BloodNGlory02
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Responded to a call today- 72 y/o male pt found lying in the garage by wife, unknown medical problem. It was by the rescue captains house so she was there right away. 71 y/o man found unresponsive in the garage by his wife. So Angie gets there, said the guy was prone, she rolled him over, he had vomit all over, had an insanely high blood pressure, barely breathing. So we get there, run up to the garage, Angie starts an IV, Marty tries to get an airway in, he wont open his jaw, so we load him up, get in the ambo, in the mean time the cops are trying to calm down his wife, so we try the nasal in the squad, we get it in with a little resistance. I must say thats the first time I've done a nasal. Its so much like stuffing it in the dummies nose! anyways, we get going, this guys pulse is all over the place and his heart rhythm wasnt really a rhythm. this guy was hairy so the leads were fallin off. Well the guy pretty much stops breathing so I suggest we bag him. start that, get another BP, I call the hospital to let them know we're coming in. This is where it gets frustrating.
** me
&& dumb nurse I wanna kill
**St Lukes ER From TCFD 1451
&& Go ahead TC this is St Lukes
**Enroute to your facility with a 72 y/o male patient, unresponsive, assisted ventilations. pt was found by wife in garage, unknown down time. pt has hypertension and takes medication for that, upon EMS arrival pt. prone in slight yellowish vomit. We currently have an IV established, nasal airway inserted and are assisting ventilations. Our vitals at this time are 224/126, pulse of 84 and fluctuating, 12 breaths a minute assisted and pulse ox of 98%, we'll be to you in 5 minutes.
&& TCFD that blood pressure is NOT POSSIBLE
**That is what we've gotten 2 times.
&& Please revital as that blood pressure is NOT POSSIBLE
** Um.. yea 10-4 standby.....
...........
...........
...........
**St Lukes our repeat pressure is (somewhere near what I originally gave)
&& (sigh & snotty) tennnnnnnn four TCFD see you in 3 minutes.
How the hell is a nurse going to tell me my blood pressure IS NOT POSSIBLE? Im not lying. Thats what the screen said. Sure we get some interferance using the machine, but our VERY competant paramedic/RN/loads of experience Rescue Captain took a manual beforehand and also had something in the 200's. I was so pissed off at that. We got to the ER, I continued to bag until the doc was ready to intubate. We stood around for about 10 min before I went to do paper work. Mind you I was still fuming. They hooked him up to their BP cuff and got 230 something over 120 something. So i KNOW my BP wasnt off. So i finished the report and the tech that came into the room was very nice, I asked her who the nurse was that took report. She pointed her out and I told her what happened. She said she does that to a lot of squads. Im contemplating writing a letter to their ER director. There is no reason for her to be telling me that a perfectly obtainable BP is NOT POSSIBLE. I've seen BP's of 200's before it is VERY possible.
The guy ended up having a head bleed. The doc didnt think he'd make it more than an hour. We went back in the room before leaving to hand over paperwork and the guy was bleeding out the nose and one of their IV lines came out and it was like he was on 200mg of coumadin. It was a faucet. So I guess ill find out in a few days if he made it.
So i have a question- im thinking about writting a letter to their ER director just because of the manner in which this occured. When does a nurse have the right to downright argue with an incoming squad with a critical patient? It was just 2 of us in the back so I didnt have time to talk on the radio and bag the pt. I had more things to attend to. Would it be a good idea to alert the ER to this nurses "practices"? Another emt said "you wont last long in EMS if you get all worked up over this" it is a big deal to me when im second guessed. Any thoughts??
** me
&& dumb nurse I wanna kill
**St Lukes ER From TCFD 1451
&& Go ahead TC this is St Lukes
**Enroute to your facility with a 72 y/o male patient, unresponsive, assisted ventilations. pt was found by wife in garage, unknown down time. pt has hypertension and takes medication for that, upon EMS arrival pt. prone in slight yellowish vomit. We currently have an IV established, nasal airway inserted and are assisting ventilations. Our vitals at this time are 224/126, pulse of 84 and fluctuating, 12 breaths a minute assisted and pulse ox of 98%, we'll be to you in 5 minutes.
&& TCFD that blood pressure is NOT POSSIBLE
**That is what we've gotten 2 times.
&& Please revital as that blood pressure is NOT POSSIBLE
** Um.. yea 10-4 standby.....
...........
...........
...........
**St Lukes our repeat pressure is (somewhere near what I originally gave)
&& (sigh & snotty) tennnnnnnn four TCFD see you in 3 minutes.
How the hell is a nurse going to tell me my blood pressure IS NOT POSSIBLE? Im not lying. Thats what the screen said. Sure we get some interferance using the machine, but our VERY competant paramedic/RN/loads of experience Rescue Captain took a manual beforehand and also had something in the 200's. I was so pissed off at that. We got to the ER, I continued to bag until the doc was ready to intubate. We stood around for about 10 min before I went to do paper work. Mind you I was still fuming. They hooked him up to their BP cuff and got 230 something over 120 something. So i KNOW my BP wasnt off. So i finished the report and the tech that came into the room was very nice, I asked her who the nurse was that took report. She pointed her out and I told her what happened. She said she does that to a lot of squads. Im contemplating writing a letter to their ER director. There is no reason for her to be telling me that a perfectly obtainable BP is NOT POSSIBLE. I've seen BP's of 200's before it is VERY possible.
The guy ended up having a head bleed. The doc didnt think he'd make it more than an hour. We went back in the room before leaving to hand over paperwork and the guy was bleeding out the nose and one of their IV lines came out and it was like he was on 200mg of coumadin. It was a faucet. So I guess ill find out in a few days if he made it.
So i have a question- im thinking about writting a letter to their ER director just because of the manner in which this occured. When does a nurse have the right to downright argue with an incoming squad with a critical patient? It was just 2 of us in the back so I didnt have time to talk on the radio and bag the pt. I had more things to attend to. Would it be a good idea to alert the ER to this nurses "practices"? Another emt said "you wont last long in EMS if you get all worked up over this" it is a big deal to me when im second guessed. Any thoughts??