Frozennoodle
Sir Drinks-a-lot
- 194
- 4
- 18
It's 3:40am and I'm just getting to sleep so you know where this story is going to end up:
"Dispatch to 540 Start heading to Random Death Camp Code 3. Facility advises that the patient is experiencing, "Funny Vitals," advised patient is sating at 85% RR 44 putting it in as shortness of breath because we don't have anything in the cad for, "Funny Vitals,"
"1004 540 En route Code 3"
One 8 minute response later the problems began at the door. No one was there to meet us and the speaker went to an empty room or an empty brain (probably the later) so we were stuck outside for about 6 minutes until we were finally able to get inside.
I don't even get to the patients door and I can hear the fluid in his lungs. I turn the corner and he is Fowler with ashen moist skin breathing at exactly 44 times a minute confused and speaking in short halting sentences with a GCS of 13 and he is actively and continuously vomiting dark brown foul smelling emesis complaining of abdominal pain. The nurse says hes been like this since 8pm when he got on and he doesn't know what's wrong and its not normally his patient. The CNA advises this patient has been like this for the last 3 days (and in my experience the CNA's usually know more about the patients than the LPN's at these hell holes) and he hasn't been having bowel movements and suspects he is impacted.
I toss the pulse ox on him and he's sating at 84% via 2lpm NC. This guy's airway is totally compromised and he's unable to protect it but he's too alert for me to drop a Combi-tube and bagging him to help with the fluid is not even an option unless I want to force fecal matter down into his lungs. I can't even really put a NRB on the guy because of the volume of the vomit that's coming up. I crank the NC up to 6LPM and he goes to 91-93%.
This all happens in around 6 minutes. I throw him on my stretcher and grab a set of vitals in the unit: 130/90 HR 140 RR 44 92% on 6 LPM NC, CBG 351, Temp is 99.1 Axillary. Patient already has a port-a-cath in place and accessed and the hospital is literally about 6 blocks from where we are. I call report and roll over there with him vomiting the entire time. Total time with the patient including on-scene and transport is 12 minutes. The hospital suctioned out a full container of fecal matter from his stomach which resolved the vomiting but this guy still has aspiratory pneumonia.
How can you let a guy vomit up his own fecal matter for days before you call someone? What kind of sick cruel person neglects someone that badly for days? How are you so incompetent that all you can glean from a patient is that his vital signs are, "Funny?" I asked him (more diplomatically) at what point in the last 3 days of him doing this did you change your mind and think "This guy needs to go to the hospital!" What was it that clued you in? I got a blank look as a response. To call these facility nursing homes is a disrespect to the profession. These people should be jailed for their incompetence and neglect. They even had the gall to demand I take the patient to a facility 25 minutes away rather than the one with the 2 minute response time around the freakin' corner.
"Dispatch to 540 Start heading to Random Death Camp Code 3. Facility advises that the patient is experiencing, "Funny Vitals," advised patient is sating at 85% RR 44 putting it in as shortness of breath because we don't have anything in the cad for, "Funny Vitals,"
"1004 540 En route Code 3"
One 8 minute response later the problems began at the door. No one was there to meet us and the speaker went to an empty room or an empty brain (probably the later) so we were stuck outside for about 6 minutes until we were finally able to get inside.
I don't even get to the patients door and I can hear the fluid in his lungs. I turn the corner and he is Fowler with ashen moist skin breathing at exactly 44 times a minute confused and speaking in short halting sentences with a GCS of 13 and he is actively and continuously vomiting dark brown foul smelling emesis complaining of abdominal pain. The nurse says hes been like this since 8pm when he got on and he doesn't know what's wrong and its not normally his patient. The CNA advises this patient has been like this for the last 3 days (and in my experience the CNA's usually know more about the patients than the LPN's at these hell holes) and he hasn't been having bowel movements and suspects he is impacted.
I toss the pulse ox on him and he's sating at 84% via 2lpm NC. This guy's airway is totally compromised and he's unable to protect it but he's too alert for me to drop a Combi-tube and bagging him to help with the fluid is not even an option unless I want to force fecal matter down into his lungs. I can't even really put a NRB on the guy because of the volume of the vomit that's coming up. I crank the NC up to 6LPM and he goes to 91-93%.
This all happens in around 6 minutes. I throw him on my stretcher and grab a set of vitals in the unit: 130/90 HR 140 RR 44 92% on 6 LPM NC, CBG 351, Temp is 99.1 Axillary. Patient already has a port-a-cath in place and accessed and the hospital is literally about 6 blocks from where we are. I call report and roll over there with him vomiting the entire time. Total time with the patient including on-scene and transport is 12 minutes. The hospital suctioned out a full container of fecal matter from his stomach which resolved the vomiting but this guy still has aspiratory pneumonia.
How can you let a guy vomit up his own fecal matter for days before you call someone? What kind of sick cruel person neglects someone that badly for days? How are you so incompetent that all you can glean from a patient is that his vital signs are, "Funny?" I asked him (more diplomatically) at what point in the last 3 days of him doing this did you change your mind and think "This guy needs to go to the hospital!" What was it that clued you in? I got a blank look as a response. To call these facility nursing homes is a disrespect to the profession. These people should be jailed for their incompetence and neglect. They even had the gall to demand I take the patient to a facility 25 minutes away rather than the one with the 2 minute response time around the freakin' corner.
