A thirty-year-old male had a seizure, according to our dispatcher. We pull on scene with the fire department, and make our way into a home that is bordering on palatial, and are directed to an upstairs bedroom, where a male fitting the description of the call is lying on top of the bed, appearing to have had his morning dressing ritual interrupted by a cadre of strange men in uniform shirts.
“I was laying in bed, kinda half awake while he was getting ready for work” reports his wife. “I heard a thud in the bathroom, and went in there and he was just kinda sitting on the floor staring off into space” she continues.
“How long did he stare off into space? Has he ever done anything like this before?” inquires the officer on the engine, another paramedic.
“It was maybe for like, I don’t know, thirty to forty-five seconds, I guess. He’s never done this as far as I know, but he told me that he used to have seizures when he was younger.”
“How did he get to the bed?” I ask as Slimm and another firefighter begin getting some vital signs, which all come back fairly normal.
“Oh, I helped him up, and he walked in here, then he laid on the bed, and kind of rolled around for a little while until you guys got here.”
The patient is awake, but looks pale and sickly. He informs us that he feels nauseous, which certainly fits with his presentation. “I didn’t have a seizure, I just kinda got weak and sorta fell down” he says, then he agrees to a gentle ride to a hospital for an evaluation.
“Before I go get my stretcher, are you hurting anywhere, or feeling anything besides that nausea?”
“No, just a little nauseous.”
The wife is kind enough to point us to a service elevator on another side of the house, and as we are bringing our stretcher down a hallway, the officer approaches us from the bedroom.
“Hey, he says his head and neck hurt. Y’all want to board him?”
“Nah, I don’t think that’s necessary.”
“WHAT? His HEAD and NECK are hurting after he fell, and you don’t want to BOARD him?”
“No, I really don’t think that is necessary.”
“Well, that’s all on you, buddy! And I’m going to put that in my REPORT!” he says to Slimm and I, a fair attempt at intimidation, but falling short.
“It always is.” replies Slimm in his soft, yet authoritative voice.
“What is always what?” asks the officer.
“Responsibility for patient care is always on us, and more specifically, him,” Slimm replies, pointing at me.
He’s right. It always is.
“Oh, I helped him up, and he walked in here, then he laid on the bed, and kind of rolled around for a little while until you guys got here.”
I love the self-clearing of C-Spine before arrival…
I work in NZ so our protocols defiantly very from the states. It would be a case where I would not think of boarding him. Besides my protocol states that we don’t transport on any hard board unless there is obvious neurological deficit. I might do a more focused assessment of his neck and back and ask more questions and if was worried in the first instance ask him to not move his head around. There is no reason to immobilize his back it wasn’t hurting or injured. Also did the officer mean well but ask the patient a leading question that made the patient think yeah my head might hurt a little. The board all people with even a little pain in their neck gets full immobilization is one reason I’m glad I don’t work in the states.
Andy, Not everywhere in the states is like that. Unfortunately, we haven’t come far enough. In some respects, worse; many places universal backboarding is still taught as the norm for the basic EMT or first responder. This makes can make the medic’s job more irritating when they choose (correctly) not to backboard (as CCC has demonstrated here).