Take that, white cloud!

I've had a very interesting last few days, pretty much starting with an asystole arrest in a nursing home notorious for killing its residents. As soon as I realized where we were, I said "Ooh, this place."
When we got to the room, cpr was in progress, 4 rounds of epi 3 rounds of atropine had already been given, and to top it all off, it was a trach patient, so I didn't get my airway! We tried to pace him, unsuccessfully, both my preceptor and I went for EJs, unsuccessfully, but a few minutes later, we had return of spontaneous pulses. Wow. The patient had been down for 20 minutes, and pupils were fixed and dilated. We transported carefully.

Shortly after, we had a patient, that, looking back at my paperwork now, I don't remember at all. I was trying to finish my Fisdap stuff and I couldn't remember a thing about them (do note the use of 'them' as I don't even remember that detail). Apparently, I even started an IV. Freaky.

Then we had my first 'belligerent' drunk. Usually, they'll just get in the ambo, happy to be inside, entertain us with random ramblings, and go to the hospital. Not this guy. As soon as we got on scene he became 'unresponsive.' He passed the sternal rub test, but failed the "you won't hit yourself in the face test." This is when you take the patients hand and hold it over their face and let go. Sounds bad, but a truly unconscious patient will let their hand fall to their face. A not so clever drunks' hand will miraculously fall anywhere but their face. The plain clothes cops on scene were talking to the patients' wife. "He hasn't had anything to drink today." Right.
So, we got him on the cot and strapped in and into the ambulance. Just as we were shutting the doors we caught him peeking, and he knew the jig was up. Longish story short, he became belligerent, cursing at us and what-not, the cop came on board and ended up tackling him onto the cot. Then, he and his partner "carefully guided" the patient out of the ambulance, so to speak. They put him back on the curb, where he made mistake 1,263 by throwing his coat off and putting his fists up to this cop. Longish story short, we bandaged his face before he was "carefully guided" into the paddy wagon. You can't buy this kind of entertainment.

Our last call was for an injury from a fall. Somehow I knew it would be good as soon as I had to walk on a plank to get into the construction site. The patient had fallen 2 stories onto his head and neck. When we got there is was conscious and completely confused. Blood was nearly pouring from one ear, pupils were good but he must have asked "what happened" 60 times before we gave up answering him. We backboarded him and carried him out. A quick assessment, a quick IV, and we were off; I felt there should be no fooling around. As soon as our driver put it in park at the hospital, the patient vomited, postured, and seized simultaneously. My preceptor and I had one of those "Uh....lets get the hell out of here!" moments, and that's what we did. The first time I ever ran a patient into the ER. They RSI'd him pretty quickly and he headed over to CT. Needless to say, a basilar skull fracture, sub arachnoid bleeds, cerebral contusions...a bit of a mess. Yesterday brought me back to (the hospital where I bet you can guess we took this guy) and he was still there. I discovered that in addition to all the head stuff, he has ribs 1-7 broken on the left side (resulting in a pneumothorax and the placement of a chest tube) but is otherwise okay. Awake and oriented, although still with the tube.
It's nice to get an update once in a while.

Comments

Anonymous said…
Hey girl... love reading your rantings. This last call for the fall w/ the oh shit sphincter factor was a sweet one. Glad you're getting some good calls and learning stuff. Ciao!

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