System Abuser

The tones woke me up at 1 am for a severe bleed at a nearby trailer park. I went to the station and responded solo in the ambulance. I pulled up to the trailer and was met at the front door by a 40 year old woman who directed me to the tiny bathroom in the back of the trailer. “I told him to take care of that….:” she squawked on and on about how her husband should have done this or that, but I really didn’t want to hear her yapping. I wanted to find her husband, and stop the bleed. I walked into the bathroom. The walls were sprayed with blood, and the floor was slick. He sat on the toilet, pale and sweaty. Blood flowed briskly from his lower leg. I wiped it away with a towel, found the exact spot where the blood came from, stuck one finger on the vein that was bleeding, and pushed, hard. Well focused direct pressure is the fix for severe bleeding. And I may have just fixed this guy, that simple. “Sir, how are you doing?” “I don’t feel so good. One of my veins ruptured.” “Yes it did. How old are you?” “45” “Any medical problems?” “No.” And I continued my assessment, while I kept my finger on that vein. The county paramedics arrived and we started a line. We ran some fluid into the patient and his color returned. We were called back to the same trailer 6 months later for respiratory arrest. I responded at 1 am alone again, walked into the trailer and found this mans wife lying on the couch, blue and snoring 2 or 3 times a minute. “Ma’am! “Hey!” I shouted as I shook her. No response. I nuggied her sternum. Still no response to even painful stimuli. I opened her airway, took out the bag valve mask and started to breathe for this lady. She had a good pulse. I took out a nasopharyngeal airway, lubed it and inserted it into her right nostril to help maintain the airway, and I breathed for her. There wasn’t much more I could do. Her pupils were constricted and that verified my suspicion that she was overdosed on pain medication. She has a history of drug seeking. Ruth, a county paramedic arrived also alone. I told her what I had, that I suspected an overdose. She agreed, took out a prefilled narcan syringe and gave a squirt of the atomized drug up her left nostril. The patient began to fight the bag valve mask and supported her own respirations. She came very close to death this morning. Had it not been for her husband finding her, and for me and Ruth making the response, she would be dead. A few months later we are called back to the same residence for back pain. It is the same patient complaining of back pain that has been going on for days, but she decided to wait till 1 am to call for assistance. She refused to go to the nearest hospital because “they don’t like her there” which I interpret to mean they won’t give her any more pain medication there. As I wait with the county paramedics for the ambulance to arrive this woman goes on about how if the short guy who wears Ravens stuff is on the ambulance I’m not going. “Last time he was here he was mean to me and said I was abusing the system. That we are volunteers coming out and she shouldn’t be calling 911 for non-emergencies.” Tim was good at doing that with frequent fliers. “I told him well if you are a volunteer then you don’t have to come out. If you don’t want to be bothered, don’t come out.” I was pissed. She looks up. “You saved my husband that night he was bleeding. “Saved you too, when you overdosed. But I’m a volunteer, so I guess I should have stayed home.” She got quiet, but I don’t think she got it. The ambulance arrived with Bill on it. I gave him a heads up on what was going on with this patient – really nothing, certainly nothing emergent. “You want to start a line?” I really wanted to. I wanted to start an IV on this lady just to inflict some pain, to give a little payback for abusing the system, and then bashing the people who work tirelessly to serve a leach on society like this. But she didn’t need one. I was grateful Bill was on the ambulance to handle the transport, because I had no patience for this lady. And I haven’t been back to her trailer since.

Stuck Pig

Holy shit, I thought. This lady should be pretty bad. There was blood squirted across the walls of the bathroom. “Hi ma’am. My name is Keith. I’m an EMT with the fire department are you ok?” “Oh, I am fine.” She said in a thick German accent. “But it looks like someone slaughtered a pig in there.” She laughed And it did. There was blood everywhere in her bathroom. “Where are you bleeding from?” “Just a little spot right here.” She points to her ankle. “It’s stopped now.” “Is it ok if I check your pulse and blood pressure?” “I am ok, but sure.” I checked her pulse and blood pressure. Both were normal. “Do you want to go to the hospital to get checked out?” “Oh no, I am fine.” “Ok.” Pretty different from my first varicose vein encounter. We were called to a residence at 4 am, down a long dirt road. Marty and I entered the residence and called out with no response. Marty looked in the bathroom “in here!” he shouted. Inside a woman lay in the bathtub, full of bloody water. I ran out to the medic to get a trauma pad, came back in handed Marty the trauma pad and left him. I was afraid of what I would see. He yelled for help, and I reentered the bathroom. The woman was beyond pale, and not responsive. We pulled her out of the tub and laid her on the bathroom floor. We started to wipe her down to try to find where the blood was coming from. It was a varicose vein on her lower right leg that was ruptured. We put direct pressure on it, then wrapped it tight with kling, put her on the stretcher and rushed her to the ambulance. She was in decompensated volume shock. She lost so much blood it was affecting her brain function. Marty started 2 large bore ivs and ran them wide open to replace fluid. I drove to the hospital. When we arrived and I opened the back doors, the woman who was pale, white and unresponsive on scene was sitting up, pink and talking. It was 5 am, the sun was just coming up, and I couldn’t think of a better way to start the day than knowing I played a role in saving this woman’s life, even if I initially was too cowardly to jump right in, I was ready to charge in first next time, and deal with it, which is just what I did tonight.