Helping The Old Lady Cross The Road

We pulled up to the intersection and saw a PD unit sitting in the gas station. Almost before we could set the air brake on the truck officer was excitedly telling us what was going on. He had an elderly female that was lost and possibly altered. He also wanted to scoot because there was a home invasion in process and he wanted to be part of that action. I assume that that would be the police equivalent of a structure fire. We told him we were good and he tore out off down the street.

We turned our attention to Agnes. Agnes had left her home to go out and do something. What it was we would never find out. She couldn't remember. She had since become lost and flustered. The more questions we asked the more she would get anxious she would get.

Agnes just lived over the bridge (and through the woods?) but we didn't feel that it would be a good decision to let her drive herself home. We managed to get the phone numbers of her children and my captain started making phone calls. My engineer and I kept making small talk with the old lady trying to place her at ease.

Eventually my captain was able to talk to the son that lived about 30 minutes away. He was asked to come get his mother. We didn't want to leave Agnes sitting at a gas station by herself so we decided to take her back to the station. I chauffeured Agnes in her mid 80's Honda back to the station.

Back in quarters we figured that she must be hungry. She had apparently been lost for quite a while. So we headed upstairs and warmed her up a plate of leftovers and dished her up a side salad. Over the next 45 minutes we got to know Agnes. She regaled us with stories of her late husband, her kids and grandchildren.

Finally her son arrived. We talked for a few more minutes. We offered ice cream but it was refused. It was decided that he would leave her car parked behind the station for a day or two until he could get someone the help him shuttle it back to the house. He thanked us and took Agnes home.

Just Knock Louder

When the tones got me up at 0230 I instantly knew that I was going to have a hard time going back to sleep. There are times when I wake up and my body thinks that I've slept enough when I clearly haven't. This was one of those time.

When we pulled up to the apartment building we noticed a young man behind the closed parking lot security gate. He said he was trying to open it for us but couldn't. As we made our way to the back of the large complex he informed us that he had been trying for several hours to get a hold of his mother. She had called him earlier in the day and asked him to come over but now wouldn't answer her phone or the door. Although he had heard her moaning a couple of times when he knocked loudly.

We stood on the 3 floor in front of my patients apartment and knocked. No answer. Her son was now getting very anxious and was starting to get in the way so I sent him to look for AMR. We discussed our options and decided to force the door. I then realized it was a steel door in a steel frame. At least the walls weren't concrete.

Instead of just making the long trek back to the rig to grab the irons so we could "properly" force the door I decided to give it a couple of good kicks to see if that might just do the trick. After the first kick I knew it wasn't going to give but I gave it a second one anyways. Mostly out of frustration. then, from behind the door, we were yelled at by our patient. "Don't break down my door!!"

I guess the son just needed to knock a little louder.

We announced ourselves as members of the fire department and asked her to come unlock the door. As we stepped inside I could hear my engineer apologize to the neighbors for all the noise.

My patient was alert and oriented but slow in answering questions. She admitted that every time she fell asleep she felt as if it were a deeper and deeper sleep. Thankfully she was willing to go in and get checked out because it was obvious that there was something wrong. Hopefully it all gets figured out and we don't have to go back.

When Snoring Really Isn't Good

0200. The lights clicked on and the speakers came to life. "Engine 51, medical aid...." I slipped out of bed and made my way toward the apparatus bay. I donned my bunker pants and slid into my seat, still trying to shake the cobwebs from my mind.

Arriving on scene we found our patient laying in bed. His wife told us that she called when she couldn't wake him up. The first thing to pop into my mind was that his blood sugar was low. It's always the sugar. My patient was breathing but his tongue was partially occluding his airway causing him to snore. I think that's what woke his wife up in the first place.

While I dealt with his partial airway obstruction my engineer grabbed the glucometer. The guys blood sugar was 35. Told you it's always the sugar.

I reached into the drug box and grabbed an IV start kit. My engineer spiked my IV bag and had it waiting for me when I needed it. While I was taping down my IV AMR showed up so I told them we had a hypoglycemic patient. The medic, trying to be helpful I'm sure, stepped up to the bedside. In doing so he managed to come between me and my drug box.

I asked the medic if he would grab the dextrose for me since he was in the way. After cleaning up the trash from my IV start (I had time since I assumed the AMR medic was taking care of the low blood sugar) I Reassessed my patient to see if he was coming around. He wasn't. It was about this point that I noticed the box for the pediatric dosage of dextrose on the bed.

I asked the medic if that's what he administered. He said yes. I then asked again if he gave D25 to the elderly gentleman. Again, an affirmative response. Since he wasn't getting my point I simply asked my engineer for the other dose of D25. Then the AMR medic realized what he had done and apologized. I can only assume that he was tired too. It was after 0200.

With the second dose of sugar on board the patient started to come around. He was still confused but he was improving. We helped AMR get him to the rig and cleaned up the rest of our mess. Time to head back to the barn.

Dazed And Confused

We were dispatched for an 88 year old man that was altered. We pulled out of the station into the damp, foggy morning and hit the growler, it's sound instantly bringing a smile to my face. Traffic pulled out of our way, some, because they were obeying the law, and others, because they were a lot smaller and less intimidating than a fire engine tearing down the street with lights and siren blazing.

We were met at the door by the wife of our patient. She said that her husband hadn't been acting right all morning. While my captain started talking to her I started talking to the husband. He knew his name and where he was but didn't know what day it was. To be fair, neither did I. He said that he was feeling 100% and that he didn't know why we were there. All of his vitals were good. His blood sugar was 154.

The Mrs. of the house told us her husbands medical history, which was lacking on thing that I thought would be on there, dementia. Finally after some more questioning the wife related a story that took place several months ago that ended with her husband in the hospital with a diagnosis of dementia.

I have no problem going out to the homes of people with dementia. It's a horrible disease. But I think the medical community as a while needs to be better at explaining the disease and it's probably progress. I got the impression on this call (and many like it) that the family members have no clue as to what to expect as dementia gets worse.

For more information on dementia click here.

Miscommunication

We were dispatched for a man feeling ill. The RP was a home health care nurse that stated her patient had a low temperature. Yeah, I was suspect too.

We walked in the house and found an old man laying in a hospital bed in the front room. It was probably the only place they had that would fit the bed without some major rearrangement of furniture. At the head of the bed stood the wife of the patient. She appeared very concerned. At his bedside, the "nurse" (I'm not sure if she is an CNA, LVN or RN).

The home health care worker, as I will refer to her, informed us that the patient had a temperature of 94º F. I quickly placed my hand on the patient's head to see how he felt. He felt like someone with a normal temperature.

The worker then informed us that his blood pressure was low, 94/52. I again touched the patient. This time I checked for a radial pulse, which I easily found. Nice and strong.

While we were getting a proper BP the worker then explained that my patient was altered (our BP was 142/82 by the way). Knowing that that phrase can mean something totally different to someone that doesn't practice emergency medicine I asked for clarification (also because he seemed to be acting normal to me). I was informed that the patient had not been responsive for the last 30 minutes of the 90 minute visit. I then asked the nurse how well she knew the patient and she said this was her first visit.

At this point I turned to the wife and talked to her. The home health "professional" was useless. His wife said that he appeared to be tired. The nurse kept interjecting that she was worried about sepsis. Every time I acknowledged her concerns but she didn't get that (there was a major language barrier).

About then AMR showed up. The CNA/LVN/RN told the AMR medic that the patient was altered. He looked to me for confirmation and didn't get it. The transporting medic was again told that the patient was altered. He looked to me again and I did a quick eye roll. He immediately got the picture. We loaded the gentleman onto the gurney and helped the guys out to the ambulance. After making sure they were all set we headed out.

Worried Kid

We got a call right in the middle of dessert. A young woman was worried about her mother.

Arriving on scene we were met at the curb by a borderline hysterical 15 year old girl. By catching every third word or so we were able to determine that her mom was in the back bedroom of the the apartment and that she wasn't acting right.

Our patient was laying in bed and not very alert. It took repeating every question several times to get something of an answer. At least her vitals were stable.

By the time AMR showed up we were able to piece together that the patient had a history of chronic pain and depression. This night she had taken a little extra medication to dull both.

The daughter was visibly relieved to see her mom getting medical attention. We made sure there was a family friend there to stay with her before we left.