EMS is one of the few career paths where other peoples’ misery makes our day interesting. As a matter of fact, it is pretty much essential to making our days complete. If we have boring calls, we are bored. Some of us are Trauma Junkies. Some love medical calls. Me, I like crazy people. Crazy people–I can relate to them. I’m just a few clicks from being off the rocker myself so crazy people are easy for me. Plus, you can mess with them…
Today we ended our shift(literally.. we were pulling into the garage and got toned out… again) with a “psych pt on the freeway”). Yes. ON the FREEWAY. Get your attention?
Apparently our lovely 22 year old passenger had fled(ran away aimlessly) from her group home(I love group homes. They supply 40%(made up statistic) of our patients. Most of them who need an ambulance about as much as I need a meth addiction.
This girl was mildly MR, but not bad. She had some depression, which is commonly associated with mild MR young adults. She said she had thought about killing herself–this was as close to a suicide gesture as she had ever made, and I’m not so sure it was intentional. None the less, she earned herself a 72 hour stay at one of the “finest” mental health facilities in the region. By finest I mean understaffed and overworked. They aren’t bright either–their ambulance garage is 500ft of winding hallway away from the ED.
Here’s where the fun starts. She states that she is 5 months preggers and due in LATE SEPTEMBER. Wait…. I looked at my preceptor, and casually asked him: “Is my math ok?” He looks up. “You’re a friggin’ math genius”. Yup… seems that our pt has planned to carry her twins–or was it quints–a few months extra. Yup. You’re nuts.
She was also the primary care provider to 3 young children from her friend who died in a car accident–or did she kill herself? Anyways. Somehow I’m not so sure that the group home has room for the 3 youngins. Whatev. I love a good story.
At least she has an excuse. Better than the uppity people we pick up who act like they weren’t drinking when then rammed that innocent pole.
Anyways–enough about crazies… more about Craziness.
Our first call of the day was for “one down, with burns”. We hear ‘one down’ as CARDIAC ARREST. Not so much. She wasn’t burned either, but that’s neither here nor there.
Apparently our mid-forties pt had just had lunch with her friends and a nice eatery in one of the burbs. She had got into her car, started to leave and apparently lost control of the car, hit a parked car… and her foot was still on the gas. This caused the front wheels to keep going till the point of starting on fire and thus where the “burns” I mentioned earlier came into play.
A bystander punched out the window(only to get himself a trip to the ED too) and pulled her out after turning off the car.
PD and FD arrived on scene about 7 minutes before us. One of our medics just happened to be at the restaurant too. He stated her BP was 240/120, she was posturing and had lost control of her bladder. Her friends said she complained of a headache.
Upon our arrival she was no longer posturing, but her BP was still 200/100. This is a scoop and go. She responds barely to painful stimuli. Not looking good.
En Route we start two 16′s, monitor, 12 lead, blood sugar, pulse ox, blah, blah, blah. I keep trying to talk to her, occasionally getting a little grunt. 10 minutes into our transfer she starts responding with coherent phrases. Appropriate too.
She can tell me she has had a head ache for a week. She has been taking Aspirin every day for it–shit. She doesn’t remember what happened at all. She can tell me everything before it happened though.
10 minutes ago I had a tube out and ready to go, and now she is holding a bucket and wants to puke. Who woulda thunk.
At that point I was dumbfounded. She presented like a classic bleed. Her history presented that way too. But bleeds don’t wake on their own. They don’t just get better.
Wrong. Her CT showed an 11mm ACA Aneurysm near her pituitary gland. WTF. They planned on going in and coiling it(spring to open the vessel).
Yup, one of those days.