Deadliest Catch has reached its halfway point for this year. The last episode of the king crab season aired tonight and we learn -- through his own words -- the fate of F/V Wizard deckhand Chris Scambler. In a phone call to Captain Keith Colburn, Chris relays that doctors don't know what's wrong with him. He is to be airlifted to a bigger hospital in order to diagnose him.
I suggest before they send him anywhere that the docs take a few minutes to review the footage. I believe once they do they'll come to the same conclusion I did: Chris was having a panic attack.
The problem stems from a doctor trying to diagnose a patient whose condition improves before the doctor gets a chance to see the signs. Chris started to get better as soon as he realized he was getting off the boat. One indicator of his improvement was his sudden urge to urinate before being hoisted into the helicopter. Folks in truly life threatening condition don't usually feel an urge to pee -- even if they need to.
In a case like this, the doctor will only know what is relayed by the caregivers who care for the patient before the doc. It's pretty simple if they recognize the signs and symptoms of hyperventilation syndrome:
- numbness and tingling to fingers, lips, fingers and toes
- muscle cramping in the hands and feet (carpal/pedal spasms)
- rapid breathing
- rapid pulse
- relatively normal blood pressure or slightly elevated
- normal levels of oxygen in the bloodstream as measured via pulse oximetry
By watching the show, it's clear that Chris was experiencing the first four signs and symptoms on the list. They don't show a blood pressure or a pulse oximeter reading, but I'd bet a crab pot that the rest of his vital signs fit the pattern.
My take on Chris's condition comes as a paramedic who's learned to recognize carpal pedal spasms -- an important point to make here. Not every medic has seen these and even when you run into it for the first time you often have to be educated on what it is you're seeing in order to understand. Plus, I recognize this pattern as indicating hyperventilation syndrome, so I would describe it that way to whomever was to receive the patient from me. Describing it correctly is of paramount importance when it comes to the doctor making the right diagnosis in the end.
In this case it's likely the Coast Guard helicopter had to rendezvous with a ground ambulance, which means the rescue swimmer handed the patient to another paramedic. Even if the rescue swimmer recognized the panic attack, the next paramedic might not.
Finally as Chris arrived at the emergency department with whichever paramedic brought him in, he most likely was doing much better. During the show Chris made multiple comments about how badly he wanted off the boat and off the Bering Sea. It's conceivable he would respond favorably as the cause of his condition got further behind him. There's a good chance what the doctor saw in the hospital looked a fair bit different than what we saw on TV a couple weeks ago.
I wish the crew could have recognized Chris's condition as an emotional response rather than a medical condition. They could have avoided putting so many lives at unnecessary risk to evacuate him. He needed to come off the deck or risk making a serious mistake, but I'm sure he could have survived just fine doing dishes in the galley until they made it back to port.
What's your take? I'd like to hear from other experienced caregivers. I'd especially like to hear from a Coast Guard rescue swimmer. Do you see hyperventilation syndrome very often?
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To me it looked like hypokalemia/potassium deficiency. I had a similar incident (though I was not sputtering as much as he did… granted no one tried to pour liquid down my throat while I was on my back) when my potassium was already low and then I was prescribed potassium depleting medications.
I was using an albuterol nebulizer treatment for a case of bronchitis (I have had asthma all my life and normally get bronchitis about once a year) and my hands went numb and started tingling and then they seized up and I could not move my arms from my elbows down. I was very calm because I figured I was just having a reaction to the albuterol (I had used two of my daughter’s vials since I couldn’t find mine so I figured I had too much albuterol or something) but the pharmacist told me to call an ambulance (I had to use my nose to dial the phone)
I arrived at the hospital and they checked my electrolytes when I told them all the medicine I was on and that I had a few drinks over the weekend and had gone on a run that morning (why I was using my albuterol when I got home), and my potassium levels were at 2.7. I was released a few hours later (after they have given me some K-Dur 20 and a prescription for it as well). My hands and arms finally relaxed about an hour into my ordeal.
When I saw this episode I immediately thought hypokalemia. He’s probably not taking care of himself like he should nutritionally and then all the deck hands seem to smoke. He also may have had low potassium to begin with and then he’s doing hard labor that he is not used to which is a great way to lose electrolytes.
Anyway, that was my guess. Hypokalemia.
99.9% hyperventilation, seen enough cases over the last 21 years. Even a Podunk hospital in BFE Alaska would be able to pull some labs, including potassium. My guess is we never find out the correct diagnosis. Could you imagine them admitting all the lives they put at risk just because of an anxiety attack, smh.
It was a seizure. He apparently had a family history of seizure disorders, that he did not know about. Not epilepsy, however. Also stress was an issue and aggravated the condition. So there ya go.
Clearly, it was NOT a seizure, even despite having a family history of this. He was NOT post-ictal as he was still conversing. He was also able to void on his own, not incontinent as many seizure patients are. I agree completely that he was hyperventilatory. I was glad that he received emergent care as I think he was also probably dehydrated, having not eaten or had anything to drink for several hours. Hopefully he has recovered completely and can pursue a career that is better suited for him. I give the captain credit for quick reaction and response, knowing that they are not medical experts and have to do what they think is best at the time. I’ve been a trauma/critical care nurse for more than 20 years and have seen this type of patient many, many times. I wish them all success, knowing it takes a special kind of human being to handle the Bering Sea!
@ Rod – My girlfriend ( 20 years Flight Medic/RN and NICU) and I (12 years SAR EMT) both immediately said the same thing! And your assessment as why the initial receiving hospital couldn’t make the diagnosis seems spot on.
I totally agree that this was a classic panic attack. The carpal spasms were another strong clue . I’m not surprised that the hospital found nothing.
Oh ya as soon as he became supposedly ill but still able to respond to flightr medic and sayin I HAVE TO PEE coherent as day not once but twicw,me and my girl both said he was full of crap and just wanted off the ship,only condition he was suffering from was chickenshititis,even when crewmates placed him on galley table he was holding his head up until they placed a pillow under his knuckle noggin,All he did was get a job he had no business doing,Chris ya should stick to working a fast food drive through
I have had panic attacks fro most of my life- I have NEVER been like Chris was- obviously, you have never had a panic attack or you wouldnt write something so clueless. Dr.’s usually say “panic attack” when they are not sure whats going on.
I am a layman and saw the curling of the hands and fingers along with his other symptoms and immediately told my husband it was a panic attack, that his adrenals were shutting his body down. It has happened to me out of the blue. I ended up in the ER thinking I was stroking as it affected just one side. It sucks to no end. Those who mock a person that gets these will one day eat their words. Many things, medical, emotional, environmental can trigger them and its not just cause you want off a stinkin boat.
The truth is a paramedicis not a doctor and is no position to diagnose. The shipcrew made the right call,have him evacuated and take him where he could be given proper care.Its better to assume the worst.They are not doctors and could not have known whether he was experiencing a panic attack or not. To ignore this would have been wrong.
I’ve occasionally had panic attacks due to social anxiety under certain conditions, but I had no idea they could be that extreme if that is indeed what happened. I usually experience them as a sort of deep, very painful stomache ache, combined with profound anxiety and desire to flee.
He was hyponatremic. That was my guess. He hadn’t been feeding himself properly, and seemed to be drinking enough. Working long days for a week or more, will sap you of your electrolytes. I remember him going to bed instead of eating one night. Not sure how often that happened, but I know he would eat if someone made something, but Chris was not what you would call a wiz in the kitchen.
Chris was totally faking it. He may have had an issue in the beginning, but clearly his condition got worse all of the sudden. As soon as the skipper came in with a panicky composure, that’s when Chris seemed to start playing the role of a victim! The crew did the right thing by contacting the CG. That’s obviously not something the skipper would want resting on his shoulders if the guy died. The having to pee issue, really? I worked SAR in the CG for 10 years and never once saw someone in that alleged condition need to stop for a pee break! He had a simple case of, I will get off this boat one way or another! Hehe!
Naomi is correct. I had the exact same episode this week. Low potassium, just had a work out and hadn’t been eating a lot or well all week because I was getting over a cold.
Lost all control of both arms and hands, trouble breathing and my blood pressure dropped.
Doctor gave me potassium tablets and said you are otherwise healthy.
Almost 10 years as an emergency nurse and paramedic, clear panic attack. Picked it from the start but the tetany was the give away. Classic symptoms as described.
It is definitely a shame that you couldn’t get a blood pressure or pulse oximeter reading, but you’re probably right.
I don’t know. The kid looked really gray. At first, I thought he was pulling a stunt to be able to go inside, but when they showed his face lying down, he looked sweaty, gray and clammy. It may have been a panic attack, but the captain definitely the the right thing.
i agree that it is not a seizure, my brother was epileptic and had gran map seizures and i also drove school buses for disabled people who had seizures and they were totally non coherant when they were seizing, they could not answer questions, could not have control over bodily functions like having to pee! My ex husband had an episode with the exact same symptoms and I took him to the ER, I was never allowed to go back but I found out later he was having some type of reaction to some type of illegal drug! I’m not saying this guy was taking drugs but the rest of it with the electrolytes and such makes sense!