It was a small, perfect little apartment full of lace doilies and pictures of the grandkids. The homey peace was in direct contrast to the tiny hallway now crowded with heavy boots, and the homemade quilt on the four poster bed now looked out of place next to the unconscious man on the floor. A hulking police officer spoke gently in the kitchen with a tiny, cuddly Grandma in a flower print apron. The whole scene was a study in opposites.
We knelt beside him, the quintessential Grandpa, and started our assessment. Pulse was very weak but present, that's a good start. Respirations were about the same, not great, but at least they were there. As we lifted his shirt for the heart monitor, my partner and I spotted it at the same time and froze for a second. His lower abdomen was pulsating - an obvious, living, breathing mass was building quickly. Damn.
We moved fast to get him packaged. He was conscious again now, lying down had brought his blood pressure up enough for his brain to clear some of the fog. He weakly grasped his wife's hand and smiled at her as we carried him out, watching his loving hand slip from hers struck me right through the heart. She didn't know what we had found and busied herself tidying up the throw rugs that had been knocked askew.
We were hoping it wouldn't be an issue on the way up, but it is now clear that we have a problem. The stretcher did not fit in the tiny apartment elevator no matter how we tried, and we had to extricate him on a backboard to keep him lying down and navigate tight corners. Now we quickly debate our options. We have to make it down 4 flights of stairs with a very serious patient, and no matter which way we choose, he will get tilted enough to pass out. The elevator will be faster, so we cram him in with my partner and watch him go unconscious as the doors close. The fire fighters and I race down the stairs, meeting them with the stretcher and lay him back down, his eyes magically open again.
As we bring him outside, the police officer follows, alone. After he's loaded, I ask him if his wife is going to be coming, and he says she's planning on coming up later with their family. "No, she needs to come now." I tell him. "He's not doing well, she needs to get to the hospital ASAP." He studies my face for a second and seeing the seriousness, nods and turns back to the building as we leave, lights and sirens blaring in the mid-afternoon traffic. I have no doubt that she will be convinced to accept a ride with him, and sure enough, I see him gently escort her into the hospital's quiet room within minutes of our arrival. He is still alive, for now.