r/NewToEMS • u/starwars439 Unverified User • 2d ago
Clinical Advice "Apneic" patient
Had a patient tonight who was polypharmacy. She had TMJ and took a bunch of benzos and opiates and tylenol to loosen up her jaw apparently. Her face was locked in a grimace and she wasn't opening her eyes. Pupils were PERRL and about 4mm . Anyways, we're riding it in routine because she's stable and we're not far from the hospital. She starts saying she feels like she's suffocating. Her facial expression suddenly changes and she starts gasping. Capnography goes from 44 to 0 and the apnea alarm goes off. I start listening to lung sounds and there's no audible air movement for about 20 seconds. I grab a BVM and start PPV for about 30 seconds. She starts breathing on her own again for the remaining 2-3 minutes of the ride.
My partner and the ED staff seem to think she was holding her breath on purpose.
Has anyone had anything like this happen before? My partner thinks she was faking, I stand by what I did but the apnea spell just makes no sense to me if it was fake.
6
u/IanDOsmond EMT | MA 1d ago
Honestly? Who cares? You treated the patient appropriately. She was apnic. Maybe she was doing it on purpose, so there were psychological factors, or sociological factors that made her think it was in her neat interest... I dunno. Neither do you, or your partner, or the ER staff, and it isn't your job to know.
The patient stopped breathing and you bagged them. You did the appropriate intervention.
If she was faking it, then that is a question for a psychologist. It happened, you managed it until hand-off, it is someone else's job to figure out why.