101 Things the Fire Department wishes you knew



Tuesday, June 30

Modern Blood Letters

It is my personal opinion that in 200 years our descendants will laugh out loud at the concept of dialysis. Not unlike the scene in Star Trek IV when Dr McCoy says, "Dialysis? What is this, the Dark Ages?"
It is an interesting life extending service, but lately, more and more, I'm encountering folks on double borrowed time. And others who are happy to get them in and get them out.

THE EMERGENCY

A man has an altered level of consciousness at the dialysis clinic.

THE ACTION

Leaving personal feelings at the house, we arrive to find a man sitting in the dialysis chair, one of the more alert of the 3 dozen folks in this giant blood filtering factory. Half are asleep, most of the rest are about to doze off and the remainder are watching us with suspicious eyes.

Our client is seated in the chair, shunt freshly clamped, and a nasal cannula hanging from one ear.
"His sugar is too high," says the heavily gowned dialysis technician.
"How high is too high?" I asked thinking it was a fair question. 200 high or "Hi" on the glucometer high.
"His reading is high, our machine said high." She responds handing us the folder clearly prepared long before we were activated.

The next question I have never thought to ask until this morning and the reason I want to pass it along.
"What was his sugar before he got filtered?"
She froze, pointed at the folder and stormed off.
Inside the folder are barely legible copies of his record and results of this mornings filtering. In the space for the blood sugar reading pre-treatment someone has scribbled initials, not a number.

Our client is a bit confused and tired, we get a reading of 501 and everything else looks OK so until the ambulance arrives, I'm off to speak to the staff.

"Did you filter an insulin dependent diabetic without checking their blood sugar?" she's trying to avoid me and run off.
"No, I told you it was high."
"So you filtered a hyper-glycemic insulin dependent diabetic on purpose?"

"Can you move him please, we have people waiting," another technician chimes in.

I look around and realize that we are bothering the flow of cash into the center. These folks have to get them in and get them out as fast as possible.

When the ambulance arrived, I was impressed the medic immediately asked for the pre-treatment blood sugar reading. when I advised her of the situation she cleared us and took a deep breath.

One day we will look back at this practice and ask, "Did they really think that helped?"

6 comments:

KD said...

Ok, can you please dumb it down for me a little bit? :(

"So you filtered a hyper-glycemic insulin dependent diabetic on purpose?" Obviously you're mentioning this because it's a problem... can you explain why? (in simple terms for me) :D

You also said:
One day we will look back at this practice and ask, "Did they really think that helped?"

I don't know if it's the lack of sleep from newborn exhaustion-ness or what, but can you explain why you think dialysis is for the birds?

Thanks, I really enjoy reading ~ obviously, since I'm asking for more!!

The Happy Medic said...

KD,
Dialysis does to the body what the kidneys can not, filtering out waste and electrolytes.

A person needs to be in otherwise good health to undergo the procedure and, often, it is done 3 times a week early in the morning so one can fast, filter, then eat.

In this case, this man had not taken his insulin and would not be able to until after his procedure, knocking his already weak system in "shock" (Don't get on me industry folk).

Had they deferred his treatment until his blood sugar had normalized, he would likely be fine.

As far as thinking dialysis is for the birds, I don't, I just think it's like a crutch we lean on instead of focusing on healing.
Imagine if we could grow people new kidneys and get them off of these archaic pumps?

We could but a minority of folks are against cloning organs for life saving measures.

For the time being, people need it to survive, I just think we'll look back and see a solution had been right in front of us the whole time.

KD said...

Ah, that really illuminates your post. Thanks for taking the time to do so. :)

Dances with Corgis said...

Interesting. Thanks for breaking it down for KD- I learned a few things from your explanation as well.

Little Girl said...

Thanks for the break down HM - I was going to play 'Dumb Dispatch with NO medical training' and ask for a break down myself.

Maybe one day we won't have to depend on dialysis so much, but if the people who worked in those centres were more 'caring' and 'understanding' of a persons other medical history then you wouldn't be called there for the diabetic with a altered consciousness.

I must comment that I don't know when that last time I sent a medic to a dialysis clinic was. I don't know if that is because the clinics up here in Canada are ultimately run by the government, or if the medical staff pay more attention to a person's other medical conditions. On a side note to my side note, I am sure at some point I have sent medics to a dialysis clinic, but it certainly didn't make an impression.

Michael Morse said...

It really is another world in those places, we go to several. Private ambulances handle the transports, we, (911) handles the emergencies, of which there are many.

I loved that scene in Star Trek. I hope we do appear tp be barbarians sooner rather than later. All the fuss about DNA and Stem Cells seems to have died down.