firedoc5 Posted July 26, 2008 Share Posted July 26, 2008 We've all had them, call for one patient becomes two, but... Called to home of elderly couple around 03:00. Gentleman answers the door with slurring speech and points to his wife in a chair. To make a long story short, obvious CVA after assessments... He then sits down "not feeling well" himself. So start to assess him. During assessment, he becomes nonresponsive prior to being able to give us hx. and medications. We knew his wife was on hydrocodone due to a past hip fx. (put 2+2 together?) Monitor showed sinus tach@ 120. BP: 120/90 Resp: 24 and deep. Adm. D50. Pt. then went into coarse V-Fib, Defib x 2 = sinus brady @ 50 Adm. 1mg. Atropine. 80mg. Lido. Followed ACLS protocols. This is very interesting to me. I'll let you know why later. Link to comment Share on other sites More sharing options...
Doczilla Posted July 26, 2008 Share Posted July 26, 2008 Did you get a CO level in the home? 'zilla Link to comment Share on other sites More sharing options...
emTpromises Posted July 28, 2008 Share Posted July 28, 2008 Hope you don't mind me jumping in--I'm only BLS, but... does the man have any med. tags? Blood sugar? Any other meds in the house? Link to comment Share on other sites More sharing options...
streetsurgeon Posted July 28, 2008 Share Posted July 28, 2008 humm.. i will have to watch for future posts. what kind of s/s was the wife having,.. what was the initial dispatch for? Link to comment Share on other sites More sharing options...
emtd29 Posted July 29, 2008 Share Posted July 29, 2008 Call for backup perhaps? since you have 2 pts and one is now a code... Link to comment Share on other sites More sharing options...
firedoc5 Posted July 29, 2008 Author Share Posted July 29, 2008 This was the deal I had to put up with. The initial call was for the woman, after assessment, obvious CVA. No med. hx on him could be determined, could not find any bottles with his name on them. But due to the way he answered the door and knew she was on Vicodin and who knows what else, thought that just maybe...So I thought D50, just in case, and Narcan. He coded before I could get to the Narcan. We did get a rhythm back for about five minutes, but lost it and could not resuscitate in the ER. Now, I had a Provisional EMT-P from another agency was there. He tried to have me written up because he thought that if I hadn't taken the time to start an IV, give the D50, we could have already had both her and him in the ER and that he wouldn't have coded on our hands. He thought that if I hadn't "stayed & played" we wouldn't have had to go through a code. One point he tried to make was that when he became unresponsive that we should have just did a "load & go", no treatment. I don't think he realized that if we did load & go, it would have been in back of a cramped rig. Oh, and no back-up for some odd reason, I think there was at least one other call going on across town. The ER nursing Director acted like she was taking it seriously. And actually to this day I'm still not sure if she was taking it serious. The Project Medical Director laughed it off, chalking it up to an up & coming "know it all", which he was. Then he wanted me to sign off on him since he defibbed once and gave epi. and atropine. Needless to say he didn't last long. I think he went to a much smaller program south of us and got certified. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted July 29, 2008 Share Posted July 29, 2008 This was the deal I had to put up with. The initial call was for the woman, after assessment, obvious CVA. No med. hx on him could be determined, could not find any bottles with his name on them. But due to the way he answered the door and knew she was on Vicodin and who knows what else, thought that just maybe...So I thought D50, just in case, and Narcan. He coded before I could get to the Narcan. We did get a rhythm back for about five minutes, but lost it and could not resuscitate in the ER. Now, I had a Provisional EMT-P from another agency was there. He tried to have me written up because he thought that if I hadn't taken the time to start an IV, give the D50, we could have already had both her and him in the ER and that he wouldn't have coded on our hands. He thought that if I hadn't "stayed & played" we wouldn't have had to go through a code. One point he tried to make was that when he became unresponsive that we should have just did a "load & go", no treatment. I don't think he realized that if we did load & go, it would have been in back of a cramped rig. Oh, and no back-up for some odd reason, I think there was at least one other call going on across town. The ER nursing Director acted like she was taking it seriously. And actually to this day I'm still not sure if she was taking it serious. The Project Medical Director laughed it off, chalking it up to an up & coming "know it all", which he was. Then he wanted me to sign off on him since he defibbed once and gave epi. and atropine. Needless to say he didn't last long. I think he went to a much smaller program south of us and got certified. I'd have told him, you wrote me up and now you want me to do you a favor, here take this pen and see how long it takes to get it out of your rear end. If you get it out without a problem, then I'll sign it for you. Link to comment Share on other sites More sharing options...
Christopher.Collins Posted July 29, 2008 Share Posted July 29, 2008 Great story doc... well great as in its a hell of a situation (training a newbie and 2 critical pts), not so great outcome though. Hey if he wanted to sit on the womans chest to perform compressions on the hubby then go for it!! Just curious what type of rig were you in? Deffinatley woulda sucked in a van. What did you have for manpower if any (by backup I would assume another ambulance to tx other pt)? Link to comment Share on other sites More sharing options...
firedoc5 Posted July 30, 2008 Author Share Posted July 30, 2008 Great story doc... well great as in its a hell of a situation (training a newbie and 2 critical pts), not so great outcome though. Hey if he wanted to sit on the womans chest to perform compressions on the hubby then go for it!! Just curious what type of rig were you in? Deffinatley woulda sucked in a van. What did you have for manpower if any (by backup I would assume another ambulance to tx other pt)? A type II Wheeled Coach. You had to move up front to sneeze hard. Had that guy, an EMT-I, and an EMT-A driving. Luckily it was a 5-7 min. ETA to the ER. Link to comment Share on other sites More sharing options...
HellsBells Posted July 30, 2008 Share Posted July 30, 2008 He then sits down "not feeling well" himself. So start to assess him. During assessment, he becomes nonresponsive prior to being able to give us hx. and medications. We knew his wife was on hydrocodone due to a past hip fx. (put 2+2 together?) Monitor showed sinus tach@ 120. BP: 120/90 Resp: 24 and deep. Adm. D50. Pt. then went into coarse V-Fib, Defib x 2 = sinus brady @ 50 Adm. 1mg. Atropine. 80mg. Lido. Followed ACLS protocols. I am curious about why you tried the D50 on this guy, did you get a sugar on him first? Link to comment Share on other sites More sharing options...
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