Wednesday, October 22, 2008

House of Horrors

The house was ready for Halloween. A graveyard decorated the front yard, a mummy hid in the bushes, a scary black cat waited for us on the porch, next to a zombie locked in a cage. The side door was open, the house dark. The door creaked when I pushed it. There was some commotion coming from the upper floor, I started toward the stairs. My old partner, Renato appeared at the landing, a forty year old woman dressed in pajamas at his side.

"She ate Dominican Rat poison," said Renato. "Her kids are upstairs."
"Get her to the truck," I said, Renato and my new partner, Rob walked her out of the house. I went upstairs. Two kids were there, with Miles, the officer of Engine Co. 11who had been called to assist and had arrived on scene a few moments before Rescue 1.

"I'm on the phone with her husband," said Miles. "Trying to get the package. Take Renato if you need him, we'll meet you at the hospital." The kids father had been with friends a few streets away. The woman went there, and there she ingested the poison, then drove home to her children. Oliver, the third firefighter from Engine 11was with the kids, a boy about twelve and his ten year old sister. They tried to be brave but tears flowed freely down their faces. Their parents have been "having problems," their mom said she's had enough and decided to "end it."

I walked out of the home, school papers stuck to the refrigerator with cheerful magnets, family pictures on the walls, certificates of achievement framed and displayed. Dinner dishes sat in the sink, waiting to be cleaned and put away. Everything here looked to be in order, but something was terribly wrong.

In the truck, Renato and Rob had the patient on oxygen, an IV established and were running an EKG. Although her vitals were stable, 128/72, HR 70, sp02 98%, the poison was starting to take hold. She was diaphoretic, foaming from the mouth and started convulsing. Her breath smelled like insecticide.

Rob drove to Rhode Island Hospital, Renato comforted the patient as best he could and I contacted the ER. A room waited for her when we arrived. The ER doctor "Googled" Dominican rat poison and came up with a treatment plan, Atropine and a lot of it.

We did all we could, then left her in the ER. Her prognosis is not good. She may be gone in twenty-four hours. I drive by her home on the corner often. I hope I don't have to add it to all the others I avoid. After seventeen years on the Providence Fire Department, I'm running out of happy places.

*Update, 2300 hrs., Wednesday.

I just talked to the RN and doctor who treated our patient. The poison she ingested is called Tres Pasitos ("Three Little Steps.") Shortly after we transported her to the ER her convulsions and abdominal pain increased, she was unconscious, incontinent and eventually went asystolic. 40 units of Atropine were administered in the ER. She is now stable in the MICU.

My old partner, Renato, who is actually doing quite well as a firefighter on Engine 11 helped considerably with his Spanish language skills. Had the patient been treated for "normal" rat poisoning, which are anticoagulants such as coumadin and their long acting derivatives, she in all likelihood would have died.

I love a happy ending and hope the patient gets all of the help she needs.