Once upon a time, which was actually yesterday, I had a strange patient. A nice little Asian lady, who practically ran when she saw me. Which made me a little confused.
We were called, with lights and sirens, to an intersection in the really ghetto area just north of one of our stations for....wait for it....a nosebleed. So I flipped on the flashy-flashy's and started heading in that direction. While we drove, I reminded my very new partner about how to best deal with epistaxis. And we mused about why we'd been called to an intersection rather than a specific address. But much more bizarre things have happened in the ghetto of the Great White North. I was also secretly keeping my eyes open for any sign of an assault since face punching can cause nose bleeding.
So we roll up and stroll over to the city bus when a woman with a bloody nose standing at the door. No one mentioned a bus, but I'm flexible.
"So, happened here ma'am?" I ask as I look at the mostly dried blood on her hands and upper lip.
"I just want to go home. Please, I live right around the block. My daughters waiting for me, please." says a very anxious Asian lady in her 40's.
"Well, my partners gonna take a quick look at your nose and help get you cleaned up. Is that alright?"
I go over to talk to the bus driver. She says the woman was sleeping, woke up with the nosebleed, asked her frantically to call 911 and then tried to leave once we were on the way. Only hearing the sirens in the distance made her decide to wait an extra minute for us to arrive. Apparently the woman was a semi-regular on the route, but never acted strangely before.
The nice lady, who's name I never managed to get, was adamant the needed to leave. So I ran though a very quick mental status check. Since she was alert and oriented, I asked her to wait a moment while I got a refusal form. But this 2 minute and 37 second encounter was already taking way too long for her and she started speed-walking down the street.
New Partner had to run down the street just to get her to sign the refusal form. All we managed to determine was the nosebleed was non-traumatic, she had a history of hypertension,she didn't take her meds today, she needed to go to her daughters house and she was oriented appropriately. Her English was fine, so I don't think it was a communication problem, but her anxiety level had been though the roof as soon as we rolled up. The bus driver and I exchanged unit numbers for each others reports and we drove around the corner to go write up the report.
I still don't know the patients name or why she was so intent on leaving. My best guess is that the anxiety and hypertension combined with the lack of meds caused her nosebleed. And that she realized there was some time-sensitive reason that she needed to be at her daughters house right away. Maybe she was supposed to watch one of the daughters small people (children).
But New Partner learned how to write up refusals and we got to go back to the station and wait for the next call.
Just another day in paradise.
(Great White North)