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Sunday, June 22, 2008

Friday The 13th - part five: Dog Bite

This was a fun call. we got toned out for a dog bite. As we approached the scene we looked to see if the perpetrator was still there waiting to take a nip at us. Not seeing any stray dogs we knocked on the front doer. We were met by a woman whose right hand was covered in blood. She had walked her two dogs to the mailbox when the neighbors male Doberman jumped the fence and attacked. My patient had tried to stop the dogs from fighting and paid the price for it. She had a small puncture wound on her right forearm, just above the wrist. She was very distraught at the fact that her little dog had been attacked. She kept saying that it was bleeding out in the bathtub. My patient had a history of heart problems, high blood pressure, and psychological problems so to calm her down, Eric went and checked on the dogs, which were OK. My patient let us treat her but refused to go to the hospital. We canceled MBA as they walked in the front door.

As I was finishing up my paperwork so that my patient could sign out AMA I noticed that she had closed her eyes and her head started to bob a little. A called her name but got no response. I didn't like this so I called loudly and shook her shoulder. At this point she looked up at me and told me that she wasn't going to go to the hospital. She then promptly passed out again. Given her history I started to wonder if this was some sort of psychotic episode. Now I asked Eric to call MBA again and he asked if I had checked her sugar. It was like a light bulb appeared above my head. I had what we call a paramedic moment, others call it a brain fart. Whenever a patient is altered you always check their blood sugar. That should be the first thing you assume is wrong. I forgot that on this patient. Even though she had no diabetic history at all, and she had dinner only two hours before, her blood sugar was down to 37 (in a healthy adult is should be between 60-100). I quickly started an IV and gave her some sugar. It brought her blood sugar up to 189 and woke her right up. It then took 2 paramedics, a Sheriffs deputy, her husband, and a doctor (on the phone with me), and 30 minutes to talk her into going to the hospital.

Meanwhile, on the outside of the house, the Sheriff deputy and my deputy chief found the Doberman. It jumped the fence and tried to attack them. Fortunately for them the officer had pepper spray and used it in the dog (the dog then retreated to it's property and wearily watched us). Unfortunately, the dog attacked from up wind so the pepper spray came back at the deputy and at Craig. Both of them were coughing pretty hard for a while. Like I said, it was a fun call.
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