Sunday, April 05, 2020

Isolation

I enter the house by myself, wearing a surgical mask, goggles and gloves. I hold a yellow full body gown in my hand, ready to put it on if need be. The daughter leads me into a bedroom where her father lays on the ground on his back in the doorway between the bedroom and the bathroom. He is a big man close to three hundred pounds and he is naked. He has soiled himself. The daughter tells me she came over to check on him and found him like this. He looks blankly up at the ceiling. His walker is still upright by his legs which are as thick as an elephants. His toe nails are also thick, uncut and ridden with fungus. From six feet away, I ask him if he knows where he is and his answer shows confusion.

“He’s had a fever,” the daughter says. “He’s been home from rehab for three days and he has been coughing.” She looks at me expectantly. Message conveyed.

I walk back outside and tell my partner, he’ll need to put his gown on. Together we bring the stretcher in, and after putting a surgical mask on him, with soap and water, we wash the man where he lies as best we can, and then slip some clean underwear on by lifting his legs up and sliding them on,

Thirty years in EMS and you learn how to pick people up, but that doesn’t not mean it is easy. In the end I have to squat behind him, and his back to my gowned chest, I slip my arms under his grasping his crossed wrists tight to his middle and then lift him up as I straighten my legs, my partner holding his legs, and we walk over and set him down gently on the lowered stretcher. On the way out, my gown catches on the door handle and rips.

I admit that in this time of corona, while we still do the same things we always did, I feel a little rattled by it all.

In the back of the ambulance, I begin my assessment. His pulse saturation is 92% so I briefly lift his mask to put on a nasal cannula.  The patient is clearly confused. He thinks he is at the business he owns. His skin is hot. His tongue is cratered and as dry as the desert. His blood pressure is 100/40 – low. His pulse is too rapid to count. On the cardiac monitor, he is in a sinus tachycardia at 190. I slow the strip down and confirm the p waves. Not a diabetic, his blood sugar is 500. I put in an IV and start running fluid wide open. The bumps in the road jostle me as I stand to reach the radio to call in another isolation alert.

Afterwards, I get out of my torn gown and take off my gloves, and wash my hands and arms with soap for a prolonged time in the bathroom.

Outside it is a beautiful day. A robin picks at a stray food wrapper that has fallen out of an overstuffed garbage can. I’m hoping we don’t get a late call and I can get home in time to exercise outside with my family while it is still light.