15 January 2007

Best & worst

Reverse 24h shift this weekend (1700 Saturday to 1700 Sunday) and here's the best and the worst...

Worst: Dispatched to police booking area for "facial injuries". 21 year old male slumped in the corner, cuffed to the bench, clearly involved in a fight. His also arrested "friend" yapping very loudly a mile a minute, interfering with care, threatening police and other prisoners, and generally being very annoying. Patient wakes up to talk to me and decides to go to the hospital. Injuries include a probably broken nose, which he claims is not new today, and some abrasions and lacerations on the right side of his face, a good guess would be a little road rash from hitting the pavement either during the fight or while he was resisting arrest. One of the cops asks if he really needs to go, and unfortunately, no he doesn't really need to go but the cop and I would both be liable for not taking him since he asked to go.

Pretty much the kid was suffering from "incarceritis" and his friend kept telling him if he went to the hospital he wouldn't spend the night in jail, which is actually a lie because if there isn't anything the hospital needs to keep him for they'll turn him right back to the police. We get him on the stretcher and go, with police in the ambulance rather than just in tow. In a less than 2 mile transport, the kid managed to vomit on the floor over and over - including just about hitting the cop, get blood on the bench seat and generally make me want to just open the doors and push him out when we got to the hospital. I do believe it was possible to become intoxicated just from the alcohol fumes wafting up from the vomit river.

Once in the hospital, staff is trying to decide where to stash him and he decides to lean over and spit on their floor. Not vomit, spit. A completely voluntary gesture he could've controlled. Not a good way to make friends your first 10 seconds in the door. We're finally rid of him and then we get to decon the ambulance. I'm just going to tell you now that no amount of cleaning solution will remove the smell of vomit. I was working that ambulance for 17 hours after that kid was in it and it still smelled enough of vomit that when we'd open the doors, the FFs would ask what the hell happened to our truck. Four separate applications of Febreeze, two complete moppings of the floor, and still the smell gagged people who hadn't been sitting in it for several hours. So, worst call of the shift strictly on the lingering smell.

Best call: Dispatched alpha response (no lights and siren) for injuries from a fall. 70's female sitting in her rocking chair with her right leg elevated. Pt explains she injured her leg when she tripped on her nebulizer, sitting on the floor, and ran into something. She has just started prednisone, a steroid which can cause major swelling, so her ankles are quite swollen. After removing the band-aid her daughter had applied, we find a 2" wide by 3" long area where the skin is really more peeled back than cut. She isn't really bleeding, but oozing fluid. She's very nice and doesn't want to be any trouble so she wants us to decide whether she needs to go to the hospital. Common agreement between us and her daughter is yes, she should go. Tight quarters in the house mean we have to take her out in the stair chair and then onto the stretcher outside, where it is raining and icy. Everything goes smoothly and we get her into the ambulance and warmed up. I ride with her to the hospital and have a wonderful time chatting with her.

At the hospital, they are just opening up the rooms on the back side of the ER where they usually put the less critical patients like this and she's going to have the attention of a nurse all to herself for a little while since there isn't anybody else back there. She repeatedly thanks us for being so nice to her and helping out and apologizes for taking up our time. I try to make sure she knows that we were happy to help and glad she called. Great call for me because it leaves the good feelings about helping someone, but also because contrary to the too common scenario, I got to see a situation where an ailing family member was able to live at home with caring relatives looking out for her, where everything seemed as safe as they could make it, and where I was able to make a difference for the patient just by doing my job.

1 comment:

Hank said...

The engine is about to go up for paramedic blogs and it will replace the static HTML links that are there now. We will go into beta in February and people can begin hosting their sites in the community.

What is the general term that you prefer to use today that covers paramedics,EMT, EMS, medics,tactical medical,firefighters, etc and everyone else who saves lives in this field? When I was younger, even paramedics were new so everyone was called a paramedic.

The site will have categories for each but it will be for rescue personnel and I don't want to sound too exclusive in the title.

Hank

http://www.paramedicblogs.com