Check out this 12-lead I found

Found this 12-lead in the EMS room the other day while I was scrounging for a banana. Sorry it isn’t the best quality, and that is mainly because I stuck it in my car where I promptly forgot about it for a week. Hence the crumples.

But I tried to make it look nice.

Some EKG I foujnd

I found the paramedic that left it in the break room just to ask her about the patient. (I also wanted to ask her how she blows her nose with a piercing in her septum, but that will be another time.) The 12-lead was only done because of our policy (a 12-lead on anyone >50 with nausea). She said she laughed at the interpretation.

“Why were you laughing?”

“Because I had the Medtronic card in my hand. He had a ventricular pacemaker put in like six months ago.”

“So the computer was just kind of winging it?”

“Probably so.”

 

This is why I don’t pay attention to the interpretive statement until I interpret the EKG myself.

Hold your applause, please

Med four, you’re available at Local Hospital?”

Ten-four. My partner is walking out now, we’re ten-eight.”

Ten-four. Copy a 911 at Local ER. Female patient, white t-shirt, blue jeans, leaving the hospital now, wants to go somewhere else.”

…oh…kay…”

Med four, EMS Captain is clear, switch to talkaround.”

Ten-four…Four on Talkaround.”

Hey, guys. I’m clear on the call, I’ll head up there if you need me.”

Okay then. I’m not sure if we will need you yet. Shaq just got back in the truck.”

I’m clear. Just be advised, we can’t transport any patient from the ER from a 911 call.”
“Come again?”

If a patient calls 911 from the hospital, they have to be evaluated at that hospital, then the hospital has to arrange for a transfer if needed. We can’t take a 911 patient off of their property. The patient will have to leave the property before we can transport”

Okay, we’re clear.”

 

“Hey, buddy. You want some of these Oreos? They had them in the EMS room — what the hell is this on the MDT?”

“We got a call.”

“How did we get a call? We just went in service?”

“The call is here. Some gal is going to be walking out of the hospital. Wants us to take her to another hospital apparently.”

“Oh, so this has BLS written all over it, and you want me to handle it?”

“You’re the professional one, Shaq. Now how about them Oreos? Did you get me any milk?”

“Boy, I swear, I’m about to smack you upside your head. That must be her right there” he says, pointing to a woman meeting the description.

“Yeah, let’s go check it out.”

My mouth is full of the aforementioned Oreos as we watch a young, marginally attractive woman shuffle out of the ER front entrance, and shuffle her way over to a bench. We walk over to meet her.

“Hi, ma’am. I’m Shaq, and this is my partner C. Are we here for you?”

“Yeah. Y’all need to take me out of here to another hospital.”

“Well, what’s going on?”

“They are just rude in there, and they won’t take care of me. Take me somewhere else.”

“What brought you into the hospital this morning?”

“Well, me and my boyfriend was having sex, then after, I started hurting and burning.”

“Okay, What did they tell you inside?”

“I’ve been here for like, four hours and they try to tell me that I have gonorrhea or some shit like that. I ain’t got no gonorrhea. Me and my boyfriend are clean!”

“Well, did they do a pelvic exam and take a swab?”

“Yeah, the doctor did all that, then he tried to give me antibiotics, but I’m telling you, I ain’t got no gonorrhea.”

“Well, they are doctors, and those antibiotics are really important for you and your boyfriend to take.”

I ain’t got no disease. Take me somewhere else!”

“Well, I’m terribly sorry, but we can’t take you anywhere else.”

“You have to! I called 911.”

“I understand, but since you are at the hospital, you have to be evaluated and treated here, then the hospital has to have you transferred to another hospital.”

“That’s bullshit. You aren’t going to take me anywhere else?”

“No, ma’am. We spoke with our supervisor, and he says that we can’t.”

“Well what the hell am I supposed to do?!”

“It seems like you have several options. You can go back inside, and get those prescriptions filled. You can call someone to pick you up and either take you home or take you to another hospital, or you can leave the hospital property and call 911 again.”

“I can’t believe this. Y’all are going to make me leave and won’t take me to a hospital!”

“We are happy to take you to a hospital, but we can’t pick you up from this one. You’ll have to leave the property.”

“Fine then, I’m leaving.” she says, after which she gets up and starts shuffling off, down the sidewalk.

I’m still enjoying my Oreos, when Shaq turns to me.

“Let’s get in the truck. It’s gonna take her at least ten minutes to make it to that Citgo. We can probably be at the next post before she calls back.”

Med four.”

Med four.”

Ten-eight again. She’s gonna call back once she leaves the property.”

Ten-four. I’ll show you guys in the area standing by. I’ll let you know when she calls back.”

Shit.

Well-earned complaint

Shaq and I are running a non-emergency for a female who is weak. Which means there is absolutely nothing wrong with this woman. This is the same county that requires emergent response to ear aches, so use that when assessing the severity of this call.

According to the notes, she “doesn’t feel good.”

Call me a library book, because I’m already checked out.

We find this lady sitting in a chair in her living room. I wish I could say she was watching Maury, but the television was off. Shaq does all the talking, and we learn that she “doesn’t feel good.”

Chalk one up for the call-takers. Good job, everyone. Strong work.

We move the stretcher a little closer and Shaq asks if she can stand up to sit down.

“Oh, no, I’m just too weak.”

“Well, ma’am, forgive me for asking, but how did you get in that chair in the first place?”

“Oh, I walked here, but that was several hours ago.”

Mind you, I’m still checked out, and I only have vague recollections of what transpired next, but it ended with us lifting her out of her chair and putting her on the stretcher.

“Which hospital would you like to go to, ma’am?” he asks.

“Oh, I have to go to North County, they have my records.”

“That certainly won’t be a problem. C knows how to get there.”

“You guys aren’t going to put me in that…that…room with all those Mexicans, are you?”

“Well, ma’am, I’m not really sure what you mean. We don’t have anything to do with room assignments at the hospital.”

“Well, I don’t want to be in that room with all the Mexicans.”

Then he lets loose. “That hospital takes care of all sorts of people, ma’am. They take care of Mexicans, Indians, Canadians, Africans, Jews, Catholics, Asians, Russians, Italians, Australians, Caucasians, Muslims, Christians, and everyone in between-”

“-that’s not what I meant-”

“-they will even take care of bigoted American women. Now let’s go.”

The rest of the ride was real quiet. And then we got to sit in the supervisor’s office for a little while.

But it worked itself out.

It worked

The drug overdoses (that either aren’t dead, or are awakened) always go the same way: Shaq and I stand around with between four and six firemen, and at least two police officers for upwards of an hour trying to convince this guy to go to the hospital.

And they always wind up going. But we waste a lot of time.

The cops can’t threaten these patients with arrest, because the state has an amnesty law. Basically, if a call for help is made, then a cop can’t arrest for drugs that are found out in the open. I think that is a bit ridiculous, but it is what it is.

Doctors won’t commit these patients involuntarily, so we can’t threaten them with that.

Usually it is just a matter of wearing the person down.

And it gets tedious.

So we ran one of those today. A guy in his thirties relapsed, and shot some heroin after being sober for two years. This guy can’t help that he’s an addict, but he certainly has to take responsibility for shooting heroin into his veins. It turns out his ten-year-old son found him lying in bed, not breathing, then called 911. The son woke the patient with a glass of water splashed on his face.

And enter Shaq and C.

There’s the requisite crew standing around: six firemen, two cops, one shirtless guy with dirty hands sitting on the floor, and one crying mother in the living room. Of course the patient first attempts to deny that he did the drugs, then admits to it when confronted with the full syringe in the bathroom. Then he says he is fine, and doesn’t want to go to the hospital. Shaq and I are standing kinda in the background when he nudges me: “watch this, dude.”

Shaq makes his way to the shirtless guy on the floor, and stands all of his 78 inches over the guy on the floor. Kneeling down to get somewhat on his level, he delivers an excellent oration:

“Hey, dude. Check this out. You’re going to wind up going to the hospital with us today, that’s a fact. You say you don’t want to, but you’re going to. These guys in light blue? They’re from the fire department, and they get off at 7 in the morning. These guys in dark blue, they’re cops. They won’t arrest you, but they won’t leave until we tell them it is okay for them to go. Your mother out there in the living room? She’s calling your wife at work, and she already called your father. They are both on the way over here. Between the twelve of us, we will wear you down like a cheap pencil, and you will walk down those stairs, and you will sit on our stretcher, and you will go to the hospital. So what my partner and I are going to do now is walk outside. We are going to go outside to your front door, lower our stretcher, raise the head of it up, and undo the seat belts. And then we are going to stand there, and stand there, and stand there, until you walk outside and sit on our stretcher. It’s up to you how long that takes, and how much bitching you want to hear from your parents and your wife. When you’re ready, we’ll be outside.”

Then he stands up, turns to me, winks, then walks out.

I’m dumbfounded. I just witnessed a sentinel moment. So, I turn on my heels, and follow Shaq outside.

We barely make it outside before he’s trying to sit on our stretcher.

We’ve been on scene for less than five minutes, and now we’re leaving. On a call that would typically take at least half an hour.

I can’t wait to try that again.

Smoothie

“Male assaulted. PD on scene” reads the MDT. It’s raining and traffic is heavy, so I have to actually pay attention to the roads instead of the book I was reading.

I’m reading the new Grisham book, Gray Mountain. I can’t recommend it yet.

We finally make it on scene to find a guy in his early thirties standing with local law enforcement in the living room of his apartment. He has blood streaming down his face, and he is holding a towel against his head.

Shaq is taking the lead on this one. He’s going to be in Paramedic school soon, and needs to get used to assessing patients. Plus, he is really good at it. Good enough that I rarely have any questions for my patients, or tips for my partner.

After sensing an opening in the conversation with local law enforcement and the injured gentleman, Shaq breaks in:

“Man, what happened to your head?”

“That bitch hit me with a smoovie!”

“A smoothie?”

“Yeah! A smoovie!”

A glance at the gentlemen with the firearms confirms the previous point: they have no idea what is going on either, and how a cold fruit emulsion could have caused such a wound.

“She hit you in the head with a smoothie?”

“Yeah! I said that already!”

“But how did it cut you like that?”

“Cuz it’s heavy, man! Damn!”

“But, it’s soft, and it’s in a styrofoam cup or something.”

“Naw, man! It’s heavy!”

“A smoothie is heavy?”

“Yeah, man. Heavy. One of them things you smoove your clothes with!”

“One of the things you smooth your clothes with?”

“Yeah!”

“But, I don’t really…I’m confu-oh! Do you mean an IRON?”