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Clinical scenario: Patient with dizziness

You are dispatched to a baseball diamond in a park, where a girl is complaining of dizziness

Squad 40, respond with Engine 7 to the baseball diamonds in East Watch Park. The caller reports a female softball player complaining of dizziness.

You arrive on the scene and are waved into the visitor’s dugout by the coach of a fifth-grade softball team. As you approach the patient, you are told that the child’s name is Christina. You see that she is awake and responds to verbal stimulus. She does not appear to be in any significant distress, and her skin is pale and damp.

Her coach states that she was playing shortstop. However, she abruptly came out of the game, stating that she was feeling dizzy and weak. Initially, the coach thought that she was dehydrated or suffering from heat stroke. The weather has been cool, however.

You introduce yourself to Christina, and ask how she is feeling now. “I’m okay,” she responds, “still a little dizzy.” Christina is fully alert and responding appropriately to your questions. She reports that she takes insulin daily for her diabetes.

Christina’s vital signs are:

  • BP: 100/66
  • HR: 124
  • RR: 24
  • SpO2: 99 percent RA

What are the next steps in your assessment? Consider the following questions:

  • What is the most likely cause of Christina’s symptoms?
  • What are some other potential causes?
  • What are some pitfalls that could occur as a result of treating the underlying medical conditions that you suspect are affecting Christina?
What are the most important things to remember when treating a patient with a history of diabetes?

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.