You are working as part of a double Paramedic crew when you are called to a 55-year-old male collapse with abdominal pain. On arrival of the property, you are shown into the living room where the patient is lying on the sofa cradling their abdomen. They seem in a lot of discomfort and are very pale and sweaty.
The patient’s wife explains that he has been passing blood in his stool for the past week but since this morning, a lot of dark blood has been coming out and he has been in a lot of pain. He had to lay down as he was feeling faint. He has had no history of trauma and is on Apixaban and Digoxin for his Atrial Fibrillation.
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What medical term is correct for dark blood/clots passed from the back passage
You quickly assess the patient; their airway is patent, breathing is raised but adequate, skin colour is very pale and sweaty with no palpable radial pulses, GCS currently 15, temperature cold to touch.
Within the primary survey review, where is the current deficit/concern
From the review of the symptoms so far, what is your initial impression of cause
As you have conducted your primary survey review, your colleague has initial observations: Respiratory rate 24, SPO2 93%, Heart rate 122, BP 79/44, Temperature 35.8°C, Blood sugar 4.9.
What treatments can you look to initiate to help with these signs and symptoms
Your colleague does to get the scoop and stretcher while you place an Oxygen mask, gain IV access, and set up a bag of Sodium Chloride. What initial dose is recommended for this presentation
You start the Sodium Chloride and administer some IV Paracetamol to help with some analgesia benefit. Can Morphine Sulfate be given in this scenario
Your colleague returns with a stretcher and scoop. You manage the patient onto the stretcher and start to wheel him out when he becomes unresponsive and starts choking on his airway. What action should you complete now
With patient positioning and an OPA, you manage a patent airway, but their GCS has dropped, and they are now in a groggy state. On the back of the ambulance, you go to review the primary survey again. As you are doing this, your colleague lifts the patients’ legs and goes to administer 1 g of Tranexamic Acid. Is TXA indicated for this scenario
You question the TXA and explain it is currently not indicated for this medical presentation. A 250 ml bolus of Sodium Chloride has been administered and you repeat the observations: Respiratory rate 28, SPO2 94% on O2, Heart rate 134, BP 71/42.
Can further boluses of Sodium Chloride be given for this scenario
You continue with a second bolus and go back to managing his airway and breathing. His respiratory rate is increasing, and ventilations are becoming inadequate. Positioning and an OPA are maintaining his airway, but what can you do to manage his inadequate breathing
You continue to manage the patient as your colleague starts driving to the hospital. Given the details of the scenario, what needs to be completed to the receiving hospital