Why We Wear What We Wear

(You like the nice alliteration in the title?) This is a news story from CBS 5 News in AZ about a firefighter getting burned. I hope he recovers quickly.

http://www.kpho.com/video/21300180/

Fast Food Frenzy

We were simultaneously toned out with station 1 for EMS calls at fast food restaurants. They went to Taco Bell while we headed to McDonald's (I found out later that both calls were for the same thing...funny how that happens).

We were dispatched for a man having a seizure. It's amazing to me how rarely we get to a call like this and find the patient actually having a seizure. This time was no exception. When we arrived on scene, PD already there (maybe for a late breakfast??), we found our patient laying on the bench seat of one of the tables. He was a 17 year old "kid" that was there having breakfast with his dad. The father noticed his son having a seizure so he quickly grabbed him and lay him down. Up till now I'm thinking so far so good...easy call. The dad then informs me that his son has Autism and doesn't speak. The son does however understand things fairly well. This proved to be overly optimistic. As I checked on my patient I found that he was acting normally (I had to check with the father about this). My patient was very skittish at first and didn't like us trying to check out his vitals. After talking to him for a little bit and with his dad's help we were able to check him out. He even let me prick his finger to check his blood sugar, which came back a little low (seizure activity can use up sugar stores in the blood leaving the person with low blood sugar levels). Once again with dad's help we had our patient suck down some glucose paste (no it doesn't taste as good as it sounds). The dad also informed us that this is the second time in as many weeks that his son has had siezures. His son is currently undergoing tests to try to figure out why they suddenly started. My patient has no other medical history, no allergies, and is taking no medications. When we have the AMR crew bring over the gurney to take him to the hospital my patient flips out and makes a break for it. He pushes right past me, swims past my Captain and tries to get by the other firefighter, where he was stopped. After about a minute the father was able to calm his son down. My patient would flip out at the first sign that we were trying to get him into the ambulance.

Now here's my question to my readers. What would you do to get your patient to the hospital? You have all kinds of resources, drugs, cops, ambulance, fire engine, restraints and probably some that I never thought of. What would you do, for your patient, to make sure he got the evaluation at the hospital he needs (the father completely agrees that his son needs to be seen in the ER and, for the sake of this question, is willing to go along with whatever you come up with)?

On a side note, the crew from station 1 had transient that had a seizure and was very noncooperative. Funny how many similarities there were.

I'm Not a Drunk, I'm Just Stupid

We got toned out about 8 in the evening for a teen with ALOC. When we got there we were let in the house by the parents. The 14 year old came into the front room really amped up, pacing and talking fast. He said that he was walking on the park when a white guy came up and offered him a drink of something that looked like apple juice. He then changed the story subtly and said that he was offered a "shot" of something like apple juice. The story was then altered one more time. He said he was offered a "chunk" of what he thought was apple juice. My patient then quickly added that he didn't want his parents to know because he didn't want them to think he was a drunk (my thought, "Yeah, right. It's much better that your parents think your a blithering idiot for taking "chunks" from strangers in the park."). Everything checked out on my patient except his heart rate, which was cranking along at 145 beats a minute. at one point my patient startd talking in Spanish to his parents. The other firefighter I work with flash me a knowing look. I'm fluent in Spanish so I just eaves dropped on the conversation to see if his story stayed the same. It did. After calming him down we sent him to the hospital.

Since the was the second patient with similar presentation (a little amped up with a fast heart rate but no other medical complaint) in a month we followed up. We were informed that Kaiser diagnosed him with acute alcohol ingestion and nothing else. I think either the kid had something else in his "chunk" or Kaiser didn't want to test him for anything else and went with the simplest of explanations.

More Ambien Please

We were toned out for an auto accident with PD on scene. Upon our arrival we found an SUV in the parking lot of a strip mall. PD had the woman standing next to her vehicle. I asked what the story was and was informed that she had been driving erratically and was followed by a city employee while on the phone with 911. As my patient tried to turn into the parking lot she hit a small tree, knocking it over. My patient was clearly not operating on all cylinders so we did some checking. All her vitals were normal. Blood sugar levels were fine. Patient had no real medical complaint. She was able to answer all of our questions but very slowly. PD had grabbed her prescription medication out of her purse and handed them to me. She had filled a prescription for 30 Ambien the day before and was down to two. I wasn't sure what an overdose on Ambien would look like so I decided to call poison control. The MD on the phone said that it would just make her really out of it like having too much valium.

He also said that she did need to go to the ER. We finished up our asssessment and handed off patient care to AMR.

Twisted Ankles, Twisted Paramedics

We get toned out at about 2300 for an ankle injury. Thankfully I was not yet asleep. I'm embarrassed to admit that when we get a call like this my first response is usually to grumble that the person is calling 911 for a twisted ankle. It's hard when I know people that refuse to call 911 when they amputate a body part to think that the person with a broken ankle really needs me. Once we arrived on scene we were greeted by the husband who said that his wife had tripped and fallen down the two steps to the living room and they couldn't get her up. He was embarrassed to have to call us.

We quickly did an assessment and found that she had no other apparent injuries other than the ankle. While we worked on her ankle, the couple told us that they were watching "Nurse Jackie" and laughed that they now had to have their own encounter with emergency medicine. We joked around as we splinted her leg with a vacuum splint and put an ice pack on her ankle. I offered her some morphine but she declined. Our patient was one of the nicest patients I've ever run a call on. That's what makes the arrival of the AMR unit so bad. Some people in the EMS field are burnt out and should get out. They hate their job. the medic that showed up showed all the signs of being one of these people. So we had to load up our nice patient into the back of the ambulance with one of the grumpiest medics I've ever met. Afterward the husband made it a point to come shake all of our hands and thank us for being there.