what is it? what to do? when to call 911?

You already called 911, is that correct?

yes we did....right after she start trowing up thatsn when she because responsive/alert....so when 911 came thought it was nothing serious...

Why did you call 911 after she threw up, and not when she first had an acute change in mentation?

hello. can please someone tell me what is this pt. experiencing..

aaox0 she suddenly became weak, like she's about to die...her eyes is open but she is not responding to us and not moving but her left hand is shaking a little...after a few min...she start vomitting then she became alert but weak....wel called 911 because she unresponsive/unconscious to us and doesn't move but her left hand..but after she vomit she became aaox3....

does this sound like she's going into shock? stroke? MI? please can someone tell me...or help me identified when we should call 911....or what we should do. thanks.

A few questions...how did you know this pt? Is she a LTC resident for whom you were caring? A coworker? A friend with whom you were having lunch? Just wondering more out of curiosity that anything else.

As for when to call 911...call with the original change in mental status. At that point we may not know exactly what is going on, but we know something is going on and it is not good. Another question: is "like she is going to die" something she said about her weakness or is this your interpretation of her weakness? If your words, what does this mean? (again, more curious then anything else)

As for what happened to the pt, it is tough to tell with just the information we have at this point. Possibilities: MI with a degree of cardiogenic shock, early septic shock (did she show any signs of an infection before this episode?), TIA/stroke. This is not an exhaustive list...there are many more possibilities. My best guess would be some type of a brain bleed...this would be the most likely of choices given the combination of weakness and emesis. If you have any type of followup on the case, let us know.

yes we did....right after she start trowing up thatsn when she because responsive/alert....so when 911 came thought it was nothing serious...

Like the others have said, the call to EMS was well-warranted with her change in mentation, etc.

I wasn't there to see how the EMTs responded, but just wanted to offer a suggestion if they didn't seem like the hyped-up trauma-junkies on TV. They may have not disregarded the seriousness of the complaint at all, but I would hope were diligently and efficiently progressing the patient towards the ambulance. For example, my partner and I are pretty low-key... we really do not get riled up even if half of an arm is missing. But, we move very quickly and get things done. Two reasons for our less-than-excitable "attitude": Calm manner allows for thought; we have a lot of decisions to make in a short period of time and very few patients ever fit protocol. Second reason: If the medics are hyped up, the family will be as well. If we remain calm, professional, but get everything done efficiently, then in most cases, we actually can see the family members assume a more calm attitude as well. Remember... they usually head to the hospital in their own vehicle. A calmer driver is a safer driver.

Most of our interventions are done as soon as we hop into the ambulance and while enroute to the hospital. If she was my patient, VS, O2, IV, blood draw, ECG with 12-lead, neuro assessment, radio report, etc. would have all been done bouncing down the road towards definitive care. My protocols allow for that. I've had family member faint while watching procedures occur in the house; I try to avoid that scenario of creating more patients, lol!

On the other hand, if I had an EMT partner who truly disregarded the potential seriousness of these signs and just blow off what recently happened to the patient, I'd ask him where the he** he hides the CT scanner and lab in the ambulance?!? The verbal education would not stop there...

Hope it helps!

Honestly, this sounds exactly like a pt I took care of that had bacterial meningitis. It presented very similarly to a CVA.

But of course, there's all sorts of stuff to rule out, especially CVA, septic shock, etc. 911 definitely should have been called with the first change in mentation. Never, ever wait to call EMS for that.

Call the doctor, call 911. No one can diagnose over the computer!!!!!!!!!!!!!!