You and your partner are working for an Urban ALS service. You are dispatched to non-emergent abdominal pain for a roughly 50 yom at a private residence. The pt states that approximately an hour ago, he was sitting at rest watching t.v., when he felt a “tearing” pain in his lumbo-sacral back. The pt states that since then, he has been feeling “lightheaded” and “dizzy”. He is lying supine on his bed and is very drowsy.
- Pt is a GCS of 15
- Skin is Cool, Ashen, and Diaphoretic
- No radial pulses present bilaterally
- No obvious trauma noted
- Resp appear rapid, shallow, and unlabored with no audible B/S
- BP: 60/30HR: 72/reg
- Resp: 24
- Pain: 10/10 with movement; 0/10 while lying still
- BGL: 164 mg/dl
- EKG: NSR w/no ST segment abnormalities; occasional PVCs
- Community hospital – 3 mins away
- Level II Trauma/PCI Facility- 15 mins away
Where do you go? What do you do?