No Happy Ending for Bathtub Burn Victim - Patient Care - @ JEMS.com


No Happy Ending for Bathtub Burn Victim

 

 
 
 

Guy H. Haskell | | Wednesday, November 10, 2010


I think it was summertime, but I'm not sure. I don't even remember what we were dispatched for. But I do remember the address was one of the large estates up on Lake Erie. Those calls were always memorable, because they were so few and far between.

As in most EMS systems in our decaying, rust-belt town, we spent most of our time responding to the same low-rent and Section 8 neighborhoods where the poor, the uneducated and the unhealthy congregate. We had the Hispanic poor on the east side, the black poor on the south side and the white poor north of what was left of downtown. Increasingly there were also heterogeneous neighborhoods of equal opportunity of despair. Of course both within those warrens and without, we had our regulars. Between those folks and the nursing home shuttle, rare was the visit to the fading glory of the manses on the shore of the Great Lake.

When we arrived on scene, a middle-aged fellow was waiting for us outside the open, three-car garage. Water was pouring through the garage ceiling onto the concrete floor, rivulets streaming down the driveway. Sometimes, when it's clear that a scene is unusual, that something out of the ordinary is about to happen, awareness is heightened, the pupils dilate, you consciously relax your body against to effects of adrenaline, your mind speeds up so events seem to occur in slow motion. You get a heightened sense of awareness, a kind of battle mode. Why was water pouring through the ceiling? What were we dispatched for again? It wasn't a drowning. What was this guy saying about his father? A bathtub?

He led us upstairs to a bedroom. The floor was flooded. Then to a bathroom, also flooded. In the bathtub was a naked, elderly man. His father. The son had come home to find water pouring through the ceiling and his dad in the bathtub. He was alive, but barely. His eyes were open, but he didn't respond. He moaned, kind of. The water was cold. He was cold, but skin was sloughing off his body wherever I touched him. Can you be in a bathtub long enough that your skin sloughs off your body? No, that can't be it. Necrotizing fasciitis? That doesn't make sense either. Then it began to dawn on us.

The water didn't start off cold. In fact, it had started off hot, very hot. And when this elderly gentleman got in the tub maybe he couldn't react quickly enough and was scalded. Then he couldn't get out of the tub. Or he fell in and couldn't get out. Or hit his head. Or had a medical episode. Whatever the case, he had cooked in the hot water until it ran cold, and then he had soaked in the cold water until we arrived. The good news was that the cold water stopped the burning process and hyperthermia. The bad news was that not only did he have second degree burns on his entire body, he was now severely hypothermic.

We did what we could, which wasn't much. We removed him from the tub with a sheet, immobilizing him as best we could. Quick head to toe, then placed him on sterile sheets to dry him off. Wrapped him in blankets with heat packs. Called the hospital to give them notice. The only unburned place I could find to start an IV was the left external jugular. Then all we could do was monitor him, especially for dysrhythmias, and crank up the heat in the squad. This was in the days before prehospital pain management. In a way the hypothermia was a blessing. Hopefully it lessened his perception of the pain.

He made it to the hospital. He made it till Life Flight arrived to take him to Cleveland Metro. We heard that he didn't last long after that. At least that was a blessing. I can only imagine the undeserved guilt his son was feeling.




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Related Topics: Patient Care, Special Patients

 
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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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