Hospital Coordination With
Fire District Ambulance Crews
Posted January 24, 2010

On November 26, 2009, I had a very bad experience with the Penn Valley Fire Protection District while their ambulance took me to the hospital following a grand mal seizure. While I was still thrashing and unaware of my surroundings as they secured me to the ambulance bed, a paramedic improperly inserted an IV needle into the back of my left hand. By the time I arrived at the hospital and became aware of what had happened, the IV drip had swollen my hand to twice normal size and it was very painful. It is almost two months later and my hand is still swollen and purple, but much less so. It was about one month after the improper IV before the pain subsided enough for me to use the hand for light tasks.

I believe that the paramedic should not have inserted the IV needle when unsure of whether or not he could do it properly. I believe he should have been in contact with experts at the hospital for advice on what to do with a flailing patient, and that the hospital expert would have advised him NOT to insert the needle, but instead just proceed to get me to the hospital as quickly as possible.

I described this sequence of events to Chief Gene Vander Plaats and he replied that it was a life-saving protocol to insert an IV as quickly as possible, but did not address the issue that it was not possible to do it properly while I was flailing. 

Since neither Chief Vander Plaats nor I are experts in emergency care, I am writing this to Sierra Nevada Memorial Hospital in the hope that hospital experts will work with local fire districts to improve emergency IV protocol such that bad results as occurred on November 26, 2009 can be avoided in the future.

Here is my email exchange with Vander Plaats:

Sent: Monday, January 04, 2010 1:15 PM
Subject: Paramedic experience


I don't know who reads email at this address but this message is intended mainly for Chief Gene Vander Plaats.
My name is Herb Lindberg and I want to thank you for the fast response during a seizure I had on Thanksgiving morning. My son tells me your emergency crew was at our home (18388 Chaparral Drive) within 5 minutes of his 911 call on November 26, 2009.
However, my main reason for writing this message is to let you know about an improper IV insertion into the back of my hand and its severe consequences during the following month. I'm told I was still thrashing about while your crew got me settled onto the table in the emergency vehicle, so it's not surprising the paramedic missed the vein in my hand. My suggestion for future such situations is that it is better to forego an IV if there is any chance that it cannot be done properly. I explain why in the following.
I learned recently that my other son took the following pictures (among others) at the hospital:

The injuries in my nose area occurred during the seizure. The point to notice is my severely swollen left hand. The picture below shows the swelling better:

As time passed during the week following this incident, the underside of my left arm turned dark purple from internal bleeding (I'm on Coumadin to avoid a stroke). Both the hand and arm were very painful to the touch and throbbed with pain for almost 4 weeks. This arm injury was the most painful and debilitating part of my recovery from the seizure. Even today there is localized swelling about the size of a nickel and the hand is light purple and painful to the touch.
In conclusion, I want to repeat:
My suggestion for future such situations is that it is better to forego an IV if there is any chance that it cannot be done properly.
Thanks for reading this,
Herb Lindberg
18388 Chaparral Drive
Penn Valley, CA 95946
Phone: 530-432-5096

Here is his reply:

From: "Gene Vander Plaats" <>
To: "'Herb Lindberg'" <>
Cc: "Clayton Thomas" <>; "Don Wagner" <>
Sent: Tuesday, January 05, 2010 9:14 AM
Subject: RE: Paramedic experience

Mr. Lindberg:
First I want to thank you for your correspondence regarding your
interaction with our crews.  I'm glad to hear that you are now home and
I am going to review the circumstances surrounding your incident.  I
will also ask our Quality Assurance Coordinator to look at the chief
complaint, physical findings and treatment and make sure the treatment
protocols based on that information were followed.
In general let me say that, unless unusual circumstances exist, an
IV can be vitally important as a route to deliver medication in an emergency
situation.  Seizures can be considered a life threatening emergency and an
avenue to provide medication is essential.
Again, I do not have all the pertinent information on your incident
but I will ask the appropriate staff to review and respond to your e-mail.
Again, thanks for your e-mail.  Our goal is to provide our customers
with the highest level of service possible with our resources.
Please feel free to call me or e-mail me if you have any additional
questions or comments.  Our QA coordinator is back on duty Thursday and
Friday of this week and should be able to review and respond no later than
Saturday morning. 

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