Fun night
Printed From: Tippmann Paintball
Category: News And Views
Forum Name: Thoughts and Opinions
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URL: http://www.tippmannsports.com/forum/wwf77a/forum_posts.asp?TID=191783
Printed Date: 18 January 2026 at 2:36am
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Topic: Fun night
Posted By: StormyKnight
Subject: Fun night
Date Posted: 07 April 2014 at 7:32am
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All started yesterday morning when we heard a convict with a dilantin overdose was being directly admitted as a 1 on 1 direct observation. The kid was pretty out of it. Couldn't tell us his name or any other information of a personal nature. Fast forward to last night. Dilantin levels are still high at 40.1 only down from 43 earlier in the morning at admit. Reacts to loud verbal commands only. Having 'tactile' issues. Wants to touch or pick at anything including his IV. Doctor orders a cherry "flavored" liquid charcoal beverage to help absorb the "not-so-much-metabolizing" dilantin. Well, he didn't like that. Can't blame him. Looks awful. Doctor orders an NG tube to be inserted into his stomach via the nose. Quick struggle later didn't pan out. Doctor orders halidol to 'relax' him. Nurse gives him the first dose and it doesn't appear to do anything. Still wants to get out of bed and mess with his IV. Finally get him back in bed and it looks as if he's starting to doze off. Second dose of halidol given. 10 minutes go by and we prepare for another attempt. Before I continue, this kid is 22 years old, 6' 3" and weighs approximately 210 lbs. I get to secure his legs by basically laying over the top of them. Sergeant has him by the handcuffs and two other officers holding him back on the bed. One of the nurses grabs his head from behind while the other nurse starts to insert the tube. I didn't see that part, but knew exactly when it happened. Kid started screaming bloody murder and began to buck. I'm north of 275 lbs and laying across his knees so he can't get any leverage. He is actually lifting me up to the point I have to reach over the side of the bed and grab the railing and lift my legs off the floor to bring my entire weight to bear on him. From the sounds he was making, you'd think somebody was sawing off his arm at the shoulder. They tried each nostril unsuccessfully. It is hard enough to get one of those things down when somebody is in cooperation. Utterly impossible when you're brain if **edited** on an anti-seizure med overdose and your fighting to the best of your ability. So, I'm nursing my sore ribs from taking that 2 minute rodeo ride on his knees. Think I'll need a couple of more beers before bed. ------------- 
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Replies:
Posted By: WGP guy
Date Posted: 07 April 2014 at 1:21pm
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I just don't understand the use of haldol acutely before procedures. The onset is about 45 minutes. I've seen people in the ED expect it to quickly calm and sedate a patient, but it just isn't designed to do that. Phenytoin is also a major inducer of all the P450 enzymes, so the haldol dose would need to be at least 150% normal to achieve a therapeutic plasma level. A short-acting benzo or anesthetic is probably a better choice for acute, preprocedure sedation, but obviously not for this patient for concerns of resp depression. Probably 20mg of ziprasidone one hour before the NG tube would have done the trick. |
Posted By: usafpilot07
Date Posted: 07 April 2014 at 2:03pm
we get it, you med school ------------- Buffalo buffalo Buffalo buffalo buffalo buffalo Buffalo buffalo |
WGP guy wrote:Posted By: WGP guy
Date Posted: 07 April 2014 at 2:06pm
It's been like 10 years and I still can't escape it. Ahhhhhhhh |
Posted By: evillepaintball
Date Posted: 07 April 2014 at 3:20pm
Have you ever tried flying away from it? ------------- 
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Posted By: Mack
Date Posted: 07 April 2014 at 5:21pm
Boy, you guys really know how to pilot on. ------------- 
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Posted By: StormyKnight
Date Posted: 08 April 2014 at 9:24am
From personal experience, nothing beats the B-52 (5mg Haldol & 2mg Atavan). But, I'm one of the guys keeping the nurses safe from the convicts and I haven't met a Doctor that appreciates the non-medical recommendation of a layperson. -------------
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Posted By: WGP guy
Date Posted: 08 April 2014 at 11:46am
Yea, the ativan will give you wonderful sedation fast. They probably didn't give it to your crazy OD guy because it can cause respiratory depression. Haldol treats the psychosis. Are you an ED LEO or security? That must be super fun. |
Posted By: deadeye007
Date Posted: 08 April 2014 at 1:36pm
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I had to respond to a belligerent drunk one day. He was about to go to treatment for being an alcoholic. The rehab facility told the guy's mother (he was 23 or so) to give him some alcohol through the weekend so he wouldn't go through the DTs(?) before he made it to the rehab facility. She ended up giving him a ton of whiskey, and he got drunk as Cooter Brown. I went to the house because his ex-girlfriend stole his cell phone, and I took a report even though he was thoroughly hammered and agitated. I left, but he had a seizure 15 minutes afterwards. The fire department and an ambulance showed up to treat him for his seizure. Once he woke up, he started beating on the fire crew that was trying help him. I showed up and four fire fighters were hanging on to him. I managed to get him cuffed, and he started calming down. I stood him up to walk him to the ambulance, and he went nuts again. He tried to headbutt me and then landed a few knees into my thigh (he was going for the jewels but I turned) before I managed to get him back on the ground. My sergeant arrived on scene and was around 250lbs at the time. Even with the sergeant on his back, the guy started lifting himself up. I stood on the guys head (I was only 150 at the time) and he still lifted us both up. We managed to get him contained and to the hospital (I rode in the back of the ambulance holding him down the whole time). He went nuts for what seemed like an eternity, until the staff pumped enough ativan into the guy to slow him down. That was the day I learned about the super human strength of drunken crazy people. ------------- Face it guys, common sense is a form of wealth and we're surrounded by poverty.-Strato |
Posted By: StormyKnight
Date Posted: 09 April 2014 at 9:10am
Somebody needs to get with the idiot that advised giving alcohol. That was patently irresponsible. So, no ECD? They are a wonderful equalizer. The Director of our Department is a retired Sheriff. He felt we didn't have enough tools to do our job. Our Taser X2s are awesome! Full HD video and sound recording capability to cover our backs. -------------
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Posted By: WGP guy
Date Posted: 09 April 2014 at 9:29am
Have you ever had to deal with someone on PCP? That's no joke, and the one I've seen a taser did absolutely nothing. It took half a dozen firefighters and cops, plus 10mg of valium to control him. |
Posted By: SSOK
Date Posted: 09 April 2014 at 11:06am
The pile of awful puns is sky high. ------------- 
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Posted By: deadeye007
Date Posted: 09 April 2014 at 1:35pm
We don't have Tasers because the chief doesn't like the negative publicity. I would disagree, but that is above my pay grade. The worst part of the whole experience was noticing that he bled on me right next to a cut I received during the altercation. Six months of testing made me nervous, but it all turned out good in the end. ------------- Face it guys, common sense is a form of wealth and we're surrounded by poverty.-Strato |
Posted By: impulse418
Date Posted: 09 April 2014 at 3:13pm
The B also stands for Benadryl. Nothing like a little bootie juice to calm 'em down. |
Posted By: StormyKnight
Date Posted: 09 April 2014 at 6:59pm
Not yet. And from what I've heard, don't want to.
The taser vs. pcp vids I've seen weren't clear enough to see if the probes were delivered correctly. If the probes are too close together anyone can fight through the current. Drive stuns do not incapacitate as it is mostly pain compliance. Anyone on PCP feels little if any pain, so drive stuns are not an option. If the probes are delivered correctly (hemispheres of the body are split to upper left quadrant to lower right quadrant) the ECD interrupts muscle control and locks you up. If they are too close together or one set of probes misses, the ECD will not be effective. -------------
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Posted By: StormyKnight
Date Posted: 09 April 2014 at 7:05pm
Geez. That would so suck. In case of something like that, we'd be taken to an E.R. for the "cocktail". I don't know what it is but it is unpleasant and makes you very ill for a period of time. Supposed to help ward off HIV infection in cases like that. No idea if it is effective or not. Makes you want to "glove up" for every possible encounter though... -------------
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Posted By: StormyKnight
Date Posted: 09 April 2014 at 7:07pm
Interestingly enough, the 50mg of benadryl are more often than not omitted in most cases with us. Silly Doctors... -------------
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Posted By: usafpilot07
Date Posted: 09 April 2014 at 9:06pm
Ugh, been there too. My 11th shift on the road ever, ended up in a scrap with a guy who was HIV/Hep positive. Did you have to take the month long series of prophylactics? Worst month ever. ------------- Buffalo buffalo Buffalo buffalo buffalo buffalo Buffalo buffalo |
Posted By: deadeye007
Date Posted: 09 April 2014 at 11:51pm
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At first I was ready to amputate my arm to keep the zombie blood from spreading throughout my body (I was Herschel before it was cool), but a nurse sat down with me and weighed out a risk vs reward for taking the meds. I agreed to go with testing(said the meds would make me sick as heck and the transmission rate for my exposure is very minimal). I was pretty sure that the blood didn't get in the cut so I did a base line test for all the heps and HIV, then tested again after three months and another three or four months. Came back fine, but I was still nervous waiting on the second and third tests. A few years later half of the shift had to pig pile a guy that was HIV positive and bleeding (after the pig pile). They were taking them meds like candy. Hindsight being 20/20 I still should have opted for the meds. ------------- Face it guys, common sense is a form of wealth and we're surrounded by poverty.-Strato |
Posted By: Lightningbolt
Date Posted: 10 April 2014 at 2:56am
| How on God's Earth do people end up getting in scrums with police. It's just ridiculous |
Posted By: usafpilot07
Date Posted: 10 April 2014 at 4:00am
Yeah, given the option, I probably wouldn't have taken the meds after that exposure. I only had a couple scratches, but policy say-monkey do. I damn sure FELT like I had AIDSs while I was taking them. Awful awful experience, though I suppose it's better than the alternative. ------------- Buffalo buffalo Buffalo buffalo buffalo buffalo Buffalo buffalo |
Posted By: evillepaintball
Date Posted: 10 April 2014 at 5:28am
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I never came in contact with the blood, but I did get to deliver the news to one of our guys that he did. One of our security gaurds decided to suck-start his pistol at the gate. My MP was the first on scene and tried to administer first-aid. Turned out the guard was HIV+. Fun night. -------------
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Posted By: WGP guy
Date Posted: 10 April 2014 at 8:47am
Truvada, a 2 drug combo for HIV. It's been shown to be 44-87% effective, but causes nausea, vomitting, diarrhea, and you can't drink alcohol while you take it. But like was already said, the exposure risk is super low, like in the fractions of a percent range.
Ativan provides plenty of sedation without needing benadryl. Benadryl does combat the adverse effects of haldol, so it's interesting it would be left out. Usually Benztropine is recommended to be give with haldol, but like you, I rarely see it done. |
Posted By: usafpilot07
Date Posted: 10 April 2014 at 10:39am
Mine was Truvada and something else. But yeah, nausea/diarrhea/constantly tired/etc. ------------- Buffalo buffalo Buffalo buffalo buffalo buffalo Buffalo buffalo |
Posted By: procarbinefreak
Date Posted: 10 April 2014 at 1:39pm
| You gotta be more worried about getting hepatitis from an exposure like that. The viral load for HIV is waaaay lower than Hep C. |
Posted By: StormyKnight
Date Posted: 11 April 2014 at 10:32am
About a year ago, we had a very manipulative self-mutilator on our unit. Bugging bad. Wasn't getting the drugs HE wanted when he wanted. We ended up 4 pointing him to the bed with medical soft posey restraints. When that didn't work, we used our restraints. He kept screaming and tugging, screaming and tugging for hours until a doc ordered ativan. Don't remember the dosage, but within 10 minutes he was flat out. 20 minutes later (YES! 20 %&#*(&^ minutes later!!), he was at it again. Tugging and struggling against the restraints screaming bloody murder for his meds. When he went down hard like he did, I thought for sure he was going to be out for hours. Nurses did too. It wasn't a good night. -------------
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