Sick people
My last shift at full time work we were called for a 'sick person.' Full of skeptism, we headed to the call. The BLS crew checked how far away we were several times, and declared that when we arrived, we would jump into the back of the ambulance and be "Class 1 all the way." Now my interested was piqued.
We arrived to find basically a woman who was nearly dead. She was responsive to pain, with no blood pressure or palpable pulses. Probably because he heart was beating 30 times a minute and her blood pressure was less than 80 systolic. I popped her on the monitor (junctional bradycardia) and as I was getting a line, my partner put on the pacer pads and cranked it up. Thankfully we got capture and I gave her some atropine which didn't seem to do anything. The family though that maybe she had taken too much blood pressure medicine. She had literally a grocery bag full of different prescription bottles. It wasn't my call so I left at that point and drove our truck back to the hospital. It turned out that the pts. potassium was 7.6. This is very high and at 7.5 the SA node stops working. Thus, the junctional rhythm. The pt. coded shortly in the ER but was resuscitated and apparently will recover.
Two days later at part time work, my partner for the day took the first call. He sent a 12 lead to the hospital and his patient was in a 3rd degree heart block with a ventricular rate of maybe 20. They used the hospitals helipad to fly the paitent to more specialized care. When they arrived to wait, I hopped in to see if I could help. This patient had suddenly felt weak and fainted, and when I got in, my partner was pacing him with success and had given atropine. He paused the pacer to see what the underlying rhythm was. P-wave, P-wave, P-wave, P-wave, okay, turn the pacer back on. The patients ventricles were now not working at all, oops. The helicopter arrived and we sent him on his way.
This morning we were called for a fainting, and we found this youngish guy sitting up, pale, sweaty, feeling lightheaded. He didn't want to go with us so we worked him up hoping to scare him into going. It didn't take much. We stood him up to do orthostatic BPs and he started to do the "duck and weave." We layed him down and he agreed to go with us. Then he fainted again, and started vomiting blood. Somehow I was alone with him at this point and was pulling him onto his side. One of the EMTs helped me, and another ran for suction. I won't lie, what he threw up was really gross. I got a whiff of the acrid blood/vomit smell and almost lost it myself. From here we got him out, started some huge IVs in him and went to the hospital.
I've lucked out, having critical patients without having to write the trip sheet about them.
We arrived to find basically a woman who was nearly dead. She was responsive to pain, with no blood pressure or palpable pulses. Probably because he heart was beating 30 times a minute and her blood pressure was less than 80 systolic. I popped her on the monitor (junctional bradycardia) and as I was getting a line, my partner put on the pacer pads and cranked it up. Thankfully we got capture and I gave her some atropine which didn't seem to do anything. The family though that maybe she had taken too much blood pressure medicine. She had literally a grocery bag full of different prescription bottles. It wasn't my call so I left at that point and drove our truck back to the hospital. It turned out that the pts. potassium was 7.6. This is very high and at 7.5 the SA node stops working. Thus, the junctional rhythm. The pt. coded shortly in the ER but was resuscitated and apparently will recover.
Two days later at part time work, my partner for the day took the first call. He sent a 12 lead to the hospital and his patient was in a 3rd degree heart block with a ventricular rate of maybe 20. They used the hospitals helipad to fly the paitent to more specialized care. When they arrived to wait, I hopped in to see if I could help. This patient had suddenly felt weak and fainted, and when I got in, my partner was pacing him with success and had given atropine. He paused the pacer to see what the underlying rhythm was. P-wave, P-wave, P-wave, P-wave, okay, turn the pacer back on. The patients ventricles were now not working at all, oops. The helicopter arrived and we sent him on his way.
This morning we were called for a fainting, and we found this youngish guy sitting up, pale, sweaty, feeling lightheaded. He didn't want to go with us so we worked him up hoping to scare him into going. It didn't take much. We stood him up to do orthostatic BPs and he started to do the "duck and weave." We layed him down and he agreed to go with us. Then he fainted again, and started vomiting blood. Somehow I was alone with him at this point and was pulling him onto his side. One of the EMTs helped me, and another ran for suction. I won't lie, what he threw up was really gross. I got a whiff of the acrid blood/vomit smell and almost lost it myself. From here we got him out, started some huge IVs in him and went to the hospital.
I've lucked out, having critical patients without having to write the trip sheet about them.
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