Any Difference

Call comes in for a stroke. We find the woman in her wheelchair attended by her husband and a friend. She is thin frail woman who is alert, but seems to be in pain. The husband says he has had trouble waking her up in the morning, and that she can't sit up straight in the wheelchair, that she stiffens up. Her grips are equal, no slurred speech, but it is hard to understand her because her teeth are gritted together.

Her pressure is 84/40(at least that's what I hear it at), but her hands are warm and she has a history of low blood pressure. She is shaking imperceptibly, but enough that it is hard to get a decent ECG tracing. I listen to her heart and count the beats at 120. I can't get a SAT either, but she doesn't seem in any respiratory distress. She has a history of IDDM, peritoneal diaylsis, and silent MI. She has no IV access, and anything I do causes her pain. Her pain is in her back, in her shoulder, in her feet.

She seems stable enough so we go on a non-priority. I put her on a canuala. The husband, who has not been much help in detailing her history both what happened this morning and her general history follows in his car. When we get to the hospital, he comes in with us. The nurse asks what this is, and as I start to explain, she turns to the husband and starts questioning him. He starts talking and before thirty seconds have passed he has her off on all kinds of tangents, and she is rattling off questions about seizures and strokes and triple As. After saying excuse me a couple times, I finally get her attention enough to have her look at me as I say, "Would you like me to give you a report?" The nurse, who is normally one of the better ones at this hospital, comes to her senses and listens to my story. Bottom line -- the woman has chronic pain and takes diladid at night, which the husband neglected to tell me and I only found out about after much questioning. It seems her pain is chronic, and since there was no pain meds on the list I got from the prescription bottles the husband gave me, I asked her what she took for pain, and she said dilaudid.

It was just a frustrating call. A family that couldn't tell me what was what. A patient who was bothered by everything, and a long bumpy ride to the hospital.

When I was a new medic I could see freaking out due to the husband's story, her blood pressure, my poor ECG strip and no SAT registering. I could be thinking anything from AAA to another MI to just play dying.

And if she was dying, she wasn't dying in the next couple hours or in any amount of time that going lights and sirens would have made any difference in.

***

We do a diabetic with a blood sugar of 34. He wakes right up with D50. It seems the pharmacy gave him a glypizide prescription at twice the normal dose.

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An old woman has a syncopal episode and we take her in.

While we are doing our calls the commercial service comes in to town three times for other emergencies.

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In the afternoon we get called for a cardiac arrest at a nursing home, but then are cancelled and told it was a mistake. I'm guessing they realized the patient was a DNR.

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I'm going out to wash the dirt off the ambulance, and hope that we don't get anymore calls in the next fifty minutes.