Last call of the day is....

Last call was a seizure, 10 min drive to get there, and then another few minutes to navigate the multi building condo complex (we were only given the street address, and there were no building numbers or unit signs or anything saying, "hey to find this condo, go this way") that was on the side of a sloping hill, just enough that Every. Single. Walkway. had stairs, some were little groups of 3 or 4 in a staircase, but most were that annoying, just close enough, but just far enough apart to break your stride...made trying to get the gurney in REAL fun as we didn't know this was the layout until we were stuck in the middle of it. Finally find the right building...and lo and behold there's a relatively straight pathway back out to the driveway where we parked (we came in through a more or less main entrance) -_-

Despite all that the Pt was still very postictal and disorientated when we made pt contact, had to spend a couple minutes just coaxing the 6'5" 220lb pt into the stairchair, go down from the second story of the condo, which due to the hill, was another flight of stairs down to the main stair littered pathway...it was easiest just to wheel the stair chair all the way to the ambulance, then I stayed with the patient while my partner and a couple firefighters recovered the gurney from where it was left inside the condo complex....20 min drive to the hospital later guy was still only just barely recovering his mental state, though still not acting appropriately per family
 
69 yom increasing SOB x 2 hrs + increasing abd pain. Pt also dizzy; no CP, nausea/vomiting/recent illness. Hx of only colon CA; Rx Norco PRN (took one with no relief). Pt had 4.5' of colon removed 10 days ago with abd pain normally 4/10 but now 8/10. Initial vitals: 128/78, 132 HR, 88%, 32 RR. Pt afebrile. L/S clear in apices, diminished in bases; improved to 98% with NRB with minimal improvement in distress. Pt vitals after move to gurney: 86/48, 140 HR, 97%, 30RR. 12L non-STEMI. Minimal improvement to BP after fluid bolus.

I suspected he had abd bleed creating pressure on his diaphragm. Turns out he had abd bleed PLUS multiple bilateral PEs.


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90 yo lady. Vomiting and abdominal pain. Chicken soup.
 
69 YoM for a Psych 302 (involuntary commit) due to homicidal ideations and violent outbursts from the crisis ward of the city hospital to the closest VA hospital (33.5 miles away) for psychiatric treatment. Had soft restraints and a third rider ready after verbal judo failed and the patient refused transport without grievous harm to himself or others. The supervising physician was paged by the nursing staff to obtain orders for chemical restraints but the doc decided to keep him for another 24 hours under observation at their hospital. Cancelled on scene by staff, cleared, and went to Arby's.
 
Kevinf said:
69 YoM for a Psych 302 (involuntary commit) due to homicidal ideations and violent outbursts from the crisis ward of the city hospital to the closest VA hospital (33.5 miles away) for psychiatric treatment. Had soft restraints and a third rider ready after verbal judo failed and the patient refused transport without grievous harm to himself or others. The supervising physician was paged by the nursing staff to obtain orders for chemical restraints but the doc decided to keep him for another 24 hours under observation at their hospital. Cancelled on scene by staff, cleared, and went to Arby's.
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Arby's was my favorite part of this post. :) brown sugar bacon FTW.
 
Boxing match. Boxer got TKO by his opponent. Out cold for about 30 seconds. 1 of the 3 ring Doctors on duty checked him out and then had us baby sit and take vitals every 10 minutes for 30 minutes before he was allowed to leave.
 
Last call of my day came in as an unresponsive, but turned out to be a homeless man who had been ****ting himself for the past week and then smeared his own feces all over his body and his beard. Refused to speech to us or move at all but was fully alert. horrible conjunctivitis and oh god don't even get me started not that smell, I've had patents that smell but this was a whole nother level of hell that has been lingering in my nose for hours and of course in the rig for the next week (sorry Tuesday crew). We had to towel off and disinfect his arm many times before we got the IV in because he. was. covered. in. dung. Not to mention the blast I had disinfecting the rig afterwards, gives a whole new meaning to the expression "****ty call".
 
Black lives matter protest... That was boring.
 
Structure Fire standby in our first in district (although FD doesn't auto dispatch us on the initial alarm so we were last unit on scene). Single story, single family dwelling, fire contained to one bedroom, but no occupants (neighbors report the house is known to have squatters though), no patients, stood around for a few minutes watching fire cut holes in the roof before being cleared back to quarters ~15 min before shift change.

(my partner was a night shifter, he didn't have a partner and my partner only worked the first half of my 24hr shift so dispatch was actually smart enough to simply put him on my shift, anyways he was still awake and remarked he wondered what the heck all the sirens were about since the call was only a couple blocks from our station lol)
 
Altered heat patient. Got off a bit over an hour late on the call.
 
Polypharm overdose that we hung pressors on then sedated, paralyzed and intubated.

Yay for 4 hours of paperwork!

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Last call was a "sick person" at a SNF.

Pt found in respiratory arrest. Pt was in fluid overload an had a pool of bloody frothy fluid in her mouth. In SNF for recovery for plural effusion. Pt went into full arrest shortly after.

The SNF did put the pt on 2lpm though. God bless 'em.
 
NPO said:
Last call was a "sick person" at a SNF.

Pt found in respiratory arrest. Pt was in fluid overload an had a pool of bloody frothy fluid in her mouth. In SNF for recovery for plural effusion. Pt went into full arrest shortly after.

The SNF did put the pt on 2lpm though. God bless 'em.
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Not my patient.
I just came on shift.
They were fine 10 minutes ago.
They just stopped breathing.

Lies. Lies. All lies.
 
Motorcycle vs vehicle TC at 30mph. Open radius ulna Fx. Splint and lots and lots of pain meds. 5 minutes after arrival at the ED the patient was being sent to CT then X-ray then OR.
 
For the second shift in a row, Cardiac arrest. Last shift, it was in the home. Last seen normal at midnight, and the call came out at 0500. ACLS protocol followed, 20 mins of CPR, 5 rounds of epi, an intubation. Asystole for the duration. Called on scene. This time, at a local nursing home. 90 y/o, family wants everything done possible to resuscitate. CPR in progress PTA x 20 minutes, Asystole on our arrival, worked for an additional 20 minutes and called. Now, I've acquired the moniker, "Angel of Death"...not sure how to feel about that one.
 
Our first call was also our last call of the night shift.
Self inflicted GSW to the head with a .45 acp pistol (bloody nice 1911 by the way).
Thought the guy was DOA when we saw the massive amount of blood, CSF and brain matter coming out of a fist size hole in his head but he still had agonal respirations and a HR of 55 with very very faint central pulses.
Needless to say he coded on us 20 minutes later. Sinus bradycardia -> VFib-> Paddle Wack - > PEA - > Asystole.

Definitely think the walls and the roof in that room will need a repaint.
 
Possible ovarian rupture. Amazing what a little fluid, pain control, and (most importantly) comforting words can do.
 
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