I Drive The Taxi - Sometimes.

After another nearly sleepless night from being entertained by the {insert adjective here} "citizen" of the county that shall remain nameless which included the hauling of a vent and balloon pump to St Joe's at 2 am, (the stop by QuikTrip on the return was the high-point of that trip) I had to go and work at the indigent's taxi service.  Since it was Saturday it was a while before we had to pick up the first fare and I napped on the love seat at the hovel.  

After about an hour we left for our first fare and then we were told to post in Hapeville.  No sooner than we get there then we're dispatched "code 3" over to Shady Mae, which is over in the NW part of the ATL, for a hypoglycemic. Eleven miles through ALT traffic, which include us interrupting a funeral procession before we got there.  Since this geriatric incarceration center is a maze we must had taken another 10 mins to find the room.  We entered to see the poor soul in a hospital bed, semi-Fowler with a NRB on.  Wonder of wonders!  The O2 was flowing at 10 lpm!  Pt  was conscious but unresponsive, breathing at about 14xpm, with two LPNs tying to start a line with, you guessed it, 22g IV caths.  They have tried numerous times and failed, this patient looked both dehydrated and famished.  Both BP and Heart Rate was elevated; the body was trying to compensate.  No blood was coming out of any of the numerous attempts so I know that the body was already shunning for the core.  No telling how many times the IV attempts had actually been successful but with out the flash into the cather one couldn't tell.  The LPNs reported that the pt was a brittle diabetic and that they had administered three doses of glucagon with no success.  Heaven help us!  Once is enough.  If it doesn't work a first time then what made them think a second dose or a third was gonna make the liver give up any more?!?  I'm sure that the liver was sitting there just being stingy and when the glucagon came a knocking for the reserves the liver shouted, "No Body's Home!"

Well, I started on one arm and my partner started on another arm and we "went to town" trying to get IV access.  No such luck.  I was thinking about getting an ALS unit out there to maybe drill the pt for an IO but too much time had been wasted already.  We had the paperwork that the facility sends with the pt and a course no one would fess up to this pt being theirs.  So, we slung the pt onto the stretcher and trotted out the door, (Yes, trotted!).  Loaded up and with me in the back we were headed towards Emory Midtown.  Grady would have been the closest, technically, but with their triage system it might have taken too much time.  I banked that Emory Midtown would see us faster.

I called in report, talked to the Triage nurse and made sure I mention a couple of times that we was a BLS service.  I also mention several times the low D-stick, that the sending facility had administered glucagon three times and that there was dehydration and none of us was able to gain an IV access.

As soon as we came strolling into the ER a nurse called out our company name and told us to give the information to the registration person then to go into an exam room.  A nurse came in quickly, sized up the situation, grabbed a couple of IV caths and attempted again.

I have not been in this business so long that I can't be WOWed, I learned.  That nurse stuck the first cath in and failed but instead of pulling it out he left the cath part sticking in the arm under the skin.  Then he took the second one and came at the opposite angle just above the first and nailed IT!.  WOW!  That first cath was holding the vein in place while the second found it's mark.  D-50 was administered.  Our pt was looking around and taking in a few moments.  The 50 long tonnes of stress just sloughed off of me in a wave of relief.  No, I never broke Joe Friday, Mr. Spock mode.  It's ME!

I have to remember that technique with the IVs.

From there we had to rush over to Baker Ferry and grab another fare to take back to Shady, then go grab our first fare and return them home.  

Then we were dispatched back to Shady Mae for another person who the staff claimed was violent.  Well, if they didn't have a 10-13 then if the patient refused to go, our hands were "tied".  We got there and the pt was the sweetest little old thing, and hadn't threaten anyone.  While the nurse was giving report she let slip that there was a mass on the pt left side chest area that needed to be seen about.  They couldn't justify sending the pt out for the mass so the "violence" was concocted to justify a trip.  

By the time we reached Grady with our "violent" pt, ( I was so in fear that I threw my partner in the back with the pt and I drove) dispatched was trying to con another call off on us.  A pick-up at Piedmont Fayetteville going back to Newnan.  The first emergency call came just a little before noon and we basically haven't stopped and lunched yet.  It was after 4 now and there was two hangry EMTs on my unit.  I acknowledge the call.  In ten minutes dispatch was calling to find out how progress was going.  Seems the Fayetteville call was going to be a Medicare charge and "big bucks" so we needed to sling this GOMER off and get going.

"We're still awaiting in the line at Triage", I told dispatch.

Only 20 minutes later dispatch was squallin' for us again.

Even thou we had placed the pt in a bed and was giving report I still told dispatch, "Awaiting on bed now."  That shut dispatch up for a moment or two.

We got out of Grady fast and grabbed us some groceries for our throats and then we called dispatch and informed then that we was clear of Grady and in route.

What dispatch doesn't know doesn't hurt us.

Found our next fare at Fayetteville and the fare could walk.  How was this going to be medicare?  Since my partner was techning this call I let him handle the details and it took about a half an hour of phone with but they came up with something.  Me, I was just driving the taxi.

We got to Newnan and dropped the fare off in the hood then skedaddled back to the hovel.

On the way back the the computer decided to update itself.  I still haven't finished the narrative on my hypoglycemic pt.  Curse Bill Gates.  After waiting at the hovel for about half an hour the computer finally finished it's "updating" and I banged out my narrative.  Clocked out and I was southward bound.  I was suppose to go to Sweetland to see Members Only and Band X, a part of the season ticket packet, but as I ran into the house I passed too close to the comfy chair.

You guessed it. I was sucked into the seat, immediately passed out and didn't regain consciousness until after midnight.

Oh, Well; I only want to see Willie Nelson when he come next month.