23 January 2007

Diff breathers and a lesson on drinking

Saturday's shift was a day of difficulty breathing. We ran three calls in a row for difficulty breathing, one of them dispatched as a fall. Good day for the students that were riding though because they got to see some seriously sick people.

The last guy (who had supposedly fallen) was sitting in his chair doing the puckered lip, accessory muscle breathing when we arrived. Poor guy couldn't even get a word out he was working so hard to breathe. I'm not sure what, if anything, he told 911 but he hadn't fallen, just couldn't breathe. We got his O2 up to 92% after the duo-neb and solumedrol, but every time he took the mask off his face for even a couple of seconds, he was back down in the low 80s. I don't have any follow-up about him, but I'm hoping maybe they got him a bit more squared away so he could go home instead of to a skilled nursing facility.

The medic I was working with has been around for quite a while and has his stuff together so we were hustling around working more like a real team than the usual tripping over each other that happens with people who've never worked together. It made for a good day and I think we taught the students a few things while simultaneously shocking them about the pace that patient care can move when people know what needs to be done.

We were also on together for the overnight transfer shift which went smoothly, but held us over three hours in the morning while we transported from tiny community hospital to an academic medical center. 19 year old out drinking with friends (BAC more than twice the driving limit) and fell over from a standing position. Patient managed to achieve a basilar skull fracture and epidural hematoma, but still walked into the hospital with friends because someone was sober enough to realize that bleeding from the ears is probably not a good thing. Patient posed no major problems during transport, but it was 50 minutes to the little hospital, 90 minutes from there to the next hospital, and over 90 minutes back, so when you get dispatched at 0500, you aren't going off shift at 0700 as planned. Still, I found it fairly impressive to have a skull fracture from a fall at standing height - makes me glad all I've been doing is bruising my hips when I fall.

1 comment:

Ambulance Driver said...

Hey Jen, nice blog you've got here! I think I'll be visiting often...