You are tasked to a 64 year old lady who was found wandering the streets in her nightie confused. Her neighbours called for the ambulance because they were worried as this is not normal behavior for her.
Assessment
Alert but anxious, disoriented an confused
Pale yellow tinged skin, and eye sclera
BP 145/85, HR 95, RR 24 SaO2 97%, Cap refill <2secs, Pupils size 2 EARRTL
Mild non specific Right upper quadrant tenderness, murphy’s sign positive.
PMHx
Relatively fit and well, HT, Mild Asthma
Medications – atenolol, enalapril, salbutamol inhaler
Her husband states that she has been taking a “cleansing substance” from the local naturopath for the last week. He noticed that she was becoming increasingly forgetful, agitated and confused over the last few days.
No Smoking
Occasional alcohol
…….
What do you know about the patient? What is the key information? What do you still need to find out?
Outline 3 provisional diagnoses.
Discuss your final diagnosis and the pathophysiology behind the diagnosis.
Discuss the implications for paramedic practice.
Reference List
please Australian ambulance services guidelines
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