to her?

>> > >>>>>>>>>

>> > >>>>>>>>> Alyssa Woods, NREMT-B

>> > >>>>>>>>>

>> > >>>>>>>>>

>> > >>>>>>>>> ----------------------------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this incoming message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> ----------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this outgoing message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>>

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Guest guest

I don't doubt you would have. I had no clue what the problem was so I remembered

a patient years ago that had unexplained siezures and they finally found out he

had an abcess. Shot in the dark on my part.

Thanks

Henry

Mystery Diagnosis

>> > >>>>>>>>>

>> > >>>>>>>>> You're called out to a 5 year old girl who was playing in

>> the yard,

>> > >>>> when she suddenly had a seizure. When you arrive on scene her

>> parents instantly

>> > >>>> calm down and tell you she has no history, no medications, and no

>> known

>> > >>>> allergies. Your patient is having a grand mal seizure which has

>> been going on

>> > >>>> for at least 5 minutes.

>> > >>>>>>>>>

>> > >>>>>>>>> What's your treatment and what's happening to her?

>> > >>>>>>>>>

>> > >>>>>>>>> Alyssa Woods, NREMT-B

>> > >>>>>>>>>

>> > >>>>>>>>>

>> > >>>>>>>>> ----------------------------------------------------------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this incoming message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>> ----------

>> > >>>>>>>>>

>> > >>>>>>>>> No virus found in this outgoing message.

>> > >>>>>>>>> Checked by AVG - www.avg.com

>> > >>>>>>>>> Version: 8.5.449 / Virus Database: 271.1.1/3759 - Release

>> Date:

>> > >>>> 07/11/11 18:35:00

>> > >>>>>>>>>

>> > >>>>>>>>>

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Guest guest

Apologies to everyone for my gmail malfunctioning.

Regards,

Alyssa Woods, NREMT-B

> Where would you transport to? Children's Hospital or closest ER?

>

> Alyssa Woods, NREMT-B

>

>

>

>

>

>> Time to treat with generous doses of diesel (carefully!). �The

ignorance of one voter in a democracy impairs the security of all.� --

F. Kennedy, 1963

>>

>> ----- Re: Mystery Diagnosis

>>>>>>>>>>>>

>>>>>>>>>>>> at this point, I'd be looking around to see what plants are in the

>>>>>>>>>>>> backyard....

>>>>>>>>>>>>

>>>>>>>>>>>> ck

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>> In a message dated 07/11/11 19:33:14 Central Daylight Time,

>>>>>>>>>>>> amwoods8644@... writes:

>>>>>>>>>>>>

>>>>>>>>>>>> The parents are rather vague about the events leading up to the

seizure.

>>>>>>>>>>>> They were moving and just unpacking and she was playing in the

backyard,

>>>>>>>>>>>> being a normal kid. They didn't think anything was wrong until they

looked up

>>>>>>>>>>>> and she was seizing.

>>>>>>>>>>>>

>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>>

>>>>>>>>>>>>> What happened right before the seizure?

>>>>>>>>>>>>>

>>>>>>>>>>>>> -Wes Ogilvie

>>>>>>>>>>>>>

>>>>>>>>>>>>> On Jul 11, 2011, at 06:37 PM, Alyssa Woods amwoods8644@...>

wrote:

>>>>>>>>>>>>>

>>>>>>>>>>>>>

>>>>>>>>>>>>>

>>>>>>>>>>>>> You're called out to a 5 year old girl who was playing in the

yard, when

>>>>>>>>>>>> she suddenly had a seizure. When you arrive on scene her parents

instantly

>>>>>>>>>>>> calm down and tell you she has no history, no medications, and no

known

>>>>>>>>>>>> allergies. Your patient is having a grand mal seizure which has

been going on

>>>>>>>>>>>> for at least 5 minutes.

>>>>>>>>>>>>>

>>>>>>>>>>>>> What's your treatment and what's happening to her?

>>>>>>>>>>>>>

>>>>>>>>>>>>> Alyssa Woods, NREMT-B

>>>>>>>>>>>>>

>>>>>>>>>>>>>

>>>>>>>>>>>>>

>>>>>>>>>>>>>

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