Earlier this week I had a patient come in by ambulance at about 6:30 am. The medics called in a radio report of a 30-something female with anxiety-induced chest pain, vital signs okay..... They seemed amused by something and trust me, it is NEVER a good sign when EMS is snickering. While they were still in route our charge nurse got a call from some wild-talking guy who said he was coming up there to "be with J because we used to be married and I think she is real sick. I've been holding her tongue for two hours!" Then he hung up. Needless to say the charge nurse had a bemused look on her face, and we spent the next few minutes trying to imagine what that might have been about. Was the woman having a seizure? Was he trying to shut her up? What? WHAT?
While we were still speculating, the medics rolled in with this tiny, frazzle-haired, wild-eyed woman on the cot. Except for looking extremely freaked out, she seemed to be just fine. I went in with one of the MSAs and as we were hooking her up to monitors, doing assessments and taking vital signs, the medics (with some interjections from the patient) told me this story.
It seems that the patient, hereafter known as J, was having a sleepover with her ex-husband, hereafter known as D. They are still on friendly terms and had decided to do a little crystal together. Fine, so far. The problem cropped up when the party ended and they tried to go to sleep. Poor J, who has a problem with anxiety and was having a nasty cough at the time, couldn't sleep. (I'm not sure but I think the methamphetamines MIGHT have been a factor) Anyway, she took a couple of Xanax bars to help her relax, and went to sleep on the couch.
A couple hours later, Mr D gets up and finds her asleep on the couch. Having crashed from the meth letdown and the Xanax, she was very difficult to awaken (read that as "nearly comatose") so he called 911. All well and good so far.... .but now comes the utterly, unfathomably crazy part. J was deeply asleep and breathing heavily, and one imagines, noisily due to the respiratory and sedation issues. So D decides that she "can't breathe" and his solution for that was to stick the first three fingers of his right hand into her mouth and throat UP TO THE THIRD KNUCKLE. Holding her tongue out of the way, you see. At which point she awakens, finds herself choking on his fingers, throws up and begins to struggle with him. Even though she was fighting him tooth and nail - and I mean that literally, he had bite marks on his knuckles- he did NOT give up on his life-saving efforts. He held her down and continued to "keep her from swallowing her tongue because then she started having a seizure". So for twenty to thirty minutes, he held this poor woman down with his fingers jammed down her throat. She was spotted with blood, hers and his. She had scratches on the back of her throat! She was (naturally) hyperventilating and began having carpo-pedal spasms, as well as being partly asphyxiated by this well-meaning but drug-crazed idiot.
So there you have it. Reason # 24 not to do drugs. Because your fellow users MAY be the people on whom your life depends later. It is a bad deal if your primary rescuer is, quite literally, smokin' crack.
When Mr D showed up later I went to talk to him before letting him into our department and into the presence of the patient. He was upset and worried, so I assured him that the patient was fine. He wanted to visit, and since she had said she was okay with that (she swore he was only trying to help) I told him he could come in IF he would remain calm. He agreed. But then.... he wanted to talk about what happened and tell me how he "held her tongue down so she could breathe". I tried to explain to him, slowly and patiently and repeatedly, that this was SUCH a very bad idea. Not surprisingly, he didn't get it. When he assured me for the 11th time that he "HAD to because she couldn't breathe!!!"...... I snapped. "LISTEN, don't EVER do that again, you could have KILLED her, do you underSTAND me?????" The silly crackhead looked at me with spaced out eyes very solemnly for a second, nodded ... then burst into tears.
Here I had to heave a HUGE mental sigh. It wasn't even BREAKFAST time fercrissake, and I was in some surreal Twilight-Zone sort of space with these people who didn't understand such simple concepts as why sleep was difficult after doing methamphetamines, and why a person "couldn't breathe" with half a grown man's hand jammed in their airway.
They were discharged not long afterward, she with a diagnosis of bronchitis, upper airway contusions, and the recommendation to stop using drugs before she had a cardio-pulmonary event that proved fatal. D had his bitten hand and scratched arms cleaned, and was advised to stop doing drugs before he did something else completely hare-brained and dangerous. Because, as we pointed out to him, his judgement was less than stellar while under the influence. Though personally, I doubt it was a whole lot better even when (if ever) he was clean.
In the ER, truth is indeed stranger than fiction!!!
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