SICK PERSON
General
This dispatch category along with “Minor Medical” is a broad and vague category that coveys very little information to the responding EMT. However, this category of patient is common and includes many complaints without obvious causes like “weak and dizzy” and “malaise”. Frequently this applies to elderly patients who do not have transportation or primary care access and utilize the 911 system.
Assessment
All levels of EMT (Basic, Intermediate, and Paramedic) are capable of assessing these patients. The assessment should be thorough in history taking and physical examination as this is largely detective work trying to determine if a significant or even life-threatening cause is behind the patient’s complaints.
1. History is important. Distressed patients, especially those with extensive medical histories, may forget or be unable to communicate everything that may be relevant to their assessment. An effort to determine the details of their current complaints, their past medical history, and especially their current medications is worthwhile. The medication list may give important clues to medical conditions not otherwise mentioned.
2. The primary survey (ABC’s) is usually done without prompting.
3. Physical examination (the secondary survey) is important. Again, there may be many clues to the cause of the complaints found in a detailed physical examination.
4. Information about resuscitation status (DNR or Power of Attorney) should be sought in the event the patient deteriorates during care.
5. Vital signs, a BGL and oxygen saturation are easily accomplished in most patients.
6. Consider whether an EKG would be helpful. Occult cardiac disease may be present with atypical symptoms in a distressed or confused patient.
Treatment
1. In general, few interventions are called for in these patients, but a high level of suspicion has to be maintained much like in assessing and treating the “life assist” patient.
2. Consider whether an IV is needed for medication administration or fluid rehydration.
3. Consider whether continuous cardiac monitoring is indicated.
4. Even without a serious cause identified transport is indicated.
5. Consider whether an MIH referral is called for.
General
This dispatch category along with “Minor Medical” is a broad and vague category that coveys very little information to the responding EMT. However, this category of patient is common and includes many complaints without obvious causes like “weak and dizzy” and “malaise”. Frequently this applies to elderly patients who do not have transportation or primary care access and utilize the 911 system.
Assessment
All levels of EMT (Basic, Intermediate, and Paramedic) are capable of assessing these patients. The assessment should be thorough in history taking and physical examination as this is largely detective work trying to determine if a significant or even life-threatening cause is behind the patient’s complaints.
1. History is important. Distressed patients, especially those with extensive medical histories, may forget or be unable to communicate everything that may be relevant to their assessment. An effort to determine the details of their current complaints, their past medical history, and especially their current medications is worthwhile. The medication list may give important clues to medical conditions not otherwise mentioned.
2. The primary survey (ABC’s) is usually done without prompting.
3. Physical examination (the secondary survey) is important. Again, there may be many clues to the cause of the complaints found in a detailed physical examination.
4. Information about resuscitation status (DNR or Power of Attorney) should be sought in the event the patient deteriorates during care.
5. Vital signs, a BGL and oxygen saturation are easily accomplished in most patients.
6. Consider whether an EKG would be helpful. Occult cardiac disease may be present with atypical symptoms in a distressed or confused patient.
Treatment
1. In general, few interventions are called for in these patients, but a high level of suspicion has to be maintained much like in assessing and treating the “life assist” patient.
2. Consider whether an IV is needed for medication administration or fluid rehydration.
3. Consider whether continuous cardiac monitoring is indicated.
4. Even without a serious cause identified transport is indicated.
5. Consider whether an MIH referral is called for.