Friday, November 21, 2008

There's 2 feet of snow out, and you called me for THAT?!?!?

Which is what I wanted to say, but didn't. I try my hardest to be nice to everyone, despite my callous thoughts. I don't get bitchy till the patient starts it.

It had been snowing since last night. The county plows couldn't keep up with it, and were only keeping the most main of main roads clear. Once we got into the developments and such, we were on our own. Sometimes, if there wasn't another call, and they got to you in time, one of the small guy plows, the guys with plows on their pick-up trucks, would preceed us into the communities, making sure we wouldn't get stuck. More often that not, especially as the day went on and the snow accumulated, we were on our own.

The call toned out for the 'sick person.' I grumbled as I climed into the officer's seat. "This better be for real," only I'm sure there were more expletives in it than that. It was barely 9am, and I had been out all night on car wrecks and a house fire (never put your warm ashes in a plastic bag and pitch it into your carport, where it falls under your car. No, it was not cold enough outside. Obviously). My partner didn't say anything, but we drove out into the snow.

The snow in the development was brushing the undercarriage of the ambo. In another few hours, we wouldn't be able to make it in here without help from a plow. It was a nice development with modest townhouses, and we found the right one with little trouble. The patient was inside at the kitchen table, looking fairly normal, if slightly pale.

I started with my usual. "Hi, my name is Gnome, and this is my partner M. What seems to be the trouble today?"

The woman smiled at us, not looking very sick. "Well, I've had this stomach bug for a few days now, along with some head congestion and coughing. I just feel sick, and can barely keep anything down. I tried eating breakfast this morning, but it came right back up, and then I couldn't stop vomiting." Her husband is patting her shoulder, and I hear the unmistakable sound of Saturday morning cartoons coming from the other room.

"And then she tried to blow her nose and her nose was bleeding and it wouldn't stop either, for like 15 minutes!" the husband chimes in.

Through questions, I find that this happened around 7am, and it took them about 2 hours to decide to call for an ambo, mainly because she was still feeling ill, and when she tried to drink some orange juice, which came right back up. We take vitals, all which are within normal limits, though she does feel a little on the warm side. She says she's been running a low grade fever since yesterday.

I start giving them options. "Well, we could take you to the hospital, and you'd probably get in pretty quick, but there's no garuntee you could get home today. The roads are all closed to all but emergency traffic, more or less, and your development has almost 2 feet of snow on the roads. The main roads are not much better; the plows can't keep up with the snowfall. So there aren't any taxis that would get you home."

They nodded, and after a brief discussion, decided to stay home. I gave her some ideas to keep food and drink down, because she was likely dehydrated. "When you drink something, make sure it's close to room temp. Not too sweet, not too acidic, or that will upset your stomach. Take a small sip, barely enough to swallow, because your stomach is sensitive right now, and large quantities will make it reject anything that gets put in it. Same for food. Dry toast, or crackers are good right now. But nibble on it so that you don't shock your stomach." They nodded, and seemed to feel better. We told them to call us back if they felt they really needed to go to the hospital, and left.

We got sent from that call to a man with horrid stomach pains. Met us at the curb, hopped into the back as soon as we pulled up. I sat him in the captain's chair. "I have these horrible pains, I don't know what they are. I've never felt anything like this before. I think it might be appendicitis." Pains were centered over the abodomen, spanning both the LRQ and the LLQ. NO change in pain level on palpation, rated 10/10. We head off to the hospital, and I'm in the process of getting vitals when he lets one of the biggest farts I've ever heard from someone. Thank God it didn't stink, cause our windows don't open.

Red-faced, the man apologized. "I am so sorry! I never meant to do that. But hey! I feel better now. The pain's all gone!" He seems more embarrassed that he farted in front of me than that he called 911 for gas pains. Then he asks the coup de grace. "Can you take me home? I don't want to go to the hospital now."

I sigh, inwardly. We are closer to the hospital than his house now, and at the rate the snow is falling now, we'd never get back into his development, plus the man is wearing slippers, so it's not like he could walk the half block back to his house. "I'm very sorry, sir, but we are a one-way service. We can't take you back to your house. We can only take you to the hospital. I am sorry." And I am. Sorry that the hospital staff will have to deal with him when there's nothing wrong with him.

He takes this news well, smiling and sitting back, and talking to me about the improbability of gas pains sending him to the hospital. He still doesn't seem embarrassed; rather he's talking about 'better safe than sorry' and how it could have been something more serious. I just keep writing, wondering how the hell a man in his 40's could possibly not know the difference between gas pains and appendicitis. We pull up to the emergency room waiting area door, and I walk him in. He has a seat in the room, and starts watching TV. I go to the nurse's window and give her a brief report. She chuckles. "At least now I've got a good story. Things are pretty dead here today, for obvious reasons."

Two hours later (about 15 minutes after we get back to the station) we get tapped out for the same address as the first call. This time, we have to wait for a plow to get us into the development...the snow is now above the undercarriage, and when the drop-down step comes out of the side door, I have to knock the snow off of it. We arrive at the house, and the husband and wife are waiting outside for us. Bags are packed. They hop in the back. "I did what you said and it was working," she tells me. But then I fell asleep on the couch for a bit, and when I woke up I was so thirsty that I drank the whole glass of water and it just came right back up. So we decided to call you back."

I only nod and sigh. They tell me that they got a neighbor to watch their kids. It takes us 45 mintues to get to the hospital, which is normally a 10 minute drive. This time, the patient was on the stretcher, so we wheeled her into the emergency entrance. I gave report to the nurse, and we headed back home. AN hour later, we pulled into the station.

Yeah, I try to be nice to my patients. I try very hard to believe that they really and truly thought that this was an emergency. Usually I succeed.