I did two twelve-hour clinical shifts in order to graduate from EMT school. This is an example of a scenario that I encountered while participating.
Twelve hours. From six in the afternoon till six in the morning, I am expected to jump right into the normal hospital rounds, and go about the saving lives business like I’ve been doing it for years. As the Probe to this particular hospital, I am supposed to be confident, intelligent, and quick on my feet. When an emergency occurs, I should be ready to take charge and know exactly what procedures to follow; however, it’s only my second shift as an EMT-basic student, and although I may have the book work down, I am not sure if my Sympathetic nervous system is prepared for any and all injuries that I may encounter.
It’s already been eight hours into my shift. The heavenly coworkers I am surrounded by have ordered an abundance of pizza from a nearby pizzeria, so I am finally able to recharge my body after standing for so many hours; yet, just I am about to sink my teeth into such a delicious slice of pepperoni and pineapple, I hear the signal from the radio go off. It’s an ambulance in the area that is notifying us of their arrival time. I can’t seem to hear all the details, but I grasp the impression that we need to expect a young male, in his late twenties, suffering from epilepsy. So I drop the slice that I have been dying to ingest, and make my way to the receiving room. There’s usually a couple rooms designated in each section of the Emergency Room for patients with life-threatening conditions, so I start power walking to Room 15. As arrive in the entryway of Room 15, there are already Technicians making room for the new patient by getting the oxygen masks, IV lines, and catheters ready. You can never be too prepared. Then the two large doors swing open and the patient is brought in by gurney.
The young male looks pale white. He has tired eyes, as if the epileptic seizures woke him during his sleep. His muscles are tensed from the “tonic-clonic phase” of the seizures in which all of the muscles stiffen, and at the moment, he seems dazed and confused, as if the Postictal state still hasn’t worn off yet. We transfer the patient to the newly prepped hospital bed as the head nurse begins her questionnaire. She reads off the questions from her computer screen, “How many seizures has Patient X (we’ll call him Patient X to protect his anonymity) had already tonight? Does he have history of experiencing seizures? How often do these seizures occur? Does he have a particular trigger? Is he allergic to any medication? Does he take any medication?” And the questions continue until the whole list is completed. During this time, I am requesting information from the paramedics who are transferring him into our custody. I ask for the pretty basic details like blood glucose levels, blood pressure, breathes per minute, pupil reactions, pulse, and so on. The paramedics also take the moment to inform me that during the postictal state, Patient X had become quite aggressive, and actually tried to stop treatment, so I was to be forewarned.
As the questioning eventually came to a close, we needed to switch out the IV catheter that the paramedics had implemented and replace it with a hospital IV line. The nurse began the process. She removed the first line, and as she was trying to insert the second one, Patient X began seizing again. His entire muscular system contracted. Face and neck included. He began regurgitating. But his jaw was locked tight. One paramedic grabbed the suctioning utensil and tried to clear away the stomach contents. One minute already passed. Then the “clonic” phase began. Patient X’s limbs began to flail. He shook from head to toe. Soon bladder and bowels lost control and released. Another minute passed. Uncontrollable tears ran down his face. Saliva seeped through his teeth. The flailing of the legs and arms began to gradually slow. The last minute passed. Finally the postictal state commenced. The patient lied there; tired from the work his body just forced him to participate in. He tried to resist care just like the paramedics had warned us, so we were forced to attach soft restraints to his legs and arms. He was not a real big fan on the restraints, but he needed the protection from himself.
Seizures are an intense situation to handle. I had no idea walking into my second clinical shift that I would find myself spending hours helping to restrain and watch over a patient with an epilepsy disorder. But I am glad to report that Patient X was eventually released from the hospital, and although he will forever be a victim to the epilepsy, the doctors were able to help him decrease the frequency.
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