Bones and Groans
Jimmy tripped going up the stairs and now his ankle feels funny. He is still able to walk, it just hurts now. It looks a little swollen. You do not see any bones sticking out, he has no bruises, and there is no active bleeding. What should Jimmy do/where should he go?
Several correct possibilities!
If Jimmy has a PCP he can call them and see if they are able to fit him in today.
If not, he can go to an urgent care where a medical professional can evaluate his ankle. If for some reason he cannot go to urgent care, he can walk into the ED to be evaluated via "fast track".
Jenna says she's been feeling really down ever since her brother died 3 weeks ago. She says she hasn't been hungry for a few weeks and spends most of her time sleeping. She says she doesn't see the point to life anymore and wonders why she is here. You've noticed Jenna has not been taking time to clean her room, shower, or wash her clothes for the last week. She says she doesn't have any energy. When you ask her if she is thinking about hurting herself, she says no. What should you/Jenna do?
Jenna sounds like she is depressed. It is normal to feel some of the feelings she is having while she is grieving, but she is having trouble with her daily life and might need some help. She should talk to her therapist (or find one if she doesn't have one!) or talk to a doctor (Psychiatrist, Family Medicine, Internal Medicine) as soon as possible. If she does not want to hurt herself, we can focus on getting her the help she needs outside of the hospital.
Will fell down and cut his arm. The cut was bleeding, but it stopped after you held some pressure on it. The cut is about 2 inches long and you think it might be a few millimeters deep. What should you/Will do?
This seems like a minor cut. You should clean it, put some Neosporin on it, and put a bandaid on it to let it heal.
Steffan was eating a hotdog when he started coughing. He continues to cough and is unable to answer you when you ask him if something is wrong. He's red from coughing and a little hunched over. What should you do?
Dustin has been complaining that he is really constipated for the last week. He hasn't been eating well and he hasn't been drinking a lot of water. He says he hasn't gone to the bathroom in a week and his stomach is hurting him. You give him some Miralax, and he says he finally went and his pain is gone. What should you do?
Dustin was constipated, but the Miralax helped the problem. Dustin should drink more water and eat more fiber. Because Miralax solved the problem, he doesn't need to see a doctor right away (but he could definitely talk to his PCP about it especially if this happens again).
Stacy fell out of a tree and her arm really hurts now. It was scraped and bleeding, but the bleeding stopped on its own. Her arm looks kind of purple and a little bigger than the other arm. You can't see any bones sticking out. Where should Stacy go/what should she do?
Stacy should stop using this arm and if possible keep it close to her body/stabilize it - it could be broken!
Stacy can go to urgent care OR walk into the ED. She will probably need an X-ray to see if there is a break and how bad it is. She does not need 911 - they will only be able to give her a *very expensive* ride to the hospital.
Jack has been super productive recently. He tells you he hasn't slept in the last week because he's working on a plan to save the world and it requires all of his energy. He is talking very fast about his plan to fix the world, which will involve "cleansing" the world of some people. When you try to ask him what this means, he gets irritated and says you'll have to find out later, when everyone else does. What should you/Jack do?
It sounds like Jack might be manic. Many people who have bipolar disorder go through phases of mania/hypomania. Jack sounds like he could be a danger to others and/or himself right now - that makes this an emergency. Jack will likely need to be hospitalized - he needs to go to the ED. If you are worried about your own or Jack's safety, it would be best to call 911.
Will had a cut he got from a fall. You cleaned it and put a bandaid on it, but it's a few days later and Will says it is more painful than before. When you look at the cut, it is red and swollen. You can see some pus on it. What should you/Will do?
Chris has asthma. You have seen him use his inhaler before. Recently there has been a lot of pollen in the air and Chris has been having more trouble breathing. You went for a walk and now Chris is wheezing. He asks for his inhaler and uses it. His wheezing is gone now. What should you/Chris do?
Most people who have asthma have a good idea of when it is an emergency and when it is not. If Chris used his rescue inhaler and his breathing has improved, he probably does not need any medical attention.
Jonathan has been complaining that his acid reflux has been really bad lately and he has felt sick more days than not. This morning, he started throwing up. First it was dark and looked like coffee grounds. Now it looks like blood. He says he is feeling lightheaded. What should you do?
Sarah was crossing the street to get to Daybreak when she tripped over the curb and landed on her arm and face. Her face is very swollen and bruised, and her nose is bleeding. She says she can still breathe but she is very anxious and upset over what happened and is crying. She is having trouble seeing out of her left eye due to swelling.
Sarah has a facial injury, right around where we keep a lot of important stuff. In this case, doctors will want to make sure Sarah's brain and eyes are okay, and that she didn't break any bones in her face. Sarah needs to go to an ED where they can give X-rays and a CT/MRI, and she needs to go quickly! If someone can't drive her right now to the hospital, it would be okay to call 911.
Reagan has diabetes. She recently lost her insurance and is having a hard time affording her insulin, so she's only been using it when she feels like she really needs it. The last few days, she has been really thirsty and drinking a lot of water. Yesterday, she started vomiting. This morning she seems very confused. What should you/Reagan do?
This is an emergency! Reagan has diabetes and her blood sugar is likely very high, but she does not have her insulin to bring her blood sugar down. She is also confused, which means she is very sick in this case. It would be appropriate to call 911 in this case, she will have to be hospitalized.
Will went to urgent care and they told him to keep using the Neosporin he had and sent him home. Will's wound has continued to drain pus and now the area of redness around it has gotten larger. Will says it is more painful than before. You put your hand to Will's head and it feels really hot. What should you do?
Will's infection is not getting better. Now he has a fever, which means the infection has probably spread. The increased pain is also concerning for spread of infection, and the continued drainage of pus indicates the infection has not cleared from the initial place it started. Will needs to go to the ED to be possibly hospitalized. If you can give Will a ride or find Will a ride, that would be okay. If not, it would be okay to call 911.
Erin is a 2 year old who was playing with a small action figure. Now when you look over at Erin, she is crying on the floor. She is making a whistling sound when she breathes, and you do not see the action figure anymore. What should you do?
Erin may have inhaled/swallowed the toy based on the wound she is making when she is breathing. The situation could become more dangerous with time. It would be a good idea to call 911.
Erica had some fried chicken for dinner and her stomach started to hurt about half an hour after. It's really hurting her on the upper right side of her abdomen and she says it's the worst pain she's had. She also has been vomiting a green color and feels like she might have a fever. What should you do?
Erica seems pretty sick - she's throwing up green stuff, which is bile that your liver makes to help digest fats. Her gallbladder probably has stones in it and now it is irritated. She will probably need surgery and needs to go to the hospital.
Derrick was riding in his friend's car on Friday night when someone didn't pay attention and hit Derrick's side of the car. He was able to get out of the car, but he's very disoriented and has some big bruises on his stomach area and chest where the seatbelt was. He says he's feeling a little faint and does not want to walk. What should Derrick do?
This is an emergency! Not only has there been a car accident, which requires police to respond, but Derrick is injured and not feeling fully conscious. The bruising on his chest and stomach could also show us Derrick may have damaged some of his internal organs and could be bleeding! It would be smart to call 911 in this situation and let some medical professionals take over.
Carla has not been feeling well lately. She said she thought she might have the flu. She's been complaining of a headache for the last day and saying her neck is really stiff. She has had a fever for two days and started vomiting this morning. What should you/Carla do?
Carla has neck pain, a fever, a headache, and vomiting. This is an emergency situation, because she might have meningitis. If you can't take her to the ER yourself, or find her a ride immediately, it would be okay to call 911.
Steve was hopping a rusty fence and fell coming down. part of the fence was broken and cut his arm open. The wound is about 2 inches long on his upper arm and is bleeding, which is partially helped by Steve holding his hand over the wound. When Steve takes his hand off of the wound, you can see it is gaping and you see what looks like yellow tissue in it. What should you do?
Steve needs to go to the ED. The cut was created by a rusty object, it is down to fat (the yellow tissue) and it is gaping. He will probably need stitches and a tetanus shot, possibly antibiotics. Since Steve is able to walk, he could get a ride to the ED (or urgent care).
Chris has asthma. You have seen him use his inhaler before. Recently there has been a lot of pollen in the air and Chris has been having more trouble breathing. You went for a walk and now Chris is wheezing. He asks for his inhaler and uses it. He continues to wheeze and doesn't look well. His lips are turning blue. What should you do?
Chris's inhaler didn't help his wheezing. You can continue to offer it to him, but it would be a good time to call 911. He is having trouble breathing and his lips are turning blue, a sign he isn't getting enough oxygen.
Mike fell out of a tree while climbing it and hit his head on the way down. He was passed out for a minute or two, then woke up. He seems confused about where he is and what he is doing. He says his head really hurts, and you can see a jagged, bleeding bump on the back of his head. What should you do?
Mike hit his head and has some confusion. He also has a wound and a possible broken bone. It would be best to take him to the ED or have someone call 911.
Chrissy was crossing the street when a less than responsible driver wasn't paying attention and hit her. She is on the ground, conscious, but in a lot of pain. Her right thigh, where the car hit, is dark purple and looks swollen. She is not sure she can get up. What should you/Chrissy do?
This is a good time to call 911. Chrissy might have a broken femur, and who knows what other injuries. This is absolutely an emergency and best in the hands of EMTs/Paramedics.
Eddie is complaining of a headache. He said it came on suddenly an hour ago and is the worst headache he's ever had. He tried taking Tylenol and it didn't help. What should Eddie do?
There are a few things that make this headache an emergency - the fact that it came on suddenly, the fact that it's the "worst headache of his life", and Tylenol not helping. Eddie should go to the ED ASAP. It would be okay to call 911.
Nancy was in a car accident. She was unharmed during the accident, but when she tried to get out of the car a loose scrap of metal cut into her leg. The cut is bleeding too much to tell what kind of tissue you are seeing, but it looks like it is at least an inch and a half deep. What should you do?
It would be okay to call 911 for this. 911 usually needs to respond to car accidents anyways - it is important to make sure people are medically okay after the accident, and police are supposed to make a report when an accident happens. Nancy's wound also seems like it might need stitches, so it would bo appropriate for the EMT/Paramedic/Doctor to look at it.
Jenna has a severe allergy to peanuts. She typically avoids them and doesn't have any issues. Today, someone brought in brownies and Jenna had already taken a bite when she realized they had peanuts in them. She looks worried and is leaning over having trouble breathing. She has started to make a wheezing sounds. What should you do?
Since Jenna has a severe allergy, she likely has an EpiPen. Most people who have severe allergies keep their EpiPen close by at all times. It's a good idea to know where they keep their EpiPen if you are around someone who needs one. You should either give Jenna the EpiPen or do it yourself (instructions on the pen) if Jenna is unable. You should also call 911 ASAP.
Lucas has been drinking a lot of alcohol lately. He said he was going to go to a party tonight and be back by 10, but he didn't come back. You go to find him at the party and find him passed out on the couch. When you try to lay him down, he starts choking on his vomit and shaking all over. He isn't answering you when you call his name. What should you do?
These are concerning signs for alcohol poisoning - which is an emergency. It would be okay to call 911. Lucas is not conscious enough to make sure he doesn't aspirate his vomit and make himself very sick or choke. You can turn Lucas on his side while you wait for the ambulance and try to watch how long the seizure lasts.