Pt: “I know CPR! I was doing it all night yesterday.”
I watched as his blood continually dripped onto the floor from his hand.
Pt: “I’m a trained first responder.”
Me: “I see.”
I placed a gauze on his hand and applied pressure.
Pt: “ABCs right, airway, breathing, circulation. Then…RBS rapid body survey…”
Me: “Can you move your fingers?”
He wiggles his fingers, I watched as his tendon sheath underneath moved just above the bone. Pretty cool. I’ve seen tendons before on cadavers, but not on someone live. He had a pretty deep cut with a chunk of his flesh missing.
I applied more gauze on top and applied direct pressure to stop the bleed.
Pt: “So what if direct pressure doesn’t stop the bleed? After two attempts? What would you do? Where would you press? The brachial artery right? Pressure point.”
My partner: “Actually I would elevate your hand.”
Pt: “But what if that doesn’t work? What’s next after that?”
He pretends to wrap something around his bicep.
Me: Seriously?!? You only have a capillary/minor venous bleed…you want to cut off your whole circulation to your arm to stop a minor bleed? Awesome.
Pt: “A tourniquet! Yes that’s what’s next.”
I glanced at my partner with an expression please make him stop.
As I prepped to get his hand bandaged, my partner asked him a couple of questions for our forms. However he didn’t really need to talk at all, as our patient races ahead.
Pt: “Oh, oh, I know, medical history…I have no medical history, my OPQRST is just fine, what’s next? …allergies…”
Now I don’t mind him rambling, but then he looks at me as he’s talking and grabs my upper arm with his bloody hands! I glanced at his hands and glared at him. It only took one look as he quickly removed his hands off of me and apologized.
Apparently this patient who is so well versed in medical first response forgot the golden rule: Keep thy bloody hands to thyself. I was not happy, I got his blood on my arms.
Regardless, I wrapped up his hand, as I tried to control the other minor bleeds. He preached direct pressure and controlling bleed, but he kept on pumping his hand and moving his fingers so that the cuts would constantly reopen and re-bleed. Now this wouldn’t be much of a problem if I didn’t have to put steri-strips on it. If you’ve ever tried, steri-strips don’t stick well to moist bloody surfaces.
Me: “I need you to stop moving your hand.”
Pt: “Oh okay, sorry.”
After a while, I took the gauze off, and the bleeding has stopped. I turned for a split second to get a steri-strip. I turned back and there he was clenching and unclenching his hand…and walla! Blood was flowing all over again.
If only I could smack some sense in him and still look professional.
Me: “I need you to stop moving your hand, because it’s causing it to re-bleed.”
Pt: “Oh, yess….sorry.”
Regardless to say, it took some time and blood everywhere before we got him properly cleaned and bandaged.
Pt: “…yeah I’ve never gotten tired from doing CPR ever before, until last night…”
I was more than happy to say goodbye to him as he left.
Pt: “I might see you again later tonight, thanks for everything, you guys were great!”
Me: Oh no, no, no, I better not see you again tonight.