Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Presyncope, Sinus tachycardia, Syncope
Clinical narrative: Narrative:  Medical response was called sometime before 1100. Medical response call indicated 1st floor bathroom. Writer arrived to scene to find patient laying on floor of handicap bathroom stall. He was laying on his left side with rt arm over his head.He was diaphoretic and shivering. Moaning in pain. He c/o SOB,dizziness, and abd pain. It was difficult to ask him questions initially due to other patients in the restroom and patient repeating,"I just got my booster! I just got my booster!" Initially said "yes" when asked if he fell. It was undetermined whether he had fallen. Connected patient to pulse oximeter. He was saturating 97% and Hr was fluctuating between 115-130bpm. 911 called immediately. Patient was perspiring profusely. Stated that he had SOB, but denied closing of throat or swelling of tongue. He was unable to describe or rate pain, simply stating, "My stomach hurts really bad." Unable to give health history. Denied being diabetic. Medical Response Note for Clinics with Emergency Response Boxes REASON FOR THE EMERGENCY RESPONSE: [ ] chest pain [X] dyspnea [ ] syncope or near syncope [X] dizziness [X] Possible fall [ ] other (specify) Comments: SITE: SETTING: [ ] Patient care area [ ] Registration area [ ] Lobby [ ] Lab [ ] Parking lot [X] Other (specify)1st floor restroom. VITALS VS were obtatined by FD BP:219/112 Temp: Heart Rate:115 Respirations:22 Pain level:Unable to rate. Severe Pulse Ox: 97 on room air INTERVENTIONS (Enter items which apply): [X] Paramedics called. Time Called:11:10 Time Arrived: [ ] Paramedics called but cancelled by (name of Provider): [ ] Automatic External Defibrillator (AED) used: [ ] OXYGEN [ ] Oxygen by nasal cannula _____liters/min. [ ] Face mask _____liters/min. [X] EKG performed by FD. Sinus tach per paramedics. [ ] IV 500 cc 0.9% Normal Saline ______rate. [X] IV saline lock. #22 left hand inserted by writer. [ ] MEDICATIONS given per Provider Verbal Order: [ ] ALBUTEROL oral inhaler. _____puffs by oral inhalation. [ ] ASPIRIN chewable 81 mg tablets. Administered ___ mg. [ ] Diphenhydramine (BENADRYL) 50 mg/ml IM. Administered _____ mg I.M. [ ] Naloxone (NARCAN) 0.4 mg/ml . Administered ______ mg by ___(route). [ ] Repeated NARCAN _____ mg by ____(route) Times administered: [ ] NITROGLYCERIN Sublingual 0.4 mg. Times administered: 1st dose: ___2nd dose___3rd dose___ [ ] EPINEPHRINE 0.3 mg/0.3 ml. Injection. Administered 0.3 mg I.M. Time administered: [ ] Repeat EPINEPHRINE 0.3 mg/0.3 ml. Administer 0.3 mg I.M. Time administered: ___ [ ] GLUCOSE GEL 37.5 gm tube: administered ____ Tube(s) P.O. Time administered: [X] Accucheck Performed by FD=300+ [ ] Repeat GLUCOSE GEL 37.5 gm tube: Administer _____Tube(s)P.O. Time administered: [ ] Accucheck (prior Blood Sugar value if known) ___mg/dl [ ] GLUCAGON 1 mg. Injected 1 mg by ___(route). Time administered: ______ [ ] Accucheck (prior Blood Sugar valve if known______mg/dl [ ] OTHER INTERVENTIONS: Comments/ including patient response to interventions: PATIENT DISPOSITION: [X] Transferred by paramedics to (location):Hospital [ ] Transfer Coordinator notified if patient transferred to outside facility [ ] Seen in Clinic for further evaluation [ ] Home [ ] Homeless Shelter [ ] other: [ ] Did not want treatment (AMA) Reason: [X] Other :Once FD arrived to seen, they planned to transport patient out via gurney, but patient was able to stand up and walk to lobby. Gait was slightly unsteady. Remained diaphoretic and appeared to be in discomfort at times. Other times, he appeared to have fallen asleep, but was easily aroused. Was able to answer further questioning. He did not fall. Stated that he layed down on the bathroom floor. Still w/ SOB, dizziness, and abd pain when paramedics transferred him to rig. Denied any chest pain or pain to neck/arm/jaw. Transferred to ER. Provider responding to Emergency response:Dr.