Edited 5/21: I try and de-identify calls as much as possible, but I'm not sure I did a good enough job the first time, so I've trimmed this one down a bit...
I've come to believe that bad calls don't just stick to individual EMTs, but to trucks too. Lately, my truck has become the ambulance OF DOOM. If this truck shows up, you are in deep trouble. Rollover accident ends up with C-spine fracture. Gunshot to the head ends up as not quite dead yet with EMTs trying to save your life. Chest pain ends up being something serious, heart attack, broken ribs with lung laceration. Difficulty breathing ends up with an intubated patient (or two). Thankfully, not all of these are my calls, but enough that I'm probably on a downhill slide for crappy calls too.
The latest fun was an overdose dispatch which actually said multiple patients were involved, and they still only dispatched 1 ambulance and 1 engine. We brought the stretcher, O2 and first-in bag up with us to the fourth floor, FD brought their oxygen. A cardiac arrest and an unresponsive patient in a tiny bedroom where most available area is taken up by the bed and dresser. Everyone in sight denying drug use, everyone having mysterious matching puncture wounds in their arms. Nobody brought up a defibrillator or cardiac monitor and no first-line cardiac arrest drugs were available upstairs either, pretty much a worst case scenario for patient care.
After the giant hassle of getting the unresponsive patient out of the room, I head out with the paramedic from the second ambulance (because the unresponsive patient was mine) and leave the second EMT with my partner. Stretcher doesn't fit in the elevator, so we have to stand the backboard up and I take a second elevator with the stretcher and meet up downstairs. We head to the more distant hospital, my partner heads to the closer hospital in town.
Cardiac arrest patient died. Unresponsive patient woke up with some Narcan. Nobody was willing to discuss what had caused the mysterious wounds and PD is following up.
21 May 2009
17 May 2009
Letter
Dear Brain,
I would like to place a request for improved coordination between the eyes and the hands. Softball is not an especially dangerous sport, but when the hands and eyes don't work well together, other body parts suffer. Obviously, the feet and legs are listening well as they moved directly into the path of the oncoming ball, but somehow the glove just didn't get there. I don't appreciate this large painful bruise, despite all the lovely colors it adds to the normally pasty white area.
Sincerely,
Left Thigh
I would like to place a request for improved coordination between the eyes and the hands. Softball is not an especially dangerous sport, but when the hands and eyes don't work well together, other body parts suffer. Obviously, the feet and legs are listening well as they moved directly into the path of the oncoming ball, but somehow the glove just didn't get there. I don't appreciate this large painful bruise, despite all the lovely colors it adds to the normally pasty white area.
Sincerely,
Left Thigh
11 May 2009
More boring waiting
Even now that I'm finally admitted to school, I am still waiting. August can't come soon enough. I'm just trying to grit my teeth through May and June because I think there will be plenty to do throughout July to get ready/moved/relaxed. There are still some open-ended questions about how my housing situation will work out, thankfully it is a situation with a couple of workable options instead of one with no solution.
I'm also in the market for a laptop and I know just enough about computers to know that I don't really need a high-end machine but I don't want one that will be completely outdated for new software before I'm done with school. Financial aid includes a "computer allowance", but I'm not really planning to wait until the money from the guv'ment comes in to buy a new machine. I've never run any version of Vista, anybody got suggestions/short cuts/useful tips?
I'll try and think of something interesting to write about soon...
I'm also in the market for a laptop and I know just enough about computers to know that I don't really need a high-end machine but I don't want one that will be completely outdated for new software before I'm done with school. Financial aid includes a "computer allowance", but I'm not really planning to wait until the money from the guv'ment comes in to buy a new machine. I've never run any version of Vista, anybody got suggestions/short cuts/useful tips?
I'll try and think of something interesting to write about soon...
04 May 2009
Redeeming night
So many ambulance shifts consist of nonsense after idiocy after dumb-assery, every now and then one comes along which make me feel a little better about the job. Not that the individuals involved are any different than the usual suspects, just that they actually needed an ambulance.
This particular night started with a lift assist for an older gentleman who was stuck between his rocking chair and dining table. His family had been unable to help him up, but we were able to get him situated and on with his evening. Next call was for an unresponsive person on the sidewalk, turned out to be someone we've picked up before, alcohol and unknown medication overdose. He woke up a little on the way and we liberated two fifths of vodka from him. Always good fun when the crowd is catcalling both us and the patient as we're trying to get him off the street. Next call was pure stupidity, the eventual solution was that the woman needed more instruction with her crutches and a more explicit explanation that a "fractured" foot meant it was probably going to develop bruises in a couple of days.
Then the fun starts, dispatch for a roll-over accident on the highway. Car is on it's driver's side, patient halfway out the window with her neck and shoulder supporting her weight and screaming loudly about her neck pain. After more than 25 minutes of playing with their toys, the fire department was able to get her out of the car and onto a backboard. (All I'm going to say is that to a man with a hammer, everything looks like a nail!) She had some periods of unconsciousness and when she was awake she was screaming and complaining. At the hospital, she got a quick dose of "be quiet" involving Haldol, Morphine and Ativan. She turned out to have a cervical spine fracture, a skull fracture and a lung contusion and got shipped out to a higher level facility pretty quickly.
Next dispatch is for a car in the median on the highway. The car was found by another group driving by, no information on how fast it was going, or even which way it had been going on the highway. When we get there, the patient is laying outside the car on the ground, unresponsive, each eye twitching a different direction. A quick transport to the hospital and she earns a helicopter trip to a trauma center in the big city. All in all, a night where 80% of the calls were legitimate and I feel like did something useful.
This particular night started with a lift assist for an older gentleman who was stuck between his rocking chair and dining table. His family had been unable to help him up, but we were able to get him situated and on with his evening. Next call was for an unresponsive person on the sidewalk, turned out to be someone we've picked up before, alcohol and unknown medication overdose. He woke up a little on the way and we liberated two fifths of vodka from him. Always good fun when the crowd is catcalling both us and the patient as we're trying to get him off the street. Next call was pure stupidity, the eventual solution was that the woman needed more instruction with her crutches and a more explicit explanation that a "fractured" foot meant it was probably going to develop bruises in a couple of days.
Then the fun starts, dispatch for a roll-over accident on the highway. Car is on it's driver's side, patient halfway out the window with her neck and shoulder supporting her weight and screaming loudly about her neck pain. After more than 25 minutes of playing with their toys, the fire department was able to get her out of the car and onto a backboard. (All I'm going to say is that to a man with a hammer, everything looks like a nail!) She had some periods of unconsciousness and when she was awake she was screaming and complaining. At the hospital, she got a quick dose of "be quiet" involving Haldol, Morphine and Ativan. She turned out to have a cervical spine fracture, a skull fracture and a lung contusion and got shipped out to a higher level facility pretty quickly.
Next dispatch is for a car in the median on the highway. The car was found by another group driving by, no information on how fast it was going, or even which way it had been going on the highway. When we get there, the patient is laying outside the car on the ground, unresponsive, each eye twitching a different direction. A quick transport to the hospital and she earns a helicopter trip to a trauma center in the big city. All in all, a night where 80% of the calls were legitimate and I feel like did something useful.
22 April 2009
Remembrance
Suicide brings up a lot of emotions in me, many I can't even name or describe through the general turmoil of my thoughts. Ultimately, the person who dies leaves everyone else to sort through the wreckage for meaning and the strength to go on. The recent suicide of a co-worker has brought on memories and questions.
TP started at the north station as an EMT-Basic, working on a transfer truck with a woman who was full of laughter and emotion. He often appeared shocked by the openness many of us brought to the station, sharing details of lives, loves, disappointments and desires. I attributed this to his younger age and general inexperience, never thinking about the type of broader experiences that might make a man reluctant to share, hesitant to open his heart. Over time, he became accustomed to the rest of us and began to join in our laughter and the general teasing that goes on in the station, if not our sharing.
He shared only a very small portion of his outside life with us, frequently deflecting questions about his family, his life or goals. He would often answer something non-committal, "Whatever you say," or just "Sure." It took me a very long time to learn that he lived a couple towns over in an apartment, no family or roommates. When he moved into a new place, it was months until I figured it out based on the few clues which came up in conversation. The one thing everyone knew was his dedication to EMS. He completed his EMT-Intermediate and was excited to do more for his patients and the services he worked for. He worked for pretty much every company or municipality in the area at one point or another, frequently for a hundred hours or more a week. If you needed a shift off, TP was always available for more work.
We noticed a change in him when he was dating more seriously. Instead of 90 hours a week, he'd cut back to 70. He took a fair amount of ribbing and pointed questioning about which woman was equal to all the fine company he had at the station. A girlfriend, or maybe two, came and went, the only noticeable change being the number of hours you could find him at the station. He began training for the 2008 EMS Memorial Bike Ride, riding to work, losing weight and generally living a healthy lifestyle. He asked for, and received, donations from his co-workers, some of us learning for the first time about this organized effort to recognize line of duty deaths for EMS workers as distinct from the Fire service. He returned a changed man. I didn't realize the extent of the change at first, but he was more focused on his profession and improving his skills. Station gossip went from substantial issues to petty complaints, a sure sign of improvement. Eventually, we found out that he also returned with a new woman in his life and he seemed quite happy for at least 8 or 9 months.
Two weeks ago, he seemed to shut down. With his history of withholding personal details, I didn't directly ask what was going on but tried to show concern. Every "How are you doing?" was met with a "Fine," or some other answer to turn us away. The station environment being what it is, we eventually got around to teasing him about his girlfriend, with someone piping in "What's wrong, did your woman dump you?" He got up and left the room. Several of us followed up with him that night and in the following couple of days to express our concern for him. He still turned us away. The next week, he seemed to be feeling better. Not quite back to his normal self, but able to smile a little and willing to interact again at the station and back to working a ridiculous number of hours. And then, he was gone.
His sudden death leaves a hole in our station. We all feel it, friends or not, and we grieve his loss. I'm working through my own emotions about the scenario, to order and organize my thoughts and feelings, to place this shocking event in a larger context, but it is not easy work. Services are being held Friday, I'm hoping a larger gathering of colleagues and friends will help me recover.
TP started at the north station as an EMT-Basic, working on a transfer truck with a woman who was full of laughter and emotion. He often appeared shocked by the openness many of us brought to the station, sharing details of lives, loves, disappointments and desires. I attributed this to his younger age and general inexperience, never thinking about the type of broader experiences that might make a man reluctant to share, hesitant to open his heart. Over time, he became accustomed to the rest of us and began to join in our laughter and the general teasing that goes on in the station, if not our sharing.
He shared only a very small portion of his outside life with us, frequently deflecting questions about his family, his life or goals. He would often answer something non-committal, "Whatever you say," or just "Sure." It took me a very long time to learn that he lived a couple towns over in an apartment, no family or roommates. When he moved into a new place, it was months until I figured it out based on the few clues which came up in conversation. The one thing everyone knew was his dedication to EMS. He completed his EMT-Intermediate and was excited to do more for his patients and the services he worked for. He worked for pretty much every company or municipality in the area at one point or another, frequently for a hundred hours or more a week. If you needed a shift off, TP was always available for more work.
We noticed a change in him when he was dating more seriously. Instead of 90 hours a week, he'd cut back to 70. He took a fair amount of ribbing and pointed questioning about which woman was equal to all the fine company he had at the station. A girlfriend, or maybe two, came and went, the only noticeable change being the number of hours you could find him at the station. He began training for the 2008 EMS Memorial Bike Ride, riding to work, losing weight and generally living a healthy lifestyle. He asked for, and received, donations from his co-workers, some of us learning for the first time about this organized effort to recognize line of duty deaths for EMS workers as distinct from the Fire service. He returned a changed man. I didn't realize the extent of the change at first, but he was more focused on his profession and improving his skills. Station gossip went from substantial issues to petty complaints, a sure sign of improvement. Eventually, we found out that he also returned with a new woman in his life and he seemed quite happy for at least 8 or 9 months.
Two weeks ago, he seemed to shut down. With his history of withholding personal details, I didn't directly ask what was going on but tried to show concern. Every "How are you doing?" was met with a "Fine," or some other answer to turn us away. The station environment being what it is, we eventually got around to teasing him about his girlfriend, with someone piping in "What's wrong, did your woman dump you?" He got up and left the room. Several of us followed up with him that night and in the following couple of days to express our concern for him. He still turned us away. The next week, he seemed to be feeling better. Not quite back to his normal self, but able to smile a little and willing to interact again at the station and back to working a ridiculous number of hours. And then, he was gone.
His sudden death leaves a hole in our station. We all feel it, friends or not, and we grieve his loss. I'm working through my own emotions about the scenario, to order and organize my thoughts and feelings, to place this shocking event in a larger context, but it is not easy work. Services are being held Friday, I'm hoping a larger gathering of colleagues and friends will help me recover.
13 April 2009
Drat!
Okay, that isn't the four-letter word I used upon opening my email this afternoon, but you get the drift. The school I've been waiting to hear from sent me the wait list letter again, for the third year in a row. I've been hoping for an end to the uncertainty, but apparently that is not going to happen. I don't really understand their wait list process but I can tell you that it hasn't favored me in the last two years, so I'm pretty disappointed in that outcome.
Maybe the new mattress will help me sleep away some of my sadness, sure wish I had it today instead of in two weeks...
Maybe the new mattress will help me sleep away some of my sadness, sure wish I had it today instead of in two weeks...
01 April 2009
Things I never expected to say
To a woman who had just left a snot trail on my shoulder while sobbing, "Don't worry about it. If that's the worst thing on my shirt by the end of shift, it will be a good day."
23 March 2009
History taking
Sometimes, the things that happen just before the ambulance gets on scene are important. I've been on calls where the patient was moved and it takes 10 minutes to get the story straight because a patient laying in the middle of a big bed should not have a softball-size lump on his head from falling "right there", or "I took that pill the doctor gave me" turns into a 20 minute search for pill bottles and a game of 20 questions which never get me to the mystery pill (remind me to tell you that story sometime).
This call was memorable because as the first ambulance on scene, I got some of the information that the second ambulance didn't have and didn't think to ask for. Responding for a "sick person" call, arrive to find a middle-age woman very upset and pointing us to the living room where there is not 1 but 2 elderly folks in a state of disarray. The female pt had clothes on, sitting on the floor propped up against the couch; the male pt was laying on his back on the floor with a shirt and no other clothes. The room looked like a tornado had hit with model cars and trucks scattered about, the coffee table in pieces on the couch, a recliner on its side, and various other items strewn about. After the Asian and I split up and each assessed a patient, it was clear they both needed transport to the hospital and we called for a second ambulance.
While waiting for the second ambulance to arrive, the FD helped us do a spinal assessment and get both patients dressed enough to head out of the house. On arrival of the second crew, I try to give them a brief idea of what we know, including the male patient's medical history, vital signs and medication list. What they didn't ask, and I didn't think to tell, was the little detail of what we had done for the patient - getting him dressed and seated back in the recliner. We took both patients to the same hospital and made sure social services got involved with possibly placing them in assisted care because their needs were outpacing their family's ability to care for them.
Later in the day, I checked in with the other crew to find out how their patient was. "You'll never believe this! When the hospital stripped him down to put on a gown, they found a model truck in his ass!" Followed by the second crew member, "I don't even want to think about what those old people were doing!" I could have let this stand, after all where the truck was or why doesn't really make any difference, but I felt bad to have the patient get a reputation for something he wasn't doing, "Well, he could have fallen on it, there were a lot of models on the floor." Other crew, "No way! He was wearing pants." "Well, not when we got there he wasn't. We figured he'd probably want pants for the trip." The other crew appeared disappointed, but they'll probably still tell the story of the elderly gent with a truck up his butt and maybe we'll all remember to seek more details.
This call was memorable because as the first ambulance on scene, I got some of the information that the second ambulance didn't have and didn't think to ask for. Responding for a "sick person" call, arrive to find a middle-age woman very upset and pointing us to the living room where there is not 1 but 2 elderly folks in a state of disarray. The female pt had clothes on, sitting on the floor propped up against the couch; the male pt was laying on his back on the floor with a shirt and no other clothes. The room looked like a tornado had hit with model cars and trucks scattered about, the coffee table in pieces on the couch, a recliner on its side, and various other items strewn about. After the Asian and I split up and each assessed a patient, it was clear they both needed transport to the hospital and we called for a second ambulance.
While waiting for the second ambulance to arrive, the FD helped us do a spinal assessment and get both patients dressed enough to head out of the house. On arrival of the second crew, I try to give them a brief idea of what we know, including the male patient's medical history, vital signs and medication list. What they didn't ask, and I didn't think to tell, was the little detail of what we had done for the patient - getting him dressed and seated back in the recliner. We took both patients to the same hospital and made sure social services got involved with possibly placing them in assisted care because their needs were outpacing their family's ability to care for them.
Later in the day, I checked in with the other crew to find out how their patient was. "You'll never believe this! When the hospital stripped him down to put on a gown, they found a model truck in his ass!" Followed by the second crew member, "I don't even want to think about what those old people were doing!" I could have let this stand, after all where the truck was or why doesn't really make any difference, but I felt bad to have the patient get a reputation for something he wasn't doing, "Well, he could have fallen on it, there were a lot of models on the floor." Other crew, "No way! He was wearing pants." "Well, not when we got there he wasn't. We figured he'd probably want pants for the trip." The other crew appeared disappointed, but they'll probably still tell the story of the elderly gent with a truck up his butt and maybe we'll all remember to seek more details.