“That explained the crash and the breath, but what about the vomiting and bizarre story? While I was puzzling that out, the patient asked to go to a small local hospital. Normally, a reasonable request, unless I have a trauma patient. I looked at the red mark on his forehead and decided to check his pupils — that’s when alarms went off.”
“With help from the police, we loaded him into the ambulance and expedited transport to the nearest trauma center. En route, he complained of severe head pain, said he could feel his pulse pounding in his head, and started screaming. His blood pressure was climbing every time I checked it.
When we arrived, the triage nurse tried to send him to general triage. I insisted he needed an immediate head CT. She pushed back. I grabbed a doctor, explained the situation, and he ordered a rush CT. As I suspected, the patient had a brain bleed. He went straight from CT into emergency surgery to stop the bleeding.
It’s probably the call I’m most proud of. If I had done one thing differently: if the police had arrested him, if I’d taken him to the wrong hospital, if I hadn’t argued for priority treatment, or if I hadn’t taken the time to really talk to him, his chances would have been so much worse. He might not have survived.”
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