Thoughts

So tonight I am starting my ride time for the last portion of
Paramedic School. I get to put all the things I have learned during
the past year and a half to the test and see how it works out. Kind
of nervous but thats to be expected.

First call is to a 89 year old womans house due to a change in mental
status. Now a "Change in Mental Status" can mean a multitude of
things and be caused by an equal multitude of things.

So we get to the residence and we are greeted by a very sweet elderly
lady. I'll never get used to the fact that my patients remind me of
family members, friends, and other people I have met over the years.
Sweet Elderly women always make me think of my Grandmothers.

The house looked neat and tidy apart from the smell of feces coming
from the living room. While my preceptor was getting basic
information from her I stayed within earshot to listen but also wanted
to observe the living room. There was a parakeet in a cage next to
the sofa chirping loudly probably due to the strangers in its home.
There were several stains on the carpet, a large one near the front
door, and a few in various stages of being cleaned up.

"Do you have a dog Mam?" I asked

She looked at me puzzled and said "No, why do you ask?"

Not wanting to point out that I had noticed the state of her carpet
due to the embarrassment it might cause her I replied.

"Just asking because I noticed the bird you have and was wondering if
you had any other pets" I smiled and made eye contact with my
preceptor who had understood why I asked the question. So I made the
mental notes and went back to the patient.

She had not eaten in three days and had called her friend because she
had just had a period of delirium in which she thought she was being
attacked and killed in the living room. She denied any previous
incidents but told us she had been having increased difficulty
remembering things and generally taking care of herself.

This had to be a very difficult and frightening feeling and I
sympathized with her. So we obtained our vital signs which appeared
to be within normal limits, collected her medication, and carefully
walked her out to the waiting stretcher. So we got her into the
ambulance, did an EKG, BGL, IV, and got her to the ER.

The elderly in general are not as willing to volunteer information if
they think it might prolong their hospital stay. the old "If it ain't
broke or hurting, it must be working right" Many times when we ask
them if they have any health problems they will tell us no but then
give us a laundry list of medications.

"Why do you take a high blood pressure medication? Do you have high
blood pressure?"

"Nope. I used to though but I take a pill for it now"

Its all a matter of perspective.

So our next call is for a 28 year old man, having a seizure. We
arrive with the fire department and go inside to find his girlfriend
quite distraught describing what sounds like a classic seizure. The
patient is diabetic and has not checked his sugar since this morning
so I do it while I am talking to him. As we are waiting for the
results he keeps telling us he is fine and all he needs is to take his
insulin and rest. His results come back as 429. Normal sugar range
is usually 80 to 120 so needless to say this was concerning.

Now what many people don't understand is that we don't necessarily
like to take people to the hospital. Meaning if we don't think you
are really in need of an ambulance or a trip to the ER we will not try
and convince you to go to the hospital if you tell us you do not want
to go. We advise you of the possible consequences, obtain some legal
signatures and we are on our way. Thats not to say we would ever
refuse to take anyone to the hospital. I could hate you as a person
and I would still do everything I can to get you to the hospital
stable, comfortable, and safe while doing anything in my power to help
you. Be it breathe or pump your heart for you as well. What I am
saying is this. If we are trying to convince you and recommending you
go to the hospital to get checked out then you should take our advice.

He was conscious, alert, oriented and able to make a sound decision so
we obtained the paperwork and info we needed and told him to call if
he needs us again.

We were back there an hour and a half later, he was more than happy to
go with us this time.

I'm telling you folks. We do have an idea what we are talking about