Qualified?

We were responding for a patient having "diabetic problems." While this can mean that they have elevated blood sugar levels it almost always means the opposite.

We were met at the front door by an elderly woman. She was a hoverer. You know, the type of person that hovers around you looking over your shoulder. To make matters worse, she was a nurse.

As she led us down the hallway to the bedroom she gave us a good report. She had last seen her husband a couple of hours before when he went down for a nap. He had had a good breakfast and they checked his sugar afterward. When she found him cool, clammy and unresponsive she knew immediately that his glucose levels had dropped.

While we continued with our assessment AMR showed up. I heard the wife in the background saying that the only place to get an IV was in his thumb. The problem was that the thumb in question was not really accessible in the position he was in. That and the vein really wasn't that good.

While the AMR medic went for a line in his right hand I went for one in the left. Wouldn't you know it, just as I advance the catheter the unresponsive patient jerks his arm. I committed a rookie mistake and wasn't ready for it. I lost the vein.

The AMR medic glanced up at the patients neck. He had great jugular veins, just like the one in the picture. I stabilized the head while she went in with an 18 gauge needle. Then the old RN started in on us again. "You're going for the jugular? What are the qualifications of the person doing that?"

We assured her that we watched the training video at least twice and that her husband was in good hands. The AMR medic then started the IV. We taped the line down and started administering some dextrose. Within a few minutes my patient was having a conversation with us and was being told not to move his neck too much.

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.