30 January 2005
"When it Rains, it Pours...Part II"
Now...Where were we??
In the front seat of the car was a woman, young in age, dressed in business attire sitting almost motionless. Around her was one of those blue plastic bags you get at the grocery store to catch what little she had thrown up.
"Ma'am. Are you okay?" Ken asked.
"I fell down. My head is killing me." She replied.
Ken kept her still and felt for any deformity to the back of her head. There was a bump there. It was the size of Kansas. (Okay, maybe not Kansas but it filled Ken's hand...and Ken has decent sized hands.)
Pulling my radio off my belt, I called dispatch to tell them we were out of service again and began to pull immobilization equipment off our truck.
Our patient was very diaphoretic and cooler to the touch than normal.
Ken grabbed a C-collar (you know..one of these)
I grabbed the backboard, , head blocks,and straps, and began to get ready to extricate her.
The female that drove in with the patient stated that she was an IDDM (Insulin Dependant Diabetic).
Well, that could play a role into this situation. Hmm...
I ran back to the truck and got the glucometer and went for the magic test. Was it the sugar, or was it something else?
Five seconds later, I got my answer.
If it were the sugar, then we could fix that right away, if not, then we have a whole other greater problem.
Her results came back.
Her sugar was 106. Well within normal limits.
Time to kick in the pucker factor.
The patient began to take the collar off and Ken would explain to her that it needed to stay on. This was only part of the problem.
Her Level of Consciousness (LOC) had greatly begain to deteriorate and it was cold outside. Soon, she could start getting hypothermia just by the door being open. (Yes, it was THAT cold.)
Ken tried to pivot her on the cot. She would fight it. Ken would try again. She would fight again.
It was time to take over for her. Ken and I looked at each other knowing that if we didn't get her in soon, our window of oppurtunity would shrink dramatically.
I grabbed her legs, Ken got her arms, we pulled her out military style and placed her on the board.
She fought a little....then stopped....completely.
Ken checked for a pulse. It was still there but she began to run tachycardia on the monitor.
The signs were beginning to stack against us.
The clock was ticking.
Wheeling her inside, the patient became even less responsive than before. She began to throw up more frequently.
I saw the doctor go in.
I heard him start barking directions...
It didn't sound good.
Ken stayed inside the room to help with the patient. I, so badly, wanted to be in there. But we were all that was left for squads in the city as the other two left on calls. I had to get the truck back together.
Shortly after, we left and went back to the station. Our curiousity kept getting the best of us as to what was going on with her.
Trying to figure out what we did in our game plan, we heard a helicopter fly over head.
They were coming for our patient.
Ken called over to the ER. He got a report, then looked at me.
"Let's go and take a ride" he told me.
I knew where we were going. I grabbed my coat.
Pulling back into the ER, the doctor there met us explaining what was up with our walk-in patient.
(This is a normal scan of the brain)
(This is similar to what she had. The arrows point to bleeding in the brain.)
All in all, she had six bleeds going on in her head and needed immediate surgery for it.
A college professor, she was also blind and just couldn't see the ice when she fell. The fall will alter her life for ever.
But wait folks....there's more.
Watching the flight crew leave and carry our patient away, Craig came up to us as we stood in disbelief over the female.
You all better sit down for this.
"You know that chest pain you guys brought in?" Craig asked us.
We both nodded.
"He has a Triple A..he coded twice so far."
Picking up my jaw, I glanced to the other side of the ER to see the code team working behind a closed curtain.
Okay, this was WAY too much now.
We walked overto the other side to see the team working on our gentleman who, 30 minutes ago, was active and had thought it was gas he was having. What he REALLY had was WAY more severe.
Ascending Aortic Aneurysm. Roughly, this is when the walls of the major artery leading to the heart, become weak and start to bulge out. Kinda like a tire. If it burst, your mortailty rate is extremely high.
Peeking in, I could see the patient tubed (intubated) and had no blood pressure. Surgery was going to be done within the hour as soon as the team arrive.
This, I knew was bad...seeing they never do that surgery here. He was too unstable to leave.
Apparently, the patient's artery burst while on his way to CT scan.
This is similar to how his artery looked.
As of now, I know he is in ICU and is doing slightly better.
Word of the woman is that she is touch and go.
Ken and I decided to call it quits for the night (no, we aren't allowed to do that.)
But first we got dinner....
After all, that is what our initial quest was.
Here is something to ponder folks. The head injury came in by private car. This was something VERY serious and potentially, life threatening. THIS is where you need to call the ambulance.
Yes, I know that we do all kinds of piddly little falls all day long, but this is what we are paid for. This is why we are here. Let US make the decision.
I am not sure that her outcome would be much different had we gotten to her, but we could have definately shaved some time off her golden hour.
Time is crutial.
Rounding Third and Heading Home,