15 July 2006

Angel of Death

First call was for a person with shortness of breath. We got on scene and the nursing home forgot to mention that he was normally A+Ox1 and combative and now he isn't. He was extremely lethargic. His blood pressure was pretty low. He was breathing erratically. Great. And they though we were going to transport to a hospital 13 miles away. Ha.

We got him loaded in the ambulance, did our normal routine, and headed towards the hospital (the closest). His SPO2 was about 94% on a NRB. I can deal with that. Unfortunately, they didn't stay that way. We were about 4 blocks from the hospital when he started to circle the drain. His sats dropped steadily- 88....82....79....76...71...yeah. Fantastic. I ended up having to bag him the rest of the way, and his sats would still only raise into the 80s. He had no history of cardiac or respiratory problems, and he was a full code. I called the hospital when we were about a block away with an update. It was a good call though. I was surprised that he hadn't coded yet when we left the ER.

Next call was a burn and return. (Radiation therapy). It was a BLS call, which should have been easy. Not today. The guy had lung cancer that was pretty advanced. His vitals were stable when we took them on the floor. We headed towards the clinic where he gets radiation and my partner asked me to pull over. His blood pressure had dropped to 80 systolic. We took it again and got about the same number. We called tele and told them what was going on. They just had us access his pic line and give him a fluid challenge. It worked. We continued on our way. His pressure continued to fluctuate while we had him. I think we gave him about 500cc of fluid.

We did a psych transport for a teen with depression. She was a real piece of work.

Next call was for a possible CVA. The nursing home was 20 miles away. These are the calls that I wonder why the nurse didn't just call 911. We figured out why when we got there. The guy had facial drooping and weakness. It started two days ago. Nice. His blood pressure was low, he was minimally responsive, and had all the signs of a CVA. No clot busters for him.

We also did an ALS transfer for a lady with swelling that had gastric bypass in the beginning of July, and is now swollen and leaking excessive fluid from the drains in her abdomen. We took her all the way to Chicago. I think we got back to quarters around 0430. Grrr.

A busy shift. I actually felt like a medic for once, and not a taxi driver.


Blogger Aucklandir said...

Great shift - I love your oncology nickname 'burn and return'haha we used to call them the ovens!

I know sometimes you just feel like a glorified taxi driver but dont forget those semi-well patients you transposrt can be a great education as well.

Great Blogg


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