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Clinical scenario: Patient complaining of weakness

You are dispatched to a report of an elderly female experiencing weakness

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Report an accurate blood pressure for every patient.

Picture CDC/ Amanda Mills

Engine 112, Medic 17 respond Priority 2 to the skilled nursing wing of Courtyard Manor in the common room on the second floor. Staff called 911 stating that the patient is having difficulty standing up. No other medical complaints at this time.

You arrive on scene with the other crew and are escorted in to the common room. The nurse’s aide walking with you introduces you to Edith who is seated on a couch in front of the TV. According to staff, Edith is mobile with a walker and generally can stand from a chair on her own. Recently, however, Edith has struggled with both walking and standing. Edith has a history of diabetes which is exclusively diet controlled.

When asked if anything is bothering her, Edith smiles and shakes her head. “I’m just feeling a little weak lately and have a bit of a cough,” she says. She also denies any chest pain, shortness of breath or nausea or vomiting. Staff also states that Edith has been treated for an upper respiratory infection recently by her doctor. Your partner takes Edith’s vital signs and reports that she has a strong radial pulse “so her systolic is 90" and a respiratory rate of 16. Listening to lung sounds he reports that they are clear in all fields.

Preparing Edith to be transported to the hospital you need to determine if you will provide patient care or if your BLS partner will attend to Edith. To assist with that decision, think about the following questions:

  • What is your initial impression of Edith?
  • How confident are you about what you already know about Edith’s health status?
  • What are some ways to improve your confidence?
  • What other assessment tools might you use?

Post your answers in the comments and view the solution for this scenario.

An EMS practitioner for nearly 15 years, Patrick Lickiss is currently located in Grand Rapids, MI. He is interested in education and research and hopes to further the expansion of evidence-based practice in EMS. He is also an avid homebrewer and runner.