8

Another hot humid energy sucking day. Started off with four straight calls.

A nursing home DNR, dialysis renal failure, MI, CHF, COPD, IDDM, etc, 80 something year old female who they found this morning with facial drop, slurred speech and a BP of 63/30.

Then a 84 year old woman who slipped in the bathroom and broke her hip. You didn't need an x-ray machine know. Unable to move leg, leg shortened and rotated, extremely painful at rest and more so on palpation of the hip. I gave her seven of morphine -- she weighed 70 kg -- before I even moved her in small increments - 2, 3, and 2, then I waited about five more minutes. We put her on the scoop stetcher with about five pillows for padding. She was still in a fair amount of pain so I called in to get permission to give her 3 more mg. I got permission for 5 more. Hooray for the doctor. She was almost pain-free when we came through the door. I was monitoring her on capnography. Her respirations which were almost 30 a minute were now to down to 8. She was still alert. She and her son, who had questioned me rather rudely when I first said my plan was to medicate her, were both very happy and thankful to us, which was nice.

Did a 24 year old pregant girl with vomiting and "seizure" activity. I had her friend describe the seizure and it didn't sound like a seizure. We got out in the ambulance and all of a sudden she started this arms and legs out straight, shaking like she was at a zombie dance party. I told her to cut it out and she stopped cold. No postictal state, no incontinence, no tongue biting. She said she was aware of the shaking, didn't know why she did it, and she thought it was strange because she was shaking, but she wasn't cold. I have a small digital camera I keep in my pocket to sometimes take pictures of accidents to be able to show the trauma team the mechanism of injury. It has a motion camera feature on it. I thought about getting it out to be ready in case she had another one of her fits -- I thought her doctors would like to see it seeing as they have been unable to make a diagnosis -- but I wasn't certain about how they fit into the privacy laws. It is an interesting question. I suppose it you had a blank disc and left it at the hospital with the patient as part of their record it would be okay.

The other calls were all at nursing homes -- some sick, some not so sick. Falls, pneumonia, etc. Total of seven calls today. Now I am home, sticky hot, sucking down a Corona and about to shower before getting in bed and turning the fan directly on me. It is supposed to be worse tomorrow. I don't go into work until two.