Wednesday, April 14, 2010

Up the Stairs

Saturday night. 9:30. A half an hour before I get off after a 16 hour shift. It’s the worst time to get a call. Another fifteen minutes later and my relief would be in and he’d take it, but at 9:30, no such luck. I am definitely getting off late.

The call is for a fall, a man in his thirties, tumbled down the stairs and has back pain. No loss of consciousness. My partner and I discuss what it is likely to be.

“I just know it,” I say. “It’s going to be a large person. And he’s going to be at the bottom of the basement stairs, and we’re going to have to board him and carry him up the stairs.”

“Maybe he’ll have already walked up the stairs for us.”

“Please, please let that be the case,” I say.

We park in the road and wheel the stretcher up the driveway, and then leave the stretcher out front and walk up the four granite steps. The front door is partway open. I am so hoping to see someone sitting on the bottom step or in the chair by the door. No one. Damn!

I look for the basement stairs, but then hear a voice. “Up here!”

Upstairs?

We walk on up and find our patient sitting on the bed, holding his back and grimacing.

“Let me get this straight,” I say after hearing the patient’s description of the event. “You fell all the way down the stairs, lay there in pain for twenty minutes, and then got up and walked all the way back upstairs to call us.”

He nods, not getting the irony. “That’s right.”

I palpate his spine. He winces as I touch the thoracic area.

No way around this. I explain what we are going to do, and then leave, and then come back with the board, collar, straps and head bed.

The patient is six-four, two hundred and forty pounds. Fortunately my partner Josh is strong and the two of us manage. With a police officer keeping his hand on my back, I also balance myself by leaning my left shoulder against the side wall, as I step backwards down the stairs. I grit my teeth and repeat the mantra, don't let go, don't let go. We carry him all the way down, and out the door and down the four granite steps, to the stretcher.

When I do these carrydowns, as my arms start to tremble and my back strains, I always wonder how smaller crews manage, and I also think how easy it would be to lose your balance or let go from the strain, and with all the improvements over the years with slide sheets and tractor wheel stair chairs and power stretchers, there has to be a better way to carry people up and down stairs on backboards.

I end up giving him 5 mg of morphine for the pain ( I probably should have done it in the house) -- at least it seems to take the edge off for him. So now in addition to writing up my run form, I have go to the pharmacy and exchange controlled substances kits.

On the way back to the base, my partner says, “Maybe he’ll walk up the stairs. Your prayers are answered.”

“Don’t even start,” I say.

I punch out at 11:10.