Gout in EMS || Medical Conditions
Gout is not a typical complaint for a 911 call, however an EMS 🚑 provider will certainly encounter multiple patients that have it in their medical history.
Gout is an extremely painful, inflammatory arthritis caused by an excess of uric acid in the blood🩸 .
Let’s talk about what is happening in the body when a person/patient has gout.
When the body breaks down purines (molecules comprised of carbon & nitrogen atoms), uric acid is formed. After the uric acid is created, the kidneys go on to do what they do best, filter. If the kidneys are unable to filter it out or too much of the uric acid stays in the bloodstream (hyperuricemia), it may actually crystallize in the joints, which causes pain and inflammation. Patients with an active gout flare may describe it as excruciating and even debilitating.
Gout can affect any of the joints, but most commonly causes pain and inflammation of the big toe 🦶(and even ankle). This area of the body tends to be the coolest and the uric acid is able to crystallize and deposit there.
In addition to being extremely painful, gout is chronic and progressive. It can be destructive to the joints and require surgery in certain cases.
Some of the risk factors for gout are
*being male
*being between 40-60 years of age
*diabetes
*insulin resistance
*hypertension
*alcohol 🍺
*certain medications 💊
*obesity
*diet high in purines
*genetics 🧬
There are home remedies, vitamins and dietary changes that doctors may recommend to prevent a gout flare like tart cherries 🍒 , milk thistle, magnesium, a low purine diet, etc. If a patient is in an active flare, these patients are typically prescribed NSAIDs, antigout medications and/or corticosteroids. 💊
You may never deal with a gout flare in the prehospital setting as they typically don’t pose an immediate life threat. If you do, be kind and know these patients are in serious pain even if all that is reported is “toe pain.” 🦶
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