I always enjoy reading the case of the month and frequently use it in the classroom for patient assessment, etc. When I was reading this month's case, I had to re-read it once during the initial patient assessment dialog. It was stated that the patient was found with altered mental status in a supine position. The assessment went on to state that there was no jugular vein distention noted. Someone please enlighten this "old" medic, I/C but flat neck veins in a flat person can mean hypovolemia is present. Additionally, one of the treatments was a NRB at 10L because of the low O2S. I agree with that but later on in the scenario, it stated that the patient was still saturating at 92-93% on ambient air. What happened to the NRB and should the 02/L been increased to maybe 12 LPM based on 02S? Any comments?

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Chuck,

Which Case of the Month was this?

JEMS

Oops, my mistake. It was the November "Case of the Month." The diabetic female with altered mental status and "LO" blood sugar reading. Point was that normally I would think some JVD would be present in a supine patient. Not that the patient was necessarily hypovolemic based on initial assessment and the O2S readings were still a bit on the low side with no mention of increasing the LPM. Thanks....

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