Sigh.
We get dispatched to a residential address in south Fairview for convulsions. After an uneventful response, we arrive on scene. The engine company that should have beat us is nowhere in sight. A family member frantically waves and yells for us to hurry. Now this isn't the typical panicked and overly dramatic waving that I've become so accustomed to over the years -- this is a distinguished looking Latino gentleman in his mid-60s in a soaking wet suit and tie. Different to say the least.
We walk in to a small but very well kept home and find the living room packed with misty-eyed adults and scared children. Our waver escorts us to the bathroom, where we find a woman trying to console our patient, a woman in her early 60s who is laying on the floor in a puddle of water and covered with a towel and a robe. The patient is altered and postictal, and keeps saying "My eye!" over and over. We ask the woman to move out of the way so we can assess the patient, and the horror of the situation becomes evident. Her left eye has been ripped from its socket and rests upon her cheek, and the trauma to the eyeball itself is devastating.
My partner and I share a silent "Holy bleep!" look and start to ask questions. The patient's daughter and husband tell us that the family was going out for an early Mother's Day dinner, and the patient was taking a shower. They heard a crash, and hurried into the bathroom to find that the patient had apparently had a seizure and fallen out the shower. As she fell out of the shower, she fell into the empty toilet paper holder, which looked a lot like this:
Unfortunately, as she fell her face hit the fixture, and the hook caught her eye, causing the horrific damage. The damage itself would be a relatively easy injury to manage, at least in the prehospital setting, but her altered mental status complicated matters quite a bit.
Due to the fall, we have to place the patient in full spinal precautions, and while her altered level of consciousness is probably a result of the seizure, it could very well be masking a further head injury from her fall. She also kept trying to hold her eye and put it back in place, and we obviously couldn't have that.
Did I mention that this is all taking place in the smallest bathroom EVER? Or that the engine company is STILL not on scene?
Just for reference, the bathroom layout was somewhat similar to this one:
The shower would be where the window is in this picture, and the bathroom door opened directly to a single sink vanity, but you get the idea. The patient was laying between the toilet and the vanity, under the toilet paper holder.
With a lot of help from the family, we were able to c-spine the patient and gently restrain her hands. We covered the left eye with a moist sterile dressing and covered the right eye as well, which seemed to calm the patient somewhat.
We carried the backboarded patient out to the living room and put her on the gurney. Between the oxygen and the passage of time, her mental status had improved to normal, aside from no memory of our arrival. She knew where she was, and knew that she had hurt her eye, and she just wanted to say goodbye to her grandkids, who were all very scared. As we loaded her into the ambulance, the engine company FINALLY showed up. Apparently they had been tied up with a small kitchen fire. Sigh.
We took off for U-Med, and after transporting across the city in light Saturday evening traffic left her in their very capable hands. They already had an ophthalmologist on the way for a consultation, and, while they don't expect to be able to save the eye, I'm confident she's in the best place possible for her injury.
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