A call came out today for a fall with injuries. Dispatch also let us know that our patient was unconscious. We arrived on scene just in time to see Engine 95 start breathing for the patient with a BVM (bag valve mask). The patient was found laying on his back next to a brick planter on the grass. There was a ladder leading to the roof where he was painting about 14 feet up. We quickly c-spined the patient and loaded him up. He had a normal sinus rhythm on the monitor at 84 (without ectopy for all you medical buffs) and his sugar was 117. His initial blood pressure was 198/p. After several minutes of rescue breathing he started to breathe on his own so we put him on an oxygen mask. The only trauma that we could see was an abrasion to the left cheek and another to the lateral portion of the thigh.
With the lack of serious trauma we began to think that he may have had a medical problem that preceded the fall. As he started to come around we noted that there was no movement of the left leg and that his grips were weaker on the left side. By the time that we got him to the trauma center his blood pressure was up to 220/120. He was able to squeeze with his right hand and that was about it. Our theory was that he felt himself start to stroked out and climbed down to the ladder to the grass where he fell and scraped his arm and leg on the planter. We are going to try to follow up but sometimes we never get a chance to find out exactly what went wrong. One thing that went right for the patient was the response time. It only took 24 minutes from the time that someone called 911 to the patient being seen by a doctor at the trauma center.
Friday, August 10, 2007
King Drew Closes
Just a couple of days after my tirade we got word at work that MLK (King Drew Medical Center) was going to close. On the Redinet (a computer program that lets us know the status of area hospitals such as closed to ALS runs, or closed to trauma runs) MLK posted themselves as closed to internal disaster. This means that they are closed to all ambulance traffic with no exceptions. They are doing this so that they can start to close the hospital without more patients coming in. I don't know hat they are planning to do with the walk-in patients. The downside is that it will be a little bit busier at other local hospitals.
Wednesday, August 8, 2007
King Harbor Medical Center
Formerly known as King Drew Medical Center and still known in EMS as killer king, King Harbor Medical Center uses surprisingly out of date equipment for a trauma center.
We picked up a patient today from King Harbor Medical Center ER that had two IVs. The amazing part was that the IV locks and tubing were the old school type that require you to use needles around the patient whenever you administer a drug. This creates a much larger chance of an accidental needle stick for the health care professional. The sad part is that because the rest of the county has switched over to the needless system the patient, upon arriving at the hospital she was going to be staying at for observation, the first thing they were going to do is discontinue the old IVs and start new ones. The poor patient ad to be stuck again because King Harbor Medical Center is behind the times.
We picked up a patient today from King Harbor Medical Center ER that had two IVs. The amazing part was that the IV locks and tubing were the old school type that require you to use needles around the patient whenever you administer a drug. This creates a much larger chance of an accidental needle stick for the health care professional. The sad part is that because the rest of the county has switched over to the needless system the patient, upon arriving at the hospital she was going to be staying at for observation, the first thing they were going to do is discontinue the old IVs and start new ones. The poor patient ad to be stuck again because King Harbor Medical Center is behind the times.
Tuesday, August 7, 2007
When it rains....
Today the flavor of the day for EMS calls was what we call in Los Angeles county an EH. EH is the abbreviation used on the county run form to indicate a person that is having behavioral problems. It could be a psych patient or drunk, a nut or a depressed person.
Our first patient came the closest to being a real call. It was for an elderly woman with supposed shortness of breath. In reality she was more worried about where her husband was, how he was going to get to the hospital, who was going to lock the door, etc. These sound like legitimate concerns from an elderly person but when you are flat out panicky about them there are issues. I did hold her hand all the way to the ER and that seemed to make it all better.
Our second patient just wanted to get out of work so he hyperventilated causing his fingers to go all tingly (yes that is a medical term). Amazing how he felt better once he got away from work.
The last one was a whopper. He was a 34 year old male that showed up at a doctors office (not his) with lacerations all over his arms and head (problem #1). His systolic blood pressure was in the low 80's (problem #2). He admitted to us that he drank a 12 pack of beer (problem #3). Because of this and the head injury he was a little altered (he didn't know what month we were in) (problem #4). He was a diabetic that was not keeping track of his blood sugar and so when we checked it his sugar was almost 400 (problem #5). So it turns out he needed a little insulin, some stitches, some IV fluids, and AA to make him whole.
Our first patient came the closest to being a real call. It was for an elderly woman with supposed shortness of breath. In reality she was more worried about where her husband was, how he was going to get to the hospital, who was going to lock the door, etc. These sound like legitimate concerns from an elderly person but when you are flat out panicky about them there are issues. I did hold her hand all the way to the ER and that seemed to make it all better.
Our second patient just wanted to get out of work so he hyperventilated causing his fingers to go all tingly (yes that is a medical term). Amazing how he felt better once he got away from work.
The last one was a whopper. He was a 34 year old male that showed up at a doctors office (not his) with lacerations all over his arms and head (problem #1). His systolic blood pressure was in the low 80's (problem #2). He admitted to us that he drank a 12 pack of beer (problem #3). Because of this and the head injury he was a little altered (he didn't know what month we were in) (problem #4). He was a diabetic that was not keeping track of his blood sugar and so when we checked it his sugar was almost 400 (problem #5). So it turns out he needed a little insulin, some stitches, some IV fluids, and AA to make him whole.
Friday, August 3, 2007
Can you send another unit?
This didn't happen to me but to one of the other crews at work. The crew had just found the address and was doing a three point turn so that they would be facing the right direction to get to the hospital. As they were in the middle of the turn (blocking the street) the drive shaft to the ambulance came off and started to roll away. A rather distressed EMT called into the office asking if we could send another unit. This story just makes me laugh.
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