The other day I was working the back half of a rescue shift at one of our out stations. It was looking as though we were going to end up with a "no hitter". In other words, no calls. Our one and only call was about 10 hours into the shift at 0400. Of course it was. Why wouldn't be?
So my partner and I are dispatched priority one for a "man down". Don't get too excitied. That could be everything from a cough to a cardiac arrest. Usually they are something in between and they usually have medicare and want to be taken to the hospital. We are enroute to the location of the call when a little bit more information is given to us by that little black box that likes to tell us what to do. Apparently our pt has been lying in bed for an extended period of time (days) but is conscious and breathing. Great. We might as well down grade to a priority 3 at this point.
Upon arrival we find the typical disheveled house with way too much um...stuff all over the place that is an all too common setting for a majority of our calls in the area. Or pt is indeed conscious and has been in the same place for at least 12 hours. However, this pt was not answering questions and appeared confused. So we do the typical ALS assessment stuff. ECG, BP, SPO2, CBG, and so on. Turns out the pt was tachycardic (135 bpm) and borderline hypotensive (90ish/60ish) and was breathing about 30/min. Oh and the sugar was normal. Now these findings as well as environment this pt was in supported the idea that they were indeed lying in bed for about a day or more. Also upon further investigation, the pt is a chronic abuser of ETOH and it usually exacerbates bouts of pancreatitis. But the pt has yet to say a word to me other than a few mumbling of what I am certain were requests to turn on the Tivo'd NASCAR race.
So after some creative manuvering of a stairchair by the FD on scene we get our pt out into the truck for transport and further care. The pt was a bit of a vascular challenge, but not the worst I have ever seen. Mean while the pt is still watching me the whole time and is pseudo cooperative. So our emaciated ETOH abuser was the now the proud owner of an antecubital intravenous line with some NACL going to hopefully bring down that heart rate a bit. As soon as the IV is in, suddenly I get a request for dilaudid. Umm...Really? You don't say a damn thing to me the entire time you are under my care and then suddenly "can I have some drugs"?
Now I don't want to sound like I am with holding pain meds to someone that needs them. However, if you are not going to talk to me the entire time and not even answer questions like "Are you in pain", "does this hurt [pushes on abdomen]", or "on a scale of 1-10, what is your pain" then I cannot just assume you are hurting and send you off into La-La land.
The rest of the transport was uneventful and we transport her to the local hospital. I don't want to sound bitter, but the whole time I kept asking myself "I had to get up for this"? Just another day in the life...
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