Stroke

I spend the morning downloading more of the new AHA material.

There are three publications:

View the C2005 International Consensus on CPR and ECC Science with Treatment Recommendations

View the 2005 AHA Guidelines for CPR and ECC

Currents 2005 Highlights

***

First call is for a possible stroke. An old woman meets us at the door and says, "You need to take him to the hospital. He ain't right. He's slurring his words, and he had a stroke, and I can't take care of him like this. Something's wrong. Something's wrong with him."

As so often happens, I begin to get a sense of deja veu. As I walk up the stairs to the second floor, I know I have been in this house before. I remember the woman and her husband and how they were always fighting. She always wanted him to go to the hospital and he never wanted to go.

I find a man on the bed, watching cartoons. He is alert, but slurring his words slightly. He says something I can't really understand about the strangeness on the TV. I check his neuros out and they are good as he tells me he is fine and doesn't need to go to the hospital. I ask him if he has been drinking. He denies it.

"Why did your wife call us?" I ask.

"My wife?" he says, "She's my mother."

I apologize, and then say I remember coming here for her husband, and how they were always fighting about him going.

"I moved in when he was sick," he says, "Now she and I go at it."

He's a diabetic and I check his sugar. It's 46.

I give him some Dextrose, and his speech is much improved.

I try to tell the mother that the son is fine now. He just needs to eat more.

She will have none of it. "You got to take him to the hospital," his mother says. "I can't take care of him. It's hard. It's hard on me. He ain't right in the head. You got to take him out of here. I can't go on like this," she says. "Always looking after him. It's hard. It's hard."

The words echo through time.

"I have become my father," the man says.

***

Get back to the base and its that annual time of the year to try to get Red Sox tickets. I stay at the computer and battle the rest of Red Sox world as we all try to get through. I know a few tricks and by opening more and more windows, increase my odds 35 fold which is the number of windows I have open into what is called the Virtual Waiting Room. Rather than taking people on a first come first serve basis, everyone is dumped in a giant vat and are grabbed by random. Within ten minutes I get a chance for an early single game ticket and get two box seats to a May game against Texas between home and first base. But the real jewel the opening day Sox Pack -- a four game package, which is the only way to get an opening day ticket-- packaged with three less desirable games -- takes awhile. I go on a call and come back, and I am still in 37 waiting rooms. I open up a few more windows, then suddenly I am in, and the tickets are bought. I am going to opening day. Crappy seats deep in right field, seats I will not be able to fit into because they are so cramped, but at least I will be there -- in the Park on Opening Day.

***

We get called for a stroke at a local store. We find a man sitting in a chair, looking quite comfortable. It seems he has had a cold recently, went to the doctor on Thursday who gave him an anti-biotic, and then did an ECG, which revealed afib. The doctor started him on coumadin. He mentioned to his wife that he was feeling dizzy, she freaked. Called his MD, who told her to take him to the ER. She dialed 911. He has no neuro deficits, good vitals, not even feeling dizzy. We work him up, take him non-priority to the ER, where a neurologist and the man's heart doctor are there waiting, and they start interviewing him before we even have him off the stretcher. before the nurse is even over to get the report, the doctor is telling the man he will admit him for monitoring, even though he thinks this episode if benign.

I am guessing that this man is some kind of VIP to get such treatment. Anyone else had a similar episode and they could be in the ED all day.

***

We do a stroke at a nursing home, right sided paralysis, slurred speech, gaze to the left. Problem is no one knows the onset time.

***

Get called for a stroke again. Go to a nice house in the hill section of town where there is a Christmas party going on. Woman felt hot and fainted. We check her out. She doesn't want to go. They offer us food and drink and good cheer. We decline politely and head back to the base.