EMS is called to a local hardware store for a 13 year old female with a possible seizure.
On arrival the patient is found sitting outside at a picnic table. Her mother and father are both present. The ambient temperature is hot and humid.
The patient's skin is very warm and moist but chalky. Her cheeks are pink which may be attributable to sunburn.
The patient's mother explains that the patient's sister had fallen off her bike and skinned her knee. The patient looked at the wound and fainted. She has fainted at the sight of blood before.
Neither the mother nor the father are interested in having their daughter transported to the hospital. A third party contacted 9-1-1.
They do, however, consent to an exam by EMS.
The patient is awake, alert, conversant, and oriented to person, place time and event.
Speach is clear and appropriate.
Equal smile, no arm drift, equal grip strengh, no pass pointing.
- Past medical history: Healthy
- Medications: None.
When questioned about family history (specifically about any history of a relative passing away unexpectedly from sudden cardiac arrest) the patient's father states that his brother died of a cardiac arrest at the age of 16.
When asked for specifics he states, "Some kind of seizure disorder. I was young."
Vital signs are assessed.
- RR: 20
- Pulse: 84
- BP: 114/59
- SpO2: 99 on RA
- Temp: 99.1
The cardiac monitor is attached.
A 12-lead ECG is obtained.
The patient's skin color is now improved and she states she feels "fine".
1.) Why did the paramedics ask questions about the family history?
2.) Why did the paramedics perform a 12-lead ECG?
3.) Do you see anything that would suggest this patient is at-risk of anything life-threatening?
4.) Is it okay for the parents to refuse transport to the emergency department?