#100 Shit happens, vomit splashes & dignity is assisted.
Transcript from an actual call to 911.
Caller: He’s down on the floor. He collapsed. He’s vomiting.
EMS Communications Officer: Is he breathing?
Caller: I don’t know. He’s in the other room.
EMS Communications Officer: You need to check if he’s breathing.
Caller: Didn’t you hear me? He’s vomiting. I can’t go in there.
I know it’s an actual call because I was down on the floor listening as my wife, Dianne, tried to place the call for emergency medical assistance after I went down with acute abdominal pain. Everything turned out okay. I stopped puking and Di came back into the room long enough to verify that I was indeed still breathing.
In our relationship, I am the designated Vomit Person. Every time one of the kids ends up kneeling in front of the toilet or blowing technicolour yawns into a bucket, I am the parent assigned to seeing them through the gastrointestinal crisis-de-jour. Which is pretty ironic, given that when I started out as a paramedic I had zero gag tolerance and often performed a duet with the patient.
Back in those days, we had big stainless steel kidney basins in case anyone felt the need to redecorate the interior of the rig. I had my own tucked away into a reserved corner of the patient care compartment. I remember one little old lady who patted me on the back from her seat on the stretcher after she got carsick on the ride to the ER. “You’ll be okay,” she said. Classic.
I wasn’t alone. I remember rolling on a cardiac arrest in a parking lot in Montreal. During our resuscitation efforts, the patient vomited. My partner ordered our student to use the portable suction to clean up the vomit on the asphalt because he wouldn’t be able to continue with CPR. And then there was the paramedic student who, after witnessing a patient vomiting, walked out of the house, hailed a cab and was never seen again in class.
Shit happens. Often, actually. More than anyone ever portrays on television or talks about in paramedic school.
When people feel bad, really bad – controlling their bowels is fairly low on their list of immediate priorities. Given the choice of continuing to breathe at regular intervals or not making it to the toilet in time, most people will opt for the whole breathing routine.
Sometimes patients are down for several hours or – even days – prior to being discovered by the person who places the call to 911. Unable to move for medical or traumatic reasons, they may have soiled themselves and the immediate area while desperately hoping for help.
The person who taught me while shit happens and vomit splashes, it is dignity that must be assisted was Normand Yelle. Norm was a Captain and Paramedic with the Pointe-Claire Fire Department. He was the one who taught me the finer points of restoring a sense of personal dignity to the life of a patient whose bowels had let go or who had lost their breakfast, lunch, or dinner.
Norm reinforced the sense of duty we had to our patients and their families to ensure they were able to face the world without worrying about yet another form of physical compromise. He provided a primer on preparing recently-deceased patients to be seen by their family. Norm was the person who shared the art of assisting dignity in being present even in the most extraordinarily difficult and awkward situations.
During my session as an EMS Director I received a call from the nursing director of a seniors residence who was concerned because one of our crews had ‘delayed the ambulance crew from transferring a stroke patient to hospital because they insisted on cleaning her up a bit before she was placed on the stretcher.’
I checked with the ambulance crew to see if they shared any similar concerns. Their response was that it was a non-emergency transport to the ER, the patient was visibly relieved at being able to wear clean clothes, and the family wanted to write a letter of thanks to our crew.
We should have told the family to send the thank-you letter to Norm Yelle.
Thanks for your consideration.
Be well. Practice big medicine.
Hal
