The Ampule of Doom

Last week, my trainee partner and I ran on a crazy person who was escalated to the point of needing some help in calming himself down. Some haloperidol-type help.* The patient was recently released from a long-term psych facility and his behavior had been escalating over the last few days. This morning he had decided to lie in traffic in an effort to either end it all or go back to his nice, safe psych facility. When the police put a stop to the killing himself plan, the patient became loudly and floridly angry. 

The patient was restrained on the bed in the back of the ambulance, shouting about whatever he was shouting about, and my partner got himself a glass ampule of Haldol. He struggled for a few moments trying to find a 4x4 gauze pad, finally found one, and used the 4x4 to break the amp.

Justin Urgitis [CC-BY-SA-2.5], via Wikimedia Commons

I may have rolled my eyes. 

In drawing up the medication from the amp to the syringe, the medication spilled, so the whole process needed to be restarted. I told the trainee to just let me do it.

I explained in my most authoritative field trainer voice that the 4x4-wrapping-the-amp technique was taught to me in paramedic school too, but it is a waste of time. In almost 20 years of EMSing, I’ve never had an amp shatter and cut me. Just tap the medication out of the top half and break the amp. Like this.

Snap.

Except it wasn’t really a snap sound. It was more of a crunch sound. The top half of the amp shattered. About a quarter of the glass shards fell into the medication and another quarter fell on the floor. The remaining half of the glass shards were embedded in my now-bleeding thumb.

Dammit! Why must the EMS gods punish me whenever I confidently say something out loud?!?

I have to give my partner credit. Most other medics would still be laughing and talking shit.

*Personally, I slightly prefer droperidol-type help in calming down.  But apparently, it is impossible to get for reasons that are confusing to everyone. Either droperidol or Haldol is better than an 80kg dose of Brutacaine per police, though.