Our computers at work have recently been plugged directly into the CAD. When everything is working right, we see all of the information the dispatchers see. In theory this is a good thing.
The radio says: syncope
The computer says: chest pain, nausea and fainting with nitroglycerin
Uh-oh. Chest pain and nausea together generally means something bad. If the patient took NTG and lost consciousness, that means his blood pressure dropped. Taken all together, this looks like a very sick person.
We find: Nausea. No chest pain, no difficulty breathing, no nitroglycerin even. He does have a past cardiac history and is worried.
The radio says: shortness of breath
The computer adds: patient shaking all over
It’s a bit of a head scratcher, but the symptoms sound serious. Asthma, COPD, CHF, a big heart attack. Seizures. Anxiety.
We find: None of the above. A middle aged man tells us he forgot to take his medications this morning and wants to go to the hospital to be checked out. All of his vital signs read normal, and he has no medical complaints. My partner points out that, “It’s only 10:30 you know.”
The patient stares back blankly. NRP tries again: “It’s still morning. You could just take your pills.”
He’s having none of it. Off we go to Local Suburban for a checkup, or something.
The radio says: difficulty breathing
The computer says: an address we know well
We find: A sleep apneic who doesn’t use CPAP. He dreams he’s choking, wakes up, and calls us regularly.
The radio says: overdose
The computer says: elderly patient, altered mental status
AMS in the elderly could be a medication issue, a diabetic issue, or stroke. Or any of a number of other less likely things.
We find: A patient whose doctor has been adjusting her chronic pain medication.
The radio says: possible heart attack
The computer says: middle aged male with a long cardiac history
I hate the words ‘heart attack.’ We usually hear chest pain, chest tightness, shortness of breath. Experienced cardiac patients may report a possible MI. Heart Attack usually translates to CPR In Progress.
We find: A middle aged male in obvious distress, with a nosy friend in tow. He actually does have a long cardiac history, and he’s worried. The friend is adamant about sending him to Distant Hospital Without an ICU or Cath Lab. We get him in the ambulance and explain to him that Local Suburban is closer, has a cardiac catheterization lab if he needs it, and has reciprocal privileges with his cardiologist (who doesn’t go to DHWaICUoCL by the way.) He agrees. Nothing we do relieves his pain, until we arrive in the ambulance bay. He burps as we unload him from the ambulance and sheepishly says his pain has gotten much better.
The radio says: stabbing!
The computer says: dunno, I didn’t bother to look
We find: a stabbing. Injuries seem relatively light, vital signs are good, and we make quick work of the transport to LSH. The trauma team is waiting.