The call was for a drunk. We were updated that he was seizing, but he wasn’t when we got there. His wife said he’d been drinking vodka for a week and she wanted him to go to detox. I put in an IV lock, checked his ETCO2 which was 35 and his sugar which was 120. His pupils were also equal and only slightly sluggish. He had grabbed my hand when I was putting the IV in, but when we tried to pick him up and put him in the stair chair, he played dead. Carrying him out of the house, I had the foot of the stair chair and backed out of the front door onto the broad top step. Then I stepped down to the second step with my right foot, but there was no second step where I set the foot, which went all the way down four steps to the ground, while my left leg went into a position where my knee was much higher than my thigh. I managed to hold onto to the stair chair without toppling the patient. It was one of those houses where the first three steps are not nearly as wide as the top landing. This is the second time I have done this — not see the narrower steps and am very lucky both times I have kept my balance and not hurt myself, other than some soreness in my left knee. (I did have a spotter, who must not have seen me stepping off).
In the ambulance, I felt the patient brush against my knee with his hand and then start shaking, doing his best gran mal seizure imitation. I glanced at the capnography.
Breathing just fine, which is impossible when you are having a gran mal seizure.
Knock it off! I said.
He stopped. He tried the same act two more times, each time brushing my knee to catch my attention while I wrote my paperwork. I just shook my head.
“What were you drinking?” I asked. I already knew the answer, but I wanted him to talk to me. He had refused to respond to my question about allergies or what meds he was on.
“I heard you were drinking wine coolers,” I said.
He opened his eyes then and looked at me. “No, no, no,” he said. “Vodka!” He said it rather proudly.
“Okay,” I said. “Are you allergic to any medicine?”
He wouldn’t answer. He closed his eyes again, and started his jerking.
I was tempted(my knee throbbing) to put the ECG electrodes on his temples and say listen, “you can’t fool this machine, you can’t fake brain seizure activity, so you just knock it off or I’m going to electrocute your head.”
Instead I ignored him and he stopped. Then he tried holding his breath and he discovered that would make the apnea alarm go off, so he would hold his breath until the alarm went off, then he’d let his breath out a little. I’d hit the alarm button off. We played this little cat and mouse for a while till I finally just shut off the monitor. I saw him glancing at the machine. He couldn’t figure out why he couldn’t make the alarm go off.
“I turned it off,” I said.
He brushed my knee with his hand again and started shaking, but this time he looked at me and said, “Give me medicine.”
At the hospital, he wouldn’t talk to the triage nurse, but when we went into the psych ward, he got off the stretcher and asked the nurse if he could have a cigarette. She said no and then gave him a hospital gown to change into. He walked into the bathroom, and came out changed while I sat there finishing my paperwork.