Eight Senses Assessment

[gwenith]

everyone seems to enjoy these "games". once again it is a no blame no shame game.

you have been on the holiday of your life camping out on a deserted remote national park. you have a mobile phone but there is no mobile phone reception in this area. you are 2 hours walk from the nearest help when you come across a camp site. there is a cold camp fire with a pot of something slowly congealing. a small tent and a person lying on their side on the ground.

for this scenario you will have to use all eight senses. the first five - sight, hearing, touch smell and taste as well as your sixth sense, common sense and a sense of dread/sense of humour whichever is more applicable.

[gwenith, BSN, RN]

i was going to give you the next part of this scenario the other night but after reading the replies i laughed too hard to type!!!

what are we exploring here? well apart from remote area parks i want to explore assessment of the unconscious patient just to see how far we can go.

you have checked around and there is no visible danger. the body on teh ground is a male looking a little disheveled but not enough to be classified as a "feral". he is in the lateral position and so is naturally protecting his own airway. however he has drool from his mouth and the tonguw is slighlty protuding causing a slight snoring sound. you notice an empty wine cask( oh darn about now i coulfd do with a drink. two empty bottles of "methylated spirits" and a spirit lamp. it was quite cold overnight.

assume that we have taken care of his abc's and that they will not be a problem. what we want to explore are teh causes for loss of conscuousness and how we would assess the patient for possible signs, symptoms and clues.

p.s. i didn't even think of bears because our bears mostly live in trees eating gum leaves - the only threat a koala usually presents is if it falls out of the tree!!

[karenG]

I wasnt thinking of bears either- went into D& D mode so was thinking more about crazed axemen leaping out from behind bushs!!!!!!!!!!!!! sorry!

ok will think about this.

Karen

[P_RN, ADN, RN]

ABC ok?

What is the color of his skin? Ruby red perhaps Carbon Monoxide poisoning from the kerosene lamps. Get out into air.

Temperature cold, hot, dry, moist? Cover appropriately.

Check for wounds, burns etc.

How much is in a cask? I'm not familiar with that measure.

I assume methylated spirits is kerosene/lamp oil?

Any in the cold lamp?

Odor of alcohol? stool? emesis? urine?

Is he arousable? Shake and shout.....if he arouses, ask did he drink the kerosene?

Eyes pupils reactive, size? hyphemic?

Abdomen, distended, tympanic?

[passing thru]

Dead drunk from a bender !!

[Katnip, RN]

Hmmm. Now that we know about the alcohol, that makes a difference.

A bear might not eat what's in the pot. They can smell some things that are bad for you.

[sanakruz, ADN]

I agree with audreyfa

Mushroom intoxication.

Medical intervention is indicated.

[memphispanda, RN]

I'm going to guess he drank the methylated spirits and caused himself some major damage.

[gwenith, BSN, RN]

A reasonably comon memonic for remembering the caauses of an altered level of consciousness is

AEIUO-TIPS-O

Alcohol

Encephalitis

Insulin problems

Overdose

Uremia

Trauma

Tumour

Infarction

Psychiatric

Siezures

Other

In Australia we would have to add "envenomation" to the above list.

Methylated spirits is wood alcohol

http://members.ozemail.com.au/~mdunk/anthony/metho.html

In Australia it is notorious as a drink for the homeless and terminal alcoholics "metho drinkers". Methylated spirits is not easily detected on the breath.

[Katnip, RN]

In the US, too. So Karen's snakes might have dun it.

[karenG]

we only have one poisonous snake, the adder and think it might run a mile! more chance of meeting a crazed dwarven axeman!!

Karen

[passing thru]

Thats a good mneumonic....... A-E-I-0-U.......TIPS

THANKS

[P_RN, ADN, RN]

Coulda been one of those heaping big SPIDERS too.