Treatment

I took care of a woman today who fell off of a roof and landed on a pile of aluminum siding about 20 feet below.

Her friends who saw her fall said she landed right on her head and just "crumpled." When we got there she was sitting under a tree across the yard, holding her arm out at an odd angle that resembled some sort of zig-zag. She was pale and diaphoretic, lethargic and mumbling about the pain in her shoulder. It was obviously deformed in at two places, and probably broken in more places than that. The woman complained to me that she couldn't feel anything in her arm at all, and, laying on our backboard on the way to the hospital, asked me if I could confirm whether it was still attached. To reassure her, I told her I would take her left hand and place it on her right elbow. She could help stabilize the extremity as well as remind herself of it's presence. Taking hold of her left hand and bringing it over to her right side, the woman grabbed hold of my hand. "Thank you," she said, "thank you so much." She didn't let go. Not sure of whether she thought she had hold her own hand or was holding mine for comfort, I sat there with my arm outstretched. With only a minute until we reached the hospital I decided that either way, I'd just let her keep it.




I took care of a young boy today who was found unresponsive by firefighters inside a burning building.

They carried his limp body away from the smoke and laid him down in the grassy front yard, franticly waving to my partner and me who were standing by. As the firefighter told his account of the story, the boy began to wake up and cough, reaching out for help from his position on the ground. We scooped him up and rushed him to our stretcher, listening to lung sounds, applying oxygen, and looking for burns. The boy was fully awake now, apparently uninjured but terrified. There was another paramedic on scene who was precepting, and we decided to ride the call in together. I sat in the airway seat and helped as the new medic ran though his routine, watching quietly and helping only as necessary. The sirens were especially loud in this older ambulance, and it was hard to hear the boy's quiet answers to my few questions. I sat forward, tilting my head until my cheek was almost touching the pillow, and face to face the boy and I talked about what happened. We were close enough so that we didn't have to yell to hear eachother, and the boy seemed grateful for it. Quietly he told me that he had fallen asleep and woke up to find flames in the kitchen. When the firefighter came he was so scared he pretended to sleep, not knowing what else to do. He felt okay, he admitted to me, but was embarrassed about what had happened. Amongst the turmoil and noise of the bumpy ambulance, sirens, and a new paramedic running his routine, I think it took only a few quiet words to make this patient feel well again.




I took care of two patients today who reminded me that even "critical" calls deserve a minute's pause and consideration. These are people, not presentations. Men, not mechanism.

Its easy to forget. I'd like to thank both of my patients today for their gentle reminders.