Beans and Okra

We were in training. PHTLS. Pre-hospital trauma life support. We had just covered airway management and brain bleeding, and dispatch must have been listening. We left training to respond to a possible stroke. Arriving on scene, the first-in engine asked for our ETA (we just put it in park, so about ten seconds?) and advised our patient was seizing. I tossed the jump bag onto the stretcher and grabbed the Narc box out of the drug box. The narc box hold three medications- Morphine, Versed, and Toradol. Versed helps stop seizures. We entered the house and found our patient on the floor, unconscious, with snoring respirations. One of the experienced guys was pretty worked up and told me "he just had a seizure". "OK." I said "Well, let's get him on the stretcher". It's not my emergency, it's not my place to flip out, but he needs to go and he needs to go now, so there is an air of urgency about the room. The fireman says "no, I mean he just had a SEIZURE" and starts flailing his fists up and down in what appeared to be an imitation of a toddler throwing a temper tantrum. I couldn't help but smile, and repeated "OK....let's get him onto the stretcher" which in itself was no easy task. Our patient was pushing 240 lbs, and we grabbed his shirt, pants, belt, arms, legs, feet- all of the above, annd hoisted him onto the gurney.

We are back on the road. We are miles and miles away from civilization. Even though it's foggy and drizzling, I ask dispatch to check availability of an aircraft. Of course nobody is flying. I figured as much, but had to try. Our patient is unresponsive. I check his pupils. His eyes are bloodshot. His gaze is off to the right. His left pupil is tiny and his right one is huge. He is having a stroke. There isn't much we can do right now- we open his airway, put some high flow oxygen on him, attempt basic airway devices but he still has a gag reflex, so out those come for now. We monitor him closely and drive fast. I was in the captains chair at his head. I leaned to the right ant toward him to check his blood pressure again. Over my shoulder I saw his mouth twitch. It looked like someone who burps and lets their cheeks balloon outward. He did that twice. I had asked another fireman to ride in with me in case his condition deteriorated. And it was about to. I told my partner "lookout! Watch him!" and just like that he vomited. We turned his head and removed the oxygen mask to suction out his airway. Navy beans, okra, and what looked like boiled eggs came out- none chewed very well at all. It was disgusting. I had the hot stench stick to my nostrils. I winced, then continued suctioning chunks and liquid out of his mouth and throat. Whole beans hit the floor of the bus. One stuck to his shoulder. After his airway was cleared, I took a towel and wiped his face. Poor guy. I was doing everything I could for him.

As we neared the hospital, his condition took yet another turn. The side of his face drew up, his eye began twitching, and he had another seizure. Only one side of his body seized. Thankfully we were able to stop it, but it didn't change the root cause of his problems. He was having a massive stroke. We took him into the hospital, the ER staff took over patient care, and he was whisked away for a scan to see exactly what was going wrong where. In a stroke, they say you have 3 hours to get the patient to medical care from the exact onset of symptoms. From the time our guy's family called 911, to the time we had him to the hospital (30+ miles away from the middle of smack-dab nowhere) was 46 minutes. We did everything we could. I hope he makes a recovery!