20 October 2006

Murphy's law

**I had this one almost ready on Friday and got distracted by other things...

Had an FD call this morning that left me chuckling - only because I wasn't in charge of anything other than driving. 84 yo man, difficulty breathing. When I arrive on scene, the FD has him pretty much loaded onto the stretcher and they're headed for the ambulance. I help get the stretcher outside and hop in. One of the FFs has already started getting the IV ready, the medic listens to lung sounds, the line is started with a large puddle of blood and it appears we're about ready to go. The medic gives the gentleman a nebulizer treatment of albuterol and turns around to get the solumedrol ready when he notices that there's something not quite right with the IV.

The FF who started it comes back over and they agree that they don't think it is blown, just leaking from the connection of catheter to administration set. So they un-tape everything (including the tegaderm, which the old guy whines about) but it turns out the connections are okay. The FF messes with the positioning a little and thinks he finds a good spot, but as soon as he turns around, the guy's bleeding again. I'm trying not to start giggling because this would suck if I was in charge of the line and the two of them are looking so serious about the whole thing. They decide that maybe it's the admin set leaking. Medic looks up and tells myself and FF #2 that he wants to spike a new bag and change out the tubing. FF #2 opens a new bag of saline, and looks up to see the me handing the old bag to the medic who is just re-spiking with a new admin set. Since I wasn't digging around in the cabinet, I heard the medic change his mind, FF #2 looks confused until I explain the change in plan.

New admin set does not fix the problem. Medic decides to have the FF hold the line until he can administer the solumedrol and then give up on it so we can get moving. He breaks out the drug box and grabs a needle and syringe. The first needle is too tiny and just about snaps in half when he tries to push it into the vial. Again, I'm holding back on laughing as he looks up at me and rolls his eyes. When he gets a needle that works, he somehow does not have a full dose in the syringe, so out comes vial #2 which provides the rest of the dose. The medic turns around and grabs the port on the admin set, screws the syringe on, and out goes the dose. Right onto the hand of FF #1 holding the IV because the medic injected it into the disconnected admin set which was still taped to the guy's upper arm. Here, I can't contain it and I laugh quietly - thankfully only heard by FF #2 who joins me. Patient's son now opens the back door of the ambulance and looks panicked, "Is my dad okay? Why aren't you going?" Medic manages calm reassurance that we were just finishing up and about to leave. Door shuts. Since there isn't any more solumedrol, the line is discontinued and patched up, and after a little haggling over who is going, riding, and staying, I drive us to the hospital.

After we drop off the patient, the medic finally lets out a little of the frustration about everything going wrong and has me laughing. We head to the pharmacy to replace the 2 solumedrol that we don't want billed to the patient and the medic has a brain fart where he can't remember what drug he wants and I bail him out. Heading downstairs, he tells me thanks because it would've taken him at least 5 minutes to remember the name of the drug he wanted. We had a nice ride back to town, still laughing over everything going wrong.

1 comment:

Ellie said...

Ah, such an educational post. Right med, right dose, right patient, right port...I like it.