Today is the start of my days off. It’s been a long week, with 3 days of my part time job and 4 days of my regular schedule.
I would estimate that 75 percent of our jobs is driving people from one hospital to another and back. The other 25 percent is responding to emergency calls (either legit or not legit calls).
There comes a point in this job where you wonder why you deal with all the B.S. on a regular Basis. Doing a transfer for Patient A because their family member doesnt want to drive them so the doctor orders an ambulance for them because it’s free.
Patient B cant get to his appointment because he has no Gas, so the doctor orders up an Ambulance because its convenient (And Free)
In Canada If you take an Ambulance from one health care facility to another you DO NOT pay for it. AHS covers those costs, at the expense of us tax payers.
So the other day we had a call, a 60 year old patient with shortness of breath, it started out as ant other call, it sounded pretty standard, we will get there, five oxygen and maybe a nebulizer Combivent (2 mixed drugs, “Combivent and Iproteoprium Bromide” to help with breathing)
The patient was in the next town over, it took us about 10 to 15 minutes to get there because all their ambulances were out on transfers.
We get on scene and the patient is in obvious distress. Having been a smoker for 40 years and diagnosed with COPD, he said he quit 4 months ago. A little late in my opinion the damage is done.
He was on home oxygen but it wasnt helping. We did a set of vital signs, his heart rate was 110 (normal is 60-100) and his SPO2 levels (essentially the percentage of oxygen in his blood) was at 80 percent. We like to see 100 percent. He was anxious, he kept telling us he couldnt breath.
You have never seen someone scared for their life unless you see them and they cant breath. This patient was legitimately scared for his life. He was pale, he kept telling us he couldnt breath, and kept asking us to help him over and over. We were doing what we could.
We swapped his nasal cannula (a tube that goes into each nostril giving you 4-6 litres of Oxygen minute) out for a breathing mask (15 litres per minute). His oxygen saturation rates didnt change and he was getting more anxious.
We had him move onto the stretcher.
This little but of exertion was too much for him, he began experiencing wheezing, and his breathing got worse. We gave him a Nebulizer with a Combivent in it to help the breathing.
It had minimal effect.
We gor him In the truck. And gave him another. The wheezing was gone and his sats were up to 85. But then his heart rate jumped to 220 a minute.
The human body cant sustain that heart rate for long, even less when you already have a series of medical conditions.
We transported to the hospital.and after assessment the doctors decided Atropine is the nest course of action. This is one of my favorite drugs because you can see an Immediate result from the treatment.
When a patient is in SVT (Supra Ventricular Tachycardia or heart rate greater then 180) you treat it chemically or electrically. The doctor opted for Atropine or the Chemical treatment. Atropine essentially stops the heart completely and the heart is forced to “Reset” back into a more regular rhythm.
One of the concerns of it is, the heart stops and doesnt reset and stops beating altogether.
The video below shows the drug in action :
It took the patient 2 treatments of Atropine to resolve his heart rate, from 220 to 120. The second treatment (the video) took double the dose as the first. We ended up taking him to the city to be admitted to ICU for further treatment.
Its calls like these that remind me that this is why I’m in this profession, why I love this Job. We legitimately helped this guy. And because of us, should he get out of the hospital he will have a few more years left with his family.
Calls like these make up for all the transfers and all the low priority calls we get on a daily basis. This is why I love my Job.