Friday, December 16, 2005

Nitro for Neck pain?

Started the day off with a hypoglycemic diabetic at a nursing home. It was a patient I have done many times before. She is always a tough stick, and while four staff members looked on and tried to hold her still I searched up and down her arms for a vein. I finally found one on her left forearm and slipped in a 24. A beautiful thing seeing the flash. I gave her an amp of D50 and she was back to normal.

What I like about EMS is the performance aspect. At times it like an athletic event. You are called upon to perform in public. You get a hit or you make an out. You get the job done or you don't. You can have a solid hitting streak, but the past never matters, you miss the IV, you've struck out. Its not like you have the Yankee stadium crowd looking on. Four nurses or nurses aides in a home, but getting a tough IV, well, it makes me feel the same as I did when I'd get a basehit in my Sunday softball league a fewe years ago, and all ten people in the stands and your teammates would cheer. The little things in life that make our days special.


We get called to the same doctor's office that has been calling us all the time of late. Man slips on the ice, hits his head, has neck and head pain, calls his doctor, they say, come on in. He goes there. They do an ECG which shows inverted T waves in nearly every lead. Keep in mind the man has no symptoms, but neck and head pain from his fall. They compare the ECG with his old one and decide to give him nitro and baby aspirin and call us. "Why did you give him nitro?" I ask.

"For neck pain with ecg changes," they say.

"Did I hear right that he slipped on the ice and hit his head?"

"Yes, that's why he came in. And we noticed the ECG changes."

"You did two sets of ECGs today and there were changes bewteen the two?"

"There were changes between the two, the new and the old."

The new and the old today or the new one today this year and the old one two years ago."

"Yes, that's right. The old one two years ago."

"Okay, got you."

We c-spine the man because he has cervical spinal tenderness. Out in the ambulance, I look at both ECGs. They are extremely similar. The man had longstanding inverted Ts.

The office never ceases to surprise me.


Last call is a four hundred pound woman at another doctor's office for an X-ray of her hip, he notices that she seems short of breath on exertion and calls us. She is short of breath on exertion. She has a lot of weight to move around.


I am off tomorrow, and am I looking forward to it. I need it. I almost snapped a couple times today, and that is not good. I just kept it inside, but it was brimming toward the surface. A day off will help.