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Original Contribution

When COVID-19 Hits Home: An Invisible Enemy

EMS World is asking first responders and healthcare workers who have been diagnosed with COVID-19 to talk about their experiences battling the virus. If you or someone you know in the field has a story to share, email us at editor@emsworld.com. Your story will remain anonymous if you so choose. 

Here is one EMS provider's account.

Wednesday last week: We had an incident with the hospital not sharing that the transfer was a COVID-19 patient. En route to the receiving facility, the patient became flaccid and was assessed for airway stability. At this time, regretfully, I didn’t have any PPE on besides gloves. The patient started bucking and coughing with snoring respirations. We maintained the airway manually and placed high-flow oxygen. On arriving at the receiving facility, we were asked why we were not wearing N95s or isolation gowns. We explained we were not informed of the patient's condition regrading the infection. 


Friday: I started having a mild cough after cleaning the house.

Saturday: I developed a fever ranging from 100.9ºF–102.4ºF.

Sunday: I continued to have a fever of 100ºF–101.9ºF while on Tylenol. The cough was becoming worse, and I had severe dyspnea on moving. At this point I brought myself to the emergency department and was put in isolation. I tested negative for flu and viral panel. I then was tested for COVID-19. I was also given 500 mg of azithromycin for upper lobe bilateral ground glass findings on x-ray. I was then discharged to self-quarantine at home per my physician. 

Monday: The dyspnea became worse, and my roommate and husband said I became altered. I was at this point unable to keep food or drinks in my system. My pulse went to the 180s for approximately 45 minutes. We called 9-1-1. I was given oxygen for hypoxia of 88% on room air. I was transported by EMS to the emergency department for evaluation and treatment. I was put into resuscitation, where they were unable to get my pulse down for five hours. My lab results were: potassium 2.1, low magnesium, and phosphate 0.5. I was admitted to the ICU, where they started IV electrolyte replacement.

Tuesday: I was in the ICU all day. I received numerous bags of phosphate, magnesium, and potassium. I was also given IV fluid boluses. My daily cardiac medications were withheld due to hypotension. 

Wednesday: At approximately 10 a.m., I was discharged from ICU to medical surgery isolation. I was taken off oxygen at this time. Around 3 p.m. I was discharged from hospital to home isolation again. My respiratory status improved, and my labs were within normal limits. I was afebrile but still had a cough, slight cramping, and lethargy.

Thursday: I started taking my cardiac medications again. I was still very tired and coughing but no longer getting winded when I moved around a lot. I was able to keep fluids and food in at this point.  

Friday: I woke up with a nonproductive cough and a temperature of 99.5ºF and also having palpitations. Vitals were otherwise still stable. I was prescribed Diflucan for thrush brought on by the azithromycin.

Saturday: Woke up around 2 a.m. to chills and nausea. I started profusely vomiting at this point. This lasted till around 5:30 in the morning. The world was spinning at this point. I was also becoming very, very weak, to the point that I got tired during daily tasks. My temperature on Tylenol was 100.2ºF.

Sunday: The body aches began getting better. I still had diarrhea and was still very weak at this time. A mild fever persisted on Tylenol. I have a doctor appointment for ICU discharge follow-up tomorrow morning.

Sunday p.m.: I began to feel a little less nauseous. I took 100 mg of pegademase bovine, 4 mg of Zofran, and 8 mg of Imodium.

Monday: I woke up feeling a little better. Had appointment with the doctor—she was impressed with my progress. Also had an appointment with a PA from dermatology. I was placed back on prednisone.

Monday p.m.: I was watching a movie with my husband and roommate. At this time I had a near-syncope. My roommate and husband assessed me: BP was 203/152, pulse in 160s to 180s. I took labetalol, and they drove me to the emergency room. I was found to be afebrile in the ER triage. Once at the ER I got more labetalol. Labs came back normal with exception of slightly elevated white blood count. X-rays showed improvement in lungs, less gunk in them. After being monitored for a few hours, I was sent home POV.

Tuesday: I woke up Tuesday morning with slight cough but no other symptoms. I was afebrile without Tylenol. I was feeling a little stir crazy, having been in isolation for so long. I was excited to be almost off quarantine. Vitals were within my baseline at this time. Also, at the recommendation of my doctor, we upped the labetalol from once a day to twice. In the afternoon my blood glucose was 259.

Wednesday: I couldn't sleep, but I felt amazing. I had a little vertigo but otherwise felt normal. I went several hours without coughing and have been afebrile since Monday.

Final update: As of Thursday I’ve been cleared from isolation and return to duty on the ambulance tomorrow, Saturday the 4th. 

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