Within the Inflamed Lung

Signs, symptoms & treatment of pneumonia in adults & children

 

 
 
 

Jesse M. Pines, MD, MBA, MSCE | | Tuesday, August 26, 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 ...

Buyer's Guide Featured Companies

Featured Careers & Jobs in EMS

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Mechanical CPR is Producing Resuscitation Results Beyond Expectations

Discover why clinical studies are finding mechanical CPR just as effective as optimally-performed CPR.
More >

Multimedia Thumb

New Technology Helps Missouri Ambulances

Strategic GPS tracking helps in Springfield.
Watch It >


Multimedia Thumb

Profile: Hospital Wing Air Ambulance

Take a look inside this Memphis service.
Watch It >


Multimedia Thumb

New Monitors for Wyoming EMS

Grant helps Torrington EMS get new equipment.
Watch It >


Multimedia Thumb

London Medics Increasingly Attacked

One medic describes her violent confrontation.
Watch It >


Multimedia Thumb

Violence, Arson in Ferguson

Crowds in Ferguson and elsewhere react to decision.
More >


Multimedia Thumb

California Bus Rollover

One killed and dozens injured.
More >


Multimedia Thumb

Buffalo Residents Dig Out and Prepare for Flooding

Flooding expected as heavy snow melts.
More >


Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >


Multimedia Thumb

Field Bridge Xpress ePCR on iPad, Android, Kindle Fire

Sneak peek of customizable run forms & more.
Watch It >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


More Product Videos >