This is a relatively recent call that I was on this semester as an Attendant with RPI Ambulance. I might have a few details missing but this was overall what happened from my point of view during the call.
At around 2:30 A.M. tones wake up the crew members and we’re dispatched to the Public Safety Office for an Alpha breathing problem. The Alpha determinant for a breathing problem was curious. How stable was the patient? The drive from the garage is short and we arrive on scene quickly, not many cars in the lot, parking next to the entrance of the Pub Safe Office. With the Pub-Safe officers around, we could assume the scene was safe. The patient was sitting inside on one of the chairs, several Pub Safe officers a few feet away. He was a young male, and holding his throat. When our Crew Chief talks to him, the patient spoke with a raspy voice, speaking in short bursts and frequently swallowing. He tells us that he feels his throat muscle felt out of place, which was confusing to interpret. I take a set of vitals; his blood pressure was slightly lower than normal (I think around 100-80), and using the pulse oximeter, his oxygen saturation was normal but his pulse was all over the place (jumping between a pulse in the eighties, nineties and a hundred). I was unable to get respirations due to his rough and labored breathing while he was talking. His face seemed very pale and his pupils dilated. Giving the patient oxygen didn’t seem needed due to his saturation levels. The patient’s airway was also stable (as evidenced by how much he spoke to us) and he didn’t seem to have a respiration rate that was abnormal.
As my CC began taking the patient info and history (18 year-old male, was going back to his dorm when the throat problem happened) a Pub Safe officer interrupted him with a question to the patient: “Have you taken any drugs today?” The patient responded that he took LSD around nine hours previously. The Pub Safe continued his questioning: Where did he get the LSD? Did he take any other drugs? and the like. The patient soon got impatient with the officer and he ends the questioning tersely. He repeats that he just wanted help for his throat. The driver moves to get the stretcher and the patient is loaded into the ambulance. Transport to Samaritan was unremarkable. We took a second set of vitals on the way (with similar results as the baseline). The CC also checked pulses on both arms and checks pupil reactivity with a pen light. During transport the patient seemed a bit airy and talked about famous users of LSD on the way. Although the patient’s mental status was in question, he was awake, alert and oriented to what was going on. There wasn’t any other treatment we could provide as the patient didn’t have an overdose on a drug like heroin and his vitals were stable. Once we get to Samaritan he is transferred to the nurses. The nurses might be able to tell how much of the LSD is still in his system.
Despite the illegal nature of the substance the patient may have used that day, our crew was not obligated to report his LSD use to the authorities (though Public Safety may have questioned him after he left the hospital) as we’re only reporters for child abuse. Considering the patient’s chief complaint was that his “throat muscle” was not in the right place and his reported use of LSD earlier that day, it seemed likely that what he was feeling was the effects of the hallucinogen. LSD effects can last up to 12 hours. He likely wasn’t experiencing strong hallucinations at the time of the call, but his interpretation of certain stimuli seemed altered. The patient was not causing a danger to himself or others, so more intervention from Pub Safe wasn’t needed.
There aren’t too many ways this scene could have been avoided. The patient was a sophomore at RPI and would have had to take Alcohol Edu and learned the risks of drug use. Social factors that could have contributed to this call was that the patient is more affluent and able to afford hallucinogens and other recreational drugs. The patient is also still a young adult, where risk taking and experimenting with drugs is common. The best way to prevent more young adults from being in unsafe situations is to expand education on addictive or mind altering drugs in high school and college. If the patient knew how long hallucinogenic trips could last, he would have been more careful about where he went or made sure a friend could stay with him just in case he had a “bad trip”.