First, I am writing this after coming off three days straight working 16+ hours. So, if I come off a bit negative, I am sorry.
As summertime has hit, things have gotten busy for me. Since I work multiple jobs (my "day" job + 3 other part-time jobs), it can get... hectic. Friday, I worked my usual 8 hours, then worked at the ballpark for a game. Got home ala 11:30pm, then was up and running at 5:30am, picking Diana up from work, going to pick up the ambulance, then have her drive home with Jonny. Got home, threw my uniform on that had been in the dryer from working the night before... then off to the soccer matches to work! Worked that from 8:00am-6:30pm, then went home, quick shower, and threw on my shorts and work shirt to work a shift at the ballpark (We had a no-show... seems to happen more this time of year). Game didn't even start until 7:30, as it was "Dusty Baker Day", and things ran late. The work at the soccer matches was BUSY. It was very hot (105 degrees), and we had kids crashing due to heat. Even sent one to the hospital, but hers really wasn't a true heat-related issue. Something else was going on there... more later.
Got home late, threw the uniform in the laundry, putting my shorts in also, since I baked that day in my long pants and enjoyed being in shorts that night at the park. Hit the pillow and that was I remember until 5:30am again yesterday. Woke up, threw everything in the dryer, got ready for work, tossed the now dry clothes on and went to pick up my partner for the day and get back to the soccer fields.
Except for one thing... I put my shorts on, since it was hot the day before. Remember what temp I said it was on Saturday? Not yesterday... the high was a whopping 75 degrees (That's a 30 degree difference!). I froze my tush off out at the field for the first 4 hours. It was cold, windy, and a little smokey from a brush fire nearby. The brush fire got knocked down quickly, so that didn't linger too much. But wow... I ducked into the rig just to stay warm! While I was in there, I made use of myself and cleaned it up. My partner helped me also (She and her husband own the ambulance). Her husband got there and I took off pretty soon after that to get ready for my shift at the ballpark. Heh... I put my pants back on instead of shorts, and dug out my jacket that I haven't seen since the first week of June. Glad I did. I got damn cold at the park last night by 7:00pm. By the time I left around 10:00pm last night, the temp was in the 50's. Wierd... I have never seen a two-day change in temp like this IN AUGUST. Normal is around 93 degrees this time of year. I honestly never thought I would be shivering in Sacramento in August.
In terms of medicine, the girl we treated at the soccer matches bothered me to no end Saturday. Her problems didn't seem like a heat issue. Usually, we cool them off, and they are doing well. She didn't really improve much. Her problems seemed more neurological (She complained of a sudden onset headache, which *can* be heat related, but most of the time is slow to onset). Crying incessently, poor grip strength, poor reflexes, couldn't follow simple commands, and overt confusion including not recognizing her mom. Mom and her coach denied any head injury, fever, anything that would explain any of this. And she really didn't seem hot. We still cooled her off just in case. Got her on high-flow oxygen. Temp slightly elevated, but nothing out of the ordinary for running around on a soccer field in 105 temps. Oxygen helped a bit. She woke up a little more, but couldn't speak at all. Completely aphasic. She seemed more post-dictal than anything (For you non-medical folk reading this, like she had a seizure). Things just didn't add up, if you know what I mean. I started considering the possibility of a hemorrhagic stroke. Yeah, it happens in kids, too. Being that she improved a bit with the O2, that was less a possibility. Got her transferred to the hospital.
Both my partner and I were just going over this in our heads constantly (and discussing it at the ballpark... he works there also.)... and for good reason. Turns out the next morning, we were told that she HAD been in a head-on collision with a goalie. Aha! Concussion and a seizure make a lot of sense now for the symptoms she had. Last I heard, she was doing ok and home. The crappy way we were treated by the fire department that showed up is enough for another blog entry... but I will leave that alone.
So, what's the take-home lesson for this? If it quacks like a duck, walks like a duck, and swims like a duck... it probably is a duck. If things don't seem right, they aren't. Trust your intuition. It will guide you well with your patients.
Last night was busy at the ballpark... slow early on, then a TON of foul ball hits, including one patient that went to the hospital (Yes, as I have said before, baseballs do hurt and can do a lot of damage). I was so busy, I didn't even realize that the game had ended for 20 minutes!
So, I am back at my "day job", and exhausted. I sure hope I don't get called to work tonight... I need the sleep tonight.
BTW, I still do love emergency medicine. Its just that I get worn down sometimes.
Does caffeine come in an I.V. form?
Labels: baseball, EMS, Misc Rants
