Wednesday, January 24, 2024

EMS Peculiar Patient Presentation - Acromegaly

EMS Providers should be aware of the condition know as acromegaly and the potential issues it may cause in the prehospital setting.

Acromegaly is a rare hormonal disorder characterized by the excessive production of growth hormone (GH), usually caused by a noncancerous tumor of the pituitary gland.

Here are some key points for EMS providers to consider:

Recognizing Symptoms:

Acromegaly is often associated with gradual changes in physical appearance, including enlargement of the hands, feet, and facial features.

Other symptoms may include joint pain, fatigue, headaches, and changes in vision.

Airway Management: Enlargement of facial features may pose challenges for airway management. EMS providers should be prepared to address potential difficulties in intubation.

Cardiovascular Considerations: Acromegaly can lead to cardiovascular complications such as hypertension and cardiomyopathy. Monitor blood pressure and be alert to signs of heart failure.

Medication History: Patients with acromegaly may be on medications to control GH levels. It's important to inquire about any prescribed medications and their potential interactions.

Communication Challenges: Enlargement of the tongue and other facial structures may affect communication. EMS providers should use clear and concise communication and consider alternative methods if necessary.

Temperature Regulation: Acromegalic patients may have difficulty regulating body temperature. Monitor for signs of hyperthermia or hypothermia.

Pain Management: Joint pain is a common symptom in acromegaly. Assess and manage pain appropriately, considering the patient's condition.

Transport Considerations: Patients with acromegaly may require special considerations during transport, such as ensuring adequate space and comfort due to their altered physical appearance.

Collaboration with Healthcare Providers: Communicate with receiving healthcare providers about the patient's acromegaly and any specific concerns or considerations that may impact ongoing care.

It's essential for EMS Providers to stay informed about rare medical conditions like acromegaly and be prepared to adapt their approach based on the unique challenges these patients may present. 

Further Reading:

Maione, L. & Chanson, P. (2022) Acromegaly. In: Tamagno, G., & Gahete, M.D. (Eds) Pituitary Adenomas. Springer Cham.

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