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[h=5]you arrive to find a 60 years old man sitting on the curb holding inside a paper bag he isn't fully alert and can only tell you that his name is andy he allow you to take his blood pressure and as you roll up his sleev you notice needle marks along his vein how do you best manage this patient ?[/h]

llg, PhD, RN

13,469 Posts

Specializes in Nursing Professional Development.

Test question? Homework assignment? or Did this actually happen to you?

khatem

22 Posts

homework assignment

khatem

22 Posts

help me

Specializes in ER.

ABCs are always a good way to start ( I like DR ABC better) if you're out of the hospital or clinic setting. Where does this scenario take place? Outside the healthcare setting?

Safety - is the patient acting violently toward you? If not, proceed to help. If he is violent or dangerous, call security or the police.

Airway - make sure patient does not have vomitus, secretions, other stuff in their mouth. Are they alert enough to maintain their airway? If not, maybe place them in recovery position (left lateral recumbent) so if they vomit they don't aspirate.

Breathing - patient breathing adequately (rate, quality, bilateral chest rise, color of skin, labored breathing)? If not - call 911, consider rescue breathing

Circulation - pulse present, quality and rate, skin signs (moisture, color, temperature), BP, any profuse bleeding from anywhere?

Neuro deficits? Pupils, AVPU, whatever.

Probably needs to get his butt to the hospital, get a banana bag and some fluids, make sure he didn't fall down and break anything, maybe some narcan.

Psychosocial stuff - don't be judgmental, be reassuring and calm, blah blah.

Other stuff - this dudes life sucks. He needs to be hooked up with some rehab, get tested for STDs and crap. Case management or something.

Circulation - check HR, br

Specializes in ER.
help me

LoL calm down khatem!

Specializes in ER.

It sounds like you're just going out on a leisurely stroll, carrying your blood pressure cuff for no reason, when you come across this gentleman. I feel like I'm missing some pieces of the puzzle here... or this was a poorly written assignment LOL

It sounds like you're just going out on a leisurely stroll carrying your blood pressure cuff for no reason, when you come across this gentleman. I feel like I'm missing some pieces of the puzzle here... or this was a poorly written assignment LOL[/quote']

He/she was OBVIOUSLY coming back from skills lab... GEEH DUH! (;

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

We need to remember that allnurses hosts members from all over the world. I have seen questions like this from students in the middle east/Palestine. Their education is very emergency medicine/scenario based.

OP we are happy to help...please tell us what you think first and we will be happy to jump right in.

KelRN215, BSN, RN

1 Article; 7,349 Posts

Specializes in Pedi.

In the real world, I keep walking/don't concern myself with drunk strangers sitting on a curb.

Specializes in Hospitalist Medicine.

If he isn't fully alert and you're just walking down the street, you can't walk up to a stranger and just start taking his blood pressure. (Why you would happen to have a BP cuff in you is another question, LOL) You risk assault/battery charges if you touch him or use the BP cuff without his permission. You also cannot roll up his sleeve or look through the contents of his bag.

Obviously, you can ask him if he wants you to help him (good Samaritan), but he needs to articulate this to you if he's able to communicate.

I would call 911 and wait until they arrive.

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

The OP is from Palestine....things may be different there.

OP this is why we have difficulty answering these questions...nursing practice in the US is very different. We don't intervene we call 911 if we care concerned.

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