"I gotta cat that just goes 'wee-oo'..."
Today I went back to the same house though it took me a while to realize it. The guy had fallen asleep with a heating pad on and had given himself second-degree burns on something like six percent of his body (measurement estimated using the 'rule of palms'). That was last week; now, one of the burns had become infected. I clued into the fact that I knew the guy when I asked him if he was allergic to anything; he said, "White coats." A bit later, he said that he had lost his wife in January; then I was positive that it was him. Sadly, he was onto something when he compared his twitching wife with his late cat.
The guy was very upbeat and funny. He mentioned in passing that he had served in WWII; I asked him where he had been. He had been in the Pacific. I said, "Oh, so you served under MacArthur?" He said, "Yes, but I don't think he realized I was there. If he did, he didn't make a fuss about it."
I find it interesting that only two years into EMS, I can roll up to a house and not remember that I've been there before. I don't think I'm losing my mind (opiate overdose = 0.4 mg naloxone via IV push, repeat up to five times until respiratory drive is stable, titrate to avoid full consciousness, etc., etc.) but it is surprising that the calls all blend together to the exclusion of prior events.
On Friday, I took a 99-year-old female to the hospital on shift with my paid squad. She had fallen in her room at an assisted-care facility. My partner and I took a long time on scene trying to make sense of what had happened. She didn't know why she had fallen. Her shoulder, hip, knee, and head hurt. We were forced to put her in spinal immobilization due to concerns of possible osteoporosis; getting her rolled onto the board was a drag because she was in some pain. Her blood pressure was high.
She had been to the fair with her housemates earlier in the day. On the way to the rig, my partner asked her if she had been on any rides. She giggled and said no. My partner, a surprisingly compassionate early twenty-something male, told her that she struck him as a Tilt-a-Whirl girl. She giggled again. He chatted her up about the fair while I drove the ambulance to the hospital.
Several hours later, we picked her up and returned her to her home. We tucked her into bed and she thanked us as we left.
When we were leaving the ED, we asked why her BP had been high. The ED staff basically said that they had no idea but it was of no consequence. I 'teched' on the way back to her house while my partner drove. I took her vitals for the paperwork and her BP was still way high. Weird.
Last night I went in to work again (I'm planning to work two shifts a week to cover for the people who went with FEMA for 120-day Katrina relief). I was going through the run sheets for the last few days and found that the woman had suffered a severe stroke twelve hours after we dropped her off. This would certainly have been an effect of the high blood pressure. In retrospect, she probably fell as a result of a TIA (transient ischemic attack), a mini-stroke.
I feel really sad about her and really angry about the ED staff. This woman is now much worse off because the ED staff didn't want to deal with her issues. They knew as well as we did that she didn't recall the fall and had no idea what had happened or why.
My friend Mrs. Turquois had something bad happen to her the other day courtesy of a doctor from the same hospital. She was dealing with a football player with a possible spinal. This doctor happened to be on scene and interjected himself into the packaging process. Unbeknownst to Mrs. Turquois, the blithering idiot taped the patient's helmeted head to the stretcher rather than to just the backboard. The EMTs got the guy to the hospital and went to transfer the patient to the bed from the stretcher... The patient was attacted to the stretcher by the head. Not good. Double plus not good; the kid's dad was watching. Hopefully there is no spinal injury that was exacerbated. In any event, Mrs. Turquois feels the whole thing was her fault, that she should have been watching the idiot doctor. I disagree.
In more positive news, on Friday evening I worked my first call 'in back' all by myself; actually, I teched for three calls. The first was the most interesting in a few ways. We picked up a disoriented hypovolemic patient with a history of dementia at her home and took her to a big hospital about forty minutes away. On the way, I put her on the cardiac monitor and 02, checked her blood sugar, monitored vitals every ten minutes, gave her a hot pack and wool blanket for her cold hands, and chatted at her incessantly. My partner later told me (in response to my question about his opinion of my work) that I acted like a fidgety waiter but that the hot pack and blankets I provided were excellent care.
I would have had the opportunity to start three IVs over the course of the night if had my Vermont 'I'. On paper, I was the senior EMT (as an NREMT-I/85 and NH EMT-I) although my partner has more practical experience. I find the guy quite amusing and hope to work with him more in the future. I'm trying to get Friday nights as my normal shift; if that works out, he will be my regular partner.