Wednesday, June 30, 2010

Confidence can kill.

Here's a life lesson I learned a year or so ago. I'm hoping everyone from a rookie to someone so seasoned they can cause hypertension just by looking at them.

I consider myself to be physically fit and damn lucky. Working in the rougher neighborhoods has toughened me up over the years. So has taking over a decades' worth of martial arts. First patient v. provider fight I got into involved me trying to calm down an irate family member after my partner had just pronounced them dead. The family member picked up a stool and went to show my partner that he was more than willing to "shove it somewhere". I reacted immediately for fear of my partners' life. I was sure that, if the guy had gotten her on the ground that it would've been over for her in a heartbeat. Why the cops left us alone; two providers versus ten freaking out family members were not odds we wanted in any situation. It was during the hasty retreat to the truck that the family decided that we were the best target to exact their anger on.

A set of bloody knuckles later, the cops were back on scene and I was checking my pulse to make sure I was still alive. I had never gotten into fights in school, so physical violence between myself and someone else was completely foreign.

After that, I felt slightly invisible. I knew I could handle myself no matter what happened. If a patient felt froggy, I'd sure as anything jump with them. I never went looking for the fight, but I was ready and willing when it came.

I was also told I had a way with psych patients. Even the most suicidal/homicidal patients were calmed and persuaded to get in the truck and calmly going to the hospital. That above anything else made me feel...well...invincible.

Jump forward a few years. I was working the late shift when a call came in for an assault at a nursing home. We arrived on scene to find out that a patient had assaulted another patient, and was now holed up in his room. The police were called, but they never showed. My partner at the time was not what someone would consider to be kind. He had an attitude the size of Kansas and the chip on his shoulder was even bigger. Top it all off with getting slammed all shift left me with one pissed off partner.

My partner swaggers into the room and within moments was running back out. The patient was getting violent and was talking about another assault if we didn't leave. Second phone call for the police were made and I then phoned in for backup. I knew that, at that moment, there were three very large men sitting at the station who were more than willing to help me make the patient more compliant. I had already gone ahead and gotten orders for chemical restraints, but if you thought I was going after the patient with a syringe full of Versed, you're crazier than you look.

In comes backup. The plan was to go in, grab the nearest body part and hold it down, while leaving me a fleshy piece of thigh in which to inject the Versed. Then, we'd all leave the room and wait for the med to kick in, then we'd put him on the stretcher and get him out of there.

Simple, right? I've seen train wrecks go better than this.

We all enter the room, trying to look non threatening. We explained to the patient that he was either going to come with us peacefully, or he was going to be given medicine that would make him come peacefully. After he verbally announced that he was unsure if both of my partners' parents were human, the guys held him down. As he was held down, he decided to question my heritage and called me more racial terms than I had the pleasure of hearing throughout my life. I nodded with him, making quips as he talked.

"Yeah, yeah, I know, you think my mother had carnal relations with a dog; No, I do know who my father is, no, my mother is not a female dog..."

And so on.

After we were done, I stood up and clicked up the sharps guard on the needle. Then I did something I had never done until then and have never done since.

I turned my back on a psychotic, violent patient.

Everyone else was filing out of the room, their backs to me. I turned around to my partners and said, "Okay, let's give it 5 minutes and we'll come back in."

Well, all I got out was, "Okay...*URGH!*"

The patient came up off his bed, grabbed me by the ponytail and dashed my head against a concrete wall so hard the paint chipped off, I was knocked out immediately, and as my partners told me afterwards that it sounded like a Watermelon had been thrown at the wall at over fifty miles an hour.

From what I was told, my body immediately seized up, then went limp. I woke up long enough to feel myself being choked by the patient as he began to bite my ear and neck while everyone else was jumping on him, trying to pull him off of me, or me out of his arms.

Being unconcious was weird. I could hear the occasional snippet of conversation, but it was distorted and off. Next thing I knew, I was lying on the floor, looking up at the lights on the ceiling. I know I got up, brushed myself off, and told everyone I was fine, but I felt off. I turned my head left, yet I felt like I was going right. I sat down, but I felt like I had stood up. I figure since I wasn't dropped off at the hospital initally, I convinced them. I remember driving back to the station in the front of the ambulance, but next thing I knew, I was laying in the back, on the stretcher, being looked over by everyone who was there.

One Trauma Room trip later, I discovered I had a severe concussion and BPV (Benign positional vertigo). The doctor believes I got my head cracked so hard that one of the calcium "stones" on the hairs in my cochlear cannals got knocked loose and are now bouncing around in my balance centers of my brain...on both sides. I am now on Antivert for the rest of my life and I don't go anywhere without a bottle of Dimenhyramine with me as well.

I screwed up that day. I was over confident in myself and I let my guard down. I preach scene safety and safe practices on the ambulance all the time. I'm the one smacking the rookie EMT upside his/her head when they charge into a violent scene without looking around and seeing their surroundings.

Please, please, PLEASE! Don't ever do this. If I was alone, say my partner went to the truck for something, or it was just the two of us, I could've been strangled to death, or had an even more severe head injury than I do now. Take this lesson from me, boys and girls; don't ever let your guard down. The one time you do may be all it takes to make it your last call.

Be safe out there, please.

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