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Scenario: Aggressive Hyper


Please note: The users who submit scenarios have declared that all patient details are fiction. We cannot guarentee the accuracy of any suggested treatment or the realism of suggested observations. You should judge these for yourself.



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Scenario Overview:
The first aiders are called to a patient who has recently been chucked out of a nightclub for being aggressive but now seems to have reduced conciousness and is slumped unresponsive against a wall near the nightclub. A patient's friend is with her and insists they've only 'had a few vodka and cokes' but is acting fair drunk themselves. The friend is unaware that the patient is a type 1 insulin dependent diabetic and does not drink and so has been having coke instead of vodka and coke. This scenario tests the first aiders ability to not assume that the patient is just drunk.
Difficulty:
First Aider Difficult
How the scenario should progress:
The patient will stay fairly similar throughout. The friend has the habit of getting in the way, crouching in and talking to/hugging the patient even during patient assessment.
Patient 1:
Name: Susie Charlton    Age: 22    Sex: Female
Medication: Insulin (but missed one of her injections earlier today)
Allergies: None Known
Past medical/family/social history: Type 1 insulin dependent diabetes
Findings on examination: Patient has been drinking coke so does not smell of alcohol. Has fruity smell on breath. Patient is breathing quickly. Has warm, dry skin. Patient last ate 2 hours ago. Friend notes that the patient had been going to the loo quite a bit and that she'd been pretty thirsty. No injuries will be found on the patient. A blood sugar/insulin kit could be found in pocket.
Possible treatment from first aiders: Not jump to the drunk conclusion straight away. Consider the possibilities for being unresponsive. Request ambulance. Deal with the friend in a professional manner.
Time after start: 0 mins 2 mins 5 mins 10 mins 20 mins
Response: U U U U U
Airway: Yes Yes Yes Yes Yes
Respirations: 26 deep 26 deep 28 deep 30 deep 34 deep
Pulse: 98 97 102 102 104
Oxygen Sats: 93 (96 on O2) 90 (95 on O2) 87 (95 on O2) 87 (95 on O2) 80 (95 on O2)
Blood Pressure: 90/50 88/48 86/50 88/50 84/48
Temperature: 37.9 38.9 38.9 38.9 38.9
Blood Glucose: 40.0 40.0 40.0 40.0 40.0



Tips for the patient actors:
You will stay unresponsive throughout. Try not hyperventilate yourself when acting!

Scenario submitted by: Anonymous