Not Your Typical Delivery

So it's a typical morning, and I'm eating an omelette for breakfast.  The radio jolts the fun out of breakfast, though, when we get dispatched to a psychiatric problem.

There are many factors taken into account when we respond to one of these calls, including: Call location, call time (day or night, weekend or weekday), patient description (age & sex), our proximity to the scene, if other agencies are already on scene, and the threat the patient poses to us, themselves and others.  All these factors come into play when we decide whether or not to stage in a safe location until the scene is safer (or at least safer...)

In this case, the call was at a liquor store right across the street from where we were eating. Wonderful.

Guess we can't really stage on this one.

As we walk outside, the patient can be heard screaming unintelligibly at passersby and customers.  He appears to be a middle-aged man of average build in a Planet Express delivery service uniform.  He has no obvious weapons or injuries.  A large gentleman (I'm talking John Coffey from The Green Mile huge) is trying to talk some sense into the man, but failing miserably.  The patient appears to be in a drug induced state of excited delirium.

Due to his erratic and threatening behavior toward our Samaritan and others in the area, we decide to attempt to restrain the patient.  While he seemed to listen and comply with requests to stay out of the store, he's otherwise non-compliant and unpredictable.  While my partner and I discuss our options, PD's sirens are rapidly approaching the scene.  That's good news, but help is still about 30 seconds away.  Mr. Coffey, though, takes matters into his own hands.

Literally.

He asks if we want his help, and before we can respond he picks the patient up and carefully but forcefully places him on to the gurney and pins him down while we apply restraints. As we finish securing the restraints, PD arrives and augments our soft restraints with flexcuffs.  With the seat belts applied, the man isn't going anywhere.  Hopefully...

We thank the Samaritan for his help, and load the patient into the squad.  The cop jumps into the rig, and we take off toward FMH.  As I obtain vitals and attach the patient to the cardiac monitor, I notice that we have a bit of a problem.  The patient appears to be in V-Tach at a rate of 280.

For those of you not in the know, Ventricular Tachycardia is a cardiac rhythm that is generally incompatible with life.  It needs to be resolved ASAP, as it frequently leads to death very quickly if untreated.  This patient is officially FUNDY - F'ed Up, Not Dead Yet.  

Before the patient can be cardioverted, the rhythm converts on its own, to Sinus Tach at a rate of ~140.  With the IV established, I make base contact and advise FMH of our situation.  The patient decides to make a liar out of me by dropping his rate further to 80 beats per minute, with multifocal PVCs just for fun.  He loses consciousness as we pull in to FMH's parking lot, the heart rate drops further to 30, and it looks suspiciously like something agonal and idioventricular.

My partner parks the bus as the patient officially codes.  I glance at the monitor - now showing v-fib.  Ventricular Fibrillation is basically quivering of the heart muscle, and is always fatal if not corrected.  I deliver a quick precordial thump - a sharp blow to the chest - with no effect.  We haul ass into the ER and get him into a bed.  Multiple defibrillations and a few minutes later, the resuscitation efforts are terminated.

We pack our stuff up and go outside to the ambulance bay.  As we stand there BSing with the officer that rode in with us, his partner rolls up in their squad car.  He was able to get the whole story out of witnesses, and the patient's friend, who sits in the backseat of the patrol car.

Apparently the patient had been smuggling drugs through Planet Express's system for an unspecified but short amount of time.  He worked for Planet Express as a ramp employee at Fairview International, and had just opened a package of narcotics when an Airport Police officer approached the plane he was unloading on a routine patrol check.  Since the Air cops typically drive slowly and safely around the aircraft, especially while on patrol, this knucklehead had plenty of time to swallow the balloons from the package he'd already opened.

The officer moved on and, with the crisis averted, he clocked out for an early lunch.  His best idea was to drink something to make himself throw up the balloons that (GASP!) contained some pretty potent cocaine.  His friend - who knew nothing about the small time smuggling - asked to carpool to lunch, which our genius reluctantly agreed to. The patient asked apparently debated between sardines (which he hated) tequila (which he also hated) and vinegar (which he didn't hate as much as sardines or tequila) to make himself puke.  Figuring that he didn't want to smell like fish or booze, he chose the vinegar.

This turned out to be an extremely poor choice, as the vinegar dissolved the balloons, dumping a metric shit-ton of coke into his system.  This, of course, resulted in his psychotic delirium and the subsequent explosion of his heart.  Thank God our Samaritan was there to help, because otherwise the cops would've likely deployed the Taser, and excited delirium + Taser deployment sometimes = dead suspect.  In this case, though, the death was clearly a result of the patient's cocaine ingestion.

So to recap: Drug smuggling patient died, nobody else was hurt (physically, anyway - the patient's friend took it pretty hard) and exactly 0 cops were taken off the street for a use of force investigation.  This all means that drugs are bad, kids.

Not to mention that Professor Farnsworth has clear policies forbidding drug use by Planet Express employees.  Dr. Zoidberg, a leading authority on nothing in particular, has long advised his patients to avoid ingesting vinegar unless it's with fish and chips.  So there you go...