It was 3 am and as my eyes shut for what I hoped would be a blissful night of dreaming, the radio shattered the silence. "Medic 12 respond to fire" My eyes opened wide as I shot up and jumped into my boots. The call came across as a fire and thats the only information we received. My Basic partner and I hop into our fly car, hit the lights, and speed off into the night. I start going over the burn protocols in my head on the way to the fire. I know I will probably be the only Advanced Life Support unit at the scene, so I want to make sure I have a plan in my head when we arrive. I would soon find out the plan(s) I had where about to go out the window and there was no protocol for the situation I was about to encounter.
We arrive to the scene, fire trucks are everywhere and the firemen are searching for patients inside. The Basic ambulance had the only patient waiting in the back of there ambulance. The patient was a male in his 30's appeared to be unconscious. I administered a sternal rub and he quickly "woke up" staring at me with confusion. Trying to find out whats wrong the patient in often a big challenge here because no one speaks English. My Basic partner is often the only one who can translate and his English is very limited. We get baseline vital signs, pulse ox-cemetery, a blood sugar, and check pupils. Everything is within normal limits. The patient appears to be very confused and is having trouble standing... Aparrently he is saying some very odd things in arabic. I start considering possible causes to his altered mental status and unstable gate. He wasn't near the smoke in the fire, and did not appear to have carbon monoxide poison, Hes pupils and vital signs where normal, his blood sugar was normal, he wasn't having a stroke, I did not smell alcohol, so why was he acting so strange? At this point I found someone who could speak pretty good English. He told me the patient had not slept in 2 days and saw a ghost.....
Apparently "the ghost" made him like this. I tried not to laugh but I could not hold it back, but as I looked around I was the only one laughing. I recommended we see if he had a past medical history, if he took any mind altering substances and he go to the hospital for a physiological evaluation by a physician but thats not what happened.
At this point as a Paramedic I was no longer in charge, but it wasn't a doctor that took over care from me it was a holy elderly man with a large beard. With a Quran in one hand he stood over the patient and began to pray. He started to perform some kind of procedure which I soon found out was like an exorcism This is when I left. I waited near by and talked with a local who spoke English. When I told him what was happening he said, oh yes... He saw a ghost and the holy man is healing him from the powers of the ghost. I said "a ghost, you believe that?" He said "yes, dont people call you in america for ghost?" I said "no... they call the ghost busters."
To make a long story short I wait for my first pre-hopspital exorcism to be completed and released the patient to the ambulance crew for transport to the hospital. I spoke with a local Medical Control doctor later that day and told him the story. He laughed and said yes a local EMT-B called him once for online medical control because of altered mental status. The conversation went something like this.
EMT: yes hello doctor I have a patient who is acting strangely and the patient says he was possesed by the spirit of a Genie. Please advise, over.
DR: Sounds like a Psychiatric patient, has the patient taken any drugs or does he have a past medical history?
EMT: Damnit doctor did you not hear me!? I said the patient is possessed by the spirit of a Genie!
DR: *Sigh*.... Yes, a Genie... Ok, monitor vital signs and treat any signs or symptoms as you usually would until you arrive the hospital so the Genie can be banished from the patient.
EMT: Copy that Doctor.
( for more on Genies check this link http://en.wikipedia.org/wiki/Genie )
I saw a lot things my first week including 3 Myocardial Infarctions (heart attacks), Assaults, Motor Vehicle Accidents, Diabetic emergency's, and Respiratory emergency's. I was so busy and had not slept in 24 hours. My body and mind where running on auto pilot. I just wanted a break or a real easy call but the last call of the week was an unstable unconscious person who was extremely hypoxic, tachycardia, had a very low blood sugar, tachypnea, an extremely low oxygenation saturation, with an uncontrolled airway. If left untreated this patient would die soon, from hypoxia if nothing else. The patient had a gag reflex but we needed control of the airway so I inserted a Nasal Airway Adjunct into her nose, then we attached oxygen to a bag valve device and started assisted ventilations. Her o2 saturations started improving immediately and all her vital signs started to improve except of course for her blood glucose level because she needed sugar. Her veins where very difficult to feel and extremely fragile. We attempted 3 IV's with no success to give dextrose, so I gave her a medication I have to mix called Glucogaun which is administered as an injection into the muscle. After I gave her the shot she started to regain consciousness as we arrived at the hospital. we re checked her blood glucose and it was now within normal range. I was soooo tired and worn out but I felt really good about the call. We took an unstable patient, fixed her airway control, fixed her ventilation problem, fixed her hypoxia and 02 saturation, which in return fixed all her other unstable vital signs except the glucose. Then we gave her the shot and fixed that, stabilized her and delivered her safely to the hospital who can continue managing her for the longer term.