An Ordinary Day until.....Bees

In the time that it takes to text someone, pet your dog, or order a great meal at a local restaurant, something went very wrong. An ordinary day veered sideways and I was no longer on a relaxing vacation. I was working to save someone’s life.

I’m a paramedic. I come prepared. I had just spent a month traveling in Mongolia. I brought a large medic kit complete with I.V. solution, needles, medicine for nausea and vomiting (Montezuma’s revenge). I have a suture kit and a dental emergency kit. There is nothing worse than being a paramedic and not having the tools of the trade at my disposal.

So after a month-long trip, I headed to my favorite place, Lake Tahoe. Traveling in the 3rd world is both exciting...and hard work. I was looking forward to spending two weeks driving paved roads, drinking water from the tap, and breathing in fresh, clean air. In other words, I wasn’t thinking about life-threatening danger. I was on vacation.

As part of the vacation, I brought with me a young twenty-four-year-old man from Morocco, Palamino. He was living with us for six months as part of an environmental leadership training internship with Earthcorps.org out of Seattle.

We arrived late on Thursday. Friday afternoon we headed out for a short ride from our house on River Drive down the Upper Truckee River meadow towards the lake. This was a quick ride and I didn’t bring any of my emergency medicines with me thinking we’d be out and back in no time. It is a flat ride and would help us acclimate to the elevation change before taking on some of Tahoe’s mountain rides. We rode from Highway 50 through an open meadow, along the meandering Truckee River. The trail went from well-tracked dirt to narrow trail lined in one-to-two foot deep grasses along the marshland towards the lake.

As the old saying goes. The first one woke them up, the second one pissed them off, and the third one got stung. Palamino, new to mountain biking and the area, was in the rear behind, me and my dog, Taz. He was the third one. I stopped and looked back to check his progress. I saw Palamino dancing, swatting himself, and trying to get out of his new clipless peddles. I thought he was having problems getting out of the new peddles and was twisting his ankle. Finally, he freed himself from the peddles and jumped off the bike. I yelled back at him asking him what was wrong. He yelled “BEES!" I said “RUN” and he did. Then I told him to go to the river and cool off the stings.

He came up to me and said he was stung multiple times and that it was so painful. I immediately asked him if he was allergic to bees. He said he had been stung two weeks prior on a backcountry trail in Washington state but only had some mild localized swelling. That triggered a concern that he could have allergy issues but I figured, most likely, this young man would be fine.

We headed out toward the river looking for a place to cross the confluence of the Truckee River and a side stream and head for the lake. The plan was to come back on a different route. We didn’t want to meet the bees again. Within 10 minutes of the initial stings, Palamino ran up to me complaining of a strange sensation in his face and itching all over his body. I had him lift up his shirt and there was the very real sign of red skin and the developing hives over his body. I immediately knew that he was having an allergic reaction to bees. I didn’t know how severe it would become but I knew we needed help.

Paddling up the river were two kayakers. One of the kayakers was in an open surf kayak. I waved them over as I dialed 911. I asked the man with the surf kayak if he could paddle Palamino over to the other side of the river near the Tahoe Keys housing development where I hoped the paramedics could get to him. It would work to direct the paramedics to him. He stepped up and loaded Palamino onto the kayak. The fear and confusion in Palamino’s face were so real. I had to comfort him, but more importantly, I had to get the life-saving help he needed.

In the meantime, I was trying to give 911 an idea of where we were located. I knew we were close to the Tahoe Keys Marina and possibly a trail from there but I knew we were farther towards the lake beyond the Marina. I worked to navigate them towards our location. Then I leashed my dog and pushed the two bikes towards the main Truckee River to cross it to the other side and meet up with Palamino. The wife of the man helping us transport Palamino was in the other kayak. I didn’t know how deep the river crossing was so I asked her to take my pack with my cell phone across by kayak and I would cross with my bike and my dog.

The kayaker got Palamino to the other side. I told Palamino to get up the bank and lay down. He needed to lay down because his blood pressure was probably dropping from the allergic reaction. He was redder and his eyes were swelling shut. I crossed the river and directed him to a place he could lay down. I checked his pulse. It was fast and weak which told me his blood pressure was most certainly dropping.

I was again on the phone with 911 working to get our location fixed. It was hard to direct them in. While I knew the general area, I didn’t know the specific access location and the cell connection was bad. Finally, I was able to tell them that we were on a wide sandy/dirt trail that hopefully came from the Tahoe Keys Marina and down towards the lake.

Palamino lay on the ground, looking more swollen and weaker. I knew he needed to get the epi-pen and Benadryl quickly. I was afraid he would die before help arrived. I kicked myself for being on “vacation” on a quick ride from the house and back. I felt helpless to give him the life-saving medications he needed but I also knew that what he needed was a well-orchestrated plan. Calm, cool, resourceful, and direct. I decided at this point I needed to ride up the trail and make sure that it came out at the Tahoe Keys Marina. I would meet the paramedics and direct them in. That was his only hope! Finally, with directions, the paramedics were able to find the trail. I met them and we came down the trail to our patient, Palamino.

When I left him, to direct the paramedics in, I had told him to hang on to my dog’s leash and not let him follow me. I needed to get the paramedics and lead them back to us. Taz, in his response to me leaving, actually pulled Palamino over from a semi-seated position to a laying position. Something I had been asking him to do to help with his loss of blood pressure from the allergic reaction. When I returned with the paramedics Palamino had a death grip on Taz’s leash and was laying flat. I had to pry it from his fingers.

“Palamino, the paramedics are here to help you,” I told him. "They will take good care of you." He was laying there with his eyes swollen shut laying listlessly on the ground. I was even more worried than I let him know. Time was running out.

I told the South Lake Tahoe paramedics that I was an off-duty paramedic and that he was having an allergic reaction and that he needed an epi-pen. They quickly evaluated him laying on the ground, loaded him onto their stretcher, started I.V.s, and administered Benadryl followed by epi. I felt comfortable enough with their response that I could step back and let them care for him. Something that is hard to do for any paramedic but it wasn’t my turf. I had to trust that they would take good care of him.

The local police had also responded. The police officer offered to shuttle one of my bikes back to the River House. I was relieved. I was trying to figure out where I could stash a bike and come back for it later. I retrieved the bike from across the river and handed it off to him to put on the back porch. At that point, Palamino was in good hands and the bike was taken care of. I headed home to drop of Taz and the bike before driving to the hospital which was a mile from the house. It seemed strange to not be the person in the back of the medic unit, instead, I was the patient’s friend pulling all the pieces back together and driving myself to the hospital. Now I understood what it meant to be the bystander.

I arrived at the hospital. I checked in and was directed back to the room Palamino was in. He was laying there like a zombie. Breathing but not moving. He had gotten two doses of epinephrine en route and another epinephrine drip in the ER. The nurse said they were about a minute from intubating (putting a breathing tube down his airway) him when he arrived. He showed me the ET (endotracheal tube) tube holder slung behind Palamino’s neck to let me know how seriously they had considered his condition. Luckily he didn’t need to be intubated and thankfully they were ready in case he did.

I touched Palamino’s arm and asked him how he was doing? “Better. They told me that I nearly died,” he said. “Can you believe that bees nearly killed me?” Yes, I could actually. I’d seen it many times before.

I watched as they took care of him. Trying to be the paramedic, the American mother, and the teacher. I had to wait. It was a difficult place to be in. I had to wait for emergency professionals, medication, time, and nature to take its course. I talked to his nurse who told me it was a very bad year for Yellow Jackets and there had been a couple of fatalities from stings this year in South Lake Tahoe. Everyone was on high alert.

Palamino received great care in the emergency room and was admitted to the ICU for the night to be monitored. I accompanied him up to the ICU and then left him in good hands. He came home the next morning and was feeling better. We even went to the beautiful Tahoe beach. An experience that he wouldn’t have experienced if everything hadn’t fallen into place for him to get the life-saving treatment he needed.

This year the bees and yellow jackets have been bad here in Tahoe and in other areas. If you are allergic to bees it is important to have an epi-pen (epinephrine) with you. As emergency responders, we can’t always reach you in time depending on your location. In Palamino’s case, he didn’t know he was allergic. In that case, you can’t plan for those things but having a map, cell phone, and a good idea of where you are is a good start to getting the emergency help you need. Also, you can carry over the counter Benadryl with you which will buy you some time. Be safe and don’t expect any day to be ordinary. But with that said get out and enjoy life. You only have today!

I’d like to thank the South Lake Tahoe paramedics and firefighters along with the Eldorado police officer who did an outstanding job of finding us and delivering life-saving treatment to Palamino. I’d also like to thank the Barton h=Hospital staff who took great care of him as well.

This story is by Lisa Parsons. She said, "It is a pretty bad year for bees and yellow jackets this year. I had an experience a few years ago when we had the same conditions. This is the story about the near-death experience of a young man who was stung by bees while mt. Biking in Tahoe. I thought it might be of use to educate and warn people about this very real danger."

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