First Overdose

We are called to a small, one level apartment complex. A low rent, 10 unit place, with a blandness that blends it into the surroundings were you not looking for it. As we pull up, two men peer out from under an old gold Cadillac up on blocks while two children look up curiously from where they were playing in the broken asphalt of the parking lot. Our customer lives in the corner unit. His daughters, who can't be more than 16 and 12, found him. Tears paint the younger girls face, while the older girl, still on the phone with our dispatchers, points us to the bathroom with an exasperated expression. He took a bunch of these pills, she says, thrusting empty bottles of Oxycodone at me.

I walk in to find a middle-aged man slumped in the bathtub, legs hanging over and head on his chest, barely breathing. A syringe and burnt spoon stick out of his pocket. The syringe has been recapped, and I appreciate his thoughtfulness. He doesn't respond to me, nor the sharp sternal rub. The engine medic and I pull him out of the tub and into the hallway, onto the scoop board there. Our customer is covered in sweat, and slides too easily as we adjust him on the board and his head runs into the top with a dull thud. I decide it's the least of my worries. I'm wrapped up in what I need to do for this man, to bring him back from what he's done to himself. My crew knows what to do, but waits patiently for me to delegate tasks. They want to be sure I know what to do. Almost before I ask for it, the engine medic packages the patient onto the stretcher, while I insert an airway and begin to breath for our customer, while another crew member pushes Narcan into his nose. Narcan reverses the effects of narcotics, such as Oxycodone and heroin.

Still squeezing the BVM to force air into his lungs, we move the customer to our ambulance. My FI asks me what I'd like to do. I decide that we will get a full set of vitals in the ambulance, start an IV and obtain a sugar reading, to make sure our customer isn't diabetic as well. If the Narcan hasn't woken him up by then, I plan to place an advanced airway in his throat, to protect him from getting emesis into his lungs if he vomits.

In the ambulance, the man still doesn't move, even as crew carries out my tasks. I ready the airway kit, and am excited. I've never had a "field tube" before. But just as I am ready to go, my FI rubs the mans chest sharply again, and this time he groans and opens his eyes. Damn. Good for him, bad for me. No field tube this time. I put my equipment away, and announce that we're ready to go to the hospital. As we bump down the road, the customer slowly regains consciousness. We remove the nasal airway and he is able to talk with us.

What did you take? Heroin. It was my first time. What about these pills? Oh yeah, those too. Any alcohol? A pint. Were you trying to kill yourself? Nah, nah. I'm ok.

These are the questions I ask, but the unasked ones float in my head. Why are you lying? This isn't your first time. What kind of role model are you to your daughters? But we aren't there to fix his social problems. Just keep him alive till his next fix.