“Barney.”
“Okay, Barney, can you tell me the last time you had insulin?”
“All day,” he panted. “I think there’s something wrong with my pump. My sugar numbers have been high for days now, maybe a week.”
Sommer glanced toward the door as the emergency staff took over the care of the woman, and suddenly Sommer wasn’t certain about the scenario. “Do you know the person who came in the ambulance?”
The man stilled. He looked up at the rescue squad, over to the blinking lights, then his car, back to the gurney, finally bringing his gaze down to the puke.
“Did you follow the ambulance here, or did you come here for you?” Sommer asked.
“My wife.” He seemed to have just remembered what was happening. He staggered forward as if he wanted to follow the gurney down the hall.
Sommer turned her head to see the door sliding shut behind someone exiting; a tech stood just inside. “Hey,” shecalled out, catching their attention. “I need a wheelchair out here. Stat.”
As Barney swayed, Sommer stepped to the edge of the puke puddle and pressed her body against the man, pinning him between her and the ambulance. He became the filling in a “I’m trying to help you” sandwich. Keeping the guy off the ground and out of the puke would make the next steps easier for everyone.
Elegant?
No.
Proper protocol?
Sommer was putting this in the so-far-so-good category. It was better than what would happen had she let the man slip to the ground. It’s what her friend Marna called the “druthers.” As in “I’druther not have a patient covered in puke with a freshly cracked skull.”
Marna often took practicality over protocol when it came to her emergency nursing duties.
So far, so good.
Right now, keeping Barney lucid was key. “Barney. Hey, Barney.”
“Hmmm?”
“Did you check for ketones?”
“What?” He turned glassy eyes on her.
“Did you pee on a strip?”
“I ran out a while back,” he slurred. “I should get some.”
One of the responders stepped through the door. He looked startled by the scene. “What’ve you got?”
“Possible ketoacidosis.” If she was right, then this was a life-threatening situation. And she saw it on the paramedic’s face: whatever happened that put the woman on a stretcher, they’d missed the secondary issue and let a man drive while his brain wasn’t fully functioning. “Wheelchair’s coming.”
Barney’s eyes rolled back in his head, and even Sommer’s weight wasn’t enough to keep him in place.
The paramedic grabbed Barney’s wrist and pulled it around his neck, one hand looping Barney’s belt, then he, too, leaned into Barney’s slack body.
The tech jogged into view, pushing an empty chair. But once he saw the situation, he turned and called over her shoulder, “I’m getting a gurney. I’ll be right back.”
Sommer would have preferred they’d left the wheelchair; she could have managed.
The unconscious part of this scenario was serious.
Seconds might just count.
Sommer had a guess borne out of years of experience. But she didn’t know what underlying issues might make the man’s insulin ineffectual and what the consequences might be.
