Unhealthy Living

Ran a rather interesting call on a 57 year old female the other day. Apparently, she had a history of back pain, and was known to use her pain medications rather liberally. That being bad enough, she also seemed to have a problem with mixing alcohol with those medications. This is a fairly common scenario and we often find people with a depressed respiratory drive and a decreased level of consciousness (LOC).

That was about the description we had rolling on this call where the woman appeared to be sleeping, but they could not wake her. On our arrival, we found her breathing at about 4 times a minute and with a heart rate of about 38. Those vital signs, being very marginal, prompted us to attempt to improve her breathing and heartrate. We also noticed that her arms, legs, and even head were cold to the touch in a normally heated room. As we began giving oxygen and starting an IV, her heart rate and respirations drastically improved to the point of being well within the normal range. With a lot of effort, due to the significant weight of the patient, we moved her to the ambulance and began transport.

Within a very short time, she suddenly took a turn for the worse, and basically died enroute to the hospital. In trying to analyze what happened, I worked up the hypothesis that this was probably caused by something we call "compartment syndrome". This occurs when a person is trapped and lose circulation to a significant part of their body such was a tree falling across the waist and leaving the legs without circulation for a period of time. When the person is "rescued" the blood that was stagnant in the lower extremities is introduced suddenly back into the body and death occurs. I concluded that this might have been the same scenario because of the lack of profusion with the obese woman just lying on her bed. Please feel free to post any comments you might have had with a similar case or just attempt to prove me either correct or wrong!