Thursday, October 7, 2010

"Medication Seeking," he mouthed...

I finished my last ride outs which were, again, pretty uneventful.

The one that stood out the most was a woman who was complaining of a severe headache and her husband said she was shaking. Upon entering the house, you could hear her moaning and making unintelligible noises from another room. The look on the EMT-Basic's face as he looked into the room was priceless. Just by that look, I knew he was either seeing something totally serious, or something that had him wondering why we were even there.

The woman was in bed, having what appeared to be seizures. I've never personally seen someone have seizures before, but this seems to be what she was going for. Her eyes were darting in many different directions, her speech as cut off as she jolted in all sorts of directions. Amazingly, her husband was able to assist her to walk to the stretcher as she had her fit, before our guys could do anything.

Turns out the husband is familiar with the EMS line of work. We loaded her up, my preceptor and myself in the back. The basic and the husband up front. Her BP was fine, her HR was fine, her pulse-ox was fine. But she said she was in horrible pain. The husband shouts through the window, "She needs atropine, or maybe morphine." (or something to that effect). When I heard "morphine" coming out of a guy's mouth who doesn't look like I'd trust on the street, I felt something was up. Nevertheless, I watched as my preceptor did his thing.

My preceptor yelled back to him, "I cant give her morphine if she's not in pain". Now, from the time we picked the lady up, she couldn't speak a single word clearly. But "I AM IN PAIN" came out clear as a bell. At which point the paramedic said that he could not give her morphine for a headache.

As we settled in for the ride, I looked over where he was sitting behind the head of the patient. "Medication seeking," he mouthed.

It all made sense to me now. This was my first "frequent flyer". Turns out this couple calls fairly frequently for absurd injuries to try and get to the hospital for meds. I had read about this in blogs, books, forums, but I kind of never thought about how I would ever know if a patient was trying to scam me out of medication. I'm not a paramedic, so I really don't know the indications or contraindications of morphine, atropine, etc.

But everything started to fall together. From what I had learned, I was kinda of under the assumption that someone who was having seizures. Unless these were some severe seizures, I never noticed a tonic clonic phase, or any sort of break in the convulsing. Her convulsing, also, was just that; It seemed to me like she needed a priest to perform an exorcism more than she needed a pair of EMTs.

In the long run she got to the hospital, it looked as if they were starting an IV line on her as we did our paperwork. Whether she got what she wanted or not, I don't know.

What I do know is that I do not want to be to quick to judge someone for medication seeking. Not at least until I know what I am doing. However, it sickens me that people do this. This was a code 3 call. We rushed to get there, ran red lights, and the works to make sure we got to this lady in time. All because she wanted some morphine.

On a lighter note, I am done with class. I got my class certificate today. I have applied for my national exam and I'll be waiting to take that soon, then play the waiting game before my state certification comes in. Wish me luck on my test!

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