The other day I was working my regular shift with a new partner. It was an uneventful morning of sitting around and just doing a whole lot of nothing. And then the tones drop in the local area for a priority one call. At least I was able to have my coffee before the call.
Enroute we are updated that we are responding to a young man that has had a seizure at one of the local AMI factories or fast food joints. The FD beats us on scene and didn't report any seizure activity over the radio upon their arrival. Well, that is good.
When we finally show up and thankfully beat the breakfast/brunch rush and find our pt who is the skinny, suburban gamer type of guy who is stuck in that awkward age between teenager and twenty something. He is alert and oriented but looks kind of sick. Grey actually. Perhaps it was the food. I know BK does that to me. The FD reports that this guy passed out and has been awake for the past 24 hours. Probably playing video games and knocking back monster energy drinks to compensate for the lack of girlfriends.
So we ask the usual questions and do the usual assessments. His blood pressure is 88/50 and is bradycardic in the 50s but its irregular. He also has a weak radial pulse. Despite all of that, he says he feels fine and doesn't want to go to the hospital. If I were him, I would have just wanted to go to bed. Some one suggests we do a set of orthostatic vitals. Sure...why not.
We get Nintendo Mclady's man to stand up for our second pressure and we watch the monitor. He still claims to feel fine though. However, his heart rate goes from 50 to 40. To 29. To 20...to 12. This is where our patient utters the words every Paramedic hates hearing, "I don't feel so good" and he passes out. I jump behind him to catch him and lower him to the ground. My partner said I moved like the wind and was basically a ninja. Oh and the monitor showed asystole for about 7-10 seconds. You gotta be kidding me!
Now that we have him on the ground I notice his pupils are now the size of quarters and that he is breathing about 3 times a minute. I apply a very vigorous sternal rub and check for a pulse. Both efforts did not result in anything. However, just as I was about to put my weight on his chest to start CPR, he takes a huge deep breath and sits up. He looked a little upset. Well, you just bought a trip to the hospital.
Mr. Personality got an IV, fluid bolus, a 12 lead which didn't show anything other than borderline bradycardia, and some 02. While the typical EMS routine is being applied to this guy, he mentions that he is pretty bored with this situation. He even states that he was really tired of the IV that my partner put in. Every time we ask him a question it basically end with him saying something to the effect of "Yeah...ok" or "I guess. Whatever". It looks like someone has yet to grow out of his teenage angst. He probably hates his parents too. I guess he was bored with his ambulance ride too because other than his bout of being dead at BK, he was asking how long he would be in the ER. Really?
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