21 February 2006

Try, try again

We receive most of our dispatching through alpha-numeric pagers. The page generally tells you where to pick up the patient, what their name is, whether they need oxygen or anything else, and where they are going. Sometimes you get 10-15 letters worth of what's wrong with someone, but usually not.

Recently, my partner for the day (J) and I received a page to pick up a patient at an ICU and transport him 45 minutes to the state mental hospital. The page also included a note to stop at the nurses station first. J called in and found out that we were stopping at the nurses station so we could meet up with the sheriff's department as they were going to escort this patient with us. Since we alternate who drives and who rides with the patient, this one happened to be my turn. J asked whether I was comfortable taking the patient. I told him we should wait and see the patient and get a little more information as to what exactly is going on. I'm thinking if the guy is 6'2" and 250lbs and grumpy, maybe J should ride with him because I'm not in the mood to be pummeled or groped.

It turns out that this patient is in a halo (screws in his head, attached to a ring, with support bars going down to a vest) because he has at least one cervical fracture and he also has compression fractures in his thoracic vertebrae. When you're in a halo, you can walk and do most daily activities on your own, you just can't move your neck. Normally the sheriffs take involuntary admission patients in their van, but they've never dealt with this kind of medical equipment and obviously don't want to be liable if something happens and the guy ends up paralyzed. As we're all having discussion with the nurse, we find out that this injury occurred when the guy tried to commit suicide by throwing himself head-first off a building (obviously not tall enough). When he woke up in the ICU, the nurse told him he had to be careful with his neck or he could injure himself and he promptly threw himself head-first out of bed. He was there a week and tried at least three separate times to run off the ward and refused to tell anyone where he was intending to go and so got himself chemically restrained. So the sheriffs were there because he was considered a "flight risk". I'm not sure where they thought he was going to go from an ambulance on the freeway, but having the sheriff there seemed like a good idea to someone.

In the back of the ambulance, it was obvious the ICU had given the guy some good drugs. He was pretty out of it and rather pleasant, after complaining the whole way through the hospital that he didn't want to go in the ambulance and he'd rather just go with the sheriff. The receiving hospital staff really rolled out the red carpet, sending about 6 people to walk the stretcher in with us because the sheriffs aren't allowed on the ward with their weapons. We delivered him with no incident and I sincerely hoped they'd be able to help him since he obviously needed it.

I found out yesterday that he once again threw himself at someone or something head-first and this time succeeded in giving himself "cervical compromise", which likely means permanent paralysis and an end to throwing himself anywhere. I only heard because they were sending another unit from our company to pick him up from the mental hospital and take him to a trauma hospital and those providers couldn't believe it when they heard someone in a halo had injured himself like this. I probably won't ever hear what happens to him in the end, but I hope someone can find the right mix of therapies to at least give him some peace of mind.

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