Thursday, September 18, 2008

For You Blue

A while back, Nurse K wrote of a patient whose pain wouldn't let her get out of bed, but somehow arrived in the ER bed-free.  I often have similar experiences with people claiming to be unable to get out of their car.  In most cases, patients who managed to walk themselves into the passenger seat (let alone drive themselves) should be able to walk out again, at least into a wheel chair.  So whenever I'm asked to break my back removing someone from their vehicle, I approach the situation with an elevated level of skepticism. 

The other night I was working triage when a nurse asked me to bring a stretcher out to the waiting room entrance and help a patient out of their car.  Apparently the gentleman's son drove, and claimed his father was unable to walk up to triage.  Managing to avoid rolling my eyes, I wheeled the bed out the doors and found one of our security guards waving me over to a hastily-parked sedan.  Still highly suspicious, I peered into the passenger compartment to ask the patient why he was having trouble getting out of the car, but received no answer.

Because he wasn't breathing.  

Looking at me with panic in his eyes, the gentleman waved his arms frantically.  Yelling at the officer to grab help, I struggled to lift the patient out of the car, over the curb, and onto the stretcher (after managing to undo the seat belt - safety first!).  A few more nurses ran out the door to help, and what ensued was one of those rare moments straight out of ER.  With the patient turning blue on the stretcher, we sprinted through the waiting room and kicked open the sliding doors behind the triage desk.  As we barreled through the main treatment area on our way to the trauma room, the patient started foaming around the mouth.  Before we even parked the stretcher people were cutting off clothes, starting IVs, getting him on the monitor (O2 sat: 79%) and grabbing meds.  After an extremely rapid Rapid Sequence Induction his sats starting climbing and his skin pinked up.  

All in all, a perfectly legitimate example of a patient who required assistance exiting their vehicle.

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