Drunks

The first in a series of 3 drunk cases that have given me problems over the last few months.

There's a reason that I don't like drunks. I never get called to the happy drunk, the one that wants to buy you a pint and hang out. I don't get called to the funny drunk or even the silly drunk. No, I get called to the guys too drunk to walk, too drunk to stay conscious, too drunk to be a nice. And it's never at a convenient moment, always right before or after the bars close--in other words, past my bed time. So when I'm paged out at 0230 for an unresponsive male in the parking garage of the Ocean Inn, I'm not thinking diabetic problem, stroke, or cardiac arrest, I'm thinking--I know--it's a drunk.

We had to park on the street and hike the gurney and equipment into the garage. The cop gave us his name as we walked up, Brian, from the military dog tags around his neck. He was still sitting in his enlistment bonus when we arrived. A brand new Ford Mustang Cobra, black with the twin gray racing stripes. It was a sexy ride, aside from the douche-bag in the driver seat.

The hotel worker said he'd seen the guy earlier in the day and that he'd already had a half gallon of Captain Morgans. The cop said he'd already tried honking the car horn and doing a sternal rub, both without effect. The driver's door was open and you could smell the alcohol from 10 feet away. Brian was passed out... completely... the “I just bought myself” an intubation kind of unconscious.

So I turn to my partner. "Look, we're gonna pull him out, put him on the cot, and then we're going to put in an nasal airway. We'll see if that'll wake him up."

My partner and I pulled him out of the car, roughly setting him to the ground so we could readjust our grip. Coming up under his shoulders and knees, we hefted him to the cot, then started to strap him in. His button down shirt was open at the collar, I could see a set of dog tags resting on his chest, and a couple of tatoos. His jeans were wet at the crotch.

As we strapped him in, he woke up--wide eyed and with a scrambling of his limbs. "Easy there, partner," I started to soothe him, "we're the paramedics."

"What happened?" he asked, still wide eyed and confused.

"You had a little too much to drink tonight and the hotel called 911 when they couldn't wake you up."

"I haven't had too much to drink!" he tried sitting up and getting off the gurney and only got himself tangled in the straps.

"Easy, soldier. You had enough tonight that you're either going with me to the hospital, or going with this nice police officer here to sober up," the cop raises his hand and gave a little hello.

So Soldier Boy complies and relaxes a bit on the cot. The fire department had arrived then and I told them, "we got it guys, but thanks for coming out." My partner and I slung our kits onto our shoulders, and then rolled the patient out of the garage and into the ambulance. My partner sets up the IV bag, while I go about getting a blood pressure and setting him on the pulse ox. With the IV bag set up, I told my partner we can get going, that I'll start the line in route. My partner jumps up front and we start towards the hospital.

Brian passed out again, his head rolling onto his left shoulder. We weren’t more than fifty feet down the road. My partner is eyeing me through the rear view mirror as I put the sternal rub into Brian again. He awakes with a violent start this time, flailing his arms, kicking is legs, and getting enough momentum going that he crawled right up the head-end of the gurney and wound up wedging himself into the airway seat. Honestly, it reminded me of that scene in Signs where Joaquin Phoenix sees the alien on the news clip and backs himself into the closet out of shock.

“Park it, Shane! Get back here!” I yell up to my partner. I felt the rig lurch forward as he hit the brakes and parked it.

Brian was thoroughly freaking out right now, “what’s going on! What happened! Where am I?” Over and over he kept asking as I tried to talk him down and soothe him. My partner had crawled in back and was awaiting instructions. I was trying to calm Brian down, to get him back onto the cot, at the same time I gave instructions to my partner to get the Inapsine and a syringe.

Brian had calmed a lot and was now moving back to the cot as Shane placed the drug onto the bench next to me. I settled him onto the cot, securing the straps around him again, explaining that I wasn’t trying to restrain him, but keeping him safe. He was calm enough at that point, so I told Shane to get back up front and we’d get going again.

On the drive in, I talked with Brian trying to get a little more history out of him, the entire time the Inapsine and syringe on the bench next to me. I talked him into letting me take his blood pressure and to hook him up to the monitor. He even said it was okay to start an IV, which I wrapped copiously with coban to keep it in place.

I patched my report to the hospital and soon enough, the back-up alarm was sounding as we came into the ER bay. We unloaded the cot, Brian still resting comfortably and the Inapsine still on the bench.

The nurses met us in the ER hallway, silently pointing to bed 6. Brian had tried scratching and pulling at his IV a few times and I was glad that I’d tied it down. He’d also started to have this smoldering, angry look in his eyes and I knew he was trying to work up to something. But he transferred to the ER cot on his own and I exited the ER bay with an apologetic look to the nurses.

Just a few steps outside the room though, he started pulling at his IV line again and trying to scramble off the gurney. I turned on my heel and dashed back into the room to give the nurses a hand. Brian was getting more and more agitated and I had to use my forearm to keep his shoulder pressed into the ER cot. It took a minute or so, but an ER tech came in with a set of soft restraints that we tied Brian down with. I backed away from Brian, pulled my gloves off, apologized again to the nurses, and left the room.

Maybe I should have used the Inapsine.