Ay, Theres the Rub

There is something better than food.

There is a thing better than sex.

It is sleep.

DTs has just come off what may be considered a 72-hour duty: 24 with the transport gig, followed by a 24 with rescue, finishing with another 24 transport for dessert.

One learns things during extended up-time. Did you know it is possible to take a brief but refreshing nap between the systolic and the diastolic? Most people waste that time staring off into space with that “I’m listening…” look. Not me, baby. “BP is… 140 over… [ZZZzzzzzzz] 80.” Refreshed!

Only one patient contact of note during this period, though.

Staffing is a little ka-ka on the rescue side, and DTs is without a driver. Lo, another station is short-handed as well. Very little head-scratching ensues and DTs is sent to the other station, centrally located for our areas. To the best of our knowledge we are the only bambulance on the East side this fine winter’s day.

We’re toned out to a call some fifteen minutes down the road – going lights and sirens – for an “injury from an assault”, in the early afternoon.

EMS and the Fellowship of The 911 System is certainly representing. We have an engine on scene; we have some police on scene. There’s an ambulance… wait a minute. Why, then, we wonder, are we here?

“Prince William, what units were dispatched to this call?”

“You and the Engine, DTs.”

“Uh, okay. Thanks.”

A member of the engine crew trots over. “You guys can go in service, this other unit came for the call.”

Okay, not a problem. Turn around. Look left, look right, begin to pull away.

Another member of the engine crew trots over. “You guys can’t go in service, this other unit has a one-person crew.”

One-person crew? What the hell is that? Turns out the fellow was in the unit, heard the call, and came along. Ten out of ten for style and helpfulness, not so hot on the usefulness side if the patient needs transport.

Grab stuff, wander over.

The patient is an adult male, glazed of eye, sitting on his front stoop surrounded by cops and fire guys. One of the folks there is finishing wrapping a bandage around the patient’s head. He looks like a homeless version of the fife-playing guy in The Spirit of ’76 painting. Both ears are covered in blood.

A fire guy tells DTs, “He doesn’t want to go to the hospital. Just get a signature for the refusal.”

“What’s going on with him?”

“Oh, he has a hole about the size of a quarter in the back of his head. He isn’t sure how it got there. He was in the park. Somebody drove him home, drove away and called 911 on their cell phone.”

Oh, the park. In this area, the park is notorious as a place to score drugs, guns, and hookers at all hours. Thursday is Ladies Night – you can score a drugged-up hooker waving a gun.

The patient says he doesn’t know what happened, never saw it. He wants to go inside. Quarter-sized hole? The fire guys say no brain matter was falling out or visible. Still, this patient looks like shit. He gives me the option to go Authority on him when he fails his “oriented to time” test – thinks it’s Saturday when it’s not – and I tell him it’s us or PD. Funny, they always choose us.

Back in the unit, take some vitals. His pulse is in the low sixties, his BP is 68/45 (!), breathing normal, sats in the 98-99% range, dexy 140, eyes constricted and unresponsive. He babbles, in a whisper. Uh huh. Let’s check that wound, shall we?

We undo the bandage job to find, not a hole, but a steadily bleeding area in the occipital region, covered by skin with a star- or cross-shaped laceration. Keen! This is just the sort of avulsion created by a gunshot!

“Prince William, you have a medic for us? Cuz, if you do, that would be just really, really swell.”

“Negative, DTs. They’re all out.”

Oh shit oh dear.

“Hey,” says DTs to his driver, “Ask the fire guys-”

“Fire guys is all gone,” says his driver, looking around. “Hey, so is the other ambulance. And the cops.”

“Well, for gossakes! Is there anyone out there?”

“Why yes, there are about a dozen good citizens striding towards the ambulance.”

“Perhaps we obstruct their flag-football game, here in this fine parking lot. Do let’s move, then.”

“Indeed we shall,” says his driver, “With lights and sirens – they are so festive.”

“‘Tis the season,” agrees DTs. “And let us listen to and be entertained by the Christmas-y thunk of door locks.”

We call the hospital with our findings, make sure they know the patient is unaware of the mechanism of injury. We can have the patient there in seven minutes, versus twenty-plus for a chopper to meet us here. “Come on in,” they tell us.

About the only thing we can do for this patient is O2, Trendelenburg, keep him warm and talkative – such as he may be. DTs’ Medic Sense is tingling as well. Feels like…. patient has drugs on board.

The patient is now complaining of neck pain. Hooray! He gets a collar. The blood around the ear is disconcerting, but there is none in the ear canal, and no other fluids. Pupils aren’t blown and the BP is so low I don’t suspect a rising ICP, but we keep an eye on what we’re allowed to, as BLS, just the same.

Patient hasn’t deteriorated by the time we get to the hospital and turn him over. All in all, a strange but entertaining call.

Perhaps I’ll ask Santa for one of those Saturday-morning cartoon character rings – you know, touch the two halves together and turn into Released Medic Man, able to do some IV and drug-box action before, at the hospital, returning to Mild Mannered DTs.

That or some NO-Doze.

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