Friday, August 22, 2008


Weird medical calls. That seems to be my specialty. Think is psych, wrong answer. It was a bi polar trying to make the manic thoughts go away took to many of the friend's medications. Ended up with the body eating it's own muscles and kidney failure...oh and hallucinations of spiders, lots and lots of spiders. Next one...Panic Attack. No way. The EKG showed a strange narrow complex bigemeny and ecscape PVCs. I did 5 12 leads because the rhythm kept changing. One did show a type 2 AV block, but then the heart onverted itself back into the odd sinus arrhythmia I started with. I looked it up in one of my cardiology textbooks. Escape-capture bigeminy (ectopic atrial escape, sinis beats with prolonged P-R) apparently. It was in the chapter of Blocks. Turned out pt had infarcted several days ago. An Inferior MI. Makes sense, inferiors tend to have strange blocks and such. How about a drunk homeless frequent-flyer. The last time he was in my truck he spit at me, then proceeded to urinate all over the back of the box. The only reason cops won't take him in is because he refuses to ambulate, so they call us to "check him out" so they can arrest him. Only this time he has a BP of 70. Goddamnit. Turns out he has been drinking and doing herion all day.

This is why I am a good medic. I tend to be overly cautious. I have come across to many strange "zebras" to think otherwise. Like my young patient who stated it hurt to breath "right here", but whose vitals were all normal. He ended up with a spontanous Pneumo. Found that with a stethescope. I do 12 leads on just about everyone. But I have found more MIs on Pts with NO Chest pain , than pt with classic signs of Heart attack. Old lady vomiting...Huge Head bleed. Middle age SZ...brain tumor. Athlete in training has abdminal pain...Aortic anyrism. Young woman violent and hallucinating...bacterial menigitis. No wonder I'm a hypocondriac. I think everyone is sick and dying. Good thing I guess in a medic. You don't want a medic who thinks everything is bullshit. But sometimes the hoofbeats are just horses, just not with me. It's always a puzzle. The EMS gods playing little games with me. Like they sit up there in their ambulance in the clouds going "Let's see if she can figure this one out..."

1 comment:

Anonymous said...

Every emergency call is a puzzle. Never blow off any pt. as bullshit until you have filled in all the blanks. Even your best fakers and malingerers will eventually have the "real thing."