The Headache Call

You are sitting in your living room, you are watching your favorite TV show, enjoying a beer, and having a nice relaxing evening at home before beginning a new work week in the morning. All of a sudden, you feel a sharp pain in your head. This pain is like no other. It is excruciatingly sharp, and it brings on a sudden photophobia, auras, and blurred vision. You have never had a headache this severe, and this sudden ever in your life. You are scared. What if this is more than a migraine? What if I could die from this?

So you call 911.

EMS is in quarters, also enjoying some down time. The tones drop, and they roll their eyes at the chief complaint. They mock your emergency from the minute the calls come in. Laughing and joking around, they halfheartedly respond to your emergency. Upon arrival, they slowly gather their first in bag, and that's it. They figure they can walk you to their stretcher. They knock on your door, but you can't answer it. You are now laying unresponsive on the floor. They gain access and find you. You are unconscious. Your breathing is shallow, and your heart rate is fast and thready. They quickly change modes, realizing that they were terribly wrong. This wasn't a fake emergency at all, and they left themselves unprepared for what they found, a really sick patient that needed rapid transport. One medic runs to the truck while the other medic begins asses you. Your breath smells of beer. The medic assumes you drank too much and passed out. But, you were only on your second beer. As the second medic returns, they discuss your alcohol consumption, missing the fact that one of your pupils are blown. You are hemorrhaging in your brain. They scoop you out to the stretcher, and load you in. They throw you on a 4 lead, start an IV and give you a fluid bolus, and start their way to the hospital. En route, you code. There was so much blood in your brain, that you no longer could hold on. The medic frantically begins CPR, and yells up to his partner, who is currently driving. In the end, you die. There was nothing that could save you. Subarachnoid hemorrhages can be lethal, quickly.

The moral of this story is not to prove that the actions of the crew killed the patient, because ultimately the patient was likely to die whether the medics took the call seriously or not. The moral of the story is, sometimes things are more than they appear to be. A simple headache call could lead to many outcomes. 

The patient that fell 5 days ago, and is now experiencing a headache, could have a slow bleed which is now to the point of possibly becoming fatal. The AMS that resulted from a headache x3 weeks, could really be a tumor effecting their mental status. The child in and out of consciousness presenting like an accidental overdose, who complained of a severe headache earlier that morning, and went seeking tylenol could have a ruptured aneurysm. 

The truth is, we all have those moments where we roll our eyes at a chief complaint. Whether it is a "real" emergency or not, is not for us to determine. We do our jobs. We go where people need us. We act proficiently, and effectively, and we move on. Never should we drop our guard because we feel that a patient is unworthy of our presence. Our job is to be there regardless. Remember this story. Remember that things can change in the blink of an eye. Work to your fullest potential, every call, with every patient. The ones you brush off, just may cost you your job. 

Take care of your neighbors kids, their lives may depend on it!

RU