Within the Inflamed Lung

Signs, symptoms & treatment of pneumonia in adults & children

 

 
 
 

Jesse M. Pines, MD, MBA, MSCE | | Wednesday, August 27, 2008


Introduction

On a cold winter night, you and your partner are dispatched to the home of a 79-year-old male whose wife called 9-1-1 because her husband was confused and not answering questions appropriately. On arrival, you note a disheveled male in bed, dressed in pajamas, who's agitated and has pushed the bedspread onto the floor. His wife says he has been coughing for about two weeks and had a high fever this afternoon. His past medical history is only mild dementia.

When you approach him, he calms down enough to allow you to assess his vitals signs. His heart rate is 135 bpm and regular, respiratory rate is 22 bpm, blood pressure is 85 mmHg/palp, and his oxygen saturation is 91% on room air. You become more concerned. On examination, his skin and mouth appear dry, his neck veins are flat, and he has focal crackles in his right lower lobe on auscultation.

You administer oxygen 15 L by face mask, establish IV access and administer a 500 cc bolus of normal saline because of the hypotension and clear signs of dehydration. His finger-stick blood glucose reading is 145 mg/dL. You carefully move the patient onto the stretcher, down the front steps and into the ambulance. After the fluid bolus, the patient appears calmer.

Repeat vital signs are heart rate of 122, respiratory rate of 22 bpm and a systolic blood pressure of 100 mmHg. The oxygen saturation has improved to 100% with supplemental oxygen. You re-examine him; his lung exam remains unchanged. Your partner starts the ambulance, and you're on your way to the emergency department (ED). You breathe a sigh of relief that the vitals have improved, but your clinical concern is that this patient may have pneumonia


Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Medical Emergencies, Special Patients, Patient Management, Training

 
What's Your Take? Comment Now ...

Featured Careers & Jobs in EMS

 

 

 

 

 

 

 

 

 

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

The Evolution of Civilian High Threat Medical Guidelines

How mass killing events have proven a need for new guidelines.
More >

Multimedia Thumb

Kentucky Firefighters, Medics Drill for Ebola

Lexington firefighters and medics prepare for possible patients.
Watch It >


Multimedia Thumb

Mid-South EMTs Prepare for Ebola

Mid-South EMTs are certified for service.
Watch It >


Multimedia Thumb

Ebola Changes How North Carolina EMS Responds to Calls

Concern about virus spread leads to new protocols.
Watch It >


Multimedia Thumb

Oklahoma Hospitals Prepare for Ebola Cases

Training and preparation are keys for metro hospitals.
Watch It >


Multimedia Thumb

Life Link III Trauma Tactics Conference in Minnesota

Conference was designed to enhance the skills of providers of all levels, covering rescue and prehospital situations, to transport and in-hospital treatment.
More >


Multimedia Thumb

EMS Tailgating

Rigs converted for football.
More >


Multimedia Thumb

CDC Ebola Training for Clinicians

Students learn the complexities of working in bulky suits.
More >


Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >


Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >


Multimedia Thumb

The AmbuBus®, Bus Stretcher Conversion Kit - EMS Today 2013

AmbuBus®, Bus Stretcher all-hazards preparedness & response tool
Watch It >


More Product Videos >