Sunday, October 18, 2009

A Sort-of EMS-type Post (For Once)

I haven’t had the will to write much lately. Maybe, between school, getting sick, and just dealing with a lot of stuff, I’ve been a little bit blocked. At least that’s what I think is going on. But I am feeling maybe a little bit better, and I am at work so I can’t be that sick, right?

Uh-huh. I have to convince myself of that before I can even try to convince those of you who read this blog of that.

The past few days have been actually somewhat eventful. Working this past Thursday was rather busy, in fact. Didn’t get much down time during the shift and much of what we did was actual, real calls instead of the more routine stuff that seemed to find its way to me for a while. There are two that I went on Thursday that I’d share, mainly because they were interesting. There are issues with these calls at the respective facilities that the patients came from, and I’m sure they will make themselves known during this post.

First one was a call at 1130 to the Spaulding Rehab for a possible CVA. Note the time – it is significant with this situation. Arrived on scene to meet a medical secretary who wouldn’t get the nurse taking care of the patient we’d come for so that we could get a report; the secretary handed us an envelope with the patient’s information in it, promptly told us everything we needed to know was in there but that we weren’t allowed to open it. And I promptly broke that rule by opening the envelope in front of her.

By the time the nurse showed up I’d gotten a chance to look at the information that I had received. She gave me a really rudimentary report, and getting further information was complicated by the secretary interrupting me repeatedly to tell me that the information was all there. I finally got exasperated enough that I interrupted her and told her in no uncertain terms that I needed to hear it from the nurse. I wasn’t rude or disrespectful, but I’m told that I have enough force of personality that I can intimidate people at times.

The secretary didn’t say another word – she let the nurse talk which, as I said before, didn’t matter a whole lot. I got more information  from the paperwork – still not a lot but more than I was able to glean away from the nurse.

The patient, a 76 year-old male, was there because he was recovering from a stroke he’d suffered about three weeks earlier. From what we were able to learn, his recovery was progressing nicely and the day before he’d walked a considerable distance during his PT the day before. He had total left-sided deficit. No left-hand grip, no lower body strength, and no way to assess pupils adequately because he had a cataract in his left eye that totally clouded his cornea. Plus he had left-sided facial droop and slurred speech. All classic hallmarks of a stroke.

Regardless of whether or not it would make much difference – the 7 hours that the staff at the Spaulding waited to call for EMS pretty much secured that – we packed him up pretty quickly and transported him to the BMC. They didn’t want him going to the Mass. General, and I have no clue why, other than he is followed at the BMC.

The other call was for the 14 year-old that was transported to the BI by one of the area fire departments who needed to go to Children’s. I never saw a group of nurses work so hard to get someone out of their ED. And this kid was a mess; struck by a car, airborne for 10 feet and landing striking the pavement with his head. A sub-arachnoid hemorrhage was found that needed to be dealt with. And my question was why he hadn’t been sent to Children’s in the first place. Nobody had an answer.

The sad part is that I’m not surprised about that.

I will continue this over the next couple of days because there is more to add. But I got interrupted – by work, no less – so I didn’t get to finish this post the way I would have liked. But there will be more soon.


Ellie said...

What a joy it is to get a real report from someone who actually has met the patient. Only one in a million nursing home transports, though. I loved it when people more or less dared me not to open the envelope. It's my patient now!

TOTWTYTR said...

I'm very happy that I don't go to the Spaulding very much any longer. I think that rehabs do great work, but that if there is anything resembling an emergency, they fall to pieces. Last time I went, they tried to hold us up so that they could draw an ABG on a cardiac arrest patient. Didn't happen.

Apparently the medics from the suburban FD never heard of a POE plan for trauma. No way that a 14 y/o should go anywhere but one of the FOUR pedi trauma centers in the city. Morons.

Medic(three) said...

While nursing home nurses epitomize it, any nurse who doesn't understand that shitty reports make them look, well shitty is a fool. While you're good at staying calm, I've been known to snap at a nurse or other interferer on occasion...

Be safe out there, Walt.

TOTWTYTR said...

One quick, and hopefully amusing, anecdote from my BLS days.

We were sent to an "ovedose" at a local mental health facility. The patient was on work release so he went out daily to go to his job. Only, he'd go out drinking instead.

The facility called when he came back drunk. Duh.

As we were getting the patient ready for the trip across the street to the ED, my partner asked the nurse if the patient was allergic to any medications.

"Only NKDA, so make sure they don't give him any." came the answer.

Yes, we somehow did manage to keep straight faces.

Ckemtp said...

Oh that's just freaking lovely. "Just 'Enn Kay Da" hehehehe.

When they don't give you a report, or tell you "not to open the envelope" they're showing you a complete lack of respect and disregard for any type of professional respect at all for that matter.

So it's no surprise that we don't respect them. Because we generally don't.

Oh, and Walt, could you update your blogroll please? I'm at now