As soon as I ran into the room, I could smell the stale aroma of alcohol and cigarettes emanating from the patient. I was assigned to the defibrillator but one of the emergency department nurses was already on it, so the code leader asked me to just hold the guys' legs down and play gopher as needed.
He just couldn't stay still, which seemed to upset most of the people working on him. I guess it really is a lot easier to run a code on somebody who has passed out. He was wide awake and hollering his fool head off, as they say.
It was only about one o'clock in the afternoon, so I thought he was remarkably drunk for so early in the day. But what did I know?
Speaking of remarkable, I remember the ST changes on his 12-lead EKG. They were as big as the thumb of a grown man. Real crowd-pleasers, those, in leads II, III, and IV. The biggest I'd ever seen, and bigger than anything I've seen since. One of the ICU nurses, a big guy that I really liked, was holding up the copy of the EKG and we were all going "Wow, nice anterior blow-out." Very impressive.
There was nothing subtle about that guy. Nothing he said, or yelled at the top of his lungs, nothing he did, jerking around like a shark out of water, not his smell, and certainly not his ST changes, were in the least way subtle.
The emergency room physician's assistant was particularly displeased with the guys legs, so she threw her body over them to hold them down. I stepped back to get out of her way. Then the guy sat straight up and hurled everything he ate that day, which was Cambell's Chicken Soup with Stars mixed with beer. All over her back. All over himself. Vomit was dripping off of him and onto the floor. Tiny little beer-soaked stars and a few meaty chicken chunks. And a smell that "could knock a buzzard off a shit wagon," as George Carlin once said.
She scooted off him and came back with leather restraints for his legs.
He was doing well enough by then that the doctor said to wheel him into intensive care to start the streptokinase.
The code team, me included, dispersed back to our regular units.
The story was the guy was drinking in a local tavern when he fell off his stool, clutching his chest.
It was a place that I knew about but had never entered, because I do not patronize establishments that serve soup from cans. I recommend that you also avoid such places.
Thursday, June 09, 2005
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