Something here is not quite right.

I'm sure you all know that feeling where things just aren't adding up and you can just tell that something about the situation is not quite right.  We get that quite often actually, and this recent call was no exception.

We were responding to a call for a man in his mid to late 60's who had fallen and possibly had a head injury.  This is pretty much the typical in my district so I really wasn't in the mindset of expecting what we actually got.  But from the moment we pulled up on scene it became apparent that this was not going to be typical.  As I pulled the engine up to the address I saw a young woman crouched in the driveway who appeared to be (or at least had been) crying and who was just staring out at the street.  I stopped the rig, turned off the lights, got out, opened the back door and grabbed some medical gear and she had not moved or spoken to us.  Tip #1 something is not quite right. We often get incorrect patient ages or genders on dispatch so my first thought was wondering if she was the injured party.  As I grabbed some additional gear from another compartment I called out to her, "What happened?".  She said, "I don't know".  Tip #2.  As we approached her she got up and started leading us around the back of the house to a small guest room addition in the backyard.  She stopped short of going in, pointed, and said what I thought was, "He's in the bedroom".  She didn't lead the way or go a step further.  Big Tip #3.  There was obviously something going on here besides an elderly slip and fall.

As I, cautiously, entered the room I looked around for where the bedroom might be and off to the side I saw, in the 'bathroom', my patient.  Much like my previous code blue, he was slumped on the floor having fallen forward from off the toilet with a pool of blood around his head.  He was not moving in the slightest and I knew right away what all those signs had been pointing to.  He was face down but it was obvious he was not breathing and when I touched him he was cool and had pronounced rigor mortis.  He had been there for awhile.  I notified the captain that this would be a coroners case and got out my monitor.  I documented that the patient was asystolic (flat line) in all three leads, covered the body, and marked a time of death.

My captain had had the same sense that things were off when we arrived and had stayed with the young woman which was a good thing because she was, rightfully, distraught.  We made the proper notifications and did our best to console the family, more had shown up by that time.  PD arrived and we turned the scene over to them and went home to do the paperwork.

Intuition is a pretty powerful thing and should probably be listened to a lot more than we do.  Fortunately there was no danger to us in this situation but it is a good lesson in paying attention to your environment, the people around you, and trusting your instincts.