Stupid policy #73,893

So a local assisted-living facility called our service directly today. Usually not a big deal, it’s something that happens quite routinely, as matter-of-fact. But it was the notes in the call that were strange:

M subj fell/No inj/No comp/Facilty req code-4 chk/No RLS/Prvt req/

So, deciphering the jargon, some guy fell, isn’t injured, doesn’t have a complaints, but the facility wants us to “check him out.” Which is complete bullshit. They don’t want us to “check anyone out.” They just want to pawn off some perceived liability.

“Med two.”

“Go ahead.”

“Your subject will be outside on the porch, smoking. White male, khakis, red sweater, approximately 70 years of age. Patient is aware you are responding, but states he does not want an ambulance.”

“Two clear.”

What fresh hell is this? So some guy fell, says he’s okay, isn’t hurt, doesn’t want an ambulance, and decided to go outside for a smoke break, yet we still have to go “check him out.”

“This is probably the dumbest thing I’ve done all year.” Smokey says.

“Don’t count them chickens just yet, buddy, we still got almost a week left in this year.”

Sure enough, there’s some old guy in a red sweater and khakis, sitting in a rocking chair, smoking. He looks pleasant.

“Hey there, feller!”

“Well howdy! I told them ladies in thar not to call all y’all, but they done did!”

“You hurt?”

“Naw, I don’t reckon so.”

“You want an ambulance?”

“Wouldn’t have much use for one of them.”

“You want to go to the hospital?”

“I really wanna finish that puzzle I got goin’ inside.”

“Cool. You mind if I smoke with you for a little while?”

So we sat down for a few minutes, Smokey had his smoke, I worked on my crossword puzzle for a bit, then an employee came out. I did my best to keep my mouth shut, and I let Smokey do all the talking.

“Hi, guys. Sorry to bother you. We just have to have him checked out.”

“Y’all can’t do that here?”

“No, we have to call the ambulance to do it.”

“Then why do y’all have nurses in the building?”

“Nurses can’t have him sign a refusal.”

“Well, we can’t neither.”

“But he has to.”

“No, he doesn’t.”

“Our policy says he does.”

“Good thing I don’t work here, cuz that policy makes about as much sense as a trapdoor on a canoe.”

 

And that’s the story of the second incident report I had to write in less than two weeks.

Genius

Some lady attempted suicide.

The MDT notes say she left her car running all night in her garage, and was found on the floor of the garage by a neighbor. It’s 6 o’clock in the morning, and she’s been there all night, and the car was still running when the neighbor found her.

The neighbor only found her because he thought the red light glow coming from her garage was strange. Apparently she left her headlights on. Neighbor broke into her house, opened all the doors and windows, turned the car off, and somehow dragged the lady outside into her driveway before calling us.

Somehow, she’s still breathing.

Brave man. Now he’s over in the bushes throwing up breakfast.

No, it wasn’t an accident. The note she left in her car removes all doubt of that.

Shaq and our supervisor are getting some stuff done while I gather information before we leave.

One of the fireman comes out of the garage and walks over to the ambulance. “Hey, do you know which hospital you’re going to go to?”

“Yeah, we’re gonna go to Saint Catholic’s. They have that hyperbaric chamber there they can put her in.”

“Cool. Good deal. Make sure you tell them the readings we got from our meter is six hunnert and fitty parts per million.”

This guy is speaking some language I don’t understand. But whatever. “Sure thing, dude. Six-fifty parts per million. Got it.”

He looks over my shoulder at my supervisor and nods “How is she doing? She gonna be alright?”

“I don’t know, man. She looks pretty sick. But her O2 sat is at one hundred percent, so at least that’s good.”

Fireman and I make eye contact and neither one of us have anything to say.

And Supervisor McDipshit wasn’t trying to crack a joke, either.

 

I looked it up later. At 400ppm, a normal adult will have headaches within 1-2 hours, and it is life-threatening after 3 hours. 800ppm is nausea, vomiting, and convulsions within 45 minutes, unconscious within 2 hours, then death. And this lady’s garage was over 600ppm, and she spent the better part of 9 hours in there.

Nobody could figure out how she survived. But she did.

The O2 sat of 100% is probably what saved her.

Church jerk

We’re running a church call. I don’t know what it is, but there’s two things working against me:

  1. I don’t like running calls around a lot of people, and there are always a lot of people at church calls
  2. I didn’t take my Celexa this morning, which normally helps me run calls around lots of people

We have a paramedic student today, and Shaq is almost done with his paramedic program, so they’re running the call and getting all the info. I’m standing back a little ways, watching.

Nothing is wrong with this lady but maybe a case of the tachylawdy.

I’m just waiting to put this status dramaticus on the stretcher so we can head out to the truck when some guy saunters up next to me. I don’t say anything, or make any indication that I know he is there.

You know, because I’m intently watching the assessment being performed on the acutely ill patient lying supine in this sanctuary.

He clears his throat.

I ignore it.

He clears his throat again.

You know,” he says in a low voice to me, “men shouldn’t have ponytails. It just isn’t right.”

Then just as quickly as he arrived, this judgmental, pompous asshat turns and leaves.

This is why I don’t like people.

Step away from the baby

Childbirth call. Some lady just delivered a baby at home.

I’m with the talkative part-timer again, who seems to be a little nervous.

But we make it to the call, and I finish my bagel without losing any cream cheese.

We encounter the first member of the fire brigade outside the well-appointed home. We can hear a baby crying, which is a good sign. At least it’s a sign that this is a legitimate call.

“Everyone’s in yonder” he says, pointing in the direction of the home.

Duh.

Sure enough, there’s a baby. Umbilical cord attached, but cut, being wrapped up by another member of the fire brigade.

Mom looks alright. Considering.

Wait. What’s that? That guy is getting out the IV kit? Whoa. Hold up. That other guy, he looks like he’s cleaning the baby’s arm and feeling for a- holy shit, that’s a tourniquet! Why the hell is there a tourniquet on the baby’s arm?!

“Hey, uh, what’s going on here, what’s happening?”

“Oh, we’re just looking for a vein.”

“Mmmkay, I see that, but why are you looking for a vein?”

“Well, the baby seems kind of lethargic, and the blood sugar was kind of low, so we were going to give some D50.”

What in the actual fuck are they talking about? “Well, what were the baby’s Apgar scores?”

“The what?”

“Apgar.”

“What’zat?”

Christ on a cracker. “Okay, what was the blood sugar?”

“Uh, lemme look, it was…42.”

“The blood sugar was 42?”

“Yeah.”

“On a newborn?”

“Yeah.”

“And you were going to start an IV and give D50?”

“Yeah.”

I have now put my hands into my pockets, lest I slap a civil servant upside his head. “How much D50 were you going to give?”

“Uh, like ten ml?”

So five freaking grams of dextrose. “What’s a normal blood sugar for a newborn?”

“Uh, between 80 and 120?”

“Give me the baby.”

“But…”

“Give me the baby and get out.”

 

Glad we hurried

We drove almost 15 miles. A little less than 25 minutes. At 5 o’clock in the morning. In a torrential downpour.

For a grown man with abdominal pain for about 8 hours.

Because he’s lactose intolerant.

And ate a Wendy’s Frosty for dessert.

Then we took him to the hospital.

And his wife followed all the way in her car.

With her emergency flashers on.

Sigh.