Am I Going To Die?

I’ve had a Patient ask me so many times “Am I going to die?” Do they really think an EMT or Paramedic would ever respond, “Yes. You’re going to die”. Of course not, yet they keep asking.

What possible scenario could exist where the emergency responder would reply with anything other than “No, you’re not going to die.” What are we going to say? “Yeah, sorry about this, but you’ve only got a few moments left to live. You better make some phone calls.” There is not a single scenario where they would ever say “Yes.”

This question is ridiculous for two reasons.

1. If you are asking if you’re going to live, you are TALKING and thus are conscious and relatively okay. The very fact that you are able to form this morbid thought and then articulate it means your brain and vital organs are functioning adequately and you are in good shape. The ones who are actually in danger of biting it are those who are unconscious, and thus do not speak.

2. If you are asking this absurd question to me, an EMT, it means you or someone has already activated the 911 system and you are getting help as we speak. You’d only be in danger when you’re conscious if you were in the middle of nowhere or alone and could circle the drain over a long period of time. Your 127 HOURS survival scenario.

So in short, if you’re talking (not unconscious or altered) and you’re talking to me (someone who is currently taking you to an emergency room) you are FINE.

This rule also applies to “Am I going to be okay?”. Of course you are. And even if you somehow weren’t, would I really say, “Naw, you’re Effed.” ?

The reality is, people just want the comfort of hearing us say “You’re going to be alright”. And I get that. But when you call 911 for nausea/vomiting, get over yourself. You’re fine.

So in short, if you are ever having a medical emergency, CALM DOWN. It’s the best thing for you and for us.

The 500 lb. Naked Man

You read that right. This was my other grossest call. We got a private call (not 911) to a home of a man who needed transport to the hospital for an appointment. He lied in bed. He was 500lbs. And he was naked. Why, you ask?

Well, he claims medication made her obese and it’s not his fault. I’ve heard this exact line from every morbid obese person I’ve ran on. “It’s not my fault”. Some medications can make you retain weight, but not 500 pounds worth.  And he was naked because a worker comes once a month to bathe him, and this was the day he was to be cleaned. So in addition to the sight, the smell was atrocious as well.

In cases like these, it takes up to 6 men to move him. We needed two other units to come in and perform what is called “A Lift Assist”. All in all, 3 Ambulances were taken out of commission in a very busy area during peak 911 hours. As a result, other units had to cover a greater area and scramble to make due. So when someone had a real legitimate emergency, the response time for an ambulance would be delayed because the unit is coming from further away. All because this man had a doctor’s appointment.

So there we were, six young men standing around the bed of a naked 500 lb. man, who hasn’t moved from his side in six months, trying to figure out how to get him off the bed and onto our gurney. At this point, I said, “Think smarter, not harder, guys.” I suggested we use the thick comforter already under him to move him. It took great strength and care to comfortably and respectfully move him, but we did it.

Three ambulances and a hospital visit was paid for by Medicare, so by you, the taxpayer. Obesity, a preventable disease mind you, causes all Americans to pay 100 MILLION dollars a year. But it’s not just that. Ambulances, Fire Department, and Doctors have to spend 3x as much time dealing with obese patients, which leaves them less time and availability to help you. In England, ambulance services have to buy larger rigs to accommodate the growing rate over obesity. See Link

This man was young and it was very sad this is what his life had become, but when obesity weighs down others, I find it hard to have sympathy.

Shock To The Heart

Ever seen someone get shocked while still conscious? Neither had I.

I recently ran a call on a 30-year-old woman who was having chest pain. She was Indian and there was a language barrier. We tried getting the story from the husband, but he was little help. Her vitals were good and we couldn’t figure out why she was in such distress. Her clinic “doctor” had diagnosed her with anxiety the night before, so perhaps this was emotional.

We got her into the ambulance and put her on an EKG heart monitor, at which point we realized she had an outrageously high pulse rate of 200 beats per minute. The firefighter on scene had taken a horribly inaccurate pulse. This was the highest pulse rate I’ve ever seen on a patient. Her heart was beating out of her chest and the monitor just showed scribbled lines. We all kicked into high gear.

On this day I was driving the rig and the medic in the back was unable to get an IV line on her to give her drugs to slow her dangerously high heart rate down. It was at this point that I heard him say,

“I can’t get a line, so… really push it”.

It my entire time as an EMT, I have NEVER had a medic tell me to drive faster. But the reality was, we couldn’t slow her heart in the field and any minute her heart could give up and stop.

If you think you’ve got road rage, try driving an ambulance during rush hour. Every lane is blocked; people are idiots on the road and get in your way. I hauled with screaming sirens, opposing traffic and swerving around cars. I kept hearing “we’re almost at the hospital. Just hang on”. This poor woman was about to go into cardiac arrest.

For some reason, this was more nerve-racking than someone who is already in full arrest. A full arrest patient is already technically dead, and you’re trying to bring them back, but when someone is on the verge, or circling the drain, it’s all on you. It takes a lot to get my adrenaline going these days, but this certainly did it.

Once we got her to the hospital, the doctors immediately tried giving her drugs, but they didn’t slow her heart. They only had one last resort left. They had to shock her heart to restart it. The trouble was, she was still conscious. I’ve only seen this done on people who are unconscious.

Everyone stood back and the doctor told her, “Ma’am, you’re going to feel a shock.” 

Yeah,.. I’ll say. As the charging sound rang, I didn’t know what kind of reaction to expect. What followed almost made me burst out laughing in the room. I know, terrible, right? The woman reacted like a confused drunk who has a huge hiccup. Her upper body jumped, and she wearily faded back with a priceless look of confusion on her face. And boom, her heart restarted itself back to a healthy rate of 104 bpm.

Turns out the woman was having a heart attack, and shocking her saved her life. Still, I’d never want to be awake for that.