Deep in the darkest hour of the night, we were dispatched for a person with trouble breathing, allegedly secondary to an Asthma attack. Or exacerbation, if you prefer the medical term. Reading the comments on the computer I noticed that it was the barracks of the state police, which meant it was very likely that the patient was a prisoner. State troopers being hale and hardy folks, they don’t have Asthma so that wasn’t very likely.

Now, stress can and does induce Asthma attacks and even though I’ve never been a guest of the Gendarmerie it’s reasonable that being arrested is pretty stressful. On the other hand, some people upon being put in durance vile, develop what Ambulance Driver has dubbed “Incarceritis”, which is the sudden onset of acute illness after realizing that yes, you are going to jail, and no you are likely not going to be allowed to bail out. In cases like this careful evaluation and examination of the patient is important as dismissing a patient complaint that turns out to be legitimate leads to incidents reports at best and more unpleasant “administrative” processes at worst.

Our BLS back up unit was coming from some distance away so we arrived before they did and went back to the cell block to meet our patient. Only she wasn’t in a cell, but lying on the floor of the booking area, thrashing about and screaming at the top of her lungs that she wanted us to give her some “F***ing Albuterol”. OK then, we had our first clue that maybe she wasn’t being attacked by wild gangs of Asthma, but maybe something else was going on.

Still, as noted above, careful examination was in order. An assessment of the ABCs revealed that she was conscious, oriented, and able to speak full sentences loudly and without any distress. Pulse = Present. Skin, warm, dry, and of normal color. These are all good things and indicate effective respiration and ventilation at the cellular level.

I applied the O2 saturation and end tidal carbon dioxide sampling probes from their respective pouches, applied them and then turned on the cardiac and other stuff monitor. Lo and behold, the patient was breathing about 50 times a minute, had good tidal volume, and perfect Oxygen saturation. Her ETCO2 was low, which indicated a lack of carbon dioxide retention. In fact, she was a little hypocapnic, which led me and my partner to believe that she might be hyperventilating. My partner, let’s call him “The Patient Whisperer” started talking to the patient in a soothing voice trying to calm her down. Despite her protestations that she “couldn’t” slow her f***ing breathing down and needed “f***ing Albuterol”, her respiratory rate started to slow down into the normal range.

She told my partner a rambling story about getting lost on the highway, pulling into an emergency stop area, and calling 9-1-1 on her cell phone. In due course a trooper arrived and after a brief interview and field sobriety test placed her under arrest for drunk driving. Which is when her breathing problems started. Again, being arrested is probably a stressful thing so her anxiety and hyperventilation was not unexpected.

In due course the BLS ambulance arrived and we conveyed her to their unit for transport and evaluation at a not too distant hospital.

So, the observant reader might ask, why do I consider her sort of lucky?

Well, it seems in her confusion she got on the interstate and drove about five miles in the wrong lane. As in, she was heading north in what the rest of us would consider the south bound lane. This was right after closing time, so she was not the only allegedly impaired driver on the roads. It’s a miracle that she didn’t collide with someone going south in the southbound lane. The non existent collision meant that no one died, no one got the dreaded call in the middle of the night, no paramedics and EMTs had to respond to clean up the mess, no police had to respond to yet another highway fatality.

The young lady is in some trouble, will have to hire a lawyer, go to court, probably lose her license, and will face increased insurance premiums when she is able to resume driving. Still in the greater scheme of things, she fared pretty well.

I’m going to call that a happy ending to a story that could have had a much sadder one.