what would you have done?

[taidan]

I was working first response at a conference last weekend. We0 were all we were limited to o2 (no epipen or neb) in terms of drugs. Anyway I was eating lunch with my partner discussing... lung sounds ironically when we heard someone cough. After about a minute it sounded like a hoarse stridor, we went and checked and found a woman sitting on a chair in what looked like acute distress grabbing her neck and screaming that it is "closing up". There was a loud stridor and some very light wheezing upon expiration. Skin was normal bp was 180 systolic and pulse was 110. By this time the patient had itching in all her extremities. We applied o2 and I called a pri.1 on the radio. By the time the time our crew and the ambulance arrived she was by and large asymptomatic. Although no one said anything I felt really stupid.

She had a negative hx expect for hypertension which she was taking an a- blocker for. She was also taking a prescribed non steroidal anti inflammatory naproxen. She claimed taking the naproxen preceded her symptoms by 10 min.

Did I do the right thing? what do you guys think the etiology of her episode was?

[IAMedic]

Um, you did what you could. What do you think was the etiology of this attack?? What is choking, allergic reaction, or something else??

[taidan]

it felt like anaphylaxis (sp?) but it Dissipated so quickly but Iv never seen or heard an attack that come and go like that. It wasent a foreign body because she presented with itching and hives

[RescuHoppy7]

Did I do the right thing?

Did you provide the best care possible for the patient???
Did you get a quick and appropriate response for the symptoms she had presented???


It's far better to call for extra help and turn them around then to need it and have no one show up, Remember EMS is not an exact science, our patients didn't read the textbook before they got sick, do what you think is best for the patient... Stay Safe!!

[Weruj1]

I say you did the right thing considering the limited resources.......

[Momo42]

I say you made the right call. Obviously in hindsight it wasn't required, but I've been in anaphylactic shock myself and I would have made the same decision. Based on her presentation she could have been in immediate danger. You had no way to know the symptoms would subside so quickly.

[thebigcheese]

I agree with everybody else. You made the right call.

Was it a really sunny day outside? I may be totally wrong here, but I seem to remember some alpha-blockers can make you sensitive to sunlight. If you sat her down in the shade it may have caused the reaction to cease.

[mcaldwell]

Originally posted by RescuHoppy7
...our patients didn't read the textbook before they got sick...

But wouldn't it be nice if they did? :D ;)

I also agree you did what you could based on her symptoms. I too have had calls where the pt thought they were dying when you got there, but felt like a million bucks by the time the paramedics arrived.

I tell my crew that the embarrasment of having an asymptomatic pt upon EMS's arrival, is far less than the embarrasment of missing or ignoring a genuine medical emergency. :)

[btroutm]

I agree... It was the right call. As the saying goes, it is better to be safe than sorry. There's no way you could have known that the patient's symptoms would clear up.