09 August 2006

Class ride time, day 2

Somehow I managed to schedule my first two days of ride time very close together, so I got day 2 out of the way yesterday. The first day didn't seem to exciting, but compared to the second day it was a thrill a minute. Yesterday there was not one "real" call. I went on 5 calls between the two trucks I managed to catch, and not one of them was anyone who actually needed an ambulance.

The first one was a "chest pain" dispatch. Cool, because I can get an IV and an EKG and maybe see something unusual. Or it could be that when we arrive on scene, we find a man in no apparent distress at all, complaining of 1/10 chest pain and telling us the last time he felt like this it was gastric (i.e. indigestion), but he makes sure to add "only an EKG can tell me for sure, so I'm going to the hospital." I've seen people having textbook heart attacks - they are gasping for air, are pale and sweaty and generally look awful, have severe pain to the point of being very vocal about it even though they can't breathe. Yes, not everyone has a textbook case, but I'm probably closer to having a heart attack than this guy was.

Hooked up to the monitor, he had a pulse of 54. Normal is 60-100 and heart attacks are usually higher because the heart is struggling to get more oxygen. 54. (insert eye roll here) Some meds can cause an unusually low rate, but he wasn't on any of them. I got an IV anyway and finally an EKG for my skills book, and we dropped him off at the hospital and when I was back with another patient less than an hour later, he had already been discharged. Any time you get out of the emergency department in less than 3 hours, they aren't busy and you aren't having a heart attack.

Other calls were for a police-initiated evaluation of "chest pain" in a prisoner (nothing going on, the patient didn't even want to go to the hospital - and every prisoner wants to go to the hospital just to get away from the police for a little while), an "ETOH problem", a "possible suicidal patient", and a "3 car motor vehicle accident" called in by one of the transfer ambulances as a minor fender bender with many occupants wandering around on the sidewalk.

When we arrived at the accident, the medic asked if everyone was okay and one woman started in with "Well, I think so, but my neck feels funny." She reported that it didn't really hurt, but when asked if she wanted to go to the hospital she said, "Yes, I think that would be good." Congratulations lady, you win a cervical collar, a backboard, and the annoyance of everyone near by who can see that you could've hurt yourself more by stubbing your toe. The accident was pretty much at the front door of the hospital, but we got to drive her around to the emergency department entrance. We hung out for a couple of minutes to see if the doc was going to get her off our board immediately, but she got the full workup and last I saw her was heading upstairs for xray. CYA (cover your ass) goes from good samaritans all the way to MDs because nobody wants to be responsible for somebody's back injury, so instead Medicaid just paid for an ambulance ride, an emergency visit, some xrays, probably some pain meds, and so on.

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