DNR DEAD

A fall at a nursing home with a probable broken nose.

As we are clearing a distant hospital we hear a call go out for a 97-year old female with severe respiratory distress and no blood pressure. A commercial ambulance is already enroute. We are too far away to respond. When we get closer to town, we hear the other unit go off on scene, then the PD are calling for us to back them up. When we arrive the patient is in the back of the rig. The medic tells me she is a DNR and she just now died. Have a nice trip into the hospital we say. There is nothing for them to do, but put a sheet over her head and drive on it, letting the hospital know with a simple patch. "Patient is DNR who just now died."

I have had that happen to me before. Nursing homes don't like the patients to expire on their beds, so they call us, even though they are DNRs. Some times I have made them call the doctor to see if he is sure he wants us to transport. Sometimes I have had to wait until the patient died. Sometimes they have insisted I take the patient, only to have what happened to the other crew, happen to me. You are the subject of some kidding when you roll through the ER doors and take your place in the triage line. "Your patient doesn't look very good." "Ah, dude, your patient's not breathing." Or better when the triage nurse asks "What have you got?" And you say, "A dead person." What?!

Sent to an MVA but no injuries.

Then a syncope where the old woman just went down at the kitchen sink. She looked grey and hadn't been eating. She'd didn’t want to go, but we were persistent. On the way in, while doing the IV, I put the vacutainer on the end of the catheter, and then got briefly distracted, and then the next thing I knew I felt warm liquid on my pants leg and saw the blood was flowing freely from the catheter. A bit of a mess, not to mention having IV blood stains on my left knee -- the mark of a rookie.

At the hospital I saw one of the ladies from the Spanish restaurant I eat at a lot. At first I couldn't place her, and then it came to me. We chatted a little in Spanish. I wish I got to talk more.

Last call is for Severe ABD pain in a 16 year old. The EMD slows us down to no lights and sirens, but the cop on scene, speeds us back up. The girl has a fever, but everything else is negative except for her occasional dramatic screams. Pulse is 64. BP 110/60. Ab soft. No vomiting or diarrhea. Had her period ten days ago. No trouble urinating. No blood in urine. She is able to walk out to the ambulance, over the snow banks without pain. We bring her in on a stretcher, and are sent from the Main ED to the walk-in section of the ER. They have us put her in the waiting room. As soon as we get her in a wheel chair, she shrieks, and closes her eyes. Her sister fans her. The triage nurse rolls her eyes.