You can watch it move through the area almost like a weather front. It starts down in Worcester or Providence and moves on up through the shitty backwater slums around Boston, up into Lowell and then Lynn. It jumps the border into Nashua first. A tubed junkie here, a cardiac arrest with the needle in his arm there. Medics from jumpsuit land (a few people in Nash still where the old school Rescue 77 style jumpsuits) tell stories of having to give astronomical amounts of Narcan in order to snap a heroin addict out of his stupor, or they just get pissed off and tube him, letting him wake up in the ICU on a vent in St Joe's or Southern. The little towns in between get it too, Merrimack had a junkie with snoring respirations and minimal effect on Narcan. Amherst had a guy with pinpoint pupils and three respirations a minute.
And then it hits Manchester. In the past two days, Manchester ALS, the division of Rockingham that I work for has worked more overdoses than ever since I've been here. My first off of this batch came on Tuesday at about two in the afternoon. He was laying in a bed in a shabby rundown apartment in the West Side. Covered up to his chin in comforters and blankets while the firefighters and I are sweating our asses off.
I try yelling at him. "Hey! Wake up, come on eyes open." Nothing, I grate my knuckles on his breastbone, which if you've never done it to yourself hurts like a bastard. He kind of rouses a bit and I ask his sister, a skimpy little twenty something whose first language died with the Soviet Republics what he took. She says he didn't do drugs but his pupils are pinpoint. His skin is burning hot and he's covered in sweat and apparently no deodorant because he smells like a Tibetan whorehouse in the middle of August.
Josh, my intermediate, shows up with the stair chair and we try to move him off the bed, he's naked and lathered in urine so we have his brother throw a pair of sweat pants on him and we strap him down. The firefighters carry him out of the apartment and I jump in the bus to set up. The guy is sinus tach on the monitor at around 125 or so, pressure is in the toilet, hovering around 80 palp, O2 Sat is 98 but his tongue flaps back over his esophogaus and he starts to do the snoring thing.
We drop a sixteen in his left hand and I push in a miligram of Narcan. His eyes widen and his breathing jumps to 10 a minute and I ask him what he took. His only response is to laugh and call me a dirty word. By the time we're pulling into CMC he's lolling back again and I give more Narcan with the same response.
The sister is already there and shes virulently denying that her brother took anything. I give the nurse my remport as they start working him up, more Narcan, less effects. I leave as they debate tubing him
Last night Mark and I get toned out for an unconcious person infront of one of Manchester's low income high rises. When we get there the crew from the engine is trying to rouse a man who is hunched over and barely breathing while the lieutenant takes some crap from the brother about his "attitude toward the people with problems."
I get annoyed and tell Mark to grab the stretcher, our student, affectionately refered to as Stu is standing there dumbly as I flick the man's nose as hard as I can. "Wake up!" I turn to the brother. "What'd he take?"
"Nothin' man he don't do that shit."
"So he's always like this? Look you called 911 we won't arrest you, what'd he take?"
"Booze and some H."
I tell the firefighters to grab him and we extremity carry him to bus, dump him on the stretcher and hop inside. Again, sinus tac in the 120s on the monitor, respirations and pressure in the toilet. He starts to make a snoring noise and Stu says. "I don't think thats good."
"No, it aint. Get me aline." Stu grabs a 20 and I tell him. "Dude he's got fuckin' pipes, bigger." But he's already pricking into the vein. He advances the cath and stops halfway through.
"I think its gonna blow."
"Mark, fix that." I am getting a bit irritated as I draw up Narcan, I already have the tube roll out in case Vitamin N doesn't do it.
Mark pushes the cath in and flushes the line, spikes a bag and hangs it. I get the Narcan on board and the respirations pop up to around 15 and our new friend becomes combative.
"What the fuck's going on? Where am I?" He takes a wild swing at Stu and I jump on him while Mark starts toward the Elliot.
"Listen, youre in an amubulance, we're taking you to the hospital. Youre brother was worried about you and called 911." I try and keep my voice as gentle and soothing as I can, telling him not to worry, he's not in trouble and won't be but that we need to get him looked at by doctors. He cries a bit and eventually as the Narcan wears off, drifts back into sleepy land. I give a bit more to keep him breathing as we pull into the Elliot.
They bitch at us for not tubing him, knowing that when he wakes up he'll be a pain in the ass again. And sure enough he is, they give him more Narcan and he starts calling the nurses the C word.
I grab and ice water and try to figgure out our new computers while security four points him to the bed.
