For Another

A nursing home person with slightly altered mental status. History of a UTI. Routine transport.

An elderly man at a senior center passed out. Hot, diaphoretic, wakes up, vomits bile. Is alert as is his norm as a mentally disabled patient. Vitals, 12 lead -- all normal. he vomits some more at the hospital while we wait in triage.

Last call is at a nursing home for difficulty breathing. We find an Alzheimer's patient in a wheelchair, who has aspirated -- thrown up while being fed, and then swallowed the vomit into her lungs. We have just approached the patient when the nurses say, no they just spoke with the doctor and they are canceling the call. The patient is a DNR, and since her vitals are good and her SAT is 96%, they don't want her to go. "She looks like she needs to be suctioned," I say.

"We'll take care of it," the nurse says. "The doctor doesn't want her to go."

We leave, but we'll be back -- if not for that patient, then for another.