Mind you as I re-write this blog post (about 6 weeks later), both my paramedic and I agree that we could have taken this old feller to hospital to get assessed regarding a Falls Risk assessment. We did mention this to his carer at the facility, but you never know. Western Australia currently has no scheme in place for proper Falls Risk Assessments. More on that in a blog post down the track.
The night continued with a chest pain; the patient was released three hours later after being cardioverted in hospital. We bumped in to her outside ED. Always nice to get a thank you and good bye from the healed and healthy!
On to an assault outside a pub, turns out that out patient was King Hit and out of it for a few minutes. There was a first aider on scene who took over c-spine management until we arrived, and then helped us throughout the call. Big thanks from us, but be reminded that if you are kneeling and bending over to stabilize the victims head, your whale tail will be exposed to the general public for a prolonged period of time....:-)
Quick van restock, followed by a GI restock (aka NomNom), and off to my first stabbing, the offending weapon being a pair of nail scissors (presumably). The wound (small) was near the spine, so it got checked out just in case.
Next order, one drunk teenager. Had a good chat to the coppers, the friends of the vomiting teen, and some passerbys until the parents arrived to pick their son up.
-~-
Blissfully unaware at that time, the god of opiates was brewing up
a nasty concoction in order to subject us to his full wrath....
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"Female, 20's, unconscious, ?OD. Underground Train Station"
That was our info. I am attending, so I grab everything I need and proceed down the escalator. Everything but the bloody airway bag.
Peeking down the long flight of moving metal stairs, I see a couple of Transit and Police Officers standing around and attending to a female lying on the ground. And she's not doing much. Not even breathing enough. And I don't have my Bag Valve Mask on me.
Not to worry, this being my proper OD I didn't even think of using the BVM. I put a high concentration mask (Non Rebreather) on the patient. As useless as a pair of tits on a canary in hindsight, as I needed to force air in to her. Paramedic to the rescue - and shoves the Demand Head in to my fumbling hands - now I can push a button and force 100% oxygen in to her lungs. Her O2 levels perk up nicely from low 60s to high 80s. We get IM Narcan in, package her up, and off to hospital. En route she starts to come round, and is not to happy, luckily still groggy enough not to be too much of a pain.
Oh yeah, and halfway through all these efforts I got to stick an LMA in :-)
Then: back to depot, restock, revive, relive, debrief, sleep, beep, get dressed, don't stress, navigate, blue/white/red lights bouncing off the walls, fill out case sheet en route, notice it's 4am. That's why everything looks like it's underwater....it's not raining after all, there is no pea soup fog, my eyes are still partially stuck closed.
Anyway, it's another OD, Police on the way. We both arrive at the same time at the house.
Enter house, enter lifeless person on the ground, enter same thoughts as last job, enter same procedures...enter oxygen!
Gee, this guy is way out of it, not looking good. Blue, sats at 61%, airway spasm means we can only trickle O2 in to his air deprived lungs.
I try to stick an LMA in, but the spasm means no air gets in. Paramedic tries to tube him, same thing. We suction, we blast him with air out of our Demand Valve.
Our portable oxygen runs out. I run out to the van to get our spare cylinder, and change it over. My paramedic is impressed with the changeover speed, he later tells me.
One dose of IM Narcan does not touch this feller. Needs more, have to call medical control, Doc allows us more Narcan. Patient seizes ~10 seconds, then relaxes. We bundle him up, and transport to hospital. He is groggy and barely awake en route.
12 hours later in hospital he is still groggy and not easily rousable...he really was out of it. Strange what people do to themselves.
That post in three words: enlightening, entertaining, draining.
More please!
