That's right boys and girls, I'm talking about "incarceritis". For those unfamiliar with incarceritis, it is a condition caused by being tossed into the hoosegow. Signs and symptoms usually include chest pain, "walking seizures" and/or having "the sugar". After a few dozen of these calls, it is very easy to become jaded to the prisoner experience.
However, occasionally, a prisoner manages to surprise you, just as I was surprised recently.
My partner and I were sitting in the box when the call came in. The always exciting "... respond priority 3 to the jail for chest pain". We were sitting right next, so we scooted on over to the jail.
Inside was a male in his early 30's. He was really tall, (I'm 6' and he was well taller then me", and of average build. He said his chest was hurting on the left. Said it started the previous night, and got worse about an hour ago (which just happened to be about the same time he was arrested). The patient said he felt like someone was grabbing and squeezing that part of his chest. While talking, I noticed he was bit diaphoretic, which could have been from a medical problem or circumstances.
I briefly talked to the jailer while my partner got a base set of vitals and tossed him on the 3 lead. The jail basically told me that the patient was a regular visitor to their fine establishment "and pulled this same thing every time he came in". This is where I get on a small soap box for new EMT's and medics. Yes, once you here this it is very easy to assume your patient is faking his problem to get out of jail. Hell, I've been doing this a long time and I'll admit, the possibility ran through my mind from the minute we received the call.
About that time my parter called me over to check the monitor and I was a bit surprised by I saw. I went ahead and set up a 12 lead and informed the officer that this gentlemen would be going not only to and ER, but for safeties sake a cardiac center. Here is what we were looking at:
That's right, some big tasty trigeminy PVC's. Again, I told the jailer we were going, and informed him that there are just somethings that can't be faked.
I won't get too big into treatment, just a quick run down. My service at this time does not have a protocol for PVC's, which pretty left me with treating the pain. He vitals were stable. BP slightly elevated with pulse around 90. Went ahead with the cp protocol. O2, ASA and NTG. After the 2nd NTG pt stated pain was going away. We got caught in a little traffic on the way in. By the time we arrived at the hospital the pt had calmed, his pulse was down to around 64 and was throwing maybe 1 or 2 unifocal PVC's p/min. I actually had to show the doc all my strips because the pt's hospital EKG was so damn perfectly sinus that he had to wonder if I knew what I was doing.
As to the pt's final outcome, no idea. We stayed too busy that shift for me to back and check on him. The important moral of the story is this: Always keep your eyes open. Because the second you think you know what a scene or a patient is gonna throw at you, that 's when you get sideswiped by a saline bag.
