11-10-2009; Night Shift

Final score for the night: 1 ETOH, 1 MVC, 1 confused person, 1 anxiety attack, 1 rape.

As I said in my first post, I work for three departments. For the sake of anonymity, we’ll call them Hometown, Podunk #1, and General Hospital. Hometown and Podunk #1 both operate a single truck on a paid day shift. General Hospital operates three stations with a total of five trucks at any given time. They share the town with Hospital #2, and the two services alternate substations on a weekly basis. It’s kind of a cooperative competition. Both services deliver patients to both hospitals, at the whim of the patient.

Anyway, last night, I was at Southside substation from 8p – 8a. I got in around twenty minutes early, and I was waiting on my partner and shooting the shit with the outgoing crew, and the tones dropped. I said, “I don’t care which of you goes home, but I’m taking the call.” After a quick debate, Lisa stayed, and Michael went home; he wasn’t feeling well.

The call was to the drunk tank for a male pt c/o chest pain. Eyes rolled, and off we went. The pt was about 50, and denied any chest pain, but was complaining of dyspnea. He was also complaining constantly about the arresting officer.

“He din’t have any righ’ to talk a me like tha! He said I’m wastin the taxpayers’ money! How ’bout the taxpayers is wastin MY money? I got five honabul discharges! World War II veteran! I got a real bad heart!” (The dude is 50, remember?)

We were assisting him to the cart, and he told me to be careful of his elbow. “It’s real tore up!” I took a peek, and was surprised to find a decubitus ulcer about two inches across, right on the point of his left elbow. In an otherwise healthy 50 year old, my mind immediately screamed “NECROTIZING FASCIITIS!!”
We got him to the truck, and took him to Hospital #2. On the way, it was IV, labs, O2, Monitor. By the way, despite his claimed heart problems, his strip looked like a textbook example of NSR.

I was about halfway done with paperwork, and the tones dropped again. “Single vehicle rollover; two patients; minor injuries”. Lisa looked put-upon. I tried to get her to go to the call by way of the station so we could pick up my real partner and she could go home, but she refused. “I knew what the business was like when I got into it.”

We got to the scene and found a car, sideways in the road, propped up on a fence post (…and me without my camera!). There were about thirty firemen, and two dazed-looking kids, sitting on the back bumper of the BRT. Both of their parents were there, neither was hurt, and we got refusals from both sets of parents. The one was more concerned about the welfare of his guitar than his own welfare.

Clear scene and back to the station. We had barely backed in, and toned out again. “69 year old male, confused”. Lisa jumped out and Jamie jumped in, and away we went. We arrived to find an old man in bed, and two concerned neighbors. The patient looked a lot like Santa Claus after a three-day bender.

He couldn’t tell us what was wrong, but he didn’t know what day it was, and the month, he said, was “about medium”. His vitals were all reasonably normal, although he was a bit warm. The skin of his legs suggested diabetes, and his BGL was 148. His lips were dry and cracked. We were thinking it was a BHU call, until we saw the pile of newspapers outside his door. he neighbors said he gets the newspaper every morning, but they hadn’t seen him in about four days, so they came to check on him. He said his last oral intake was breakfast, “With this morning’s paper”.

So. No food for around four days, probable diabetic history, a low fever, and a BGL of 148. Ordinarily, I’m happy to see 148, but when you haven’t eaten in almost a week, 148 is pretty high. Jamie and I agreed that sepsis was likely, and dehydration was obvious, so we ran fluids from the scene back to General Hospital. Santa Claus was admitted, and is currently getting through a course of antibiotics.

The remaining calls were, from a clinical standpoint, nothing special. We were on the sofas by three, and up again at seven-thirty with no interruptions in between. All in all, a decent shift. I’m back again tonight with a different partner, so we’ll see how that goes. Cheers!