first call of the day is...

Start of the 48, the day before yesterday, elderly fall at home with some skin tears to the arm.....turned from a simple BLS fall to an ALS emergent run to the hospital when pt had new onset unilateral left sided weakness, facial droop, and slurred speech......

Day 2 of the 48 (different shift at a different station just back to back), 2 17-year-olds totaled a Stingray Corvette driving down a canyon road, attempting to pass someone, overcorrected, lost control, went head-on into an SUV, fortunately, speeds were slow enough that although pieces of the car were all over the road, only 1 real patient with a nice little forehead lac.

LAST call of the shift was a bit of a doozy though, 2 hours before getting off, reported seizure, rural canyon area, fire medics said they had a 10 min response (we had like a 15-20min on the ambulance.....didn't help it was the second call in someone else's district up in the mountains...) and the kid (another 17 yr old) was still seizing.....polypharm overdose, 1-1-1 on the GCS, had to break out the BVM to assist ventilations, medic said the only reason he didn't intubate is that he was clenching his teeth so hard I couldn't even get an OPA in (NPA dropped in no prob ha) and his heart rate and BP were bad news (I was too busy bagging to really get the actual numbers off the monitor as it was facing the medic not me ha), friends only said he took LSD, but the pinpoint pupils, respiratory depression, and that he woke up in the hospital shortly after 2mg naloxone IV en route point to other drugs ha....kinda cool to see the ED Doc straight up RSI the kid
 
Unconscious in a store approx 60 yom.. apparently pt ( who is, according tothe store owner, a homeless) went in and complained he didnt feel well then collapsed. ended up a code (asystole, yea sounds like vf i know) with rosc and attempted cardioversion afterwards (afib with rvr).
 
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Sudden non traumatic hip dislocation. Guy was driving along, had to take a piss, decided he couldn't wait, so he pulled over to the side, and went to go in a cup or something....and when he twisted....pop! No other trauma, didn't get hit by anything, no history of recent injuries or surgeries or anything like this happening before. Positive shortening and inward rotation and obvious deformity..getting him out of his truck and into the ambulance (then the hospital bed) was a bit of a chore as he screamed bloody murder every time he moved a little.
 
34 y.o. male with sudden onset of chest pain radiating into his back. Waited an hour, when it did not improve called 911. Monitor showed inferior MI, 6 minute scene time, Nitro and ASA. Two minutes later he said he did not feel well. He arrested, defib x 2. Became AxOx4, monitor now sinus tach with no elevation, pt. is pain free. Arrived at the ER looking good. Doc. was skeptical of the MI until I showed him the first 12 lead.
 
cruiseforever said:
34 y.o. male with sudden onset of chest pain radiating into his back. Waited an hour, when it did not improve called 911. Monitor showed inferior MI, 6 minute scene time, Nitro and ASA. Two minutes later he said he did not feel well. He arrested, defib x 2. Became AxOx4, monitor now sinus tach with no elevation, pt. is pain free. Arrived at the ER looking good. Doc. was skeptical of the MI until I showed him the first 12 lead.
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Good job! Those are the ones that make it all worth while.
 
Yesterday, got a call to expect a 77 yo F, who had a pulmonary embolism, kidney failure, and who needed a blood transfusion to arrive at the local Port of Entry. No aircraft available. So, we are waiting and get a call for a 79 yo M who fell and broke his knee. Had to respond to him and take him to the hospital.

Little old lady finally showed up and second unit ended up taking her, but, lucky for them an aircraft was able to make it by then and she got flown out.
 
Sunday it was a trauma transfer, 14 y/o with L4-L5 spinous process fractures.

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Jim37F said:
Sudden non traumatic hip dislocation. Guy was driving along, had to take a piss, decided he couldn't wait, so he pulled over to the side, and went to go in a cup or something....and when he twisted....pop! No other trauma, didn't get hit by anything, no history of recent injuries or surgeries or anything like this happening before. Positive shortening and inward rotation and obvious deformity..getting him out of his truck and into the ambulance (then the hospital bed) was a bit of a chore as he screamed bloody murder every time he moved a little.
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Any pain meds given? I tend to load up these patients before moving them, but I've also had hip dislocations that didn't respond to even large doses of analgesia.

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NPO said:
Any pain meds given? I tend to load up these patients before moving them, but I've also had hip dislocations that didn't respond to even large doses of analgesia.

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Us and BLS engine co got the guy loaded up in the ambulance and still had to wait a little bit for the medic squad to show up, but they did give 4mg of MS before sending us BLS to the hospital
 
Jim37F said:
Us and BLS engine co got the guy loaded up in the ambulance and still had to wait a little bit for the medic squad to show up, but they did give 4mg of MS before sending us BLS to the hospital
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LACo... *Rolls Eyes*

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An atypical AMI with right sided involvement. Initially it had presented like an epidural bleed, and came across as a "fall". Alas, the ever so reliable EMD-coding strikes again.
 
64 year old female who said she wanted to go to the hospital because she thought her home medications were being switched out for cyanide. She also thought a coke bottle she just bought was filled with cyanide.
 
Chest pain transport from the local hospital to the PCI capable facility. Tridil, zofran and Morphine made for a mellow ride.
 
Pseudo seizure to get pain meds.
Fooled the jail nurse. Didn't fool me.

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Chest pain secondary to multiple AICD discharge. Guy was mostly stable with lots of ectopy and couplets of PVCs. We both gave the monitor the side eye during the transport. Guy said, "if those big beats string together my defib lights me up right?"

Yep. That's about it.

I had a chat with the cardiologist at the ED and he debated with his colleagues about amio or lido during the 50 minute transport, then decided to just have me transport him.

Totally uneventful and we chatted about remodeling projects through the entire transport. A good call.
 
NomadicMedic said:
Chest pain secondary to multiple AICD discharge.
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I had a call like that once. Guy called cuz he thought his AICD was malfunctioning and periodically shocking him.....monitor showed runs of V-Tach and then he'd get shocked. We were like "Uh no sir, your defibrillator is not malfunctioning, it's actually working exactly as designed, if not this would be a VERY different call, why don't you go ahead and sit down on thus here gurney and we'll get the nice doc at the hospital to help you out..." The medic left the Zoll printer running and i swear we burned through an entire roll of paper
 
Unknown medical.
Partner turns to me and says, "I hate bulls*** unknown medical calls, it's always stomach pain!"
Turned out to be a TIA. I knew better than to say anything to my partner, she's feisty.
 
Code 3 for the male patient who has been attacked by a rattlesnake.
We find this naked guy who is frantically searching his living room. He states that he was watching TV on the couch when he felt a snake slip into his pants and bite him in the crouch. We find no bite marks, and no snake whatsoever. Then while a police officer is searching his pants he starts screaming at the top of his lungs at the sight of an invisable snake and for us that´s the last missing piece of the puzzle, to take him in for a psych analysis of his psychotic behaviour.
 
IFT of a very pleasant female with multiple PE. A nice mellow trip, hoping she stayed stable.

She did.
 
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