Subaqua Sternal Rubs

Last night's EMS shift was busy…no sleep. I missed some of it, because I went to go pick up my parents at the airport. Since they had been traveling for 40 hours straight, they went right to bed, so since they weren't going to miss me, I headed in to the ambulance corps to help out. A couple of the more memorable calls:

The elderly woman who was the subject of a previous post called again at 2 am for a taxi ride to the furthest possible hospital for urinary catheterization. The hospital had just discharged her 8 hours previously with a self-cath kit, but she told my partner "I can't find my urethra." This time she was even more snippy than usual, and she refused to answer any questions about her medical history, simply stating that we should know it by now. I'm sorry, but between the ambulance and my job, I've seen thousands of patients. Just because between me and my partner, we transported this woman 5 times, does not mean we have memorized her medical history.
To make things more enjoyable, the patient refused the stretcher and insisted on walking out of the ambulance. Well she had some difficulty, and she is now writing a complaint letter to the ambulance that we should have more steps installed so they are not so steep. I wanted to say, ya know, a taxi is much closer to the ground, and much easier to get in and out of. But oh wait, you have to pay for a taxi, whereas the ambulance is free to the patient (since I, the taxpayer, am covering that bill for her.)

Just after getting back from the call above, dispatched priority 1-C with the fire department for an elderly female, rule out stroke. Upon our arrival on the scene, found a female unresponsive being held up in the sitting position by her elderly husband. Patient went to bed at 10PM with a headache, and was found to be unresponsive at 2AM. The patient's pupils were fixed, GCS of 10, and was incontinent of urine. The patient's daughter (who increasing became an annoyance and a hindrance to care) said that her mother had eaten a piece of month-old tiramisu prior to going to bed, and in her esteemed medical opinion, the patient's condition was most likely simple food poisoning. We advised the daughter that the symptoms, history and pt condition were more likely due to a cerebral event. The daughter wanted the patient transported to the hospital where the pt worked. This is a small community hospital with a 10-bed ER, 2 nurses, 1 MD, and no CT tech on the overnights. Definitely not a stroke center. When advised of this hospital's limited capability and our recommendation to transport to a more appropriate facility where the patient would stand a greater chance of survival, the daughter said "they can transfer her if they need to." Ok fine, but by that time the patient's brainstem will have herniated, and they can ship her to the morgue instead. The patient finally became fully unresponsive in the ER and had to be intubated. To give you a glimpse into the quality of care, one of the nurses asked me if he could have an OPA out of the ambulance, and they used our bag-valve-mask, since they couldn't find theirs. All this for a patient that the daughter didn't think we needed to put oxygen on, since her main concern was that the patient might vomit from "food poisoning."

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