Out of Here

Get woken from a sound sleep for insulin shock at a nursing home. The patient just got out of the hospital following a stay for increasing edema throughout her body and increasing dementia. They have already given her 2 milligrams of glucagon with no effect. She is cold and clammy with junky lungs and drool in her mouth. Her blood sugar is laess than 20. On the paperwork they give me she has a list of 15 diagnoses. She is also a full code -- take all heroic measures.

I get an IV in her arm and give her 25 grams of D50. She wakes up and starts thrashing. The IV line comes loose and blood flows out until I can refasten it. I end up giving her almost another amp.

She is alert for her now which is a state of complete dementia, where she makes a fist and tries to punch me and talks like a two year old. When I am not looking she grabs my skin hard and pinches me. I yell at her to cut it out. We're in the ambulance now headed to the hospital. Her lungs still sound junky and she is wheezing, but her saturation is okay and she doesn't appear in too much distress. I try to put the oxygen that she has torn off, back on her, but she tears it off again.

This is probably about the fourth time I have transported her. I remember the snarled lip, the clenched fist held out ready to punch like an archer with bow drawn.

She trys to get loose from the straps.

"Where are you going to go?" I say. "Where are you trying to get too?"

Anywhere -- out of here.