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Saturday, March 21, 2009

Possible OD

We were toned out for a person down. When we arrived on scene we found what would best be described as a small shack. We were met by a man that told us his friend was inside and unconscious. As I walked in I found a woman about 60 years old that was laying on the couch, barely breathing. Grant immediately grabbed the BVM and dropped in an OPA (an airway adjunct that keeps the tongue from blocking the air passage). We had been called to a different location for this same patient only a couple of weeks prior. I immediately checked her pupils which were pinpoint (indicative of narcotic overdose which would explain her breathing problems). I also checked her for Fentanyl patches (said narcotic) and found several. I gave her 2 mg of Narcan IM (in the muscle) and managed to make it so that she was breathing a little better but still out of it. About this time we got her blood pressure which was in the toilet, 64/48. Just as I was blowing the first attempt at an IV MBA showed up. I gave the medic a quick run down and he started looking for an IV. While he did that I got a blood sugar, which was 27. My patient was one serious problem after another. The MBA medic got an IV in the jugular vein and we pushed an amp of D50W and gave her a fluid bolus. She also go 2 mg of Narcan through her IV. She would go back and forth between being able to protect her own airway and choking on her own spit. the medic from MBA asked if I would tag along since she had so many different issues going on. In the back of the ambulance we tried to nasally intubate her 3 times but were unsuccessful. We did get both her blood sugar and her blood pressure up. We found out later that she had overdosed on her seizure medication as well and that's why we couldn't get her to stay conscious.
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