Wednesday, December 20, 2006

Yesterday's Work

It's 11:45AM in Manchester as I write this. I woke up about a half-hour ago and I am writing while I'm still in my PJ's (in my case, a t-shirt and gym shorts) while A&E's "Cold Case Files" is on TV in the background. Since I got off work last night I've been ruminating about the day I had. It wasn't a terribly busy day, but we had a couple of calls which were not unusual in the sense that these sorts of calls happen every day. However, they were sad because of the fact that there are a lot of these happening at this time of year.

The first call we went on was for a 53 year-old male patient who overdosed. The dispatch information directed us to wait on scene for police to arrive and secure it because the patient could potentially be combative and violent. We arrived on scene where a Manchester Fire Department engine company was staged (standard procedure, depending on the severity of the call), and I counted 4 police officers already there. The patient's niece and her husband were also there, and they gave me information that I needed: patient is a chronic alcoholic and has a history of pain due to bi-lateral hip replacements and back surgeries. He had been taking Oxycontin (his own that he had a prescription for) and had been drinking along with the medication. We had no idea how much Oxycontin he'd taken or how much alcohol he'd ingested. Police went into the house and found the patient in his bed; from my position in the kitchen I could hear the slurred speech and he did sound agitated. But he cooperated with the officers and walked out to the kitchen where he promptly lost control of his bladder and urinated all over his kitchen floor.

Anyway, we were able to convince him that he needed to go to the hospital, but he was still agitated and really ready to fight with someone. I brought a police officer with me in the event that he lost control and decided to try to get out of the truck while it was moving. So we brought him to the hospital, and it was almost uneventful, other than his not being willing to let me treat him. In taking a blood pressure he raise his fist as to throw a punch as I was removing the cuff, and I put my hand on his to settle him down. It worked. All I said to him was that he couldn't raise his fist to me or I'd have the officer sitting next to me on the bench put him in protective custody, which meant he'd be handcuffed. He immediately became contrite.

Once we got him into the Emergency Room the nursing team took over and I gave report to the nurse in charge. For a good 15-20 minutes after I turned care over I could hear him yelling and screming. I found out a bit later that he was dealing with pain; they suspected internal bleeding, as well as with the amount of Oxycontin in his system he was starting to withdraw from it. I stopped in to see how he was doing later in the day and he was still agitated, but he wasn't speaking anymore; he was extremely fidgety and unable to settle down, and he had been given a lot of medication to try to settle him down which hadn't had any effect.

The second call was for a 29 year-old female who had been assaulted earlier in the day. The patient told 911 that she had been drinking and was afraid for her safety. We found her in the area of Memorial High, in the south end (sort of), sitting on the curb waiting for us. She was a little unsteady on her feet, but she was covered with bruises across her arms and legs, she had a bump on her head, and she was sensitive to light. In talking with her she was a bit erratic in her speech, and we found that she'd stopped drinking early in the morning (it was almost 3:00PM when we picked her up), and she had been smoking crack cocaine - she had used her last supply up about 4 hours before our call. We transported her, and she became more agitated on the ride to the hospital; when we arrived she was "talking smack" to both my partner and to the nurse who we transferred care to.

I don't know whether it's the holidays or the drugs, but people tend to be more difficult at this time of year. I think that one tends to affect the other; what I mean by that is if a person has a hard time with the holidays and they have a habit or chronic problem with alcohol, they will use it so they don't have to feel the pain. Or I could be wrong about that - it's possible that the habit has a hold on the person using regardless. I don't know what the reason is. I do know, however, that it bothers me just the same.

No comments: