Thursday, July 21, 2011

Nausea

This is the third time we've transported her in three days. She can't stop throwing up. She goes to the hospital, comes home, feels awful for a while, and calls us again. I'm trying not to be grumpy, and failing. I was sleeping, comfortable finally, curled up just so that the pager and keys and trauma shears don't dig into my side and leg, waiting out the last few hours of a slow night.

* * * *

The fireman -- a friend of mine -- starts to give me report, but it's an hour before the end of my shift and the hospital is a thirty minute drive away. I brush him off and speak more harshly than I intend to her.

"Still puking? Yeah? Taking your meds? Okay, let's go. Come on, the stretcher is outside."

She's a former drug addict and has the scars -- all up and down her arms, and just as much in her demeanor. There's something in the attitude of many addicts that is a bit whiny and pathetic; it's like the drugs have robbed them of all their dignity and self-worth, and they can never really get it back.

Or, it could be that she's been hurling for a week.

* * * *

Paramedics don't love these calls. Even though we know we aren't actually there to save lives, we want to make a difference. We want to take care of breathing problems and heart attacks and gunshot wounds and car wrecks; not nausea and foot pain and difficulty urinating and all the minor, non-emergent complaints that we end up handling as the healthcare safety net.

We run the calls anyway, and we either get bitter or make our peace.

* * * *

I climb into the back of the ambulance, trying not to sigh audibly.

"Anything different?" I ask, and she shakes her head. Just not getting any better. Couldn't get an appointment to see my primary doc.

I hook her up to the monitor, get a blood pressure, glance at the EKG, all the usual business. When I go to attach the electrodes, I find one that I attached yesterday on her shoulder. Huh. I put the fresh electrode in my hand down and clip the wire on the old one. It works just fine.

The old scars on her arms are now mixed with a fresh crop of track marks from the past week. I know, I've put four or five of them there myself. She's not an easy stick, but the past couple nights I managed to get something, maybe get a bit of fluids in, give her some meds.

Last night I went all the way to the end of the nausea protocol and gave her the quarter-cc of inapsine, as she filled up three biohoop bags.

I rub my face with the back of my arm. I know there's no line to be found on her arms. Whatever. I put one in her leg, mid-calf, in a big vein that I spot without even a tourniquet, hoping the hospital won't raise their eyebrows too far. I dump half a liter of fluid and some zofran in it, and she doesn't puke for a bit.

Great. I pull up my chart from last night and copy her meds, allergies, history. I contemplate copying and pasting my narrative.

* * * *

"I don't want to go to the hospital, you know," she tells me as we unload her. "This is the last thing I want to be doing. I wish I was sleeping, not in the ambulance. I just feel so awful."

"I know," I say, patting her shoulder briefly as my partner punches in the code to open the door to the ER. "I know."

4 comments:

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Nurse and Hospital Stories said...

Too hectic and busy you were, eh. I guess, no one wants to be in a hospital or even in an ambulance, even medical workers, yet we don't have any choice for eventually all of us will be sick someday, and hospital is the place for sick people (though not the right place for a right sleep and rest).

Thanks for sharing,
Peny@uniform discount

Godson said...

I know it gets tough some times with patients like these. But our emt training and experience is for all. Be it emergency patients or patients like these.