I was riding as an Attendant on crew with RPI Ambulance for this call. We had just finished the RMA for a patient with a nosebleed when we overheard Public Safety over the radio discussing a girl who was having hallucinations. In anticipation of another medical call, the driver tells dispatch that we’re in service and starts a leisurely drive toward the garage. We slowed down when we heard our tones again. It was around 6A.M. We acknowledge the call (an Alpha determinant for hallucinations) and get on route to Quad. We quickly arrive on scene. A Pub Safe car was already parked in front of the White stacks; the scene should be safe then. We drove past them, made a U-turn and parked in front of Pub Safe so we’re able to exit easily. I put on gloves and grabbed the jump-bag as I left the back of the ambulance.
We met the patient and Pub Safe officers just inside the doorway of White III. I make sure to move inside and not block the exit. The patient is sitting on the steps; a freshman, 18-year-old female. She looks pale and diaphoretic, with dark circles under her eyes. My CC greets her and kneels down to the patient’s level. The patient sounds quiet and tired when she gives her name and states that she took her usual dose of antidepressants along with Ambien but hasn’t been able to sleep for a day; her hallucinations started happening a few hours earlier. I wondered if we needed to have the patient’s meds with us to bring to hospital staff, but since they were all prescription medications and she didn’t overdose, then they probably weren’t necessary.
I kneel down on the steps next to the patient to take vitals, starting with her blood pressure on her left arm. Her blood pressure was normal, but her pulse was slightly high (over 90 beats per minute). I get normal respirations as well. I would consider this to be a psych call, but from interacting with the patient early on it was clear that she wasn’t violent or had the urge to cause harm to herself. She overall just seemed very fatigued and disoriented. After I finish up vitals I pick up the jump bag and prepare to leave for the hospital.
The driver went out to the ambulance to get the stretcher. He pulled it up in front of the dorm and lowered the stretcher halfway. The CC asks if she can walk; the patient gets up on unsteady feet and we guide her to sit on the stretcher. The driver set the head of the stretcher to be at a 45 degree angle; the patient lies down and we strap her in. Before we leave a Public Safety officer stops the CC to ask what hospital we’re heading to. Once we load the patient and stretcher carefully, I sit next to the CC in the back with the patient, setting the jump bag next to me on the bench. The CC places a blanket over the patient, speaking calmly to her as her body seemed tense. Before we leave the CC gives the med patch to Samaritan.
During transport, we get a second set of vitals. Her blood pressure is about the same and with the pulse oximeter, her pulse is similar to her baseline and her oxygen saturation is normal. When the ambulance first started moving, the patient cries a bit, citing a fear of ambulance or is still hallucinating; eyes seem distant and face a bit blank and fearful. During the secondary assessment the patient is still oriented to where she was and what time it is. Transport to Samaritan goes smoothly. The patient’s condition didn’t deteriorate, and the ride to the hospital took only two minutes. We transferred the patient to the ER nurses when we arrive.
I’m still not sure what more we could have done as EMTs for this patient besides monitor her condition. Keeping the patient calm and safe for transport to the hospital seemed like the best we could do for her, as we don’t really have any protocols for treating someone hallucinating. Some factors contributing to this call could be the mental health of college students, particularly freshmen since the transition from high school to college can cause a large amount of stress. It was only the first month and school and they probably didn’t have many healthy ways of dealing with the new environment and workload. This call could have been prevented with more stress and time management training with freshmen. Appointments with the health center therapist should be advertised more as well for students whose health care providers are not in the area. There could also be more doctor discretion over what medications their patient is taking at the same time. Reports of hallucinations as a side effect of taking Ambien and other prescription sleep medications are becoming more publicized, and having such a young adult using both Ambien and antidepressants seemed a bit dangerous.