EMT Curriculum

4.06.D.1

Situation: 42-year-old, dispatches as altered mental status

DKA I

Scene Size-up:

Safety:

Scene is safe, cops are on scene

BSI:

Gloves

Patients: 1 Mechanism/Nature: NOI – AMS Resources: ALS

Primary Assessment:

General Impression: Person collapsed at home on couch Mental Status: Pain only Airway: Patent Breathing: 10 per minute, very deep and loud Circulation:

Palpable pulse at wrist, hot dry, no severe bleeding

Desired Response: Primary then focused secondary

Physical Exam:

Head:

Acetone breath

Neck:

Unremarkable

Chest :

Unremarkable Breath sounds clear

Vitals: 1

2

3

Abdomen:

Unremarkable

Pulse: 62

64

62

Pelvis:

Unremarkable

BP:

100/70

98/74

102/72

Extremities:

Unremarkable

Resp:

10

10

10

SPO2: 96

97

96

Posterior :

Unremarkable

OPQRST: O:

SAMPLE: (bystander provided) S:

He has sugar issues but this is really bad

He is unconscious and breathing deeply

P: Q: R:

Not sure

A:

None

He is REALLY loopy this time

M:

Insulin, but he hasn’t had it for 3 days

Not sure

P: L: E:

Diabetes

S: T:

This is the worst I’ve seen

Meat loaf 5 hours ago

It’s been getting worse over the last 6 hours. He was just tired this morning

He was watching TV in bed

OTHER: The patient is waiting until his next paycheck to buy insulin. He was run down this morning, but 6 hours later he is completely unresponsive