It’s a busy evening, you’ve already been to a rollover on the interstate with an ejection and several other EMS calls with minor complaints. You just made it back to the station when the printer rolls again.
“Engine twenty three…”
You don’t even bother listening to the rest but you gather from the talk in the cab that this is some sort of neck pain. Seems rather menial as described, probably someone with a stiff neck after a trauma hours or even days ago, or they just woke up from sleeping on the floor. They have all happened before.
The engine winds its way through traffic under the skillful direction of an experienced driver. The cab sudden jerks off to the right and slows to crawl as you begin scanning numbers. Finally, it comes to a stop in front of a small house. Several people inside are speaking Spanish.
“English?” the lieutenant asks the person at the door.
“Yes, please come in, my daughter is right here.” the lady at the door points to a teenage girl seated on a chair in the living room. We appears to be very uncomfortable as one of her sisters holds her head back at a near 90 degree angle.
“Her head has been like this for a while,” she explains, “it has been getting worse over the past few hours.”
Your partner palpates the right side of her neck. “Yeah, it’s pretty stiff.”
He starts asking the usual questions about allergies, recent trauma, past medical history such as asthma and heart problems, and then comes to questions about recent illnesses.
The following information and vitals are gathered:
Demographics – 15 y/o F hispanic female
VS – BP 124/86, HR 122, RR 22 rapid, lung sounds unlabored and clear, sinus tachycardia without ectopy on monitor
No trauma, no past medical history.
The family responds to questions regarding any other types of illnesses.
“She’s been sick lately with a cold, the doctor gave her some medicine,” the older sister explains.
You look inquisitively at her over the top of your safety glasses. “Let me see them.” She brings you two pill bottles, one marked “Amoxicillin” and the other marked as “Prochlorperazine.” This piques your interest. You turn to the AEMT. “Start an IV, I know what the problem is.”
What are your thoughts?