TBD: Think Before Denying

Newguy and I are inside the home of a delightful lady who was complaining of chest pain, at least according to our dispatchers.

Our intrepid local first responders are huddled around the patient, in a mad dash to save her from the throes of death.

They seem to be succeeding at preventing her imminent demise, and also are sucessful in their attempts to create a large pool of blood all over the patient’s hardwood floors.

It’s a win/win situation so far.

One of the patch-wearing heroes rattles off some vital signs, and they are all better than mine, with the exception of her blood sugar: 331. Alas, she is a diabetic.

I really enjoy when the pieces of the puzzle assemble themselves.

Our infirm female has said several times now that she needs to “tinkle,” and asks if she can go. Newguy wants to get the 12-lead first, so he asks her to wait just a minute or so. It’s normal, by the way.

“Okay then, can I have a glass of water while I wait? I’m really thirsty.”

“Nothing to eat or drink until you see the doctor” the intrepid hero reflexively replies.

Newguy is nonplussed. “Why can’t she have anything to drink?” he asks.

“I don’t know” is his reply. Clearly, he has no idea.

“Were you guys going to put saline in that IV over there?”

“Well, yeah…”

 

Why don’t we think about these things? Don’t we all recognize what is going on here? This lady is hyperglycemic, and polydipsic and polyuric. Because her blood sugar is ridiculous. Granted, I’ve seen higher, but she’s going to get a large amount of fluids in her IV on the way to the hospital, so is there really any harm in giving her a glass of ice water?

Comments

  1. But, but, I saw the nurse do it to a patient the other day. And if they do it, then we HAVE to do it.

    Right?

  2. Checking formulary…nope, I don’t see tap water. We will need to get authorization from State EMS office to do a pilot study on water administration.

    Also we had a guy that scratched a patient’s eye when assisting patient with a drink from a bendy straw so now we have to fist apply safety glasses to all patients that might be exposed to bendy straws.

    Good luck with your water administration project. When you have a chance can you provide more information about dose size, administration routes, delivery devices, etc. I will forward to our protocol committee.

    :)

    • I forgot to add that patients with known hypersensitivity to water may ask for the “cold water pill” and claim that it goes down easier if they can swallow cold water pill with a large splash of vodka.

  3. I used to complain about the first responders doing nothing more than giving what we called “The Stare of Life”. It turns out that they were probably doing more good for the patients than your heroes.

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