Monday, August 22, 2005

Or Vice Versa

Called for seizures at a nursing home and found a woman having a partial seizure. She was alert and oriented, but the right side of her body was twitching. It had been going on for almost forty minutes. She said she'd been having these episodes lately, but they usually stopped after fifteen minutes. This one didn't stop, so she called a nurse. There was nothing in her records about having seizures. I gave a miligram of Ativan and stopped the seizures. She slept most of the way to the hospital.

One of my small pet peeves these days is how equipment doesn't all work together. In an effort to make our gear safer, we are using retracting syringes. The problem is Ativan is very viscous -- nearly impossible to draw up through a 25 gauge or even a 23 gauge needle. We used to take the little needle off the syringe and attach a 20 or an 18. Can't do it now. The retracting needles don't come off. Today I drew up the Ativan with a 5 cc syringe. Our Ativan comes 2 mg in 1 cc. So I had to draw up a 1/2 cc, which is a little more difficult with a 5 cc syringe than with the proper 1 cc syringe.

I had to change narcs at the pharmacy. They have a buzzer you have to ring to get them to come to the window to help you. Next to the buzzer is a sign that reads "One buzz will get you service, two or three might not." Well, I buzzed once, was ignored. Buzzed twice. No deal. Three times. No luck. These are all at five minute intervals. There are people in there. Maybe they all assume someone else is helping me. The fourth time finally does it. A cheery pharmacist helps me. While waiting I was thinking about vandalizing the note, writing something like "Or Vice Versa." But there is a hidden camera in the hallway down there, hidden in one of those casino style round domes that hang down from the cieling. They probably would have no sense of humor if they caught me on tape. I'm thinking about maybe writing a note, palming it with tape on it, and going down and leaning against the wall very casually and sticking it there.

***

Got called for an unresponsive at a nursing home and found a elderly Down's patient, who had passed out, and had no blood pressure or pulse for awhile, but then was now back at her norm, except her pulse was a little slow. While they are telling us this the patient is passing her bowells. She had according to the aide, who changed her diaper, a "humongous BM."

Our guess was she vagaled out while trying to go earlier.

***

Did two refusals -- a 13-year old with a bee-sting and a 16-year old with a small cut on her palm. We waited over forty minutes for the first patient's mom to show up. The second patient's mom I talked to on the phone and got a refusal that way. The girl was at work and was planning to continue working. The mom said she would come get her in a while.

That was the day.