2019 EMT Refresher Instructor Manual

Situation: 78-year-old, dispatched as altered mental status

B.3.B

DKA

Scene Size-up: Safety:

Scene is safe, cops are on scene

BSI:

Gloves

Patients: 1 Mechanism/Nature: NOI – AMS Resources: ALS

Primary Assessment: General Impression: Person lying in bed not moving Mental Status: Pain only Airway: Patent Breathing: 4 per minute gasping Circulation:

Palpable pulse at wrist, hot dry, no severe bleeding

Desired Response: Primary then focused secondary

Physical Exam: Head:

Unremarkable

Neck:

Unremarkable

Chest :

Unremarkable Breath sounds clear

Abdomen:

Unremarkable

Vitals: 1 Pulse: 58

2

3

56

58

Pelvis:

Unremarkable

BP:

98/72

96/74

90/72

Extremities:

Unremarkable

Resp: 4

4

2

Posterior :

Unremarkable

SPO2: 88 Bagged: 98

87 98

85 98

SAMPLE: (bystander provided) S: He is unconscious A: None M:

OPQRST: (bystander provided) O:

He’s had diabetes for a long time

P: Q: R:

Not sure

Insulin -not sure when he had it last

He seems exceptionally out of it

P: L: E:

Diabetes

Not sure

Breakfast 7 hours ago

S: T:

Seems pretty bad

He was resting because he didn’t feel good

Its been slowly getting worse over the last 7—8 hours

OTHER: