You are working as a solo Technician on an RRV and have been called to a 29-year-old with a reduced level of consciousness in a public Highstreet. You respond to the call 15 minutes away. Control notifies you that Paramedic back up will be 25 minutes.
You arrive on scene and can see a number of people around the male patient who is sat on a bench. He seems very confused and agitated, and isn’t talking much sense. A passer-by noticed that he didn’t seem right and called for the ambulance.
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You start your assessment of the patient using a primary survey. You quickly note there are no CABC deficits. On assessing disability, there is an obvious deficit present in the behaviour and actions of the patient. The patient has eyes open spontaneously, is confused, and withdraws from pain. What GCS score does this make the patient
You assess for any head injury but cannot find any obvious injuries, you look into the pupils and use the PERRLA mnemonic, what does this stand for
The PERRLA assessment shows no deficits. You complete a FAST assessment of the patient to assess for a potential CVA and it comes back negative. What other scoring tool can be used to help assess the risk of Strokes in TIA patients
The ABCD² covers age >60, BP >140/90, Clinical features of a TIA, Duration of symptoms, and what else to come up with a final score
You complete a temperature reading of the patient and it come back as 35.9°C, within a medical context this is classed as
You complete a blood sugar analysis of the patient and the reading comes back as 2.9 mmol/l. In this scenario where there are no other concerns of deficits found in any of the observations or assessments, what is the likely cause for the patients’ behaviour and reduced GCS
You note that he has a small bracelet with information stating he is a type 1 diabetic which further confirms your impression of cause. In a patient with diabetes the definition of hypoglycaemia is a blood glucose level of less than
You aim to treat the patient for their hypoglycaemia. Having assessed the patient, although a GCS of 12, he is able to talk and you note no risk of choking or aspiration. Given this information is Glucogel still able to be administered
You administer a 10 g tube of Glucogel and the patient takes it well. What is the maximum total dose that can be given
What further IM drug could you consider for a hypoglycaemic patient if Glucogel doesn’t work or cannot be administered safely
As time passes, the patient becomes more alert and their GCS returns to normal. They are now fully conversing with you and give you a detailed history that their diabetes is normally strictly controlled but today he missed breakfast and lunch due to work commitments and deadlines. His blood sugar reading is now 4.2 mmol/l, is it advisable that he consumes starchy foods
The Paramedic crew have arrived and you give them a handover of the events and observations. The crew complete some further assessments and paperwork is completed. The patients’ friend has arrived and they are happy to keep a close eye on them. Within this setting and following a hypoglycaemia referral, can the patient be discharged home with their friend
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