Saturday, August 09, 2008

911 on speed dial

EMS presence has been a regular feature are newFNP's clinic recently.  The trend started last week when newFNP had two ambulances at the clinic at the same time - a first for newFNP.

NewFNP's first ambulance-requiring patient was a depressed woman.  She came in complaining of headache, but her affect screamed depression.  As it turned out, she had two suicide attempts requiring hospitalization last year and was suicidal again.  She had a plan (run out into traffic) and means (busy urban area with lots of traffic).  She didn't trust herself to leave clinic and go to a psych appointment the next day.  She wanted inpatient admission.  

She got it.  

NewFNP called her local psych response team at 1:30.  She kept her patient in the room, supervised at all times.  The 'team', which was comprised entirely of one gentleman, arrived at 5:15 PM.  That is when he began his assessment.

NewFNP is a strict believer in not having anyone be alone in the clinic after closing, given that when the lights go down, the sex workers and drug dealers and rival gang member come out.  Adopting a team player attitude, and possibly to get out of his sister-in-law's wedding planning activities, newFNP's clinic manager agreed to stay with her until the psych patient was safely escorted out.  NewFNP and this 24-year old guy were just sitting around when he decided to take a peek outside and find out just where in the hell this ambulance was.  

He returned, clutching his head and telling newFNP that he needed the O2 mask.  Having had a mock code the day before, newFNP briefly thought that he was kidding.  

He was not.  He told newFNP that he had 'blacked out' and couldn't feel his left hand.  He was clutching his left parietal area and complaining of intense pain.  

At this point, newFNP had the suicidal lady and her mental health assessor behind closed doors in room 3, the clinical manager in the lobby and the custodian somewhere in the clinic.  NewFNP quickly assessed the manager, yelled for the custodian and ran to get the emergency equipment and called 911.  

The fire department arrived for the clinic manager at the same time that the first ambulance arrived for the suicidal lady.  It was 6:15.  The second ambulance, expecting to transport the clinic manager to the ED, arrived at 6:25.  NewFNP's clinic manager was hooked up to a portable EKG, normoglycemia confirmed, Romberg negative.  The suicidal lady, much more relaxed, was strapped into her ambulance gurney and departed for her psych evaluation.  

At 6:45, a handsome paramedic asked newFNP, "What time does your clinic close?"  "Five," newFNP replied.

At 6:50, newFNP's clinic manager decided, to newFNP and the paramedics' protests, that he'd prefer not to go to the emergency department after all.  

NewFNP and six firemen/paramedics can lead a horse to water...

No comments: