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Friday, January 31, 2014

A Shakey Situation

We arrived at the business park and were ushered upstairs. In one of the many generic offices a man had had a seizure.

We talked to the person with whom my patient was meeting and he said the guy just stiffened up, started shaking and rolled out of the chair onto the floor. Apparently the seizure lasted several minutes.

The business had their own emergency response team that was activated. I don't know what type of training they had but they did show up and check a pulse and they placed the patient on oxygen. I told them after the call they did a great job.

My patient was still postictal. A time period after a seizure when the brain is sort of trying to reboot. It can take several minutes. The person that experienced the seizure can be quite confused if they're responsive at all during this time. My patient wasn't responsive.

I grabbed a quick set of vitals, kept the guy on oxygen and checked his blood sugar levels. All were within normal limits.

At this point AMR arrived. While they loaded him onto the gurney we talked by phone to the wife of the patient. He was in town on business so no one around knew his medical history.

According to his wife her husband had recently been out of the country on vacation and had also been snow skiing. There was no medical history to speak of and he wasn't on any medications.

We couldn't rule out head trauma as a possible cause of the seizure. It also could have been something else entirely. Without the hospital and the tests they would perform there was no way to know.

After the patient was loaded up we headed for the rig. We took the stairs while AMR took the elevator. I waited for the crew at the back of the ambulance holding the door open for them. When the elevator doors opened the medic yelled that she needed me to start a line (meaning an IV). The patient was seizing again.

I jumped in the back of the ambulance and had an IV started in no time flat. But by that time the seizure had stopped. I asked if the AMR medic wanted me to ride along and she declined. I later found out that the patient seized one more time in the ambulance.


Note about this call. A couple of weeks later the AMR medic let me know that the patient we had here had been found to have a brain tumor which was causing the seizures. He was scheduled for brain surgery.
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