Tuesday, April 28, 2009

A "good" stroke

I dare say there is such a thing, but those of us in EMS see so many false calls, any "good" call, is simply a truely legit call.

We were toned out for an 80 year old having a stroke. Unfortunately, I work for a very busy department and our ambulance was coming from a great ways away.

We quickly locate the patient and without even touching her, I knew she was stroked out. She's laying on the bed, and her gaze is fixed to the left. As a family member relays her history to my partner, with me interrupting with questions I felt were more pertinent than her birthday and social security number.

She's had TIA's in the past, and had a stroke without any lasting defecit just a month ago. She's normally walking and talking just as good as you or I. The last time anyone spoke to her was last night, and it's around noon now.

As we start getting some vitals out of the way, my heart sank a bit. Her blood pressure was quite low, 88/42. To me, this basically means it's been too long since the onset of symptoms for any treatments to be overly successful. There's a maximum 6 hour window for thrombolitics (if appropriate), and she's most likely surpassed that.

Of course, being only EMT's, all I could do was gain IV access, administer a bit of oxygen, and wait on the ambulance to arrive. Thankfully, they made awesome time and we didn't have to wait long.

I relayed the story, vitals, and our treatments to the medic.

Found after unknown down time, normally ambulatory without assistance, B/P 88/42, pulse 80, sat. 92% on room air- 96% with 3 lpm by nasal cannula. 20 ga INT in the left AC. Fixed left lateral gaze, slightly responsive to verbal.

She didn't really respond to me, just nodded while her partner pushed the stretcher around the bed to us. One of the guys from my truck grabbed the lady's torso while I got her legs, and we moved her to the stretcher (I'd already ensured she was wearing a long nightgown). We put a sheet over her, secured her with the seatbelts, and moved her outside to the ambulance.

After giving the EMT directions to the hospital since he wasn't the least bit familiar with the territory, we returned to service. The last thing I saw of the lady was the medic preparing to start another IV.

I'm not very optimistic, but I hope she's ok.

My good friend and "adopted" dad, was working one of our dispatch channels. Seeing as the call came out as a possible stroke, I sent him a text, something along the lines of "I know you're extremely busy and may not see this till your lunch, but that lady was definately stroked out." He never responded but I could hear how busy he was so it's ok, I understand completely. I just hope he had a moment to pass the news along to the calltaker.

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