Dispatch
Medic 4 was dispatched to the above-listed address for altered mental status.
Chief Complaint
Pt is a 58 YOM with a chief complaint of altered mental status. Pt was located supine on the couch at a residence. Pt was altered upon arrival and alert to verbal stimuli.
History
History was obtained from Family. Pt has a history of diabetes. Pt denies recent surgery was unknown to the family. Family reported that Pt became confused after missing lunch. Pt has symptoms of weakness and is not speaking in full sentences.
Allergies: no known drug allergies. Medications: insulin, as listed. Last oral intake was breakfast.
Events leading up: Family found Pt confused on the couch and called 911.
Assessment
Airway is intact. No airway compromise noted. Respirations are initially 16. Respirations are regular, adequate, and unlabored. Initial BP was 146/82. Pt's initial pulse is 100. The pulse is strong and regular. The Pt's skin is pale, cool, and diaphoretic. Pt appeared emergent. ER evaluation is indicated for altered mental status.
Physical Exam
Head: atraumatic. Pupils are equal and reactive. Pt is alert to verbal stimuli.
Neurological: speech was slurred before treatment. Facial droop and arm drift were absent. Pt is alert to verbal stimuli.
Chest: lung sounds are clear. Abdomen is soft. Extremities move all four limbs. Pt is negative for DCAP-BTLS.
Diagnostic Tests
SPO2 97% on room air. Blood glucose 42 mg/dL. ETCO2 35 mmHg.
Primary Impression
Hypoglycemia.
Medications and Procedures
An 18 gauge IV was placed in the right antecubital and flushed with 10 mL of normal saline.
Dextrose 10% 100 mL was given IV. Pt became alert and oriented. Blood glucose after treatment was 124 mg/dL. No adverse reaction.
Transport
Pt was transported nonemergent to Kettering Health-Washington Township. Pt remained alert during transport. A report was called in prior to arrival. Pt was released to the RN staff in the emergency department in a stable condition.