Saturday, November 27, 2010

Epistaxis

I showed up at the station a little early. I was working an OT shift and hoping to get something good. The tones went off right at 0800. Welcome to station 3. The call was forgettable. Just another ill elderly person that was feeling a bit weaker than normal.


Less than 20 minutes after we arrived back at the station we found ourselves again splitting the sea of cars on their morning rush hour commute headed for another medical aid. Most of the drivers tried to wedge their cars into whatever space they could find to get out of our way.

Arriving on scene we found a 45 year old woman with a bloody nose. She said that it had been bleeding for the last 2 hours and nothing helped. She had had this happen once before about a year before and she had her left nostril cauterized. This time it was the right one. She also admitted that she had a history of hypertension but wasn't taking her medication. And what a shocker, her BP was high.

I used a nose clamp and an ice pack to try to stem the blood flow and gave my report to the AMR medic that had just come in the door. Another life saved.

Fast forward 12 hours. 2123 hours.

The tones were going off for the 13 time that day. This time we were being dispatched for another medical aid. As we responded with our lights reflecting off the exterior walls and windows of the buildings along our path dispatched advised us to stage. PD was en route to a fight outside of Home Depot. The victim had been hit with a pipe and the assailant was thought to still be in the area.

While we waited down the street the AMR crew decided to stage on the far side of the parking lot. The patient spotted the ambulance and walked right over, arriving before PD. The 45 year old male had been struck by a lead pipe right in the face. He had am avulsion that started about an inch above his left eye and traveled down at a 45 degree angle across his nose to a point about an inch below his right eye. We tried to stop the bleeding with direct pressure but that was only slowing it down a bit. Despite being drunk, which no doubt helped with the pain, the human pinata was amazingly alert and oriented.

One of the cops asked the patient if he knew who hit him. When he named his assailant the officer then asked if that wasn't the guy that the victim had stabbed in the hand the previous week. I guess these guys have a history. Maybe next time I work an OT shift at station 3 they'll have upped the ante a little. Medics love trauma.

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