You Mean You Want to Intubate Me?

 

 
 
 

Guy H. Haskell | | Monday, March 23, 2009


The township EMS agency NEVER called us. They hated our guts. First of all, we were an ALS service, and they weren't. Second, we were a private company contracted by the city, so as far as they were concerned, we were the Whore of Babylon in their midst. One time, we were dispatched to an MCI involving a school bus on the border between the city and the township. Children were critically injured, and every bit of help was needed. After the incident, the township chief called our director to complain that our units intruded on his territory. Go figure.

So, we were NEVER called to respond to an incident in the township that was outside the city limits. When the call came in to respond to an ill person in the township late one evening we were immediately suspicious. But it wasn't the time to argue with dispatch as to whether we had a duty to respond, so Tony and I took off to foreign territory in Medic 85.

When we arrived at the middle-class ranch house, we were greeted at the door by an older woman. "My son is really sick. He needs to go to the hospital," she told us as she led us to a bedroom. There, in the glow from the nightstand's light, lay her son, a middle-aged man, with the covers up to his chin. Our questions about what was bothering him elicited numerous vague responses. He apparently suffered from various illnesses, fevers, vapors, ague, imbalances of the humors and existential angst. But one thing was certain: He wanted to go to the hospital.

The poor fellow could barely manage to drag himself over to our cot. The moans of anguish and anomie still echo in my memory as we, with heartless disregard for his suffering and weltschmerz, declined to lift him from his sick bed and carry him to the stretcher.

We loaded him into the back of Medic 85 and got a set of vitals. His moaning increased, and his complaints became more focused -- nausea, weakness, anorexia, sick for days.

"Sir, if that's the case, you're probably dehydrated and we'll need to start an IV," I said. "Tony, do we have any fourteens?"

The patient asked, "You mean a needle? A really big needle?" We couldn't help but notice the barely concealed pleasure and anticipation this thought brought him. We glanced at each other, puzzled. Our patient then began to complain of severe shortness of breath, gasping between breaths.

"Tony, it looks like we might have to tube him if his breathing gets any worse," I said.

"You mean intubate me?" The man asked, a glimmer in his eye. Tony rolled his eyes and heaved a sigh as only Tony could.

 

"Nah, let's hold off on the tube and the IV for now," I said. You could almost hear our friend's sigh of disappointment as he continued to thrash on the cot. And, you could almost hear Tony's poorly suppressed giggling from the bench seat.

The only remaining question was how to pay the township back for their treachery!




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Related Topics: Patient Care, Airway and Respiratory, intubation, Guy Haskell

 
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Guy H. HaskellGuy H. Haskell, PhD, JD, NREMT-P, has been an EMS provider and instructor for more than 25 years and in four states. He is a paramedic with Indianapolis EMS, Director of Emergency Medical and Safety Services Consultants, LLC, firefighter/paramedic with Benton Township Volunteer Fire Department of Monroe County, Indiana, and Clinical Editor of EMS for Gannett Healthcare. Contact him via e-mail at ghasell@indiana.edu.

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