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Last evening I was riding as an observer in an ambulance on the way to Keene, NH. It was a quiet ride; the patient was not in bad shape, mostly upset, and we were just driving along without lights or sirens. The primary caregiver was a grizzled old EMT-Intermediate. He was getting some additonal patient history on the twenty minute ride; the patient's condition did not require any active interventions other than monitoring vital signs. The EMT-I noticed that the patient had really cold hands, so he pulled a chemical heat pack out of one of the cabinets. He had a quick look at the instructions... Squeeze to pop the inner bag, shake to mix the contents... Then took the heat pack and squeezed it tightly. He hadn't read the instructions closely enough to realize that he was only supposed to squeeze the top half of the bag. The outer bag popped and erupted some watery (hopefully non-toxic) chemical all over the inside of the rig. The EMT-I was soaked from hat to pants. The patient's jacket was wet, I was wet, and even the driver had been sprayed through the little window. There was heat pack stuff everywhere. It was dripping off the ceiling. It was running across the floor. The patient care report was soaked. It seemed like way more fluid than could possibly be in the bag had come out of it, all at once.

Our patient laughed. I was reminded of 'Curious George Goes to the Hospital', where George makes a horrible mess but manages to raise the spirits of sad Betsy.

The EMT-I made me trade places with him... He said he needed to make a radio call, but I think he just didn't want to be sitting on the wet spot under the dripping ceiling. It did gave me the opportunity to practice taking vitals in a moving, noisy truck, and I was already wet, so I guess it was okay.

After we turned over care to the emergency department, the (still wet) EMT-I took me aside and told me sternly, "No one finds out about the heat pack. No one." He had that look in his eye.



( 2 comments — Leave a comment )
Oct. 30th, 2003 04:11 pm (UTC)
This sounds dangerous. As someone who used to work for a medical consumer advocacy group, I think that this incident should be reported. The exploding bag could happen to anyone in a crisis situation, and had the patient had open wounds/eyes/mouth affected, it could have been ugly.

If you don't want to get the EMT-I involved, you can pass the info to me and I'll pass it on to the proper agency.
Oct. 30th, 2003 04:51 pm (UTC)
I'm not sure what brand the heat pack was. To be honest, I was surprised at the force the thing exploded with. Certainly it could have posed a real danger, regardless of the toxicity of the chemical, if we'd had a defibrillator on the patient. Of course, we wouldn't have been treating the patient's cold paws. I've seen heat packs used to warm IV drip bags, though, so I guess you really don't know how stressful the scene might be be when you're employing a heat bag.

I'll get the brand name and model number of the heat back the next time I'm down there.
( 2 comments — Leave a comment )


Bjamexza Q. Pyndejo / James O. Payne, Jr.
Bxiie Q. Pyndejo

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