Cold Pizza

I worked a 16 in the suburb. A 16 can be great on a Saturday, but today we were busy at least early on. Started off with an MVA where we took a mother and a daughter to the hospital with neck and back pain. They were struck from behind at a low speed and did not appear to be too injured.

Then we did back to back nursing home pneumonias – both pretty severe. One patient had COPD. She was SATTING at 88% on a cannula at 2 lpm. Her temp was 103. Her respiratory rate was 60. I put her on the capnography and she was rebreathing, meaning she was breathing in before she was done exhaling. Her capnometer was 20, which is low. I put her on a nonrebreather at 15 lpm. Her SAT went up to 99%. Her respiratory rate went down to 36. Her wave form leveled off, and her capnometer went up to 32, close to normal. Then after about ten minutes, I tried to put her back down on a cannula –same thing happened – she went back into a higher respiratory rate with rebreathing, declining SAT, and declining capnometer. At the hospital the nurse said she was getting too much 02. I told her how I had tried to wean her down, showed her the capnography waves and numbers and made a remark about the hypoxic drive being more theory than clinical experience. She said maybe she would try her on a vented mask. Worth a try, I said. When I came back two hours later, she was still on a mask.

We checked out a prisoner with a bruised arm and took a man bleeding from his dialysis shunt to the hospital, even though the bleeding had stopped.

Doesn’t sound like a lot of calls, but all back to back, particularly when you had an uneaten large pepperoni, sausage and onion pizza in the front during two of them, it seemed like a lot.

The night ended quiet.