Week 6: Getting Anxious

Sofia R -

Hi!

Overtime, I have found myself being able to better understand vitals! As I continue to go on different calls, I am able to distinguish a good or bad blood sugar level, as well as blood pressure. This might not seem so important, but they are both very telling. For example, one patient we got had altered mental status, and when we checked their blood pressure it came back low. The medics asked them if they had diabetes and they said yes. After a day of taking insulin and not eating much at all, their sugar crashed. Once they started eating and drinking orange juice, they bounced right back.

This week I saw what it is like dealing with a case where there are not the most reliable sources. This is how it went: we arrived at a nursing home where an older woman had fallen and hit her head. There were open wounds with active bleeding, but it was starting to slow, and she had not passed out when she fell. She was crying from the pain and when asked what medications she took, she could only remember one. It was for high cholesterol, so we could not rule out that she might be on blood thinners (which you can imagine could make this situation dangerous). When we asked her husband what medications she took, he had no idea, and did not want her to go to the hospital. For this couple’s case we also couldn’t ask staff for medications or medical history because they did not pay for assisted living. She ended up being transported to the hospital, but I thought it was very interesting that there was an uncertainty of where her prognosis could go. In EMS you are not supposed to diagnose, and you usually do not know what happens to patients after being admitted to the hospital. If her condition declined and without much information on her, I wonder how the medics would have treated her.

Another interesting thing I saw was manifestations of anxiety. As we were driving to this call, we got information from dispatch that their whole body and part of their face was numb. This immediately raised concern for the crew that it could be a potential stroke, which is a sensitive time matter. Then we learned the patient had a history of Multiple Sclerosis, a neurodegenerative disease. They had neuropathy from this condition which caused pain around their body. This feeling started the night before they called 911, and they became extremely anxious their health was declining. As we went to take their blood pressure, they screamed in pain. Their anxiety mixed with their potential MS flare up created a patient who was very aggravated and distressed by smaller things, causing it to become harder to treat them. The medics from both Prescott Fire and Lifeline tried to get a good blood pressure, but because the patient was writhing around they couldn’t. When I started this project, I went over the guidelines every EMT and paramedic had to follow in our area. In this case, I wonder if trying to find a nonmedicated route for lowering the patient’s pain would have helped make them calmer, as well as verbally comforting them.

Finally, it is time for me to start looking into what Fire Chief Durre asked me to look into, which is low-acuity calls. I still have a few questions about it which I will ask different firefighters about and start my research process to see how to combat the pressure from this call type.

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