Ambulance Ride

Stanford's cancer center is an interesting entity. It's physically connected to the main hospital by a skybridge but technically counts as a freestanding outpatient center. When a code is called in the cancer center (most commonly in the infusion treatment center where outpatients get chemotherapy), the inpatient code team (including myself) responds. At the same time, the staff usually calls 911 as is the policy in any freestanding outpatient center. The Palo Alto Fire Department usually responds.

When I arrive at the code, a patient who has received a bone marrow transplant for malignancy is getting ongoing chemotherapy. He has a rapid supraventricular arrhythmia. After making a few interventions to make him more stable, I know that he will need more workup: labs, imaging, studies, and consultations that we cannot provide in the cancer infusion treatment center. As he's currently an outpatient, he will need to go to the emergency department for evaluation. Strangely, though, the protocol is to take the patient to Stanford's emergency department by ambulance. Though it requires more resources, it's probably more efficient than going across the skybridge and down to the emergency department.

Since the patient was modestly unstable, I decided to ride with him in the ambulance. It was the first time I'd been in an ambulance, it was a lot of fun. I was fascinated by the equipment, resources, and capabilities of the vehicle and thoroughly enjoyed the five minute ride. How do you compactly array everything you might need, from an infant to an adult, from trauma to a heart attack? How do you harness things in a moving vehicle? I was impressed. The patient was quite stable and we got him safely to the emergency department.

First image is in the public domain, second image shown under Creative Commons Attribution Share-Alike License, both from Wikipedia.