Saturday, June 30, 2007

- MedicMarch, MD (the Denture Call)

Spiderman (my preceptor) and I are in the northern (way northern) part of our coverage area when we get a call out for a traumatic injury. The past two days we've run nothing but transfers and both of us are itching for a real call.

Beep Beep Beep! goes my partner's pager.

Bee-bee-bee-bee-bee-beee----booo boo bo booo booo. Beee Beee BEEEE beee BEEE BEE, Beeee Beee BEEEEEEEEE! goes my pager.

"Is that the theme to Hawaii 5-0??" asks Spiderman.

"Book em, Dan-O."

I look down at the call notes:

-78 y/o female, trauma to the mouth

Ok, I think. I start going through all of my shiny new protocols in my head....is she going to be at risk for failing to maintain her airway? Is there going to be an obstruction? Be ready to tube that puppy!

Our pagers beep again.

- Fire and PD on scene.

Hmm, I think, Northern Exposure VFD is a pretty tight squad. I'm glad they're on scene. If I need to aggressive they'll be able to help. And PD can control the scene. What the hell happened to this lady?

The Theme to Hawaii 5-0 fills the cab for the third time in 2 minutes.

-Tongue is stuck in Dentures.

Abruptly, the protocol book in my head slams shut. This is not an emergency. Spiderman looks at me as we read the notes.

"She must've used too much of that stuff to attach it to her gums."

Spiderman is trying to FIGURE IT OUT. If we can FIGURE OUT what the patient might have been thinking we might be able to help the patient better.

He's silent for a moment.

"What the hell'd she put on there, though? Gorilla Glue??"

"They're not F---ing around with that Poligrip they came out with." I retort. "It's new and improved...I bet you could put some cabinets together with a couple of tubes and have enough left over to mortar down some bath tile . "


We ride on.

On scene we find the is lady waiting for us in her house. VFD gives me a report. "She says she was sticking them in about two hours ago and her tongue is caught. I can't really tell how."

I grab my safety glasses, walk in, and introduce myself.

"Hi, I'm MedicMarch with XXXX, what seems to be the problem today?"

"My tungh ish cot!" Her speech briefly reminds me of Mistress Freakout's and I suppress a shudder.

"Ok, let me take a look." I hook a miller 0 (a small, flat blade - like a tongue depressor) to my laryngoscope and hold it upside down, tomahawk fashion. With some Magill forceps I gently grab her tongue and explore her mouth. I immediately see the culprit. The lady has partial dentures that fit around her natural teeth with two wire clips. One of the clips is broken and is stuck in the side of the lady's tongue like a fishook. Using the Magills I ease her tongue around and off the broke clip and remove her dentures. Almost instantly the right side of her mouth fills with blood and I pack it with the gauze Spiderman was bright enough to grab.

Honestly, it wasn't that difficult to do. I'm surprised the lady didn't do it herself. Maybe she was just eager to see some muscular, strapping young lad in uniform (heh heh heh, she got stuck with me. That'll teach ya to abuse the system!) I change her gauze out and the wound is already starting to clot up a little. My partner gets a refusal on the lady and we walk back into the sunshine, triumphant. I clean my scope and blade and forceps. I put a very solemn look on my face and walk over to the cop and VFF after sanitizing my hands.

"How'd it go?" says the cop.

I look at Spiderman, who's joined us, and at the VFF and Cop.

"The extraction was a success. There was a puncture to the right side of the patent's tongue, but any blood loss was controlled with careful application of gauze. She's hemodynamically stable and, although it may be to early to tell, we think the operation was a complete success. She's going to live."

Everyone cracks up. The cop laughs so hard his mustache flaps,

Spiderman shakes his head. "You should be a comedian."

"What, and miss out on calls like this where I get to save lives? You've lost your mind."

-MM

4 comments:

Loving Annie said...

There are the serious calls, and then the 'worth a story they are so absurd' calls.
I bet when you left she was telling all her neighbors that you were her hero :)
Now that she can use her tongue.

Anonymous Therapist said...

hahaha, wow. I like that it was called in as oral trauma. "Tongue stuck in dentures..." too funny.

And the pager thing? classic!

Medicmarch. said...

Sadly, her speech post-op was more difficult to understand then when her mouthparts were skewered on her false teeth. I could barely understand her. Although I guess that's normal for the area we were in. The back of everyone's neck there is a bright cherry color.

Holly said...

Actually, this can happen to kids with orthodontic braces, too. I was yellin' at one of my brothers one day and my tongue got stuck on one of the hooks for my headgear.

He about laughed his a$$ off. So I guess you could say it was a double trauma.

BTW, I've now read your COMPLETE blog. From the beginning. You are so gut bustingly funny...when you choose to be.