CRINGE! I can't imagine the pain folks go through when solidified crystals try to pass through...well...you know. So it always amuses me when: A. A diagnosis has been made prior to our arrival and B. A course of treatment has already been decided upon.
THE EMERGENCY
A middle aged gentleman is experiencing extreme pain in his retroperitoneal (lower back on the sides) area and is immobilized on the couch in pain. His adoring spouse decided to call 911 when she couldn't take his agony any longer. Well, that's the picture they painted over the telephone to the dispatchers anyway.
THE ACTION
First responders have the man on high flow oxygen and the EMT from the fire engine is actually pale and sweating. "What do you have?" I ask him, known to be a caring responsible EMT, and he replies, "This guy is hurting BAD." The patient looks up at me, shakes his head ever so slightly, looks up at his wife and sighs. It was then I realized what was happening. Before I could open my mouth to speak to her, I discovered why our dispatch information had included a field diagnosis.
"He needs morphine for his kidney stones. He can't sit still and its driving him crazy. I think 5 will do for now and another 5 in the ambulance." Wow, she knows our dosing which means she's either a nurse, physician or they've been through this before. "Are you a doctor or nurse ma'am?" "No, but I know what you're supposed to do in this situation, that's why I called last night too. They gave him the medicine and he felt better."
I looked to our patient who appeared a shade redder now. "What is it?" I asked. "Her. the doctors last night gave me some medication for the pain but she won't leave to go get the prescription so I'm stuck." I stood up and walked over to where she stood for a little Medic on Fam discussion. She told me all about how the doctors told her he would feel better and to get him seen if it got worse. I explained how the medicine can't work unless he puts it in his body first and she got upset. "Take him or I will!" On that our patient stood up, took off the mask and asked for a hand to steady him as he walked out to the family car parked between the door and the ambulance. We assisted him into the passenger side as the wife came running out following asking what we thought we were doing. "Take me to get my pills already!" he shouted and told us he was sorry she called, he didn't want us, just his pills and some quiet.
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