A three ambulance wedding...

[Adam D. RN2005]

I had attended my cousins wedding last week, it is now a three ambulance wedding. And it wasn't even an irish one. (My cousin use to be an EMT, so there were quite a few medics, a couple of nurses, a PA and one gynecologist there.)

After the ceremony, during the cocktail hour, while I was shoving pigs in a blanket in my mouth, my aunt comes up and just says "Adam, we need you, someone is sick." She wouldn't elaborate beyond that. I follow her expecting to see a guest drunk, and I was going to say something to the effect of drink water for the rest of the evening. Last thing that I expected to walk into was a elderly gentleman having a full blown stroke.

When I came up to now my pt, I did my standard set of questions. He complains of lightheadedness and genalized weakness. Instinct told me something neuro was going on. He's speaking normally, no sluring, and is AOx3. Go through my neuro assessment, and everything is normal. The only thing that is abnormal is the fact that his arms and hands are ice cold, and his legs are burning up. But everything is normal. Not diaphoresising. Everything is just normal.

I switch gears and keep CVA as a possibility. start asking the wife calmly for a history. HTN, boarderline Diabetis, and a few sx here and there. Last meal was at 1300, it is now after 2000. DM is a possibility, and he may have some PVD going on (can't tell you how many DM pt's I witnessed this on) which explains the legs and arms bit, generalized weakness and lighthead.

By this time the PA and gynacologyist comes and the PA starts doing an assessment as well, I focus on the wife and let the PA know my first instinct is CVA but maybe Hypoglycemic. 911 is called, PA is getting the same results on the neuro assessment, and then I noticed it, the PT started to slur his words. At this point, I start speaking to the wife, wanting t know everything about this afternoon. She said he c/o a severe headache that went as quickly as it came, and massive sweating this afternoon at about 1800. (Bingo, now I am thinking of some sort of headbleed event.)

I am now thinking headbleed. PT is starting to show confusion and rightsided weakness. Very visable, this guy is stroking, I wish I had my stethoscope and B/P cuff, which are back at the hotel (I don't leave home without them. You never know)

The Wife is getting anxious. Just in case, he is a candidate for TPA I started to ask questions on Meds he took this afternoon and evening. Did he have any ETOH. Any ASA. Every question that could possibly R/O the pt as a canidate. (PA later commented to me that she could not believe the questions I was asking. Because she would have never thought to ask those. And was very impressed by my thinking and how I was able to keep the wife calm. And how calm and cool I was (despite the tux I was wearing) during the entire ordeal to the point that the MD offered me a job if I ever decide to leave Bedside RN'ing.

When the EMT arrived, the wife got very anxious. I had my fingers on her wrist worried that she was going to MI on me. At one point she states I feel SOB and am having difficulty breathing. Her pulse was very high. I turn to the EMT and motion one over to me, identify myself as an RN and say quietly not to make the wife more anxious. "She is feeling a little SOB and is having difficulty breathing..." before I could finish my sentence and ask for 02 with a NC to calm her down the EMT turns to the wife and loudly states "Ma'am. you having difficulty breathing. Do you want us to call an additional rig?" I wanted to kill the EMT because the wife got very anxious at this point. I was able to calm her down without the O2, but the EMT defeated what I was trying to do.

After I the PA gave her report and I gave my report to the head paramedic, he commented to me that this is probably the most complete report he has ever gotten on the scene concerning a pt. I just smiled.

After we shipped the pt off, the other 911 call was for a ETOH drunk cousin who fell and broke her wrist. She was last seen refusing to let go off the full wine glass. The final 911 was for a employee who tripped and broke her leg.

The next morning my aunt comes up to me and just says that she was impressed with how I reacted during a chaotic situation and stayed calm cool and collective, and said she now knows that pts are in good hands under my care. And that the wife told her to thank me, that I was a true hero that night. My parents also commented on how many people came up to them afterwards commenting on my performance. We also found out that he had a cerebral bleed. My first instincts were completely correct

I feel very humbled by all of this. I don't feel like a hero, I was doing my job, taking care of a sick patient and trying to keep everyone calm and get as much info as possible to help find a diagnosis and get the correct treatment to the patient.

We also found out that he had a cerebral bleed.

The family now jokes about the new rating system for wedding. For me, I just was glad that I was there to help. But next time this happens, my nursing bag will be in the trunk of the car.

Adam, RN

[LadyT618, MSN, APRN, NP]

This was a pleasure to read. I am very proud (and I don't even know u). I always imagine if I would react the same way in similar situations. What else besides your bp cuff and stethoscope do u carry in your bag? Truly inspirational.

P.S. What type of nursing do u do for a living?

[medsurgnurse, RN]

Well done.

[vamedic4, EMT-P]

Feels good knowing you helped, doesn't it? Well done...

Have a great night...you've earned it.

vamedic4

Sleep is 8 hours away

[suzy253, RN]

Great job! good for you!!!

[mt33133]

I had attended my cousins wedding last week, it is now a three ambulance wedding. And it wasn't even an irish one. (My cousin use to be an EMT, so there were quite a few medics, a couple of nurses, a PA and one gynecologist there.)

After the ceremony, during the cocktail hour, while I was shoving pigs in a blanket in my mouth, my aunt comes up and just says "Adam, we need you, someone is sick." She wouldn't elaborate beyond that. I follow her expecting to see a guest drunk, and I was going to say something to the effect of drink water for the rest of the evening. Last thing that I expected to walk into was a elderly gentleman having a full blown stroke.

When I came up to now my pt, I did my standard set of questions. He complains of lightheadedness and genalized weakness. Instinct told me something neuro was going on. He's speaking normally, no sluring, and is AOx3. Go through my neuro assessment, and everything is normal. The only thing that is abnormal is the fact that his arms and hands are ice cold, and his legs are burning up. But everything is normal. Not diaphoresising. Everything is just normal.

I switch gears and keep CVA as a possibility. start asking the wife calmly for a history. HTN, boarderline Diabetis, and a few sx here and there. Last meal was at 1300, it is now after 2000. DM is a possibility, and he may have some PVD going on (can't tell you how many DM pt's I witnessed this on) which explains the legs and arms bit, generalized weakness and lighthead.

By this time the PA and gynacologyist comes and the PA starts doing an assessment as well, I focus on the wife and let the PA know my first instinct is CVA but maybe Hypoglycemic. 911 is called, PA is getting the same results on the neuro assessment, and then I noticed it, the PT started to slur his words. At this point, I start speaking to the wife, wanting t know everything about this afternoon. She said he c/o a severe headache that went as quickly as it came, and massive sweating this afternoon at about 1800. (Bingo, now I am thinking of some sort of headbleed event.)

I am now thinking headbleed. PT is starting to show confusion and rightsided weakness. Very visable, this guy is stroking, I wish I had my stethoscope and B/P cuff, which are back at the hotel (I don't leave home without them. You never know)

The Wife is getting anxious. Just in case, he is a candidate for TPA I started to ask questions on Meds he took this afternoon and evening. Did he have any ETOH. Any ASA. Every question that could possibly R/O the pt as a canidate. (PA later commented to me that she could not believe the questions I was asking. Because she would have never thought to ask those. And was very impressed by my thinking and how I was able to keep the wife calm. And how calm and cool I was (despite the tux I was wearing) during the entire ordeal to the point that the MD offered me a job if I ever decide to leave Bedside RN'ing.

When the EMT arrived, the wife got very anxious. I had my fingers on her wrist worried that she was going to MI on me. At one point she states I feel SOB and am having difficulty breathing. Her pulse was very high. I turn to the EMT and motion one over to me, identify myself as an RN and say quietly not to make the wife more anxious. "She is feeling a little SOB and is having difficulty breathing..." before I could finish my sentence and ask for 02 with a NC to calm her down the EMT turns to the wife and loudly states "Ma'am. you having difficulty breathing. Do you want us to call an additional rig?" I wanted to kill the EMT because the wife got very anxious at this point. I was able to calm her down without the O2, but the EMT defeated what I was trying to do.

After I the PA gave her report and I gave my report to the head paramedic, he commented to me that this is probably the most complete report he has ever gotten on the scene concerning a pt. I just smiled.

After we shipped the pt off, the other 911 call was for a ETOH drunk cousin who fell and broke her wrist. She was last seen refusing to let go off the full wine glass. The final 911 was for a employee who tripped and broke her leg.

The next morning my aunt comes up to me and just says that she was impressed with how I reacted during a chaotic situation and stayed calm cool and collective, and said she now knows that pts are in good hands under my care. And that the wife told her to thank me, that I was a true hero that night. My parents also commented on how many people came up to them afterwards commenting on my performance. We also found out that he had a cerebral bleed. My first instincts were completely correct

I feel very humbled by all of this. I don't feel like a hero, I was doing my job, taking care of a sick patient and trying to keep everyone calm and get as much info as possible to help find a diagnosis and get the correct treatment to the patient.

We also found out that he had a cerebral bleed.

The family now jokes about the new rating system for wedding. For me, I just was glad that I was there to help. But next time this happens, my nursing bag will be in the trunk of the car.

Adam, RN

Adam -

For how long have you been an RN? Do you have a BSN or an ADN? Hopefully one day I will feel that confident in my skills!! In what area of nursing do you work?

Thanks!

Alissa

[KellieNurse06]

:balloons: Great job!

[prmenrs, RN]

I went to a wedding a week or so ago, and all we had to deal w/were the groom's uncouth relatives (his dad and bro sat thru the entire church services w/their hats on! No, not Jewish, either), and the bride's nasty birth father (we started refering to him as the sperm donor).

Thank you, God!!

[pamc217]

Way to go Adam! I am a new nurse grad, EMT for 5 years, I too have had to handle accidents both off and on duty, with one fatal. Gee do you get invited to parties alot now? just kidding!!!!

Good Luck!!!

[NRSKarenRN, BSN, RN]

What a first year your having. Kudos on those assessment skills...

[Chaya, ASN, RN]

Adam, that was awesome!

First, for your timely and thorough handling of a very serious situation.

And second-WE all know that nurses ROCK- now everyone who was at that wedding has seen exactly what it is that nurses do! (Hope it was a big wedding!)

[Princess74]

Great Job Adam!