...just another of two million Murphy's Law of EMS cases that continues to haunt us
by

One evening working the medic unit we responded on a call for a male in seizure. Callback to 911 reported that the patient was out of seizure, conscious and alert. We promptly downgraded our response as he had a seizure history and the "RO" was competent, according to dispatch. Thinking we were dealing with a group home (hence the dispatch use of "RO" for the 911 caller), I cancelled the engine company response.

Three flights of stairs later.. and mind you, these were the most unlighted, creaking, and windy stairs possible.. I walk into an apartment with my partner to find a postictal male in his 40's. Hmmmmmm... not conscious and alert, and never was.

After examining him and beginning to work him up (O2, pulse ox, IV, glucometer, ECG, etc.), he was still very far down for being postictal. I
knew better than to struggle with a 150 kg patient down the stairs with only my partner and I, so I recalled the engine company.

The only bystander (the "expert" 911 historian) couldn't tell sobriety from lactose intolerance. Working in the dark and expecting a seizure patient to awake from his demeanor with fists flying, I slyly slid an IV into a hand vein. The sugars were normal, ECG actually was normal sinus rhythm, pulse ox high 90's. Then he seizes again.

So in the dark I'm dealing with this seizing patient. My engine company is locked downstairs at the entrance with no way in until my "sober" witness finally agrees and unlocks the padlocked door the "bad guys were pounding" on. The BLS engine walks into the room after I gave some Ativan IV with successful cessation of the recent seizure.

During the transfer, in this dark space mind you, I see something black and liquidy squirting about the room. Apparently a stopcock on the IV tubing broke loose and the patient was now exsanguinating all over the apartment and the EMS providers. Once I managed to stop the flow, we continued the move. Seems simple, eh? Nope....

When I tried to flush the IV line of blood, for the first time in 14 years of EMS I experienced a blowout of the IV drip chamber. Unfrigin' real. This was not just a crack, but an absolute explosion of the drip chamber as I squeezed it. I actually looked at the broken chamber and shards of plastic in shock until an EMT reminded me of the critical situation at hand.

In the end, I had to give Ativan IM while another medic attempted re-establishing IV access in the short transport to the hospital. The patient survived, but this was just another of two million Murphy's Law of EMS cases that continues to haunt us every year.

fire junkie