Tricky Extraction

You voted for it…Which makes me worry a little about the type of people you are…
I think I've mentioned on more than one occasion how, when working in a hospital, the patients are often nicely 'packaged' ready for examination, this can often hide the trauma that the ambulance crew has gone through in getting the patient into hospital in such a condition.

Me and a temporary crewmate got called to a 'collapse', and we made good time getting there to be met by relatives of a 72 year old female who had vomited altered blood (probably from a stomach ulcer) and had collapsed to the ground hyperventilating. The woman was around 20 stone in weight (280 pounds to the Americans in the audience). She was in a bungalow, so we had no stairs to get in our way, and the relatives were willing to be helpful. The patient was laying on the floor and had just finished an episode of hyperventilation (a panic attack).

Should have been a nice easy removal, even with the patients weight and reduced ability to walk. We had our carry chair and after struggling a little to get the patient on it, we didn't expect any trouble.

Heh….

It turns out that the patient was an agoraphobic and hadn't left her house in 20 years…

Sweating profusely, the patient fought us the entire way out of the house, she grabbed at anything tied down, at door-frames and at the handrail she had installed in her house. Trying to get a sweaty 20st patient out of a house is tough enough without them fighting you the whole way.

We had explained that she needed to go to hospital – and she had logically agreed, but this didn't stop her panicking when we started to move her. When we finally managed to get her into the open air her panic rose to a dangerous level.

She was shaking, her eyes rolled back into her skull, sweat was pouring off of her and her thrashing about in the carry-chair got worse (if such a thing was possible). Both my crewmate and myself thought that she was going to have a heart attack, in fact she had all the classic symptoms of a massive Myocardial Infarction (posh medical term for a heart attack). Then she started a strange screaming/moaning call that sounded completely unearthly. I could just see the next days newspaper headline, “Ambulance Crew Scare Patient To Death!”

All I could think about was to try and calm her down, so I tried using some hypnosis techniques that I (just happen) to know, which helped a little – but by then she was in such an agitated state that horse tranquillisers probably wouldn't have touched her.

We managed to get her into the ambulance, where we shut the doors very quickly and made as smooth a transport to hospital as possible. During the transport my crewmate and the patients family worked constantly to calm the patient down, but they were only having a fairly limited success; every so often I would hear her moan in that alien fashion, and my crewmate start babbling at her to calm down.

When we got to the hospital, we nearly threw her off the ambulance into the A&E department; actually she was so slicked with sweat we could have slid her off the trolley. She calmed down a bit once she was in hospital, which only made our exhausted faces seem over-dramatic to the nursing staff.

You never know what you are going to get in this job, but nine times out of ten it isn't the illness that surprises you, but the circumstances around the job.

8 thoughts on “Tricky Extraction”

  1. You would think the patient or the family would have mentioned the “small agoraphobia detail” when you mentioned she would have to actually go out of the house. Funny what can just slip your mind. Are relatives normally that forgetful ?

  2. i would hate to be the family member that draws the short straw when it is time to transport granny home when she is well enough

  3. 20 stone in weight (280 pounds to the Americans in the audience)And what about the rest of the world which uses that logical metric system, eh? Couldn't help but snark about that. Love the blog – it's one of only three or four non-political ones I read regularly.

  4. I had a similar experience once with one of my patients who was phobic about cigarette smoke. Unfortunately, the day I saw her I forgot to place the rolled up towel along the miniscule gap under the clinic door and she fell to the floor hyperventilating. Since the clinic is in a hospital, smoke wasn't exactly billowing around the building, but she swore she could smell it coming from the main road! These things are sent to try us.

  5. I almost had a panic attack just reading this. Oh, and I'd love to see 'Baby in a Bottle', too. The mind positively boggles …

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