Emergency scenario part 1
Emergency scenario part 1
The day began as normal in the dental office treating a few patients in the morning for prophylaxis, lunch went as normal. After lunch, around 3 p.m. there was a patient scheduled for full mouth prophylaxis following their first evaluation appointment a week prior. The patient was a bit apprehensive, sweaty, thirsty, and reported that after his workout he did not have a chance to drink much water but did eat breakfast. He said he was training for a half marathon (13.1 miles) after being in track and field in high school and wanted to get back in condition for this strenuous race.
He had run 3 miles the day prior and 7 miles the morning of the appointment and amongst his chief complaints (non-dental) was twitching in the medial head of the gastrocnemius muscle and soreness, the twitching was intermittent but non-discomfort or pain. A bit of light sensitivity which I provided some dark protective goggles for. He laughed it off as he believed it was due to his training. In my head as a dental hygienist, there may be some dehydration causing the soreness and training without breaks in between days was of concern, his light sensitivity was odd but not bothering him in an adverse manner. I proceeded to take vitals and review the medical history of a seemingly healthy young adult.
The patient is a Hispanic male, nonsmoker, non-alcohol user, 20 years of age. I brought him a small cup of water which he powered down. Vital signs were normal with an elevated BP of 129/79, pulse 88, SpO2 95%, and respiration at 20 breaths per minute. No allergies were present and ASA was calculated as ASA I. I spoke to him about being a runner myself and having run half marathons and 10ks promoting the importance of proper nutrition and hydration both before and after a strenuous workout, stretching, and rest days to prevent injury before the big race.
We carried on and the demeanor was less apprehensive as I explained his treatment and began to position supine he began to jerk and his lips began to quiver and open and close rapidly. I began to ask if everything was okay but no response, as he stared blankly and stretched his body out in a rigor mortise-like contraction to a full extension almost like stretching when you wake up in the morning. I knew that this was not a normal reaction and the protocol of a pending emergency began to race through my head. Keeping calm I began to prepare for a possible emergency in my chair.
- Considering the facts presented, please make an educated guess as to what medical emergency is being played out/described
- Please list two (2) actions, that should be taken (by the clinician), in response to the medical emergency you believe to be taking place
