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Monday, July 29, 2013

Frequent Flyers Have Actual Emergencies Too

We have a household in our jurisdiction that is a hive of frequent flyers. It's an elderly couple and their son all of whom have medical problems. We respond for a variety of reasons, most of which are legit.


Last week we heard the computerized voice say their now familiar address. At that point we play a guessing game: Him, him or her? This time it was her. Our update from dispatch informed us that the mother wasn't acting right, possible drug overdose.

Hmmm. That didn't seem like her and this wasn't one of the usual reasons we get called.

We arrived to find Mrs. Smith laying on the bed. She was alert and talking....sort of. I asked her if she was in pain and she said, "Yes." I asked what hurt and she said, "My bathroom hurts."

Bummer.

I asked her a few more questions and she was able to get out about 75% of the answer. The other 25% was either the wrong word as in the case with her 'bathroom' hurting or just unintelligible gibberish. We checked her grips, pushes and pulls which were all equal. We also had her go through the Cincinnati Prehospital Stroke Scale. She passed with no problem.

Unfortunately for my patient she appeared to be having a stroke. One in which the speech center of the brain (Broca's area). This caused her to have expressive aphasia. This means she was unable to talk (or write) normally. There is also receptive aphasia in which a patient can not understand what is being said by others. 

Before AMR showed up we had placed the patient on oxygen to keep her O2 sats above 95%. We did a blood sugar check and had an IV going. The EKG was normal and we were just setting up to do a 12 lead when the ambulance arrived. We gave them a quick run down on the situation and they transported the woman to the stroke center.


********************

The following week at work we were toned out to the same address (I did mention that they're frequent flyers right?). My patient was back to normal. This time she was experiencing a migraine. While waiting for the ambulance I asked her about the stroke. She said that she had been diagnosed with a TIA and had spent 3 days in the hospital. She had woken up on day 2 and had no idea where she was or how she got there. She also had no recollection of me coming to talk to her.

She dodged a bullet....for now.



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