Instead of writing about one of my calls – I haven’t had much to write about lately — I’m going to write about a call a medic I know did a few weeks ago. In addition to being a good story, it is instructive.
The call comes in as a syncope. A basic crew responds along with the first responders. They find a fifty-year old woman who passed out while running on the treadmill. She has no medical history. She insists she is in good shape and refuses transport. Her vitals are BP 118/70, P-64, RR-18. A medic has been drifiting toward the location in case the basic crew needs ALS. The dispatcher checks with the basic crew, who relays what the first responders told them — that the patient is refusing so they won’t need the medic.
The medic, even though she has been told she is not needed, goes anyway (keeping herself available) — call it a sixth sense or whatever. She finds a woman who is pale and clammy, whose skin the medic says feels like a cold fish. The woman repeats she has no medical problems. No history, no meds, not even an allergy. But the medic will not take no for an answer. The patient finally agrees to let the medic do a 12-Lead ECG.
Even with the poor quality of the copy, you can see the tombstone ST segments in the inferior leads — the hallmark of an acute life-threatening heart attack.
Can we say on our way to the hospital? The medic gives the patient some aspirin and due to the possible right-sided MI, withholds nitro.
The hospital, notified over the radio by the medic, is getting the cath lab ready.
The medic drops the patient off, and then goes to write her paperwork. A few minutes later, her partner comes into the EMS room and tells her the woman just coded. The medic goes back down to check and sees the MD shocking the patient. The patient’s eyes open suddenly, she sits up, sees the medic and says “You again? What you’ve come back for a tip?”
Even the medic is speechless.
The patient then apologizes for going to sleep. The doctor has to explain that they were actually doing CPR on her, and they need to get her up to the cath lab right now.
You can talk all you want about medics with great intubation or IV skills, medics who get blood pressures back from dead people in arrest, but this medic saved this woman’s life simply by deciding to go on in and check her out. She knew that syncope is not something to trifle with and then seeing the woman, and knowing that a workout isn’t going to leave a healthy person that cold and clammy, refused to settle for a refusal.
The woman is lucky to be alive and people of her fair city are lucky to have a great paramedic riding their streets.