So 2 shifts down with my new preceptor and we have had zero ALS calls. As a matter of fact we've had zero BLS calls. Nothing but transfers in two shifts. Fabulous. So here is a call I ran a while back with my first preceptor...for your amusement, this month's entry for the Haldol Critter of the Year contest.
-Pt is yelling and screaming, b/f says she is hallucinating
-Pt has psych History
-Pt has Hep C
-Pt located in front yard
-Pt has history of sniffing Paint Thinner
Outstanding. We're out in the boonies and are trying to grab a lunch meal courtesy of the local greasy spoon (it sticks to your ribs...even if you don't want it to. ::shrudder::) when these call notes come across. Wheee. We turn on the flashy things and the loud things and drive over to the call. Mom-Partner is precepting me today and we chat idly about possible airway maintenance issues. If she's sniffing something really corrosive to fly the skies of Sherwin-Williams Land she might have burns to the whole breathy area (that is the correct medical terminology) and that is a BAD THING.
We creep up to see three people in the front yard - a nicely dressed older lady, a rotund middle-aged guy, and the lady I will now sweetly refer to as Mistress Freakout. Mistress Freakout is currently sitting in a lawn chair FREAKING THE FUCK OUT. Hands rubbing everything, along her shoulders and through her hair, speaking at an increased, rapid rate, with one eye squinting and the other wide open. Approximately three teeth. She looks like a deranged pirate. If they brewed Captain Morgan out here in BFE she would be the spokesperson in the big red overcoat and boots. I hate to think who would want a little of that captain in them...
The rotund middle aged man's face has lit up and he is doing his impression of a windmill, International Brotherhood of Bystander's standard signal for "Over here, ya'll". I briefly curse the fact that I didn't stay far enough back, but luckily I see the Deputy about two blocks behind us, rolling on in.
So yeah. Mistress Freakout runs towards Mom-Partner, Deputy Droopy, and Myself as we get out, gibbering and pointing at the sky. Fantastic. Having gloved up and put my safety glasses. I deftly grab her hands from in front of her and hold them in one of my hands and place the other just below her neck, above her breasts. This stops her pretty good and I can start my assessment.
"Hi, I'm MedicMarch with XXXX. What's bothering you, ma'am?"
"Meda-Marsh? Blgsi Amubluanech?" she asks me. She is meth addict skinny, wearing boxers and a tee shirt. I don't see anything immediately life threatening but I can feel her heart pounding at what I guesstimate is about 130 beats per minute. I let one her hands loose and take a pulse on the other one: bounding and regular, w/ a rate of 134. I kick ass. While all this is going on Rotund Bystander is telling the story to my partner and Dep Droopy. Apparently Mistress Freakout hasn't been hitting the turpentine, as far as he knows, but she has been "Out of Control" for 3 hours and now he's "Starting to get worried."
"Mklespitz! Nopaint shniffgsh!" interjects Mistress Freakout, eager to help.
"Can you tell me what your name is?" I ask.
"Fishnchipzer here flor me!"
"Her Name is Bobby-Joe!" (not her real name - I don't want to get sued, although I don't thik any of the yokels can even spell internet, much less access it) adds Rotund Bystander.
"Bobby-Joe! Namesh Bobby-Joshge!" says Mistress Freakout.
"Can you tell me what day it is?" I ask.
"Gish-I dont know-vmklps!" replys Mistress Freakout.
"Thursday!" Pipes up Rotund bystander. From the look on his face he's almost sure this is the correct answer, and he looks at me expectantly. I barely have time to stifle my outrage and to keep from slicing this guy to ribbons with smartassery, so I mentally image nailing a gold star into his fat, sweaty forehead. I chuckle, and this sets of Mistress Freakout, who I am still holding. She starts laughing, cracking up, and this sets of Mom Partner, who, with a very unladylike snort, bursts out into cackles of amusement. This, in turn sets of Droopy, and so now we have three first responders and one goofy ass, paint sniffin critter laughing in the sunshine.
Oh, happy day.
We get her loaded up after my partner concludes her interview with Rotund Bystander and his mom, and they ask for her to be transported to Our Lady Of Something Or Other. She gets in the back.
"Restraints," I tell her as I hook up the writhing, sweating Mistress Freakout to my EKG. Sinus Tach, looks like, but there's a lot of artifact and she's bouncing around too much for me to get a good BP. "And get an IV for me, please."
Mom-Partner quickly gets her stick and grabs the restraints. Apparently Mistress Freakout doesn't like this idea because when I turn to grab one from Mom-Partner she leans forward and tries to take a chunk out of my arm with her three teeth. I manage to dodge the chompers and I grab her forehead and slam it against the back of the upright head of the cot.
"NO BITING!" I tell her.
"Bitey! BITEY Mar-Medic!" I can't make this shit up.
"NO BITEY MEDICMARCH!" I yell into her squished up pirate face.
This sets of Mom-Partner laughing again. "Hahaha, oh Shit, March, you made a new friend, hahaha, stop it, heeheehee I'm gonna pee in my uniform pants HAHAHA!"
I'm not amused and we get Mistress Freakout tied down. Mom-Partner has recovered enough from her laughing fit long enough to put an O2 mask on the patient. "What's that for?" I ask.
"You said no bitey::giggle snort:: so this makes it so she can't BITEY! Hahahahaha! Oh, shit!"
I grumble a thank you. I try to finish my interview but Mistress Freakout is content to glare at me and grumble nonsense.
"Fergh shish MedaMarsh. Bitey"
We take her to the hospital. Other then sinus tach, everything else on the lady is fine, with a CBG of 126. I push 2mg of Narcan to see if that will do anything but Freakout just pulls against her restraints and chews the inside of her mask with her three teeth.
We spend 20 minutes on the wall. They give us a room, I give my report. As I'm walking out of the room I hear "Marsh gj ksel!" and the sound of someone having a large, liquidy bowel movement. The nurse and tech let up twin wails of disgust. I chuckle.
I walk by the Nurse's station on my way out. "Code Brown in Iso-1," I tell them.
Outside Rotund Bystander Boyfriend envelopes me in a sweaty, clammy hug before I can escape and thanks me profusely. I shudder involuntarily and grab some paper towels to wipe myself off. I get in the front of the cab and sit in the air conditioning for a minute. My stomach grumbles loudly, reminding me that we still haven't eaten. My partner is trying not to laugh.
Mom-Partner can no longer contain herself. "Want to grab a BITEY to eat? BWAHAHAHAHAHAHAHAHAHAHAHA::snort::.!"
"Oh, Shut up."