Can I borrow that black cloud for awhile?
One Monday I did an overtime shift. I was pretty excited because no matter what I did, I knew I was getting paid reasonably well for it. My partner was a new medic (newer than me, believe it!) who started the evening by informing me that he has a black cloud following him. I figured together we’d make a nice gray cloud that would allow us to sleep. We had calls spaced out enough for me to be really tired Tuesday morning.
The highlights included a car accident with 6 patients and a sexist firefighter whom I may later thrash. Three women were on scene from my company, and this guy managed to leave them all seething. It’s a talent, I assume he’s been perfecting it for forty years or so. Note to self: next time I see him on scene, ignore completely.
Later we had a call that came out as unconscious. En route we were informed that CPR was in progress. My partner and I divvied up the skills, and the tube was mine, sweet. Just as we arrived on scene the engine company reported ‘possible cardiac arrest.’ “Huh?” We both thought. So we grabbed basically the entire contents of the rig and moved in. I walked in just as the firefighters were pressing ‘analyze’ on their defibrillator. I could see that the patient was definitely out of it, but breathing on his own. “No shock advised” reported the AED. I threw him on our monitor to reveal a sinus rhythm as my partner confirmed a pulse. “Hmm…” We both thought.
We put him on the backboard straight away and moved into the ambulance. I told the wife to call her children, and we were doing all we could. Once I saw the patient in the light of the ambo, I figured it was a stroke, unconfirmed, of course. I put in an oral airway with no problem, and prepared for a tube. He was too clenched, and had a deep down gag reflex, so I abandoned the attempt. Dammit! Just as the IV was established, he started seizing, so we gave him valium, and I bagged him as his breathing rate fluctuated somewhere between zero and thirty. We were both hoping the valium would relax him enough to give him a tube, but nope! Once the seizing resolved, he continued to breathe on his own, keeping his sats up and me satisfied. We transported quickly.
The rest of the shift was full of patients whom I forgot completely. Hurrah for overtime.
The highlights included a car accident with 6 patients and a sexist firefighter whom I may later thrash. Three women were on scene from my company, and this guy managed to leave them all seething. It’s a talent, I assume he’s been perfecting it for forty years or so. Note to self: next time I see him on scene, ignore completely.
Later we had a call that came out as unconscious. En route we were informed that CPR was in progress. My partner and I divvied up the skills, and the tube was mine, sweet. Just as we arrived on scene the engine company reported ‘possible cardiac arrest.’ “Huh?” We both thought. So we grabbed basically the entire contents of the rig and moved in. I walked in just as the firefighters were pressing ‘analyze’ on their defibrillator. I could see that the patient was definitely out of it, but breathing on his own. “No shock advised” reported the AED. I threw him on our monitor to reveal a sinus rhythm as my partner confirmed a pulse. “Hmm…” We both thought.
We put him on the backboard straight away and moved into the ambulance. I told the wife to call her children, and we were doing all we could. Once I saw the patient in the light of the ambo, I figured it was a stroke, unconfirmed, of course. I put in an oral airway with no problem, and prepared for a tube. He was too clenched, and had a deep down gag reflex, so I abandoned the attempt. Dammit! Just as the IV was established, he started seizing, so we gave him valium, and I bagged him as his breathing rate fluctuated somewhere between zero and thirty. We were both hoping the valium would relax him enough to give him a tube, but nope! Once the seizing resolved, he continued to breathe on his own, keeping his sats up and me satisfied. We transported quickly.
The rest of the shift was full of patients whom I forgot completely. Hurrah for overtime.
Comments
Then again, if you can manage it as a BLS airway without problems, why make trouble for yourself...
We don't have RSI in the field here yet. This patient was RSI'd right after we arrived at the hospital.