101 Things the Fire Department wishes you knew



Monday, May 25

...for the man down/ ICE saves the day again...

I told you awhile back about the girl who's phone had the entry ICE (In Case of Emergency) that led to her sister being able to help her out.

There were discussions about how much info to enter into the phones, privacy issues, etc. Even Fossil Medic over at Firegeezer weighed in on the topic. (I just hate that old picture of me)

Not long ago I bumped into another ICE situation and knew I had to pass it along.

THE EMERGENCY

A caller states a man is on her doorstep, altered and incoherent.

THE ACTION

Expecting one of our regulars we roll up to the address ready to pry a pickled retiree off the steps of the house. Shocked we were to find a young man, possibly in his early twenties, semi-conscious leaning up against a handrail.
We assist him to sit and begin our assessment. He is one of the kind of patients I love. You have to apply everything you learned in school to figure out what is pertinent and what isn't. My EMT partner gets a finger stick glucose of 69, looks up at me and says, "There you go."

I am not so easily fooled. We're finding no life threats, other than the brain's inability to control the body, so we get him into my office and on some O2 to start.

Monitor shows Normal Sinus Rhythm at 90.
BP was unremarkable, in the 130's if I recall with a good diastolic to match.
Pupils were at 3 and reactive.
No evidence of ingestion or injection.
Physical exam finds skin is warm, not hot, no trauma noted.
He's trying to speak, slurring really, seems postictal to me but something just isn't right. He's ABOVE the level he should be post seizure. You know the patient, semi-conscious, altered, then you administer O2, maybe a little glucose paste as they perk up and viola, they tell you they have seizures.

But this kid bothered me. Something was off.

We performed a field surgical walletectomy and found he lived in another part of town completely. To even get to where he was was at least 2 or 3 bus transfers and it's not like we're in the drug neighborhood either.

Then I find his cell phone.ICE is the first entry and I hit send.

A woman answers and I explain my situation and she is near hysterics.
"Where is he?! We've been looking everywhere!"
Turns out our friend is autistic.
I looked over at him again and it clicked clear as day.

What we perceived as an altered state was a tired, lost and confused low functioning autism sufferer. Not the autism label they give to kids who read slow so schools can get more funding, closer to Dustin Hoffman counting tooth picks autism. Only exhausted and afraid.

We bundled him up and turned the radio to his favorite music station while Mom made the 20 minute drive to get him. When she arrived and climbed in his face changed and turned towards her, reaching for a long hug.

Had he lost his phone or not had an easy to find entry, he might have had to wait in the ER for hours while someone tried to figure out what was "wrong" with him when all he needed was mom.

8 comments:

Little Girl said...

Amazing!!

I never thought of a ICE on my cell phone, and to think of it, even if I did have that on my cell no one would be able to access it because my cell phone locks automatically after 10 mins of inactivity.

I am glad you got your patient home, and that he didn't have to spend hours in the ER waiting for someone to figure out who he is.

Medic(three) said...

I never, ever think to use the ICE contact... But these few posts might get my attention!

I have one in my phone, but never do I check them in the field.... hmmm...

GOod story, too!

Mr. 618 said...

"Field walletectomy?" Love it!

directpressure said...

this was a great story. imagine if you had gone further down your clinical rule in/rule out tree and come to the conclusion that there was really nothing wrong?

in my earlier years, i undoubtedly would have decided IV access was absolutely warranted. nothing like terrifying an autistic child. what about the potential change in his affect then?

tried to put myself in your shoes here, ended up deciding not sure where i would have been without ICE.

strong work.

MotorCop said...

"a little glucose paste as they perk up and viola..."

He was playing the viola? That is one high functioning autistic dude.

That's what you get for pointing out my foibles.

The Schorrs said...

Aren't all diabetics issued violas? then what are all these insurance bailouts about?

brendan said...

If the person who picks up my phone can't figure out "Home," "Mom," or "Dad," I don't think ICE will save me.

Anonymous said...

@brendan

My phone has a "mom" entry. I don't give a sh1t about her and the feeling is mutual.
So I really hope the person who picks up my phone doesn't call "mom".

Pretty dumb of you to imagine that everyone wants "mom" or "home" in an emergency.
Or do you still live in your mom's basement ?