Crazy ass night

Tonight marks the most...interesting...night I've had so far. Granted, I've had two patients start to code in flight in the last three weeks, but this was a bit different.

It started out as a simple patient transport from Chinle to PHX, nothing special, just there with a patient and empty back. Weather was good, no forecast turbulence, didn't even have to rush since the patient was originating from a facility about 40 minutes away. I was already looking ahead to drinking coffee and watching the big ass TV in the pilot lounge.

My first indication that something was amiss should have been the way the patient smelled. it's an uncomfortable fact of life, but many times our patients have various unpleasant odors about them. While some can't help it (cause they're completely unconscious), I swear some create a stank just out of indignation. (I'll let your imagination figure out how they make their own stink.) But, like I said, this isn't an abnormal thing, so I passed it off as just another part of the job, though this odor was admittedly a bit different from any other patient.

Takeoff was normal, climb out was fairly normal, till we were maybe 10 minutes in. The medical team alerted me that there were some test results they didn't like, and therefore I needed to keep the cabin altitude as low as possible, preferably as close to the altitude at Phoenix as I could. This was a bit unexpected, but not a big deal, just requested a lower altitude and reset the pressurization controller. So far, so good.

Then it gets weird: I look back to see one of the medics grabbing the patients arm, which had been heading for the emergency exit, the other prepping a push (IV medication with a saline "push" to get the med's through the IV tubing and into the patient). Seeing as it looked like the patient was getting combative, I figured they were getting ready to knock his ass out. Then I saw something I had only see once before.

Both medics (well, the medic and the flight nurse) suddenly get up and start hovering over the patient, doing God-knows-what-to-him. At one point I see the flight medic with a "convenience bag" (aka barf-bag), holding it against the patients mouth and ordering "SPIT! SPIT!" I thought "WTF is going on back there?" That's about the time my medical team starting asking where we were. When I told them "over Winslow" they directed me to divert to Flagstaff. Whatever was going on back there was getting intense, as I have never had to divert mid-flight due to patient condition.

Ten minutes later we were on the ground in Flagstaff, with an ambulance waiting and the ER briefed on what was about to hit them (thank goodness for the sat-phone, when the damn thing works). After off loading the patient, (smell and all) with a warning from the medic about possible urine exposure, I was notified that we were on standby with a possible flight to PHX, as they (Flagstaff) weren't equipped for the neurological diagnosis the patient had.

So, I grabbed the crew van and went to pick up my crew. After meeting them at the hospital, they told me were were waiting while the hospital staff re-diagnosed the patient. Off to kill time we went, all the way to IHOP (all you can eat pancakes, F yeah!). And here's where the reason for the diversion gets clear, and it gets a little gross.

Once in the hospital, they started cleaning up the patient and making sure he was stable. Apparently, while he was being combative in flight, he started seizing. Repeatedly. The medics requested the diversion to get him on the ground and into a facility to stabilize him and find the reason for the seizures.

At the hospital, they unwrapped the patient from the life blanket, and that's when they found a surprise no one had been told about: possible gangrene in one leg. So bad in fact, that when they unwrapped it, several people started gagging from the smell, my flight medic included (my flight nurse did the responsible thing, and made fun of the medic for it). As it turns out, the people at Flagstaff re-diagnosed the patient using this previously unreported malady , and determined continued transport to PHX was not required, since it wasn't a neurological issue after all.

So I missed out another thirty minutes of flight time, but hey, on the plus side, IHOP has all you can eat pancakes for like five bucks. And the patient lived, which puts me at 58 and 0. Oh, and now I know what leg-cheese smells like.