Friday, June 17, 2005

7.5 milligrams/Yucca Root

We get sent for a lady who dislocated her hip. The regional Dispatch EMD tells us to go BLS cold. I rarely ask them questions back, but this time I ask, "Is the person in any pain?" They say the caller is not with the patient. BLS cold.

That just doesn't seem right. Dislocated hips are almost always painful.

We're coming back from another call when this one comes in. It takes us nine minutes to get there going without lights or siren.

The lady is in tears when we arrive. She is 10 out of 10 on the pain scale.

I give her 5 mg of morphine sitting in the car, let it set in a bit, then move her to the stretcher. She is still feeling the pain. In the ambulance, I ask her her weight. 169, she says. I calculate that out so at .1mg/kg I can give her up to 7.5 on standing order rounded off. I give her the additional 2.5. I am excited because this is the first time I have been able to give the higher dose on standing orders since the new protocol when into effect on June 1.

She says she is down to a 7 on the pain scale, but she seems pretty calm now, no longer clenching her teeth. I have found many people say they still have pain after morphine, but often I don't believe it is as severe as they say, beacuse they look pretty darn peaceful compared to how I find them initially. And they talk slowly and have a glazed look in their eyes.

I tell the woman I have given her all I am allowed to give without consulting the doctor. Would she like me to call the doctor to get her some more pain relief. "Wait till the hospital," she whispers.

She even sleeps some on the way to the hospital. It is rush hour and with all the construction downtown and that fact tht we are going to the southern most hospital, it takes awhile to get there. Total transport time is 35 minutes. I gave her the last 2.5 of morphine en route at 4:15. We don't get her to the hospital until 4:47, and then, thanks to a long line at triage, not into the room until almost 5:10.

They want us to put her on an xray frame, but we can't find one. Often if I can't find one, I will move the patient anyway and they can transfer them later when they find one. We normally can't wait. But this woman is starting to feel her pain again, and it will be too hard to move her to the bed, then after lift her up and slid a frame under her. I go back and look again, searching all the supply closets. I find the nurse and ask what he wants me to do. We have to have a frame, he says. No one can find one. They finally send a tech off to a distant section of the ER to find one. In the meantime, the woman is crying again, and moaning, please, please help me. And I am feeling like a bad guy for not taking her pain away.

The thing of it is, I got the regional protocol changed so patient's could get weight appropriate relief faster without having to call medical control, but if the protocol hadn't been changed, after 5 mg, I would have called for an additional 5, and she would have gotten 10 instead of the 7.5. I should have called for more. Then I could proably given her 12.5 and she'd be feeling no pain then. Why was I even asking her if she wanted more. I should have just taken the pain away. Called and gotten the dose needed. Here it is now almost an hour since I gave her the medicine and it is wearing off.

I tell the nurse about her pain coming back, and he goes off, then comes back with a syringe, and shoots her up with more medicine. We finally, get a frame and move her, but she still looks uncomfortable. I'm hoping the fresh medicine will kick in soon.

Bottom line. Just yesterday, I was swearing I would be the man, take their pain away, sell them on the curing powers of my wares. And again, I let them down.

Tomorrow, tomorrow will be different.


Did a lift assist, a canceled call, and a lady with a skin tear that basically took half the skin off her forearm, exposing fat and muscle. Nasty looking.


I was in a bit of a foul mood today. When I get tired, I am easily agitated. I don't know if it is not getting enough sleep or not eating enough. At the lift assist I was abrupt with the woman who just wanted her husband lifted from one wheelchir to another because the first wheel chair had a problem with the wheel. He's heavy, she said. Don't drop him, you'll need the hoyer. You can't do it, by yourself.

"Yes, I can," I said, then snapped at my partner for fumbling with the man's legs when I lifted the man up from under the shoulders. We moved him fine. My partner was sweet with the lady and man. I just went outside to the ambulance and got the glucometer and checked my sugar, I have never had a problem with sugar, but was looking for an answer as to why I had a headache and was crabby.


Nothing wrong with that.

I will tell you those little finger prickers hurt. I would rather have an IV then one of those little bee stings in my finger tip.

I ordered a pepperoni pizza, hoping the fat and carbs would help my brain. The pizza didn't help much. I took a little nap this afternoon, then for dinner ordered take-out from the Hospital's EMS room phone to the Comerio, where I got stewed codfish, root vegetables(Yucca, boiled bananna and plaintain) and tostones. Didn't get to eat them until just now, and didn't start feeling better until I ate the Yucca root.

Yucca Root

Yucca serves as a blood purifier. (Maybe I should try to get Yucca extract added to the EMS formulary.) I feel a little better, but think sleep will probably be what I really need.