C09970930 / invoice 10000

-----------------------------TRIAGE NURSE:History:Client Discussions:    Vital Signs    

Reason: Seizure 10 Mins AgoAppointment Notes: lcm o aware of feeRVS name:Initial estimate:Contact details checked:CPR code:History:Seizure-type event 10 minutes prior to presentation. Was swimming in pond, started  circling to one side, then collapsed with rigid limbs. Was non-responsive for ~2 minutes. Immediately followed by ~5 minutes of hyper-reactivity before return to normal mentation. No previous seizures, though biological grandfather had CNS tumour according to owner.No known access to medications or toxins. Unlikely to have scavenged anything. Previously and otherwise well. No current medications - on immunotherapy for skin allergies.Examination:BAR, bcs 3/5, NAD chest auscultation and abdominal palpation. Eyes - bupopthalmic position, normal PLR and eye movements. Ears, teeth ok. MM pink, CRT 1 sec. Skin and LNs WNL. Mild reaction on lumbar spinal palpation, NAD rest of orthopaedic exam.Assessment:Description most closely resembles seizure.Main DDx: extracranial (hypoglycaemia, renal/hepatic disease), intracranial (syringomyelia, hydrocephalus, neoplasia, meningitis), idiopathic epilepsy.Currently stable. Offered hospitalsiation for seizure watch, owner elected to monitor at home.Plan:Blood taken for CBC/biochem. Await results.Laboratory:PHOS 0.74 mmol/L (0.81 - 2.20)ALKP < 10 U/L (23 - 212)Assessment:No significant abnormalities.Client communication:LB discussed above with owner Mel. No further seizures today, will continue to monitor tonight and pursue further care if seizures reoccur, >1 per 24 hours, or if severity or frequency increases.    Vital Signs    Weight: 9.4;