Wednesday, May 15, 2013

The monitor is deceiving... no, I was just lazy.

Yup, precisely that... I was too lazy to reach over the stretcher & press the PRINT button... even though I have made it a habit to try and do so... but occasionally we get lazy, tired, frustrated, annoyed, or whatever... so we don't do what we "always" do... and we get burned... as did I one night.

55yoM found unconscious on the side of the street... highly intoxicated or so I stereotyped him given the time of day, the location, and the plethora of empty ETOH containers around him. Upon loading him up & doing the usual VOMIT protocol (Vitals, Oxygen, Monitor, IV, transport), I noticed that his heart rhythm was borderline brady & a bit irregular... those were my first and last two clues... but again, I was lazy, tired, de-caffed, or whatever... he had a good pressure, and otherwise stable, other than his inebriated status bordering on needing a tube... he was just peachy... so I did NOT print out a strip.

How many of you have ran that or a similar type of call? How many of you have ignored your better judgement because you decided to slack off a bit... or cause you woke up from that deep 3am sleep still trying to figure out how you even got to the call? If you have been doing this long enough, it has happened... if it hasn't yet, just wait.

I took the patient to the local non-specialty hospital ED that was 0.6mi away (aka 6 blocks)... vs taking the pt to a referral facility 2.5mi away. Upon arriving at the ED, giving my turnover report to the staff, and the patient being hooked up to their monitor... a 2nd degree type II block came out clear as day.........

**facepalm** this time it was on me.

My point in describing this little story is that it happened to me... I got too comfortable on my own bench seat... this happened recently... not when I was a new medic... so if it can happen to me now, it can and will happen to me again... and can happen to you as well. I let my guard down... and I got burned... the pt did fine, was fine... but I was not fine... he should have gone to a cardiac facility, and it was on me... I deserved every crooked look that the nurses gave me.

EMS... emergency medicine... public safety... will grind you till you can't go any further... but the pt's don't know that, and they don't care what faze of your sleeping cycle you were in when they called... or how much caffeine you've had or did not have... they don't care if you just broke up with your boyfriend/girlfriend/husband/wife or if your dog died or you wrecked your car... they will call you expecting you to be at your BEST from the moment you show up... no matter what is going on in your life, at that moment... they are a PRIORITY... we are there for them on their BAD day... no one cares about our day.

I will continue having patients like this that will slap me upside the head & pull me out of whatever slumber or lazy haze I am in at that moment... but I hope to minimize those instances... never let your guard down... that is when we get burned.

Stay safe.

~EMSDoc911

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