Tough… well, not love, but…

Not everyone who dials 911 does so in the spirit of receiving help.

We were toned out for “an adult male, thinks he might have broken his neck last night.”

My partner and I exchanged “WTF?” looks, shrugged, and went blinkies and woo-woos. We were the first unit on-scene to the private residence. In the interests of saving time, and anticipating our needs, we tossed a backboard and the backboard kit, along with our usual baggage, onto the cot and proceeded inside.

Our patient was sitting at the kitchen table, elbows on the table, holding his head in his hands.

“Hi, what’s going on?” I asked.

“My neck hurts, I think I broke it or something,” he mumbled.

“Okay, well, I’m going to stand behind you and hold your head still in case there’s a problem,” says I, quickly checking for step-offs (finding none) and taking c-spine. My partner fished out a cervical collar, sized it and began to gently apply it.

The patient went ballistic – screaming, flailing arms, stamping his feet on the linoleum. “Don’t put that on me! My neck hurts!”

“Okay, okay,” I say. “You need to keep your head still. The collar keeps it from getting worse.”

It took some time talking before the patient calmed down and allowed the collar to be placed, during which he reluctantly answered questions. He had “been drinking some” and fallen down the stairs in the wee hours. Lightening mental calculation concluded that the patient had waited some eight hours before calling 911.

“Did you, uh, try any medications for the pain before calling us?”

Why yes, he did, he related. Many Valium washed down with vodka – until that ran out – and then liberal quantities of beer.

As my partner turned to take the backboard from the cot, the patient again went crazy – clawing at the collar with one arm, flailing around with the other – attempting to hit me! – Profanity and Wailing, and a great Weeping and Gnashing of Teeth.

“Stop! Right now!” I was surprised to find it was I who shouted, in a voice an octave lower than my usual pleasant tenor. I was shocked. It was as if I was standing outside myself, watching Me – and I looked Pissed.

“I don’t want this on,” wailed the patient.

Still Deep-Voiced and Pissed-Sounding: “Okay – listen up. You may have a neck injury. If so, you can make it worse and be paralyzed. If we take you to the hospital, it will be with this collar on, and anything else we need to do to keep your injuries from getting worse. Or we can go. You now have two choices: You can let us do our job, or tell us to leave. Speak.”

“I want to go to the hospital.”

“You have spoken. And if you try to hit either of us again, I’m calling the cops.” A glance out the window showed we were still the only unit on-scene. No engine, no medic. Hmmph.

I considered the KED, since the patient was sitting, but his stomping feet and denial of back pain – plus unpredictability – all pointed to The Faster The Better. We assisted the patient in standing and did a standing take-down onto the backboard. About the time we were strapping him in, the medic shows up. Except for the drugs and booze this was strictly BLS, so they assisted us in packaging and loading the patient and waved to us merrily as they departed.

In the unit I placed an NRB at 12lpm, more for me than the patient – the heady fumes of his medication regimen were filling the box. As I was placing a BP cuff he suddenly went limp, his free arm flopped down and with a small “uuuhhh” he stopped breathing.

Poor thing.

“Okay, I’m going to take your blood pressure now – this may get a little tight on your arm,” said DTs in a cheery voice. Still not breathing.

BP finished, I began working on the paperwork. From time to time I glanced at the pulse oximeter on the patient’s finger, still snug, and checked the reading on the Lifepak. O2 sats in the mid-nineties, heart rate steadily climbing.

I figured he’d have to take a breath pretty soon, and so he did.

“Sir,” said DTs solicitously, “Don’t pretend to be dead anymore, okay?”

Alas, his reply is unprintable.

My partner says I should have taken the event of my patient’s “death” to say something like, “Oh my God! Maximum Shocking Power Engaged! Everybody Clear!” and, um, “bring him back” that way. Although it sounded like a fine idea, and I kicked myself at the time for not thinking of it, on further reflection it may not have been the best thing to do, seeing as he was strapped down and may have exacerbated his injuries. And so, I am glad I did not.

Professional. Yeah, baby, that’s me. Right.

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