Some Interfacility Fun

We were called to go priority to a nursing home that is fairly far away. It took us more than 30 minutes of emergency driving to get there. The call was for a patient who was vomiting blood and had high blood pressure. So we arrived finally and found our patient sleeping quietly. The nurse said that he had an episode of vomiting coffee ground substance about 45 min ago. No other issues at the time. We got him into the ambo and checked him out. Everything looked to be in order, he was answering us, albeit shortly, and his vitals were pretty good.
When he nearly punched me as I put a nasal cannula on him, I checked out his paperwork. Oh, dementia and Alzheimer’s, that would explain it. That would also explain why he called us GD SOBs as well. He basically wouldn’t let us do anything without a fight, except put him on the monitor, so we decided to head to the hospital.
About half way there, he all of a sudden started vomiting coffee ground blood all over. I was like, ahhh! I wasn’t quite sure what to do first, so I sat him up straighter and grabbed a towel…or six. I was pretty grossed out, but looked at the monitor and I saw his rate go down and down has he vagaled himself from the vomiting. My partner noticed all of the commotion I was causing and asked if she should ‘step it up.’ Absolutely, says I, as now I can’t wait to get to the hospital. I cleaned him up as best I could, and then he either refused to or couldn’t answer me. Needless to say, I got the oxygen on him and the IV fluids in him like I wanted to in the first place.
We didn’t have anymore incidents en route, and left him in the hands of the ER where later I saw that he had vomited again later all over the floor. The nurse was less than thrilled.

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