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Focus: Anatomy, Physiology, and Position

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Patient Update

The intersection at the corner of Shawnee Boulevard and South Sheridan Road was chaos. Two vehicles—one a car and the other a delivery truck—had collided. Police, fire and rescue units, and ambulances were on the scene. Police were securing the perimeter to keep onlookers and reporters from interfering while the emergency medical personnel attended to the accident victims. Traffic was blocked on all sides of the intersection (EMT), and a couple of police officers were rerouting it away from the scene.

Near the car, an elderly woman was pacing back and forth in the company of an emergency medical technician. The older woman was wringing her hands, and she seemed to be muttering to herself. EMT Shondra Wallis was speaking calmly and softly, trying to convince the woman to sit down. It was near noon, and the temperature on this sunny June day was increasingly hot. Even so, the EMT offered to drape a blanket over the woman's shoulders. "Here, put this on. I don't want you going into shock," she said quietly to the woman. It was brushed away. "What's your name?"

"Stevie-Rose," the woman replied. "Stevie-Rose Davis."

"Well, Ms. Davis, you've been in an accident, and you need to sit down and let me take care of you. My name's Shondra, and I am an emergency medical technician with the fire department here." Ms. Davis did not respond and instead stared out into the intersection and at the commotion there. The EMT was able to do a preliminary assessment of Ms. Davis while this occurred; she noted no obvious external injuries but did notice that the woman was very pale. Because Ms. Davis was ambulant, EMT Wallis touched her elbow and gently began to direct her toward a grassy spot on the median of Shawnee Boulevard. EMT Wallis then assisted Ms. Davis into a sitting position under a tree. "Ms. Davis, do you have any pain anywhere? Are you hurt?" in-quired EMT Wallis as she began a more comprehensive assessment for signs and symptoms of trauma.

"What's that, dear? Pain? No, I don't think so. What makes you ask me that?" Ms. Davis replied. Then she swayed momentarily and raised a hand to her head.

"Are you all right?" EMT Wallis interjected as she reached out to steady Ms. Davis.

"Yes, yes, I'm okay. Just a little lightheaded. Must be the heat," replied the elderly lady, now looking at Wallis directly. The EMT took the opportunity to quickly evaluate Ms. Davis's pupils for size and response to light as part of a neurological assessment. The woman's eyes were dilated, and this concerned the EMT. While Wallis was using the penlight, the patient reached out to move it away from her eyes. As she did so, Wallis noted a fine tremor in the woman's arm and hand, and she also noticed some disfigurement of the woman's ...

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