This scenario begins in a patient’s home where paramedics were called because the patient is not acting right and is unresponsive. Their family believes the patient may have overdosed on medications as she has been depressed since breaking up with her girlfriend last week. The learner can observe several medication bottles next to the patient lying on the floor. Learners must immediately intubate the patient. If they fail to do this, she will aspirate and decompensate. After the patient is intubated, she moves to the ambulance and has worse hypotension that does not respond to fluids while QRS is gradually widening. If sodium bicarbonate is given, vital signs will improve and the patient will recover.

Learning Objectives

– Perform focused assessment
– Prioritize ABC’s
– Recognize abnormal vital signs
– Recognize abnormal ekg/rhythm strip
– Recognize signs and symptoms of TCA overdose
– Know treatment for TCA overdose, and treat abnormal QRS