29 November 2005

0430 wake up call

K and I went out this morning for a girl having a seizure who was reported to be unresponsive but breathing at the time of the 911 call. Nothing gets me out of bed for this sort of thing like the thought of a kid in trouble. Running through my mind on the way out the door are all the things I hope I remember when I get there, and a checklist of clothes to be sure I'm actually fully dressed. K being with me takes a lot of the pressure off because his experience and higher level of training means he can take charge, but I feel like I'm not going to improve my skills if I don't at least think through what is going on.

Travel at this time of morning was less than easy as there was thick fog and once off the main route the roads are slick with melting snow and ice compacted to the road. After the first couple of minutes, I was able to relax a little because K was driving slowly and promised me he wouldn't crash us because then we wouldn't be able to help anybody. En route, we hear the update that the patient is now awake and responding, although still dazed.

We're first to arrive (barely) and we work on getting all the important info out of girl and mother and then eventually K starts to explain what is going to happen when the ambulance arrives, what might happen on the way to the hospital, and what might happen when they get there (including the long wait while the hospital locates the on-call neurologist). We work under the assumption that the patient is going by ambulance, mostly because it would generally be a bad situation to have a parent driving to the hospital and have another seizure happen. It wouldn't necessarily be bad for the patient, but it tends to panic the driver and cause accidents especially when the mother is already agitated.

Although one of the other staff that K knows and likes is on the ambulance when it arrives 10-15 minutes later, she mentions to the mother that they don't have to go by ambulance if the mother feels comfortable driving the girl. K is visibly biting his tongue at this point, and eventually that is exactly what they decide to do. The whole way home I get an earful about what might happen to these people, how there isn't even cell phone coverage so the mother could call for help if she needed it, and how disappointed K is with the "sign her off and clear the scene" attitude.

I'm not sure where I fall on the issue because I know that they wouldn't have actually done anything for the girl in the ambulance on the way to the hospital, so essentially it would be a really expensive taxi ride, but I agree that if she had another seizure while the mother was driving, that would be bad news. I do know that if anything ever happens to me or anyone I know, I definitely want K right there because he's the best patient advocate I know. He even made a call to the emergency department to let them know the patient was coming so that they might actually start locating the doctor before they arrived.

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