Young Man's Mysterious Weakness Reveals Life-Threatening Condition

The paramedic crew on Medic 3, dispatched to a bus stop for a "sick person," arrives to find an approximately 25-year-old male sitting alone on a bench. He's in obvious respiratory distress and complaining of worsening dyspnea, as well as weakness, fatigue and muscle spasms in his extremities. The patient reports that he just traveled across the country by bus. He also reports extensive medical history and says he "sees a bunch of doctors," but is unable to give further details. Upon initial assessment, the patient is awake, with diminished lung sounds in all fields, but no obvious rales, rhonchi or wheezing. His pulse is irregularly irregular. A tunneled dialysis catheter (TDC) is noted in the patient's right chest. Upon further questioning, the patient reveals that he suffers from glomerulosclerosis, which led to end stage renal disease (ESRD), causing him to require regular dialysis. However, his last dialysis treatment was over a week ago. The crew quickly places the patient on a cardiac monitor and obtains vital signs which reveal blood pressure of 130/70 mmHg, heart rate ranges from 35-125, labored breathing with a respiratory rate of 26, with an oxygen saturation of 88% on room air. The patient is placed on oxygen at 4 Lpm via nasal cannula, and his oxygen saturation quickly improves to 97%. His blood glucose level is found to be 76 mg/dL. The patient is moved to the ambulance where IV access is obtained and a 12-lead ECG is performed. The patient c...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Source Type: news