Monday, August 20, 2012

This. This is the reason I wanna be a paramedic.

So I had a "Basic transfer" from one hospital in Maine to one in Massachusetts. 3 1/2 hour transport time. Below is my narrative of what happened.

Now my main issues with this call is all of it could have been avoided and we would have had a nice ride if I had been through Paramedic school. 
1. I would know that a common side effect of Morphine is Nausea/Vomiting and Hypotension.
2. I would have been able to Push anti-nausea meds or even pain meds! we have Zofran in our open drug box!

Now all HIPAA information has been removed... cause well, I like my job :) even if I have to deal with puke!
55 Y/O Male DX appendicitis.
PT went to the ER after having LRQ Adb pain. he was DX with appendicitis and is going to XXX for surgery to have it removed. Prior to leaving the ER pt pain
level was a 6/10. Doctor gave Pt 4 MG of Morphine via IV. ER gave Pt one full 1000ML normal saline prior to XXX arrival, The second 1000ML Normal saline was
started when Pt was packaged for transport.
Pt had a pain level of 6 on arrival, on reassessment Pain was going down to a 3.
23:15 Pt had an episode of nausea and vomiting. Denies Nausea after episode.
00:02 Pt had a second episode of nausea and Vomiting. Pt claims it was going over bumps and curves in XXXX. Denies nausea after. BP maintaining normal limits.
01:00 Pt had a third episode of nausea. in vomit was amount of Pink/Red sputum. Called Supervisor for advice and Phone number for ER. Supervisor advised
that I call ER before diverting. MD in ER was called and informed of the situation. MD asked if we had anti-nausea medications on board and was
informed that we are unable to provide medications due to license level. MD advised that we should keep going as we were to XXX
01:24 Fourth episode nausea and vomiting. very little vomit, no red or pink sputum.
Upon arrival to XXX Pt care and report given to staff.
Is it normal to have MD's shaft you like this in the field? cause this sucked. Has anyone else seen appendicitis  and morphine W/O anti-nausea meds? How did you handle it?