Had my second meeting with St. John Ambulance (SJA) today. The first meeting I went to was three months ago, near the end of May before I left for Japan. Today we quickly reviewed Emergency Scene Management and Patient Assessment (just the primary survey and critical interventions) then went straight to hands-on learning which I love. After going through some basic pt assessments with the pt conscious and unconscious, we practiced rolling a pt with delicate spine from prone to supine and also reviewed placing a pt in recovery position. Then came the fun part: Scenarios.
Half of the class went outside of the classroom as First Aid Attendants (with the door closed of course), and half of the class stayed in the room as our Superintendent prepped the patients with the scenarios and what they’re suppose to act out. During my turn as an attendant, our Superintendent told us that we were working at a Beer League (where players drink beer), dispatch has been told by a bystander that one of the players has heat exhaustion. After determining that the scene is safe to enter, I approached the patient. I found that he didn’t fall, so no spinal injuries, he’s conscious and talking, breathing rate and heart rate is normal, he keeps on complaining that his finger hurts.
Me: What’s happened to your finger?
Pt: I don’t know!! My finger! It hurts! It hurts!!
I checked his skin and it was moist, warm, and pink.
Pt: My finger!! My finger!!
Me: Are you feeling dizzy?
Pt: No…but my finger, it hurts!
I took a look at his finger, it was swollen and a bit red. I’m now confused. I know that heat exhaustion means that the patient should be cool and clammy. He’s a little sweaty but otherwise warm and dry (which is normal since he’s out in the sun). Could it be heat stroke? Yet he doesn’t appear ill enough or hot enough to be having a stroke. He keeps on complaining about his finger, yet he doesn’t know what happened to his finger. The patient is stable but is he coherent from all the beer? I’m starting to feel very confused.
What is there to be confused about? Nothing.
I remember being told that a call is usually not what it’s said to be. Medics have told me they have been called for a 5 year old for difficulty breathing only to arrive and with no 5 year old in sight. In fact, they ended up with a 50 year old patient. I know that what dispatch tells you usually isn’t what you’ll find at the scene. I know of this, yet that did not translate to not being influenced at a scene.
My patient in fact, did not have heat exhaustion but what he did have was a bee sting to his finger. I’ve been totally played. In my mind I kept on thinking heat exhaustion, heat exhaustion, heat exhaustion. I kept looking for signs of heat exhaustion only to be confused when my primary survey showed otherwise. Instead of trusting my assessments, I kept on worrying about heat exhaustion, worrying that my patient may actually be worse than he appears to be, worrying about something that was not actually there. I also neglected to ask the pt what type of pain he was feeling.
My Superintendent taught me a good lesson today: Keep your mind clear and be confident in yourself, take what bystanders and dispatchers tell you as a possible scenario, but always follow your assessments and treat your findings not what you’ve heard from others.
But seriously, I think I would’ve known it was a bee if a bee stung me on the finger.