Something else to make me smile, telling a good yarn.
It was another long weekend, with little slothage for me. Saturday was the annual Mayberry VFD Shrimp Feast, our annual fundraiser. It’s a big outdoor party with all you can eat shrimp, fried fish and the usual side dishes, and lots of beer. Imagine 500 sloshed rednecks whooping it up on a softball field. It’s generally a good time, but if I hear ‘Soljah Boy’ one more time, somebody is going to be beaten severely.
We were about an hour into serving dinners when there was a combined fire and rescue page for a motorcycle accident in Hooterville’s district. Great. The rescue squad had a very rough time scheduling crews for the day, and there was not even a first run ambulance to go. One member answered right away, and went for the truck. Then they started paging for an intermediate. Well, most of them were at our function eating seafood and getting gassed. By the fourth page, I went to the chief, said I was the only one available, and got his permission to go. Fortunately, the softball field was very close to the rescue station, and I started walking there while the ambulance was coming to me.
The patient was part of a group that was riding one of the rougher roads in the county. He rear-ended one of his companions, and was launched over his handlebars onto the pavement, hitting his helmeted head and knocking himself out. He also has some pretty impressive road rash. We had him flown to Norfolk because of head impact; the whole call was pretty routine for a wreck. I got back to the Shrimp Feast with about a half hour to go in dinner service, and found out we ran out of shrimp, which was a first.
I slept as late as I could Sunday, avoiding both bona fide church and services at St. Bluegill’s, but the dogs conspired to get me up anyway. I went to the station late morning to do my truck inspections, and managed not to tear off any equipment doors this time.
When I got home, I had a short window of naptime opportunity before I had to go help tear down Shrimp Feast. The rescue squad was busy, of course… I had just drifted away to dreamland when the page happened; an 85 year old woman at the Mayberry [del]Warehouse for the Elderly and Chronically Ill[/del] Nursing Home having chest pain and difficulty breathing. Wunnerful. A heart attack in progress, and the scheduled crew is busy. I got up and donned my rescue duds.
VWife: “Are YOU going?” Extreme annoyance was in her voice.
“Yes”, I replied, in a ‘don’t-fuck-with-me’ tone. :rolleyes:
She rambled on in her usual manner about me not getting her household projects done, yada yada yada. Bite me.
Then I sat in the ambulance at the station for a half hour waiting for a partner. Harrumph. The dispatcher kept paging, and I started going through the list looking for someone close to the station or the nursing home to run with me. After about the fifth call, I struck pay dirt with BrassyDeb, one of my favorite running partners.
We got to the scene, and the patient was sitting on the edge of her bed, and having difficulty breathing. This was no little old lady either; she was no older than 45. :dubious: When you could understand her through her nearly incoherent mumbling, she admitted to no chest pain. Most of the time she was barely conscious. As is standard for the place, she wasn’t on oxygen. :smack:
Her history included cardiomyopathy, congestive heart failure, and a long list of other things that would interfere with respiration and oxygen transport in her blood, so that was how we began to handle her. Mistake, and remember that little detail.
We took her to the unit and got her settled. Vitals were odd for heart and lung problems. Her BP was very low, her oxygen saturation was great; despite the high flow oxygen, she did not come around to lucidity. :dubious: Her heart rhythm looked OK to me, but it wasn’t beating very strongly. I tried twice to get an IV going, but her veins had collapsed. I told Deb to go, and don’t watch the scenery.
When we have a nursing home transfer, we get a big stack of paperwork to take to the hospital. I went through it to fill out the report worksheet. Her medical history was very long, and I saw ‘substance abuse’ and 'noncompliance mentioned several times. That started my little mind working, because it was bugging me that she was not acting like a heart patient.
I checked the time, and it was time to do vitals again. I glanced at the PulseOx to check her blood oxygen, and it read 84%. :eek: A normal saturation is 95-99%, and we tend to get uptight when they read in the low 90s. A prolonged reading below 80% will cause brain damage. Mind you, she’s already getting as much pure oxygen as she can get, unassisted.
“SONOFABITCH! Deb, get me a paramedic! She’s starting to crash, and I’m gonna bag her!” I went for a bag valve mask, hooked it up to the oxygen, and started assisting her respiration.
We picked up the Suffolk paramedic a few minutes later. I briefed him on what I did, her vitals, and I mentioned the inkling that was forming about this being a substance issue and not cardiopulmonary. Then I said, “This is Willadene…”
“Willadene? Willadene! This is Roy! I didn’t recognize you!” Strange way to introduce yourself to a patient, I thought.
“Where did you pick her up?” I told him the nursing home.
“Oh, I know her well. She goes way beyond frequent flyer with us. Willadene, did you take anything?”
::mumble mumble mumble:
“What was that?”
:barely coherent: “Pain pills.”
Roy turned to me and said she was a notorious addict, and was hauled in by Suffolk to be treated for overdoses on a very frequent and regular basis. He got an order to administer Narcan to counter the pain meds, and he managed an IV, grumbling about the rough stick she was. We arrived at the hospital before the Narcan went in.
We wheeled her in to the ER, to nearly every one shouting “Willadene!” I swear it was like Norm walking in to Cheers. When we transferred her to the hospital bed, that hard fought IV was ripped right out of her hand.
The cavalry arrived. When I saw her last, the ER attending physician was putting an IV into her jugular vein (very painful), Narcan was drawn up to go in, and they were tying her down so when her high ended, she couldn’t go anywhere
After we left, I called the charge nurse at the nursing home and told her about Willadene having an OD, not a heart attack. They had no clue, but they also are quite clueless on a regular basis. Apparently, she was transferred to Mayberry from Suffolk in an attempt to cut her off from her supply, and it didn’t work.
I deserve about half of a head smack for missing the OD symptoms for so long, but I think I did well in reacting to what did happen. Had I caught the overdose symptoms, I could have done the Narcan myself, but doing it solo is dangerous, and Willadene has a reputation got reacting violently.
It also legitimately got me out of cleaning up Shrimp Feast … 