Monday, September 19, 2005

MIs and Crazy bitches

I was a busy 24 hours. We had 9 calls, only one really and truly needed an ambulance. He was an older gentleman mowing the grass in the hot South Carolina heat and began having chest pain. He had a long cardiac history, so my partner and I loaded him calmly in the ambulance and hooked him up to the monitor. Normal Sinus without ectopy, the 12 lead EKG showed the same. Nothing jumped out, no elevation in any of the leads. Now just a quick explanetion to my non medical people reading this. Normal Sinus is a normal heart tracing, ectopy is any unusal beats, like a PVC ( premature ventricualr contraction). And elevation on a 12 lead is elevation in the ST segment of a heartbeat. A Heartbeat is sperated into several segment. PQRST. the firts little bump is the P-wave which leads into the QRS that big pointy part of the beat and the last little bump is the T-wave. If there is Elevation in between the S and T wave it means basicly the patient is having a "cardiac event" or possible a heart attack (or Myocardial Infarction). If it depressed it means the Patient has already had an MI and it shows Cardiac tissue damage. Now a 12 lead EKG is like several cameras taking several diffrent pictures of the heart at diffrent angles at the same time. So there might be elevation in some pictures and not others. So not only can I tell that my patient is have an MI, but I can also tell where in the heart my patient is having one. This is hard to explain really w/o a picture of some sort and if one is so inclined check out Emergency EKG.com for further information. Okay back to story at hand...So we took a quiet ride to the hospital, gave the Nitrogylcerine, the asprin (yess the commercials on TV are true Asprin can help save your life during a Heart Attack) the oxygen. And dropped him off with the nurses at the ER. We came back a few hours later to find our that our patient had had an Inferior MI. Now that is just proof of everything our Med control Doctor drill into our brains at every inservice every month. "Just because you don't SEE the MI, does not mean your patient in NOT HAVING the MI. Treat every chest pain patient as if they are having the BIG ONE."

We also had a compleatly out of her head patient, who keep yelling and cussing at us. She kept screaming that the police "attacked her" and that my partner has assaulted her, which of course is not true. As I sat in the back with her she kept flinging herself areound the back of the box, refusing to let me touch her, eventhough she kept screaming That I was not doing a fucking thing. I should be "Like, doing a fucking physical exam or something!" Well you nutjob, I would if you would let me. But everytime I tried to talk she would scream "RAPE!" at me (I'm a female Medic, so I get the joy of riding in the lunatic females) so I just gave up at let her continue to scream nonsense and cuss. Now when I encodeed the hospital, she was still carrying on so I basiclly encoded softly, keeping the mike keyed up, so that the receiving hospital could hear the comotion going on the background. And then They asked me if HER VITAL SIGNS WERE STABLE?! I told them I think so by how many times she had dropped the F-bomb on me. I heard a chuckle from the staff and they told me to bring her on in. She then proceeded to scream Rape at the ER doc, then throwing a tray at the nurse.

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