Wednesday, November 14, 2007

One Word: Batty

Those who have volunteered with me for some time are well aware of the tendency for crazy things to happen all around me for no apparent reason. Not much happens actually to me, but around me. I have an uncanny ability to always be in the vicinity of traffic accidents, people falling down, crazy patients and the like. In firefighter terms, I am considered a Black Cloud. And yesterday, that tendency shone through like the sun's rays piercing an overcast sky.

The day began with me reading, and passing onto my fellow ERT members, a very excellent post by Baby Medic, who spoke of the various methods in which EMS providers handle difficult and combative patients. My good friend Rakesh blogged about this, and my views on the issue are identical to his. I am a helper, an advocate and a provider of care. I show compassion and understanding to my patients, regardless of the situation. I have no desire to use my martial arts training on anyone, much less a patient in need of assistance. However yesterday, I almost had to.

The call came out for a patient who had fallen. Her wrist was bothering her, there was no head trauma, and while she had full range of motion, I was concerned about the swelling. Her face was very pale, her hands were cold, and she was complaining of being dizzy and nauseous. I gave her some oxygen to help with her symptoms.

As the Fire Department was questioning her, they started to notice a pattern of repeated answers. I had noticed this too, and was not certain of the cause. Taking no chances, they did a complete workup on her, including a 12-lead EKG and a conversation with her coworker about her baseline mental status.

The coworker mentioned that she was somewhat flighty, but nothing could have prepared us for her erratic behavior.

She absolutely refused to go to the hospital, going so far as to loudly yell at the paramedic "I NEED MY CAR !!! I won't leave without it !" Finally, they were able to convince her to get on the gurney due to Worker's Compensation rules, but only after she could go to the restroom. I, being the only female responder, followed her.

The restrooms in our buildings are in the middle of the floorplan, and have two doors, one to either side. The patient entered the restroom, asked for help fixing her clothing... then, without warning, bolted out the other door, to the other side of the building.

Perplexed, I followed her, to the cube of a friend of hers. The patient ranted and raved that she absolutely MUST call her 90-year-old mother, and that she was worried about her.

Her mother ? When she was the one that had a possible fractured wrist ? Why would she need to call her mother at this very second, when a gurney was waiting for her ?

When I tried to convince her that she could call her mother on the way to the hospital, she yelled, "I NEED TO CALL MY MOTHER RIGHT NOW !" The look on her face was that of a wild animal, snarling and baring its teeth, ready to attack.


Without a word, I retreated out of the cube, and radioed for help.

As a volunteer, it is not my job to restrain a patient or to force them to do anything. Had she physically attacked me, I could have easily defended myself. But that is the absolute last resort, and something I don't ever wish to do. I volunteer because I want to help, not because I want the satisfaction of restraining someone. The prospect of doing that is frightening to me, and something I wish to avoid at all costs. In my 6 years of volunteering (4 as an EMT), this was the first time any patient had ever made me feel afraid for my safety. It was disturbing, to say the least.

Even after the patient was loaded onto the gurney and meticulously belted in, she attempted to jump off to retrieve her laptop and her purse. We had to convince her that her friend would take her purse off the floor and secure her laptop (which she did). All we could do was be patient, and silently shake our heads when she spouted off about one thing or another.

We deal with all types of people in this business. Even in an office environment.


Blogger Rakesh said...

That's why we look out for each other. You don't know, and it'd be unfortunate that we let our guard down just because we were lulled into ignoring scene safety just because it's one of OUR buildings and we're in a 'familiar', 'safe' place.

December 19, 2007 at 10:33:00 PM PST  

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