05 November 2007

Recipe for confusion

1 dispatch, "Meet PD for psych problem"
1 caseworker outside building
1 naked patient
2 unhappy cops
3 people on the ambulance (1 student)

Apply dispatch to EMTs, stir gently for 3 minute response time while student verbalizes potential patient scenarios. On scene, add caseworker. Allow complaints of patient medication non-compliance, conditional discharge, and other caseworker jargon to saturate EMTs, eventually requiring them to be rude and ask for entrance to the building to assess patient. At apartment, add 2 cops to a separate dish, laughing at EMTs and being grumpy for getting dispatched to a medical call where they had to request an ambulance. Add sweaty, naked patient, breathing heavily, answering "yes" to all questions. Wait patiently while EMTs stick to floor, seek clothing, dress patient, continue to be mocked by PD, attempt to get non-jargon information out of caseworker, and walk patient down stairs. Place PD aside for potential use in different recipe. Place mixture in ambulance, find out patient is schizophrenic with violent hallucinations, caseworker knows nothing further about medical history, knows nothing about what medications patient takes. Continue assessment, find blood sugar reading "HIGH" on glucometer. Agitate gently for 4 minute transport to hospital. Remove from ambulance and deposit mixture into ER room. Serves 6-8.

Sounds tasty, no? This entire call left me completely confused. The patient was trying her best to do everything we asked of her, so I was fairly irritated with the caseworker complaining about "non-compliance" when there was clearly a bigger problem going on. No known diabetic history, but this patient was in DKA (diabetic ketoacidosis). We missed it initially because there were so many funny smells in the apartment and we had been focused on psychiatric issues. At the hospital, they intubated her immediately. We later found out that she was also in renal failure and had some sort of fungus in her blood.


manchmedic said...

Geezus.... And leave to the PD for being a-holes throughout the call. Sometimes they can be more of a pain in the ass than a help, don't'cha know? I still remember the time I got punched by the OD that Squid and I had after 2 of Narcan. They laughed at me that time, too. I was rather pissed....

Ellie said...

Love the recipe bit, very clever. Good old ManchVegas.