Thursday, December 22, 2005
Stupid Medic Tricks
Wow, I had a dumb medic moment last night. Now every one of us has an off day (or night in my case). So we get called to a Severe Respiratory Distress at 0400. Not a time when I am on my A game to begin with and then walk into an actual sick patient who is really having respiratory distress. Now in the four short years I have been in EMS (less than one of them as a paramedic) one of the things I have learned is that calls at 4am are one of two things: complete and udder bullshit or fucking sick. This old woman was the latter. Now walking in the small apartment you could tell she was fighting to breath. I listened to her lungs and she was very very diminished and what I could hear was wheezes. She stated she had asthma and had been short of breath since this morning. She had been taking her Advair all day, and of course that didn;t help, as that Advair is a treatment not for acute onset. I loaded her up and she was still very short. I get her in the back of the ambulance noticing the swollen legs and the enormous bag o meds she had. One of the pill bottles had the label for furosomide (Lasix or Water pills as they are also know) Still that didn't tip me off that what was going on was not asthma. ( like I said dumb medic moment) SPO2 still in the 80s, still fighting to breath. And of all things to forget we have on the ambulance now I forget that we now have access to CPAP. Yes, I forgot. It's fairly new to us and I completely forgot. Plus I was still treating Asthma not CHF, which is what was clearly going on with this woman. However we were two minutes from the hospital, so I start a quick treatment of albuterol for the wheezes and encode the hospital. Now of course the Blood pressure monitor isn't working and she moving so much that a manual pressure is impossible. Everything I tried to hear it all I got was an earfull of diesel engine and siren. And of course the hospital keeps asking me what the pressure is and, well I don;t have one. Finally I palpate a shitty way off pressure. Give them that. And we pull into the hospital. I have no IV, given no Nitro, and forgot about the CPAP. So I felt about two inches tall. And to make it worse the MD on duty HATES medics, thinks we are all incompetent boobs. And he tell me she is in Florid CHF, which I have no ideas what that means. (it apparently means she be real full up) so then I felt really stupid. I did everything I could just to get the hell out of the hospital. I felt stupid and angry at myself that I missed it. I had suck tunnel vision that I didn't see the forest for the trees. Now I know everyone was a bad day, but being a medic your bad day can turn into a death. She didn't die, she was fine. As soon as we pulled into the ER they had the BiPAP ready and everything was good. I am not normally this retarded. I know the treatments. I know my meds. I just had a bad call, made a bad call and tow minutes from the hospital doesn't give much time to think, especially when the nurse on the other end of the radio is yelling for a pressure. I got this AM and called my mom. Being an ER nurse she understands what goes on in the streets. She knows that everyone makes mistakes, we are not always perfect. She told me, so you made a mistake and forgot something. The next time you won't make that same mistake.