Sunday, July 03, 2005

Spark 'em now...Apologize later

Now in mine line of work there are two types of people. Sick people and NOT sick people. You normally can just look at someone and tell. Shit, this patient is S-I-C-K. Their skin color is off, they are sweaty, maybe weak or dizzy. Sometime they will just give you a vague description on how they feel. If a paramedic hears "I just don't feel good" and the patient looks like shit normally they are really sick. The patient just feels so bad that don't really want to use the energy to try and think of how to describe how they feel. Case in point...I got called to a respiratory. Now when we got there he was sitting in a van in a parking lot. Struggling to breath and diaphoretic, his skin was pale and ashen. Just pulling up and seeing him, before I even spoke to him, I knew this man is fucking sick. Something is terribly wrong. Unable to find a radial pulse we just quickly moved him into the back of the ambulance. As soon as I put him on our cardiac monitor I found out what was wrong. This guy was in VTach, a highly lethal heart rhythm. Now mind you that this man is Awake and alert. He kept telling me to lock his car door and to find his glasses. Now the treatment for this a quick, very painful intervention. I was going to have to shock this man with 200Joules of energy to get his heart to quit quivering, which is essentially what it is doing, (think of the heart as bag of worms, just worming around) And because this man had no obtainable blood pressure I was going to have to do this without the aid of sedation. So as my partner was on the radio with the MDs at the ER I was preparing this old man for pain he has never experienced in his life. As I slide and IV into his arm I tell him "What we have to do to help you is going to be very, very painful, but it will only last a second and you are very sick. Your heart is not working like it should"
He responds with "I know...I have bad heart. My Doctor called it Atrial fibrillation, Please don't hurt me"
"I have to."
"no please don't hurt me"
"sir, if I don't hurt you, you will die"
As soon as I said that my partner yells "CLEAR!" hits the "shock" button. The man jumped, just like on ER, and yelps. Then turns to me and says "Did you lock my van?"
After that he was fine. His heart went back to normal and he was able to breath. His skin pinked up and dried up. My partner looked at me then hopped out and drove us to the hospital. On the way I ask my patient if he felt better. He took my hand and said "Thank You"
"Im sorry I had to hurt you"
"No...I feel much better, Thank you"
Then I thought about my mother, who is an ER nurse herself. She once told me two things :
Never let your pulse get higher than your patients...And spark em now...Apologize later.

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