Thursday, July 16

Liar, liar, pants on fire

No his pants were not actually on fire. All day with this crew they kept talking about "that guy" who lived a few blocks over who seems to call 911 everyday. Until recently there was a specialized program to deal with such nuisance calls but, poof, away it went with recent budget cuts.


A man is having 10/10 non radiating chest pain.


As the address goes over the radio after the bells the crew is cheering, "There he is!"
They know his address by heart. I am infrequent in these areas so I keep my mind open to the possibility that the chief complaint stated to the operator is in fact the problem at the scene.

When will I ever learn?

We're into the tiny, dirty apartment and I'm performing my assessment on the overweight, dirty, 60ish year old who claims to be having "an extreme pressures all over my chests."

I am taking it seriously and, thankfully, so is the crew. They stopped cheering and commenting as soon as we were in drive. At the scene they have him on O2 in a flash and a BP cuff in my hand while I'm talking to him. I want to call out for a scalpul and see if he actually opens the OB kit, but I don't.
Our client's complaint shifts from his "extremes" chest pain to the swelling in his legs that his doctors won't fix. Every time I try to get him back on the chest pain subject, he brings up the legs.

I'm about to call BS on this guy, with inconsistent descriptions of a chief complaint, normal vital signs and no signs of distress whatsoever, when my EMS supervisor wanders in.
"What have you got?" He asks, thumbs in his belt like an old west gunslinger. White shirt, collar brass...striking. (Caddyshack reference #3) It's a slightly offensive posture and I can see what he's doing so, knowing I'm taller and in full turnouts from our recent building alarm, I rise to respond.
"Initial complaint of chest pain, but I'm looking at an activation for leg pain, non-traumatic. Still going the ASA route."

And I was, so I offer him 2 aspirin to chew and he brings up his hand to take them and begins shaking it wildly, dropping the little pink pills onto the floor.
"Look! I am seizuring! Help me! Help me!" he screams and I want to raise my voice and tell him I know he is faking, but my clinical supervisor is just outside the door.

I decided to do the right thing and call his bluff.

"Did you call us for leg pain and tell them your chest hurt so we'd get here faster?" I'm towering over him in the little room.
He looked at me like Puss in Boots from the Shrek movies, eyes big and just a hint of a pout. That white shirt in the hallway is now half in the doorway looking from me to the client, no expression on his face.

"My 3 year old knows that won't work on me, gave it up a year ago. Man to man, just tell me the truth. Did you call because of your legs or are you having chest pain?" I ask while loading another round of ASA into my hand.

"I need someone to fix my legs! I can no walk! Look!" and he does a half stand/half fall back into the chair.
I look to the EMS Supervisor who laughs to himself and asks if I need anything from him. I shake my head and take a deep breath.

Groan. Actually, it sounded more like Krusty the Clown from the Simpsons.

Our ambulance, a 24 hour car from 4 Battalions over, finally arrives and our client admits he called for leg pain. Leg pain he has been seen for 3 times this week. He made us carry him down 3 flights of stairs, even though last time he walked.

Last time he was intoxicated, I am informed as we're pulling away, and he wandered down the stairs just fine.
There are few things I hate more than lying. Especially when we crossed a few major intersections against traffic to what we thought was an emergency.


TheNanny said...

My personal favorite call, from a ride-along in a wonderful neighborhood in Los Angeles, was a woman who called in for an "imminent seizure." As in, it hadn't happened yet, but she was damn sure it was about to.

So we get there, expecting a seizure dog to be freaking out or something, but nope. Just a woman sitting on her porch.

"What happened?"
"I felt funny."
"Are you epileptic?"
"So... you thought you were going to have a seizure?"
"Yes. I felt funny."
"How do you know what a seizure feels like, if you've never had one?"
"I just know, okay? And, I passed out!" (the magic words! Everyone with Medical knows we have to transport post-syncopal)
"You passed out?"
"Yes. I was sitting right here on this chair, and I passed out."
"You passed out... while you were sitting outside in the hot sun..."
"Yes. I passed out."
"You sure you didn't just fall asleep for a second?"
"I PASSED OUT! I have insurance, assholes, you have to take me to County!"

So, of course, we did.

Dances with Corgis said...

At least Puss in Boots is cute, and has that sexy voice... which I'm sure your pt. had neither!