Sunday, August 21, 2011

Extrication via a slide

Yup. That's right you heard me. We "extricated" someone via a slide. Now let me paint you a better picture...

     I was on what was the beginning of a very busy 24 hour shift when my partner and I get a call for a teeny-bopper having a seizure. So this is not the type of call that as one of my fellow medics puts it, a "red cabinet call". You know, the red cabinet that says "only for emergencies" and requires two keys to be turned simultaneously to be opened, and for some reason there is a man standing next to it with a briefcase hand cuffed to his wrist. That kind of call.
     Anyway, as I digress...we arrive on scene with the local FD on scene doing their BLS thing for this pt who was in obvious distress. This kid was A/O x 0 and was unresponsive. Still a pretty vanilla scenario. It gets better. For some reason this kid in his early teens was at the top of a slide on a children's playground when he decided to just not respond anymore and start twitching. There were some concerns as to how we should get him down from this monument to the recess period. A few of the guys wanted to get this kid on to a back board and off the top of the slide. Oh, side note ... this "kid" weighed more than me. He was a good 200 lbs. Ok, back to the story. Our "fluffy" teen was unresponsive to pain, breathing approx. 20/min and appeared to be contracted in all extremities. But since he was at the top of the slide, I decided it was best/easiest on everyone if we just slid him down it. So after some careful maneuvering, we got him from the top of the slide onto our gurney with me at his feet making sure he didn't go to fast or over the sides. After all, he was a big boy.
     So we get him onto our gurney and do the usual IV, O2, monitor, v/s protocol. This poor kid was tachy, hypertensive, and contracted. When I say tachy, I mean really tachy. Like 190-200. Not SVT, but seriously over stimulated. Oh and his pressure was 180/100. So we get the fluid going and a phone call to the local hospital for some good old fashion online medical direction. I tell them what I got and ask for an order of Valium to help calm him down. Again, I was pleasantly surprised to find a cooperative physician. So the pt gets a dose of 5mg of IV Valium and shortly there after he relaxes his extremities and slows his breathing down to a more acceptable rate and depth. Still unresponsive to pain at this point but his V/S are starting to calm the #$%@ down.
     We continue our transport and reassess frequently with a gradual return to baseline. He never got there for us but a few minutes in the resus room and he was talking again. And of course, he had no idea what happened and never took anything a day in his life. But before he started talking, as we rolled into resus we move him over to the bed and his IV gets pulled. WTF? Really? I guess it was better than pulling a central line on a CCT transfer. Just saying...
     Anyway, as it turns out he finally admits to using K2 or Spice earlier. I have to say nothing about that stuff sounds appealing. I guess it is easy to get so kids will use it and brag about it. Nothing like being tachycardic, hypertensive, contracting, and being completely out if that sounds like a good time.

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