Monday, October 31, 2005

Nothing To See Here

Started day off with a dsypnea – old guy with lung CA sitting on his front steps with his oxygen canister. Been having a problem for several days, but he could still talk in full sentences.


Next they sent us on priority to an MCI (mass casualty incident) at a high school in a suburban town we don’t normally respond too. We were the fifth ambulance in. It seems there were some sorts of fumes in the chemistry lab. We got canceled when we arrived. Most of the students were going to be refusals. They felt a little dizzy, I guess. It seems like the majority of MCIs I have been to over the years are at high schools and involve the chemistry lab. They are never anything serious. Some MCI's border on the ridiculous -- at least in terms of anyone who grew up in the 60's. I have several times been called to mercury spills, which involve someone breaking a thermostat and the little ball of mercury coming out. For this they evacuate the school. When I was a kid we used to break the thermometers to play with the cool balls of mercury. On the way up we joked about the scene we would find -- people in space suits all surrounding a little ball of mercury from a small thermometer. I would enter the room, pick up the ball of mercury and swallow it. "Scene's safe now," I would say. "Nothing to see here, nothing to see. Move on." My partner said I would be locked up for twenty years of observation if I did that today.


We get sent on a priority to a nursing home in a distant town for a 91 year old man with dsypnea. We find a man who is a full DNR having long periods of apnea. I look at his W10. He has Alzheimer’s Dementia, severe arthritis pain, and suffers from hallucinations. He is unable to speak due to a stroke. I ask the nurse if she called his doctor. The doctor wants him transported, she says. That’s how the doctor handles these cases. I am watching the man and he looks like he has died. He has frozen with his mouth open and there are no breaths coming out of it. His chest does not move. He looks very grey. I finally put my hand on his forehead. I am about to say, looks like his time has come, when his chest heaves suddenly and he starts to breathe again. I don’t understand the point of the transport. We can’t do anything for the man, but supportive care. We put him on the stretcher and take him in – to a distant hospital we almost never transport too.


Coming back into town, we are sent for a woman punching herself in the head on Main Street. “Maybe she’ll knock herself out,” my partner says. It takes awhile to get there and we find no one in the area. Clear. No patient.


Called for abnormal behavior. Find the police there who tell us about the lover’s quarrel they had to break up. Two Hispanic men in their late teens, early 20’s. One accused the other of cheating on him. Now one of them is threatening suicide. In the apartment foyer there are pictures of a beautiful woman -- many very sexy shots. It is Jennifer Lopez. It is a shrine to her, complete with candles. The one cop can’t understand it. “Why do they have pictures of a chick?” he says. “Are they trying to hide it?” “No, it’s all about the way she dresses,” the other cop says. “It’s about style.” “Yeah, right.” The cop says, “It’s style.”

We take the crying young man to the hospital for evaluation.


Next we are sent to a prison almost on the state line, for an inmate having chest pain yesterday with supposed ECG changes. We have to pass through several gates, all layered with razor wire. The man, in leg and wrist chains, in no distress. His new ECK looks just like an old one. A corrections officer travels with us. It is rush hour and we have to go all the way to a town on the other side of the city, to a suburban hospital where they have a prison ward. A long 26 mile through rush hour trip.

We are just coming back into the city when we hear a car dispatched to a man bleeding from the neck. Shortly after the PD requests a second ambulance. The second car is dispatched. We ask if we can go since we are precepting, but they tell us we are the only car left. It turns out to be a man with multiple stab wounds who is very combative. It takes the second ambulance awhile to reach the scene. They end up requesting orders to sedate the patient so they can contain him enough to transport him. We wish we were at the call. My preceptee who is just short of his required 30 calls could use some more traumas.

We get dispatched to for an unresponsive and find a sixty year old man who has passed out in the kitchen and wacked his head. He has no recollection of the event. I’m guessing he had a syncopal episode due to his bout with the flu, taking percocet and antibiotics and having a drink, then wacked his head and got a concussion.

At the hospital we hear about the stabbing. The medic on it said the guy was cut up so bad, he looked like he had gills.


Our last call is for a maternity. Woman’s third child. Her water broke and she was having contractions, but we got her to L&D on time.

And I punched out on time.