Special K or Ketamine if you're calling it the right name was originally made as a horse tranquilizer. Now I'm EMS we use it for a few different treatments like pain or excited delirium. We're gonna talk about the case of one of the craziest calls I've ever been on.
Excited Delirium is classified as an "Extreme Agitation" which can be determined by body language, actions, behavior, and physical strength. Many variants can contribute to the delirium such as injury, stimulant drugs, and other mental health factors.
Once my truck pulls up on scene myself and my partner approach a 2 story single family home. Once inside the residence we are directed to a small laundry room with a toilet. To explain the toilet in the random small room, we live in a city full of blue collar men, and after a hard day working at the mills they would come into the basement, or back of the house to use the restroom and shower.
Anyway wedged between this toilet and a wall an older woman, let's call her Christina. The way the room was set up was a large washer and dryer to the left, an old shelf full of miscellaneous shit, and the toilet and my girl Chris in the back corner. Access was AWFUL. We requested the FD for help with extrication due to her size and position.
Once extricated, we assisted her to the couch where we checked her out. During this period she began to become extremely agitated, with periods of calm. Excited Delirium protocol was new to us prehospital providers and our command for that matter. We rely on Doctors to help us, when we're in a pinch or just having to ask a Dr to administer a certain drug or preform life saving interventions.
During this time we learned that Chris was a heavy alcoholic, and she definitely hit her head when she fell. Alcohol thins your blood, that made me worry about brain injury. At this point taking the patient to the hospital is the highest priority. Let me tell you Chris didn't want to go, and she was becoming very violent with us. For the safety of the crew and myself I decided that her actions fell under the ketamine protocol and called command per protocol for a dosage. I gave command all of the patients details, weight and vitals.
Doc told me to administer 160mg to her IM (intramuscular), and then if that didn't work redose her with 60mg. Now something that I learned this day was that if you dose them to low at first it basically knocks them down to a point where they are unbelievably strong. Even with the second dose it didn't effect her at all the way we had hoped.We took the patient out to the unit where she began to thrash violently. I'm a paramedic so I've seen a seizure or 100 in my time and this thrash was definitely one of trying to get the fuck out of whatever was restraining her. It was at this time we realized she was having a dystonic reaction to the ketamine.
An acute dystonic reaction is characterized by involuntary contractions of muscles of the extremities, face, neck, abdomen, pelvis, or larynx in either sustained or intermittent patterns that lead to abnormal movements or postures.
I had to call command and ask for help, because I had been a medic for about a month at this point . I was a little frazzled to say the least, and as I was on the phone I described what was happening. The doctor said "paint me a picture." I did much more than that. "Doc have you ever seen the movie the exorcist?" I asked "yeah." He answered. "Good because that's what's on the fucking stretcher in front of me right now!" I said loudly. "50mg of Benadryl and transport." So we secured all the doors and headed to the hospital. As we eased down the road she relaxed for about a minute. I thought the worst part of the call was over...boy was I wrong.
After I gave the Benadryl Chris relaxed, before absolutely losing her shit. I mean she was thrashing and trying to get off the stretcher. The only thing I could do was try and restrain her while me and my partner finished the 6 minute transport. I am 5.11 280lbs and my patient was in her early 60s and frail. I had to lay on her to keep her from hurting herself.
I SHIT YOU NOT
That 65 year old woman lifted me off of her...
Once we arrived at the hospital security was waiting for us just in case. We took the patient inside and handed over all info and gave report.
And that is the story of the first and only time I've made anyone ride the K train.
A:N
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The Lights and Sirens
Non-FictionA story of a young paramedic and the crazy things shes seen. (All names have been changed to protect patients and comply with HIPAA standards) (All based on true events and calls that have taken place)
