EMT Challenge Cases

CASE: FIXED GAZE

You get a call from the mother of a teenager who was apparently in a fight and didn't come home for several days, but when she was with him, she was frightened and called 911. This 17-year-old man presented with a 3-day history of double vision on upward gaze after having been struck in the right eye with a clenched fist. The periorbital ecchymosis, edema, subconjunctival hemorrhage, and paresis on upward gaze (patient is shown with upward gaze) are suggestive of a particular injury. In addition to his appearance as shown in the photograph, he complains of headache and blurred vision. Pupils are somewhat constricted and slow to react. His vitals are WNL other than borderline HTN. You suspect that he is probably involved in drugs and that he was intoxicated and possibly using some other illicit drugs which is why he didn't come home immediately as well.

How would you handle this case?

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