Discuss Paramedic decision making in Low Acuity, non transport and palliative care
We been called to priority 3 to 85 year old male who was is complying of dizziness . We arrived to location his older son was waiting for us outside the house. We introduce ourselves to the son and the patient. First of all, I asked my partner start to take the vital signs and attaching the monitor to the patient the vital signs were the following :
- Blood pressure: 150/85
- Tem: 37.3
- ECG: sinus tachycardia
- R: 110
- BGL: 1.3
- PLUSE: REGULAR /THRUDY
- GCS: 8
WE decided to administer glucagon via IV according to our guidelines. After 5 minutes we recheck the B.G.L and it was 3.5. Patient started to respond to the treatment and his GCS I got improved. I start ask about
- Past medical history : D.M / PREVOUS C.V.A
- Social history : He lives with his three sons his wife died three years ago
- He was a smoker , and he used to smoke 10 cigarette per day
- No allergies
- Last meal was : rice and meat
Reassess the vital signs again we found that his BGL increase to 18 after 10 minutes of giving him glucagon. We decided to transfer him to the hospital. However, his older son refused the transfer, we explain the consequent of not going to the hospital. He said my father will be fine, he just need some rest. We try to connives him to take his father to a hospital and call his J.P . I told his son if you do not want us to take your father to the hospital for further investigation, I need you to sign a form that improves your refusal, he said ok. I spoken to the emergency operation center and inform them about the case. We return to our station after that.
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