Monday, August 9, 2010

Seizures: Part One

As all good calls are, it was some hour just after we had all gone to bed. We had three on the ambulance and we knew the engine from a near by station with a medic was headed out to the call too.

Dispatch was for Status Seizures.

I was still not a crew chief at this point in time but I was almost there so I was trying to be more aware of myself and what I would if I was in charge, even if I wasn’t.

We get to the apartment complex and manage to squeeze everything inside the elevator before heading up to the room. Not seeing the engine out front, we were assuming we were first on scene. Large red fire engines are kind of heard to miss.

We get to the apartment to find the engine crew half in, half out of the door, our patient on the floor still actively seizing with the medics trying to get a line. He was elderly, mid-eighties, and somehow still moving air despite the face that there was no sign of these seizures stopping any time soon. The engine had parked at the other apartment entrance and in rare occurrence in my area, had two medics on it.

I promptly get to pin the arm down so my medic can go for the IV stick, as does one of my fellow crew members for his medic. My medic misses. His get the IV. My medic goes for a blood pressure. His medic goes to mix up drugs as my fellow arm holding crew member is making sure the IV stays in place. Our third is setting up O2 for the NRB that he fished out.

Pressure is decent all thinks considered and there is a prompt debate over the proper mixing and dosing of medications (it is after midnight and everyone wanted to get this right). That was about when I realized that the arm I was holding was bleeding. And not just a trickle, really bleeding from where the medic had gone for a stick. Hand is promptly slapped over that as I pin the arm down. Someone passes me a 4 by 4 to help with the holding of pressure.

The meds are pushed and in what I can only describe as a "better living through chemistry" moment, he actually stops seizing. We all breath a small collective sigh of relief before quickly getting him into the cot. Downstairs we go in two elevators and hop in the back of our ambulance.

I help with a EKG (simple four lead, Smoke over Fire, Sky over Grass), other arm holder is driving as fast as safely possible and our third is working the O2 when our patient stops breathing. That leads to a whole new set of flurry, our third bagging, as we find an oral airway just as we pull up to the hospital, no time for an update.

In we go, nurses and doctors promptly taking over to keep this man out of cardiac arrest. I slowly back off, hoping that this man lives. We stopped his seizures, we made it to the hospital, we did what we were trained to do.

I never found out if he lived or died. Never found out if he seized and hit his head or seized because he fell and hit is head or if a third possibility was running around. I will probably never know but we did our best. And I learned blood pressure cuffs really do work well as tourniquets.