MENINGIOMA – DIFFERENT LOCALIZATIONS AND PRESENTATIONS

Depending on localization, the same type of expansive process may result in different clinical presentations. Such is the case of our patients. Patient A suffered her first focal motor seizure while sitting, which was briefly followed by loss of consciousness. Clinical examination revealed initial stupor, which reversed to fully conscious state, and by brisk involuntary clonoid movements involving her left side of her body, which were self-limited within several minutes. Brain MRI revealed frontal and parietal enhancing lesions protruding into the right hemisphere (arrows).

Assessment of the EMT-P Medications Used by Baltimore County Fire Department EMS Supervisors/EMT-Ps

Many authorities in EMS have cited the lack of data concerning the efficacy of medications administered by prehospital providers. This paper reports the results of a prospective assessment of the efficacy and safety of certain medications used by emergency medical technician-paramedics (EMT-Ps) in a three-tiered response system. Data were collected for six months using forms that were completed by the EMT-P at the conclusion of an incident. Medication efficacy was measured for: bretylium tosylate, 14 patients/3 conversions to a sustaining rhythm (21 %); diazepam, 20 patients/17 stopped seizing or converted to focal motor seizure (85 %); dopamine hydrochloride, 14 patients/9 experiencing increase of blood pressure (64%); furosemide, 49 patients/28 instances of decreased respiratory distress (57%); and terbutaline sulfate, 46 patients/34 instances of decreased respiratory distress (74%). Serious side effects were rare and well managed by the EMT-Ps. These data indicate that these medications are effective and safe when used in the prehospital environment. Analysis of more data from different delivery profiles is necessary prior to drawing appropriate scientific conclusions. Data collected should include patient follow-up through hospital discharge.