Ochre River Rescue: Dauphin Emergency RoomBy Peter Berg
Readers may recall the intriguing three-part story we ran last year about SCI Manitoba member Peter Berg’s helicopter rescue from Riding Mountain National Park. We are excited to be able to continue Peter’s story with his arrival at the Dauphin Hospital Emergency Room.
The Dauphin ER wasn’t too busy when I arrived. I was ushered right in to a treatment room, probably because I had a suspected heart attack, and had experienced a blood pressure crash in the ambulance. Overall I wasn’t feeling too bad at this point. I was awake, and lucid, and not in pain . . . I just couldn’t move my legs much. The doctor was a lady, and she began to do a workup to assess my heart. (I would later meet her daughter, a nurse in the city) I donated blood, 12 vials in a batch at one point, for analysis. They performed an EKG test. They listened, and poked, and prodded. Within a couple of hours it became clear that I had no indication of a heart condition. They set up a saline IV in case what I had was just an electrolyte imbalance from a severe case of dehydration.
Meanwhile a staff member came and got my information for the admission process, and I was put in the care of a young nurse named Vanessa. She is a bit short, but makes up for it with a very large cheery personality matched to her bright pink shock of hair. Vanessa tended to my needs through the afternoon. The backpacks from the woods arrived some time after I did, and were stuffed in a corner of the treatment room. A roommate arrived during the afternoon, a gentleman who was suffering with various complications of an illness, and on this day chest pains as well. We talked a bit during the down times between procedures, and he had also lost a daughter not much older than my Catherine in recent months.
Allen Unger arrived to visit me. Allen is the pastor of Ochre River Baptist Church, where the pastors’ gathering had been held earlier in the day. He stayed with me for a couple of hours, and we talked and joked. Eventually Curtis made it to the hospital. His ambulance was from Ochre River and this was out of their territory, so they had dropped him on the highway and Brad Muller from Ochre River had driven him to Dauphin. He arrived flustered and very glad to see me alive.
It wasn’t long before our conversation turned to what to do about the car. Here was my station wagon, parked and locked at the trailhead, with an expiring parking permit on it. We were afraid it would get towed, or vandalized, or somehow incapacitated so it wouldn’t be retrievable. We had to get it to Dauphin. Once in town, I knew a couple of people whose houses we could park it at for as long as necessary for someone from camp to mount a rescue mission. Allen offered to drive Curt to get the car.
Curt looked up in panic and blurted “But I haven’t driven a standard transmission car in 28 years!” Allen shook his head and snorted, “City boy.” They decided to drive and get the car. Allen would drive it back to Dauphin, and Curt would follow in Allen’s automatic car. They left on the errand, appreciating some time together as they only really see each other rarely at the pastors’ lunches, and this would allow them to get to know each other a little better. They were gone about 2 hours.
Meanwhile, I was getting steadily more uncomfortable. I had not peed since mid-morning. In fact, when my mountain man rescuer had reported in and we were waiting for assistance, he asked me if there was anything he could do for me, I asked if he could help me pee. He propped me against a tree and held me there with a big bear hug while I tried. I couldn’t, and I put it down to holding it for a long time and a colossal case of stage fright. During a pause in the carry-out I had made a second attempt without success.
On arrival at the ER, they had given me a urinal jug, and encouraged me to try while propping against the side of the bed. I tried several times through the afternoon, getting nothing out. The saline IV had not helped with this issue. In the late afternoon, Vanessa announced that the doctor had ordered a bladder scan for me. The machine they use for this is a version of an ultrasound like what is used for in utero baby images, but housed in a small portable machine and configured to discern how much fluid is in a person’s bladder. Vanessa scanned my bladder and asked, “Do you need to go?”
“Yes,” I whimpered, “but I can’t.” I explained that it had been sometime in the morning that I last was able to relieve myself. She said, “We need to do something about that.” And as simple as that I was on my way to my first ever urinary catheter.
The Foley catheter comes in various lengths and is a semi-rigid tube inserted into the urethra. Once the end is in the patient’s bladder, part of the tube is inflated and a ball forms at the bladder end to secure the device. An extension hose and graduated collector bag are attached to the outlet and a valve allows fluid to flow. The Foley that Vanessa selected seemed unnecessarily long. Sizes from 8” to 26” were available in the ER, according to the marks on the storage shelves, and I think I got one of the longest sizes. I was a bit concerned with the diameter of the tubing, but I very seriously wondered if it might not poke out my nose if inserted fully. I hoped it was clean.
Urine did indeed begin to flow as soon as Vanessa attached the collector bag. 500ml collected before Vanessa even managed to put the remains of the catheter kit away, and by the time I was finished draining a few minutes later 3 full litres had collected and she had already emptied the collector bag once. The insertion process was not as uncomfortable as I imagined it might be, but the relief that followed was absolutely indescribable.
Meanwhile, the doctors were trying to determine what was wrong with me and a second doctor began to test reflexes, strength, and sensation in my legs and get a detailed description of the extent of the numbness. This was where they began to think that a spinal issue might be at the root of my problems. They began to talk about my condition as a possible transverse myelitis, and started to make plans to move me to Winnipeg’s Health Sciences Centre for further diagnostic testing. I need to stop and salute the lady who was my attending physician, as I understand she made absolutely heroic efforts to get me accepted at HSC and transferred there with all haste. A helicopter transfer was ruled out, but it took here something like 12 spirited phone calls to gain acceptance of an ambulance transfer that evening. It was set up and called off at least once.
Meanwhile, Curt had checked local hotels for space and found none. He concluded he would have to make it home that night in order to make it to work the next day. He was resigned to driving the car. On the Monday, he had been asking questions and trying to remember how to pilot the manual-transmission car. He was glad he did. He told me later he stalled the car once in the hospital parking lot, then made it the rest of the way home. He said goodbye a little after 21:00, steeled his resolve, and walked out to the parking lot to confront his demons and the infernal machine that would take him home. My transport was finally arranged and I was on an ambulance by 21:30, and on my way to HSC.
Transports from Dauphin are routine for the ambulance staff. Which is not to say they are well-liked. There is a hand-over process for the crew to take over an ambulance and ensure the appropriate equipment and supply inventory is in the unit and prepared for action. The drive time for the transfer is 4 hours each way, with the processing time at the Winnipeg hospital in the middle of the trip, and another handover process at the end. A smooth transfer already requires a full 12-hour shift, and it can be longer if there is any friction on the trip.
My ambulance crew started into the rainy darkness with me, and drove into the night. I sent Curt a text asking him to text me when he arrived home safe. I drifted off to sleep for a little while. We stopped in Neepawa for a quick break for the driver, then continued on. Curt also stopped in Neepawa for a break, and when the ambulance pulled in he realized it was my transfer. He followed the ambulance to the city, then broke off for home. He texted me shortly after I arrived at HSC to say he got home safe. His text also said “You can keep your car. It takes too much thinking to drive.”
After Neepawa I slept for a little over an hour, then came to as we drove through Headingley and into the city. As we drove along Portage Ave. the EMTs were getting progressively more nervous. How busy would the ER be? How long would they have to wait. Once, my attendant confided, they had been required to attend at the HSC ER for over 8 hours waiting for a patient to be admitted. Hope started to bubble up in them when there were no ambulances lined up outside, and when the door opened before them and they pulled in to the unloading area with no one ahead of them they were positively giddy. HSC processed my transfer paperwork immediately and I was in a bed in their ER within 10 minutes of leaving the ambulance, and they were free to go. I wished them well. “We’ll get something to eat here, and then we’ll have to stop on the way home again for my partner, but otherwise it’s straight home and done!” my attendant confided. I had arrived in Winnipeg. It was 01:30.