I had an interesting call the other day. We were called to the local prison for an assault victim, an inmate. As I get into the ambulance where the pt was I see the pt is just lying there with his eyes closed. The medic tells me he was stabbed in the arm and hit and kicked in the head. Apparently he was very combative when they first arrived. Now he is just lying there and only opened his eyes to PAINFUL stimulus (sternal rub, trapezius muscle squeeze). GCS 7. He had a huge swelling and lacerations to his forehead. The medic tells me he is posturing as I do my assessment. Hard to tell as he was all immobilized and shackled. I tell my partner we will intubate in the aircraft and as soon as we take off the shackles and secure him down with our restraints and get the guard settled we take off. We intubated with no problem and his assessment really didn't change much, including his BP despite the fact we had to give him quite a lot of sedation as he would start fighting the vent.
So the final diagnosis..... blood alcohol level >300!!! No head bleed or injury (Besides some lacs needing sutures) and he was shipped back to jail the next day. Moral of the story is even if it looks totally like a horse it could still be a zebra.
Flightgypsy
6 Posts
I had an interesting call the other day. We were called to the local prison for an assault victim, an inmate. As I get into the ambulance where the pt was I see the pt is just lying there with his eyes closed. The medic tells me he was stabbed in the arm and hit and kicked in the head. Apparently he was very combative when they first arrived. Now he is just lying there and only opened his eyes to PAINFUL stimulus (sternal rub, trapezius muscle squeeze). GCS 7. He had a huge swelling and lacerations to his forehead. The medic tells me he is posturing as I do my assessment. Hard to tell as he was all immobilized and shackled. I tell my partner we will intubate in the aircraft and as soon as we take off the shackles and secure him down with our restraints and get the guard settled we take off. We intubated with no problem and his assessment really didn't change much, including his BP despite the fact we had to give him quite a lot of sedation as he would start fighting the vent.
So the final diagnosis..... blood alcohol level >300!!! No head bleed or injury (Besides some lacs needing sutures) and he was shipped back to jail the next day. Moral of the story is even if it looks totally like a horse it could still be a zebra.