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Wednesday, August 6, 2008

My Patients Are All Young

Over that last few days of work I have not had a patient over the age of 23. The first call was for a 20 year old female that was having chest pain, shortness of breath, and a headache. She stated that she had a history of high blood pressure and that she had not been taking her medication.

The next call was for an 18 year old patient having a seizure. More accurately, she was having multiple seizures. By the time that we arrived on scene she was able to walk but her mom told us that, over the last hour, the patient had had 3 seizures, each lasting about 10 minutes. I did a quick assessment, plugged in a line and checked her blood sugar. I asked the patient if she had an aura (a tell tale sign that she was about to have a seizure). She said that she did and that she would let me know if she was going to have another seizure. At that point there was not much else to do other than wait for the ambulance.

Our next call was 22 hours later...for the same person. She had been discharged by the hospital later that night and started having seizures the next day. It made my assessment a little easier since I remembered her name, medical history, medications and allergies. Other than that the call went just about the same as the previous one.

My next patient called at 4:30 in the morning. She was a 23 year old female complaining of sever menstrual cramps. As a paramedic I have the ability, at my discretion, to do something for pain. Unfortunately some people know this and they call 911 and fake pain. This patient had called 911 3 times in the last couple of months with three different complaints of severe pain. Putting that aside, the way she acted on scene did not coincide with a patient in that much pain. Her vitals were all wrong and she was amazingly able to talk with so much as a grimace whenever we asked her a question. I wasn't willing to give her any morphine and I'm fairly liberal with it. The best part was when MBA showed up because the medic was female. Eric went outside and explained everything. Then the medic walked in and asked what the problem was. When the patient said that she was having severe menstrual cramps the medic asked rhetorically, "You called 911 for menstrual cramps?!" The patient then got really defensive and said that she didn't understand to which the medic said, "I'm 35 years old and have a kid, I know about pain." hehehe There are some things that a male paramedic just can't get away with saying.

My next patient was a 21 year old female that passed out while doing the dishes. When we got there she was laying on the couch complaining of a severe headache. We checked everything from her heart to her blood sugar it all checked out. After talking to Katie she thinks it may have been the start of a migraine. Who knows. We put her on a backboard, gave her some oxygen and started a line. After that all we could do was send her to the hospital for further testing.

Another call we had was for a fall with injuries. A 15 year old boy fell on a cup in his room and dislocated his patella (knee cap). We found him still laying on the floor in a lot of pain, especially when he tried to move. I started a line on him and tried to dope him up on morphine. By the time that MBA had shown up I had just finished giving him 6mg of morphine but he said that it wasn't doing a thing for his pain. Unfortunately there isn't a lot that I can do for someone that has a high drug tolerance for morphine so we packaged him up as best we could (we used a backboard and some pillows for support), gave him an ice pack, and sent him on his way. We told him that he better listen to his mom and clean his room after this accident.

My most recent patient was only 4 years old. His older sister knocked a TV over onto his head. His mom was panicking thinking that her son had a severe head injury. As I talked to the kid it became apparent that he was fine. He pointed to the spot where the TV made contact with his head and there wasn't even a red spot. Half way through my assessment the kid looked at his mom who was crying and he stopped talking. At this point I had my firefighter go and grab what we call a pedi-buddy. It's just a stuffed animal that we carry on the engine for just such occasions. With the help of the stuffed animal the patient again started talking to me. Thankfully the mom decided to sign him out AMA and take him to the hospital herself. This was one of those times where calming the mother down was the best treatment for my patient.

The average age of my patients over the last 8 calls is only 17!

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