Daytime temps of 40C/104F. Your group of four encounters a patient lying on the ground under the only small juniper in the area. You ask if everything is OK. The patient’s companion is fine but he asks if you can help with the patient, who he worries is dehydrated or having a “heat stroke.” You perform a patient assessment then discuss your findings and the situation with your companions, the patient, and their companion.
Subjective
The patient is a 30-year-old female complaining of fatigue, dizziness, and a headache. The patient is hiking with a companion in the desert. This is the second day.
Objective
Patient Exam: The patient has no mechanism for injury and there are no findings on a head-to-toe physical exam except swollen fingers, which patient says she has never had before.
Vital Signs
|
TIME |
1030hrs |
|
LOR |
According to companion the patient is slow to respond but is A+Ox4 |
|
HR |
90, strong, regular |
|
RR |
20, regular, easy |
|
SCTM |
pale, warm, moist |
|
B.P. |
radial pulse present |
|
Pupils |
PERRL |
|
T° |
38C (100F) oral |
History
|
Symptoms: |
Fatigue (unanticipated in a fit person), dizziness, dull throbbing headache. Denies thirst. |
|
Allergies: |
None |
|
Medications: |
None |
|
Pertinent Hx: |
No relevant history |
|
Last in/out: |
Yesterday: drank 8 liters of water and urinated several times. Today drank 4 liters of water and urinated once in the morning prior to stopping. Drank 1 additional liter in last hour. Urine was clear. Ate only one bagel at breakfast. |
|
Events: |
Hiking yesterday (8 miles) and today (5 miles) in 40C/104F temperatures and cloudless sky. The patient is wearing a broad-brimmed straw hat, shorts, and a loose, thin, white cotton shirt. |
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