Buried Acorns and other nuts

So we get the call to meet the inbound ambulance. I was mobile and pull into the ambulance bay. As I am getting out of the car I hear sirens coming closer, not unusual at a hospital. A black and white pulls up loud and kills his lights and siren, right at the door. This is unusual, as the busses usually shut off at the beginning of the driveway entrance and come in silent. So I figure this might be a bad one. The cop jumps out. I ask him what's coming in. He says "I got him in back, he has a plug in his throat." I figure airway obstruction and call for a stretcher. Cop pulls this old skinny dude with long gray hair out of the back. The dude is handcuffed. I ask "can you speak?" trying to determine if its partial obstruction and he can get air. Dude honks at me. Then I see the trach hole in his throat and I recognize him as an occasional flyer, usually ETOH, sometimes suicidal, a wife beater. Cop says he's drunk too and was combative in the cruiser. He had picked him up on a warrant and the guy started faking breathing problems on his way to booking. His BAL was in the 300 plus range.

The only problem we had with him all night was when he was in a room. We had restraints on the bed in case we needed them, but we didn't have to hook him up. He go up 4 hours later to pee and peed in a wastebasket in the hallway outside the room, then went back to bed in the wrong room, across the hall. Fortunately that bed wasn't already occupied. He also has been known in past visits to smoke cigarettes through his blow hole. Not a poster boy for wellness. Drain material.