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Paged: You were paged to a frequent residence for a male pt in his 30’s complaining of difficulty breathing. As you are responding you’re slightly confused, because usually you are responding for an older female.
As you arrive on scene you find a male pt sitting in a chair. Pt was sitting in a chair breathing very deep and rapidly. Pt would not talk to you. He would just simply nod his head yes or no. The mother states that he was in the emergency room earlier in the day because of an upper airway infection. She also hands you some papers they received at the emergency room. As you review the paperwork you notice that these very papers are dismissal instructions for anxiety attacks. After reviewing this you feel that it has helped narrow down your differential Dx drastically.
Hx: (given by mother)
Diabetes- insulin dependent. (non compliant)
Obese
And recently dismissed with a panic attack.
You and your partner decide to have pt walk to the unit due to the size of the pt and the fire department is not present. He obviously is dizzy when he stands up and walks although he was able to ambulate to the unit. Once in the unit you began vital signs and further detailed assessment.
Assessment: Airway was patient, No inflammation noted. Breathing: Deep and rapid. HEENT: Normal, Slightly diaphoretic, Eyes/Ears normal. Neck: No jvd, tracheal deviation, or Sub-q. Chest: CBBS, Denies pain. Abd: Soft non-tender, no pain. Pelv: intact. Exts: normal, Dnv’s intact x4. Pt denies any extremity spasms or cramping.
Vitals:
Sp02 – 100%
RR- 50
B/P- 190/110
HR- 140
Monitor- Sinus Tach
Accu Check- 393 mg/dl
What is your differential dx for the field?
What would your treatment consist of?
Or maybe you want more info?
As you arrive on scene you find a male pt sitting in a chair. Pt was sitting in a chair breathing very deep and rapidly. Pt would not talk to you. He would just simply nod his head yes or no. The mother states that he was in the emergency room earlier in the day because of an upper airway infection. She also hands you some papers they received at the emergency room. As you review the paperwork you notice that these very papers are dismissal instructions for anxiety attacks. After reviewing this you feel that it has helped narrow down your differential Dx drastically.
Hx: (given by mother)
Diabetes- insulin dependent. (non compliant)
Obese
And recently dismissed with a panic attack.
You and your partner decide to have pt walk to the unit due to the size of the pt and the fire department is not present. He obviously is dizzy when he stands up and walks although he was able to ambulate to the unit. Once in the unit you began vital signs and further detailed assessment.
Assessment: Airway was patient, No inflammation noted. Breathing: Deep and rapid. HEENT: Normal, Slightly diaphoretic, Eyes/Ears normal. Neck: No jvd, tracheal deviation, or Sub-q. Chest: CBBS, Denies pain. Abd: Soft non-tender, no pain. Pelv: intact. Exts: normal, Dnv’s intact x4. Pt denies any extremity spasms or cramping.
Vitals:
Sp02 – 100%
RR- 50
B/P- 190/110
HR- 140
Monitor- Sinus Tach
Accu Check- 393 mg/dl
What is your differential dx for the field?
What would your treatment consist of?
Or maybe you want more info?
