Wow, its been a *really* long time since I've posted. I've been meaning to post for a while now but the photo business and life in general have been crazy busy. I did a shift swap yesterday so I could go to our annual family reunion. So, in order to go to the party (also a welcome home party for a cousin home from Afghanistan)... I had to work Mothers Day.
It was a non-stop shift from 12N to 1230 in the morning. Literally non-stop. No dinner. Bathroom breaks were envied. It was mostly for legitimate calls and 2.5 hrs of that time was on a 2-alarm apartment fire. That pretty much made it all bearable. My only prayer was to not have any cardiac arrests. Anytime anyone dies, it is a tragic thing for family. But for a child to lose a mother, or a mother to lose a child... on Mother's Day... the tragedy is compounded.
Unfortunately, it was something we became a part of. A family, whose mother was in hospice and had a DNR, called us out of panic when their mother passed. We stayed until PD arrived and while waiting learned that one daughter had just lost her 30-yr old son just a few months earlier. My first thought was, "Lord... she must be an amazingly strong woman for you to have given her this much to bear at one time."
I remembered back to my dear sweet grandmothers. I lost both my maternal and paternal grandmothers within 4 days of each other. On the afternoon of my maternal grandmother's funeral I went by to visit my other grandmother and brought her a strawberry milkshake, her favorite. We had a nice visit and I cried a bunch... she had suffered so many TIA's that her aphasia was extreme. Looking into the eyes of someone you love who knows what they want to say but it just wont come out is utterly heart-breaking. To this day it breaks my heart to have seen her such turmoil. But the smile on her face when I tipped the straw to her lips was beautiful. That night she died.
Our Mothers, our grandmothers, our great-grandmothers if we've been blessed to know them... they love us. Unconditionally. They nurture us, they kiss our heads when we ache, they hold us til the pain subsides, they laugh at our flimsy jokes, they bake last minute cupcakes and they run late-night poster board projects. They shape us into the women we become and the women we choose to have in our lives.
I hope you adequately conveyed to the special mothers in your life just how much they mean to you. How much you love them and how different your life would be if not for them. Without my Mom, I would not be where I am today. She has taught me how to cook like Julia Childs, laugh like Sally Field, what its like to have the grace of Audry Hepburn, and to love like nobodies business. I love you Mom!
Monday, May 10, 2010
Friday, November 13, 2009
CPR, Collapsed Lungs & Tour Guides
Well there is plenty to anecdote about yesterdays 24 hours. The usual 911 abusers are always there and when dispatch is rattling off the address my partner and I can always look at each other and know what we're in for.
We respond to our frequent flier who is a 25 yo kid who lives with his mom and sisters. He is a hypochondriac who is always afraid that if we don't rush him to the hospital he's gonna die. We haven't been to his house in a month or so, but the other 2 shifts have. We get there and he's complaining of a cough. Yes, a cough. He's been congested and coughing for 4-5 days. He has no medical hx and has taken nothing OTC. It kills me how some people refuse to go to the giant local Walmart or Kroger and pend the $5-8 for some decongestant and stay at home. Anyways... his ribs hurt. He's called 911 because he's afraid he has a collapsed lung. O2 is at 99% with all vitals w/in normal limits. We educate him a little and we leave. Oh yeah... and tell him if he wants to go to the hospital, the 7 cars in the driveway can take him.
Later in the night we get dispatched for a man w/ diabetic problems. Its an address we got to very often. Very non-compliant diabetic on dialysis. Normally we get there, give him an amp of D50 and leave. We walk in and he's supine on the floor. Still. Calm. Initial assessment... sternal rub... talking to the family to get an update... MM (my partner) says is he diaphoretic? I look up and say Is he breathing? Damn. We call a cardiac arrest as the engine company walks in. It goes as well as any cardiac arrest can. The family has absolutely no clue what is happening and start calling other family members to come over. As we're doing chest compressions I overhear a family say on the phone, "They're trying to wake him up". Well, yeah I guess you could say that. We keep working. Unfortunately, lots... let me rephrase that... a plethora of vomit showers us while getting the tube. Mmmmmmm.... keep working. You force yourself to keep working. His glucose reads HI. He stays in Asystole throughout. We call him. While we have the family's consent to call him, all hell breaks lose when it hits them. PD really is needed to help maintain the scene. Lots of decon, laundry and showers later we're back in service. I can't write yet the rest due to legality issues... maybe another day.
And lastly, our tour guide at the county jail. We respond usually once shift. Our patient is an "A" patient who seems to just want some fresh air time outside the four concrete walls. We always just have to take them. They know the key words that get them transported. Anyways, like I said we're at the jail almost every shift. We walk in and get a detention officer who is like Mr. Rogers and gives us *literally* a play-by-play guide of our trip up to the 3rd floor medical sector. This is the elevator... We'll be getting off here... We'll be curving to the left here... (mind you there are no other options but the turn here or there) MM and I start eyeing each other and giggling. This guy's funny. He totally means well and is just so happy to be at his job. ...And this is the door we'll be going into... LOL. Stay safe out there!
We respond to our frequent flier who is a 25 yo kid who lives with his mom and sisters. He is a hypochondriac who is always afraid that if we don't rush him to the hospital he's gonna die. We haven't been to his house in a month or so, but the other 2 shifts have. We get there and he's complaining of a cough. Yes, a cough. He's been congested and coughing for 4-5 days. He has no medical hx and has taken nothing OTC. It kills me how some people refuse to go to the giant local Walmart or Kroger and pend the $5-8 for some decongestant and stay at home. Anyways... his ribs hurt. He's called 911 because he's afraid he has a collapsed lung. O2 is at 99% with all vitals w/in normal limits. We educate him a little and we leave. Oh yeah... and tell him if he wants to go to the hospital, the 7 cars in the driveway can take him.
Later in the night we get dispatched for a man w/ diabetic problems. Its an address we got to very often. Very non-compliant diabetic on dialysis. Normally we get there, give him an amp of D50 and leave. We walk in and he's supine on the floor. Still. Calm. Initial assessment... sternal rub... talking to the family to get an update... MM (my partner) says is he diaphoretic? I look up and say Is he breathing? Damn. We call a cardiac arrest as the engine company walks in. It goes as well as any cardiac arrest can. The family has absolutely no clue what is happening and start calling other family members to come over. As we're doing chest compressions I overhear a family say on the phone, "They're trying to wake him up". Well, yeah I guess you could say that. We keep working. Unfortunately, lots... let me rephrase that... a plethora of vomit showers us while getting the tube. Mmmmmmm.... keep working. You force yourself to keep working. His glucose reads HI. He stays in Asystole throughout. We call him. While we have the family's consent to call him, all hell breaks lose when it hits them. PD really is needed to help maintain the scene. Lots of decon, laundry and showers later we're back in service. I can't write yet the rest due to legality issues... maybe another day.
And lastly, our tour guide at the county jail. We respond usually once shift. Our patient is an "A" patient who seems to just want some fresh air time outside the four concrete walls. We always just have to take them. They know the key words that get them transported. Anyways, like I said we're at the jail almost every shift. We walk in and get a detention officer who is like Mr. Rogers and gives us *literally* a play-by-play guide of our trip up to the 3rd floor medical sector. This is the elevator... We'll be getting off here... We'll be curving to the left here... (mind you there are no other options but the turn here or there) MM and I start eyeing each other and giggling. This guy's funny. He totally means well and is just so happy to be at his job. ...And this is the door we'll be going into... LOL. Stay safe out there!
Thursday, October 08, 2009
History and Trauma
Wow... what a day... and my tour isn't even over yet. I am emotionally and physically drained but need to get this stuff down before I forget it. That, and my little squirt and I are spending the day together tomorrow and I'll never get it written. First, the good stuff.
Ya know how sometimes you are a part of a moment in time when you just know that you're witnessing a little bit of history? Well today, two of our department's finest have decided to retire. 30+ years they have served the citizens of this area. It just amazes me. I'm so far on the other side of the mountain I can't even fathom it. But these 2 great guys, 2 awesome leaders in our field, 2 excellent senior guys who love the job, who have that bone-deep passion for the job... are leaving. And I'm happy that they get to start a new chapter in their lives.... but also so sad that I've missed out on learning and laughing with these two. One is a moderate acquaintance in another territory and the other is a dear friend who I admire and trust very much. This place just won't be the same without them.
And now the crappy part. We just got back to the house after running an entrapment call. Crazy still how the dispatch rarely matches the scene. Usually it's a "all hell is breaking lose" dispatch, matched with a trash can fire. Well this was a fender bender dispatch, matched with a full entrapment, patient's losing consciousness, multiple (and I MEAN multiple) system trauma, compound fractures, etc.
We were on scene within 3 minutes of dispatch. Our patient had approx 7" from the edge of the steering wheel/dashboard and windshield and the back of the seat. Extrication was extensive and there was miscommunication between the bird I requested and our command. We arrived at the landing site only to find out they were another 14min out and going to land another 3-4 miles in the opposite direction of the ER.... when where we were at had a perfectly set-up LZ. Oh well. It ended up being conducive to just get on the highway and transport ourselves. We did everything we were trained to do, but unfortunately our patient did not make it.
But why is it always the post-adrenaline, post transfer of patient, de-con, re-stock, and paperwork that makes it so exhausting? I'm heading to bed. I'm exhausted.
*** Follow-up *** We found out a couple of shifts later that the original helicopter we requested for our patient had a bird strike while approaching the LZ and had to divert to an immediate drop-down. Just a shout-out to the flight medics, nurses and pilots who have an incredibly dangerous job to save others' lives.
Ya know how sometimes you are a part of a moment in time when you just know that you're witnessing a little bit of history? Well today, two of our department's finest have decided to retire. 30+ years they have served the citizens of this area. It just amazes me. I'm so far on the other side of the mountain I can't even fathom it. But these 2 great guys, 2 awesome leaders in our field, 2 excellent senior guys who love the job, who have that bone-deep passion for the job... are leaving. And I'm happy that they get to start a new chapter in their lives.... but also so sad that I've missed out on learning and laughing with these two. One is a moderate acquaintance in another territory and the other is a dear friend who I admire and trust very much. This place just won't be the same without them.
And now the crappy part. We just got back to the house after running an entrapment call. Crazy still how the dispatch rarely matches the scene. Usually it's a "all hell is breaking lose" dispatch, matched with a trash can fire. Well this was a fender bender dispatch, matched with a full entrapment, patient's losing consciousness, multiple (and I MEAN multiple) system trauma, compound fractures, etc.
We were on scene within 3 minutes of dispatch. Our patient had approx 7" from the edge of the steering wheel/dashboard and windshield and the back of the seat. Extrication was extensive and there was miscommunication between the bird I requested and our command. We arrived at the landing site only to find out they were another 14min out and going to land another 3-4 miles in the opposite direction of the ER.... when where we were at had a perfectly set-up LZ. Oh well. It ended up being conducive to just get on the highway and transport ourselves. We did everything we were trained to do, but unfortunately our patient did not make it.
But why is it always the post-adrenaline, post transfer of patient, de-con, re-stock, and paperwork that makes it so exhausting? I'm heading to bed. I'm exhausted.
*** Follow-up *** We found out a couple of shifts later that the original helicopter we requested for our patient had a bird strike while approaching the LZ and had to divert to an immediate drop-down. Just a shout-out to the flight medics, nurses and pilots who have an incredibly dangerous job to save others' lives.
Wednesday, September 30, 2009
Poo.... lots and lots of poo
We've all read the blogs and "about my job" stories from medics how we've all been vomited on, poo-ed on, spit on, bled on, etc. And everyone also knows... one time is one time too many. We got dispatched to a call for seizures. We get in the truck thinking its most likely either hypoglycemic or epileptic seizures. Enroute the computer updated us that the patient was now combative, running through the house and defecated everywhere. The patient had family there who was trying to help but also stay out of the patients way while they were combative.
Leads me to think hypoglycemic. We arrive on scene and are glad there is a fresh restock of BSI gowns in the cabinet. Its a dark home. The kind of home where there is one shade-less lamp in the corner of each room. The patient is supine and postictal on the bed (thank goodness) in a back bedroom. A bedroom where the headboard is wedged behind the door so that we only have a 12-15" clearance to get in... and get him out. Quickly find he is not hypoglycemic so we throw on some O2 and cocoon him in some sheets to get him out. He becomes very combative so that the only way to get him out is to grab ankles and wrists and drag. Not a pretty situation, but one with little to no alternatives. I administer some Versed to stop the new seizure activity and restrain him to the stretcher. Poo is still everywhere and growing. We get him into the rescue and head off to the ER. He has stopped seizing but is still very combative. Finally we get the pearl of information we've been needing. He is in stage 5 kidney failure. Ding. Ding. Ding. At least we have a most probable cause. He is so acidotic that his system is not compensating at all. After turning him over to the ER, they run his blood and get him stabilized. I see a long dialysis future for him.
It was a long and *very* detailed decon of our rescue, our equipment,... and ourselves. I don't think our rescue has been cleaner since it was delivered to us. Probably cleaner. After a good shower and some dinner (although I wasn't really hungry by now)... we were back in service to wait for the next one..... Stay safe out there.
Leads me to think hypoglycemic. We arrive on scene and are glad there is a fresh restock of BSI gowns in the cabinet. Its a dark home. The kind of home where there is one shade-less lamp in the corner of each room. The patient is supine and postictal on the bed (thank goodness) in a back bedroom. A bedroom where the headboard is wedged behind the door so that we only have a 12-15" clearance to get in... and get him out. Quickly find he is not hypoglycemic so we throw on some O2 and cocoon him in some sheets to get him out. He becomes very combative so that the only way to get him out is to grab ankles and wrists and drag. Not a pretty situation, but one with little to no alternatives. I administer some Versed to stop the new seizure activity and restrain him to the stretcher. Poo is still everywhere and growing. We get him into the rescue and head off to the ER. He has stopped seizing but is still very combative. Finally we get the pearl of information we've been needing. He is in stage 5 kidney failure. Ding. Ding. Ding. At least we have a most probable cause. He is so acidotic that his system is not compensating at all. After turning him over to the ER, they run his blood and get him stabilized. I see a long dialysis future for him.
It was a long and *very* detailed decon of our rescue, our equipment,... and ourselves. I don't think our rescue has been cleaner since it was delivered to us. Probably cleaner. After a good shower and some dinner (although I wasn't really hungry by now)... we were back in service to wait for the next one..... Stay safe out there.
Wednesday, September 23, 2009
Turkey-neckers
Crazy, I know? 2 posts in one day? Say it isn't so. I'm on way home from the grocery store this afternoon and pull up on an MVC that literally just happened. At an intersection, its a cross between a t-bone hit and side swipe. One female driver not hurt but cant get out (and is on the non-hit side) and a male trying to crawl out of the passenger side. Both of his airbags deployed and has light to moderate smoke and liquids coming from the engine compartment. There are also 3-4 other vehicles that have stopped to.... not render assistance... but stand around and holler to seemingly no one, "I'm going to call the police" or just making a broad announcement like a crowded restaurant "Is anyone hurt?" Jeez folks!
So I walk up to the crawling man and introduce myself. Ya know, when someone is able to crawl out of a vehicle, walk 10-15' and sit down, that already tells some of the picture. I assess him and ask the lady who is hollering about calling the police (because she still hasn't done it yet) to please relax, call 911 and tell them we have one injured and just need a basic rescue, etc, etc.
So I'm assessing the guy who is A/O x2 and a little wobbly still, and behind me I hear this engine just scream and make an awful racket! I turn to find some well-meaning but not-so-bright older woman who had crawled into this guy's SUV and try to crank the engine and revved it all the way!!! WTH!!! I holler for her to shut the engine off and get out of the vehicle! What the hell are you doing lady? "I was gonna try and move it out of the way" Move it where?? Why? It's wedged into another vehicle and its draining a ton of fluid underneath.... ugh! Then she comes and stands over my back so much so that she leans onto me for balance. OK, I've had enough. Yes, I'm not on duty. Yes, I'm not in a uniform. I've clearly identified myself to her as well as to the gentleman I'm assessing.... walk away lady. Walk away.
As soon as the rescue gets on scene, I give the basics and get out of there. They're on duty today. Not me. Now I'm home and the milk and eggs are in the fridge. Hhmmmmmm.....
So I walk up to the crawling man and introduce myself. Ya know, when someone is able to crawl out of a vehicle, walk 10-15' and sit down, that already tells some of the picture. I assess him and ask the lady who is hollering about calling the police (because she still hasn't done it yet) to please relax, call 911 and tell them we have one injured and just need a basic rescue, etc, etc.
So I'm assessing the guy who is A/O x2 and a little wobbly still, and behind me I hear this engine just scream and make an awful racket! I turn to find some well-meaning but not-so-bright older woman who had crawled into this guy's SUV and try to crank the engine and revved it all the way!!! WTH!!! I holler for her to shut the engine off and get out of the vehicle! What the hell are you doing lady? "I was gonna try and move it out of the way" Move it where?? Why? It's wedged into another vehicle and its draining a ton of fluid underneath.... ugh! Then she comes and stands over my back so much so that she leans onto me for balance. OK, I've had enough. Yes, I'm not on duty. Yes, I'm not in a uniform. I've clearly identified myself to her as well as to the gentleman I'm assessing.... walk away lady. Walk away.
As soon as the rescue gets on scene, I give the basics and get out of there. They're on duty today. Not me. Now I'm home and the milk and eggs are in the fridge. Hhmmmmmm.....
Flood of 2009
Unless you've banned watching the news for the past couple of weeks, you've seen the devastating flooding that has hit the Southeast. Atlanta is under water in many hard hit areas. Thankfully where I live has not been flooded, we've just have copious amounts of rain... therefore... mud. But the West side of the ATL metro area has been ravaged. So much so that major interstate arteries have been completely shut down after being submerged in raging waters. It was been quite a sight. So what happens when crazy weather mixes with no so bright citizens? Tragedy and Ignorant comments made on TV. I'm not saying that the people who lost their lives deserved it, I would never wish that on anyone.... but when public safety agencies and every news outlet is telling you to stay home and *not* drive into standing water.... WTH are you thinking?
And when the sound-bite hungry news reporter is sticking a microphone in everyone's face asking "How does all this make you feel?".... well.... opportunities are endless. One genius who was speaking about how he was trying to get home and every road he tried was blocked off, continued saying... "I just don't know what is going on." Did you just fly in this morning from Egypt? Its been raining for 40 days and 40 nights silly! And others who expressed frustration at fire & police for closing roads. That's our job, to protect you from yourself. And when people are told to *get out* of their homes cause its gonna flood and they refuse. They flat out refuse.... then want a big rescue when they decide... nnooowwwwww I want out. Now I want out after there is 3' of water in their living rooms. This frustrates me. A lot. Text on a screen can only convey so much emotion.
I've been off work for a bit recovering from the bug. Don't go back for another week. I'm accomplishing a lot of fall cleaning in this time off. When I get back it'll be back to the 24hr tour on our new mama-jama rescues. Our new ambulance is about as big as our engine. There are some kinks that *really* need to be worked out but I am getting a little acclimated to it. We'll see how it goes. Stay safe.
And when the sound-bite hungry news reporter is sticking a microphone in everyone's face asking "How does all this make you feel?".... well.... opportunities are endless. One genius who was speaking about how he was trying to get home and every road he tried was blocked off, continued saying... "I just don't know what is going on." Did you just fly in this morning from Egypt? Its been raining for 40 days and 40 nights silly! And others who expressed frustration at fire & police for closing roads. That's our job, to protect you from yourself. And when people are told to *get out* of their homes cause its gonna flood and they refuse. They flat out refuse.... then want a big rescue when they decide... nnooowwwwww I want out. Now I want out after there is 3' of water in their living rooms. This frustrates me. A lot. Text on a screen can only convey so much emotion.
I've been off work for a bit recovering from the bug. Don't go back for another week. I'm accomplishing a lot of fall cleaning in this time off. When I get back it'll be back to the 24hr tour on our new mama-jama rescues. Our new ambulance is about as big as our engine. There are some kinks that *really* need to be worked out but I am getting a little acclimated to it. We'll see how it goes. Stay safe.
Monday, August 31, 2009
I'm sorry what? I can't hear you!!!
We ran the wheels off our engine yesterday. 8 calls before 12N. We decided to splurge and get crab legs for dinner. Figures. I cooked up a decent meal of some gigantic crab legs, roasted potatoes, corn on the cob and broccoli. Cooked for a good hour and half. The rescue ran a call but was back before we put dinner on the table. And as sure as it usually does... the 5 of us sat down and the bell went off. Medical call for the engine, was easily helped into the rescue and we were on our way back when.... "respond to a gas leak at Memorial and X St." Well, so much for the crab leg dinner. A construction crew hit both a gas main and a water line. Loud. Very Loud.
So we evacuated everyone in the proximity and stood by til the Gas Dept could get there. And we waited. Some more gas dept supervisors showed up and said it be a little bit longer. And we waited. The whole time copious amounts of natural gas blasting in the air. It was quite a spectacle. Gas breaks aren't hard calls. Potentially dangerous, but generally we stand by to make sure no one lights themselves off.
Ignorant citizens never cease to amaze me. Hundreds of feet of yellow "do not cross" tape is stretched all over the place and people walk under them, cars drive through them, etc. And these folks get mad at us for inconveniencing them. Oh gee... sorry... and whose fault will it be when you blow up?
But the good guys on the HazMat truck got us some drinks. After 2.5 hours, the Bat. Chief called another engine to relief us for a bit. By this time it was 2230, I wasn't hungry... just wanted to shower and go to bed. Face was burning from the gas in the air and a shower sounded heavenly. Oh, I'm sorry, did I say sounded? I couldn't hear a thing. We ran another couple of calls through the night. It was one busy day.
So we evacuated everyone in the proximity and stood by til the Gas Dept could get there. And we waited. Some more gas dept supervisors showed up and said it be a little bit longer. And we waited. The whole time copious amounts of natural gas blasting in the air. It was quite a spectacle. Gas breaks aren't hard calls. Potentially dangerous, but generally we stand by to make sure no one lights themselves off.
Ignorant citizens never cease to amaze me. Hundreds of feet of yellow "do not cross" tape is stretched all over the place and people walk under them, cars drive through them, etc. And these folks get mad at us for inconveniencing them. Oh gee... sorry... and whose fault will it be when you blow up?
But the good guys on the HazMat truck got us some drinks. After 2.5 hours, the Bat. Chief called another engine to relief us for a bit. By this time it was 2230, I wasn't hungry... just wanted to shower and go to bed. Face was burning from the gas in the air and a shower sounded heavenly. Oh, I'm sorry, did I say sounded? I couldn't hear a thing. We ran another couple of calls through the night. It was one busy day.
Sunday, June 21, 2009
Ready yet?
Damned if you do, damned if you don't. Sometimes you get patients who are waiting for you at the front door, keys in hand, suitcase packed with their favorite pillow, their face pressed against the screen for fear of missing you drive by. And before you've even put the truck in park and put your gloves on, they're bolting the front door and walking down the driveway. Whoa, whoa, wait a minute Ms. Sweet Elderly Lady... lets check you out first. This kind of presentation, if you will, by our patient usually leads me to believe that this is in fact NOT a life threatening call. And because we have the option to call for a basic rescue to come transport and/or refuse transport at all if deemed appropriate.... I'm usually headed down that path. I've run a plethora of these... usually constipation or trying to get to a surgery appointment on time. Frustrating to say the least, but I have an affinity for older folks and don't mind taking the time to check em out, give them the "next time..." speech and help them lock their house up.
Then you have the calls where either the patient or the family calls and while from initial presentation its not a load and go.... after you hook them to the monitor, a few flags raise.... then the 12-lead... more flags... and you're like, "OK, lets get going, we'll do everything else enroute." That's when your patient keeps finding just one more thing that they just HAVE to have. Be it insurance card, meds, ... their favorite pillow.... and you're approaching the line of either snapping that, "Look, we can't stay here any longer, we really need to get going, now." vs. getting that one more thing that will help relax them and not cause any undue distress. Its that affinity for older folks that keeps me tottering on that line. Sometimes I just have to be the bad guy. But its only for their health and well-being.
Then there was the call at 0800 this morning for a 20-yr male with a cramp in his foot. Really son,.... really? The cabulance is here...
Then you have the calls where either the patient or the family calls and while from initial presentation its not a load and go.... after you hook them to the monitor, a few flags raise.... then the 12-lead... more flags... and you're like, "OK, lets get going, we'll do everything else enroute." That's when your patient keeps finding just one more thing that they just HAVE to have. Be it insurance card, meds, ... their favorite pillow.... and you're approaching the line of either snapping that, "Look, we can't stay here any longer, we really need to get going, now." vs. getting that one more thing that will help relax them and not cause any undue distress. Its that affinity for older folks that keeps me tottering on that line. Sometimes I just have to be the bad guy. But its only for their health and well-being.
Then there was the call at 0800 this morning for a 20-yr male with a cramp in his foot. Really son,.... really? The cabulance is here...
Thursday, June 04, 2009
Stereotyping
How many times are you getting dispatched and before the address is complete you already know the patient you're responding to. You can already picture their face, their living room (or street corner), their presentation and even their vitals. You get tunnel-vision.
Other times you get dispatched for the chest pain or difficulty breathing and on arrival you greeted with someone who appears to be having an emotional breakdown. A para-suicide-threatening moment. A psychosomatic anxiety attack. And again... you get tunnel vision.
A dangerous place to be indeed.
So we get called for a 40-yr old woman with chest pain. She's sitting in a chair at the county courthouse after standing in line to pay a ticket, hiding her face behind her large mane of hair. She looks like a model. Tall, thin, dressed to the nines with 3" stilettos. Not saying much of anything, rather letting the first responders answer after long pauses to our questions. I'm getting some tunnel vision. I ask about history. She is as vague as she can be. She thinks she had an MI in the past but doesn't remember. She can't remember anything else she might have. She says she takes meds but can't remember a one. My suspicion of anything serious is diminishing.
I put her on the monitor. Whoa!!!!! Quadrigeminal PVC’s on a NSR with runs of V-Tach. Well darlin, lets get going. We secured a line enroute and was on the apron in just a few minutes. All her other vitals were normal. Come to find another tidbit of information that, I at least, never learned in medic class. Hyperthyroidism causes tachycardia. I had known about hypothyroidism causing bradycardia.... why a=b therefore -a=(-b) didn't connect with me I don't know. I do know. Tunnel vision!!! She had hyperthyroidism and was not taking her meds!
So watch your tunnel vision. From those patients that we'd love to just buy a bus pass for to the atypical presentation. Full assessments folks. It's patient care. You just may be the only person on this world that gives a flying flip enough to respond to their need. Whether it be just some human interaction, a friendly face in their world of despair, or a true call during a life-threatening emergency. Trust me... I need to be reminded of my own advice everyday. Stay safe out there.
Other times you get dispatched for the chest pain or difficulty breathing and on arrival you greeted with someone who appears to be having an emotional breakdown. A para-suicide-threatening moment. A psychosomatic anxiety attack. And again... you get tunnel vision.
A dangerous place to be indeed.
So we get called for a 40-yr old woman with chest pain. She's sitting in a chair at the county courthouse after standing in line to pay a ticket, hiding her face behind her large mane of hair. She looks like a model. Tall, thin, dressed to the nines with 3" stilettos. Not saying much of anything, rather letting the first responders answer after long pauses to our questions. I'm getting some tunnel vision. I ask about history. She is as vague as she can be. She thinks she had an MI in the past but doesn't remember. She can't remember anything else she might have. She says she takes meds but can't remember a one. My suspicion of anything serious is diminishing.
I put her on the monitor. Whoa!!!!! Quadrigeminal PVC’s on a NSR with runs of V-Tach. Well darlin, lets get going. We secured a line enroute and was on the apron in just a few minutes. All her other vitals were normal. Come to find another tidbit of information that, I at least, never learned in medic class. Hyperthyroidism causes tachycardia. I had known about hypothyroidism causing bradycardia.... why a=b therefore -a=(-b) didn't connect with me I don't know. I do know. Tunnel vision!!! She had hyperthyroidism and was not taking her meds!
So watch your tunnel vision. From those patients that we'd love to just buy a bus pass for to the atypical presentation. Full assessments folks. It's patient care. You just may be the only person on this world that gives a flying flip enough to respond to their need. Whether it be just some human interaction, a friendly face in their world of despair, or a true call during a life-threatening emergency. Trust me... I need to be reminded of my own advice everyday. Stay safe out there.
Wednesday, May 27, 2009
Catching up
Well I haven't written in quite some time, but think its time to once again share my tales. I should have blogged several shifts over the last few months as some calls just defied the imagination. I so wish I could invest in a lapel camera on my radio strap as some things I just have no words for.
But for now the first thing that comes to mind to get on soapbox about is the upcoming changes to ACLS and what is in the pipeline. Just to state the obvious, no, I am NOT a doctor. But these changes just don't make sense to me. We go to these ACLS recert classes and they hand down what are the new guidelines and there is nothing to back up these new guidelines. Reminds me of the saying, "There's a reason they call it practicing medicine." For anyone in EMS longer than 1 year, think about how many things are different that when you first started. Heck, the new medics coming out now are reciting things that are 180 degrees from what I learned.
Granted, we're all doing the best we can for the patient at any given time, its just so frustrating when "powers that be" make changes that just dont always make sense.
But for now the first thing that comes to mind to get on soapbox about is the upcoming changes to ACLS and what is in the pipeline. Just to state the obvious, no, I am NOT a doctor. But these changes just don't make sense to me. We go to these ACLS recert classes and they hand down what are the new guidelines and there is nothing to back up these new guidelines. Reminds me of the saying, "There's a reason they call it practicing medicine." For anyone in EMS longer than 1 year, think about how many things are different that when you first started. Heck, the new medics coming out now are reciting things that are 180 degrees from what I learned.
Granted, we're all doing the best we can for the patient at any given time, its just so frustrating when "powers that be" make changes that just dont always make sense.
Sunday, January 04, 2009
1st of 2009
Hope you and your had a very Merry Christmas and a Happy New Year! I had a great one. It was nice, relatively quiet and mellow. Spent with family and friends and celebrating the reason the for the season. I'm excited about what 2009 will bring me.
With the holidays and filling in at other stations and then my Kelly Day, it feels like I haven't been at my station in forever. So I have a bit of a renewed sense of "lets get it done". Our first call of the day slams me head-first into reality and the bread-n-butter calls we get everyday. Its a difficulty breathing call for a woman who I ran on just last week. She hates using her CPAP machine and is really wanting some attention from her family so she feigns, and hums and hoos. We get there and its really her belly. She says she has a hernia for the past few years but now its hurting when she moves. She wants an ambulance because she thinks she'll get seen faster. When the basic unit arrives she feigns some more and cries for her family to not leave her. We try and get her to the door to the stretcher. After a good 10-15min of trying to get her outside she says she has to pee. But in a not urgent kind of way. I say, "Ma'm, we need to get you to the hospital, do you think you can hold it, or do you need to go back inside?" Nope.... no answer.... just all of the sudden hear a drip, drip, dribble.... and yes... she is urinating on herself in the front yard. Of course we maintain our professional composure, but I am just perplexed at her non-chalant attitude as if of course thats what you do when you have to pee. Hhmmmmmmmm.
We ran a pediatric arrest on a 5-week old. It went textbook but did not end well. I need to call my hubby and check in on my own infant for a little reassurance. I say a prayer, one of many, for the family.
With the holidays and filling in at other stations and then my Kelly Day, it feels like I haven't been at my station in forever. So I have a bit of a renewed sense of "lets get it done". Our first call of the day slams me head-first into reality and the bread-n-butter calls we get everyday. Its a difficulty breathing call for a woman who I ran on just last week. She hates using her CPAP machine and is really wanting some attention from her family so she feigns, and hums and hoos. We get there and its really her belly. She says she has a hernia for the past few years but now its hurting when she moves. She wants an ambulance because she thinks she'll get seen faster. When the basic unit arrives she feigns some more and cries for her family to not leave her. We try and get her to the door to the stretcher. After a good 10-15min of trying to get her outside she says she has to pee. But in a not urgent kind of way. I say, "Ma'm, we need to get you to the hospital, do you think you can hold it, or do you need to go back inside?" Nope.... no answer.... just all of the sudden hear a drip, drip, dribble.... and yes... she is urinating on herself in the front yard. Of course we maintain our professional composure, but I am just perplexed at her non-chalant attitude as if of course thats what you do when you have to pee. Hhmmmmmmmm.
We ran a pediatric arrest on a 5-week old. It went textbook but did not end well. I need to call my hubby and check in on my own infant for a little reassurance. I say a prayer, one of many, for the family.
Saturday, December 20, 2008
You called for what??
So... I have some folks who read this blog and friends who scoff at my callousness at some of my patients. They don't seem to understand some of the ridiculous calls we get and the absurd abuse of Public Safety / Emergency Services. Well, let me give you two glaring examples of this abuse and then if you multiply it by the ballpark 9 calls per shift times every shift and hopefully you'll entertain my (albeit "our" aka public safety) frustration.
Now for those of you that are not in public safety, a little foundation. We treat every call when dispatched unless otherwise told (which these calls are not the root of this discussion) as a life or death emergency. By traveling lights and sirens the average 2-6 miles to your location, traveling at a higher rate of speed, weaving through traffic... most often with other drivers competing with us for the lane, the right of way, whatever which puts our lives and other drivers' lives in danger for your call. Now if its a true life or death I have absolutely NO problem at all with this risk. Its a weighed risk, a risk of helping someone who without our skills or equipment would otherwise be in more pain, more distress, whatever. Time of day shouldn't matter, and in a true emergency it doesn't matter at all. But these abuse calls, at 0300am tend to add insult to injury.
Ok.. now on to the 2 examples that just took place.
We get dispatched to a severe respiratory distress. Generally implies Asthma, COPD, CHF or a cardiac event. Any of these can be deadly so we are on the ball, out the door, and down the street. Imagine, at 12M, you get such a call. You pull up to the residence, grab your gear and head to the door when you see a gentleman in the driveway who says, "Whoa... hey, thanx for coming... I really just need a jump for my car." E....Ex....Excuse me?????? Your kidding right? "No, I just needed a jump for my car and called 911" So, you're not having any respiratory problems? "Well, I was about 15 min ago, but I'm fine now" AAGHH #^%&#&^!!!!
I want to know who raises folks to believe that 911 is the end all be all of anything you need whether it be shoe polish, a jump for your car or your pooch. Speaking of pooch.....
The next call, about 2 hours later... yes 0200am was from a guy who locked his dog in the car. Now, middle of summer, 12N, 100 degrees outside... fine, I'll grant some leeway. We're still just gonna break your window. But its 60 degrees and.... and.... there is a 1/4" opening in the window and his sister could be on her way with a spare key, but he didn't feel like waiting that long. So he calls 911. If only he could really grasp the thought that you,his neighbor down the street, who's just been shot or is having a heart attack is going to have to wait for responders from 2 territories away because we're on this call. But I doubt he ever will.
I, as well as any other public safety professional, could go on and on. I would love to create a PSA. To try and educate our general public and remind them what 911 (& an EMERGENCY room) is there for. And that there is now 311, 411, 511... the phone book and the Internet to get information that is not an emergency.
As for the calls we ran tonight... we ran an OB call in the local WalMart. We all talked about the movie where the girl gives birth in Walmart on the way there. Our pt's water had broken in a grocery aisle .... "clean up on aisle 11"... Anyways. Whew.... hhhmmmmm... she's 26 years old. 7th pregnancy. Yes, 7th. 28 weeks with no contractions, last pregnancy was 11 months ago. She's used to the drill. All vitals were good, so we helped load her into the rescue and off they went. I'm gonna try and get some sleep while I can. Stay safe out there.
Now for those of you that are not in public safety, a little foundation. We treat every call when dispatched unless otherwise told (which these calls are not the root of this discussion) as a life or death emergency. By traveling lights and sirens the average 2-6 miles to your location, traveling at a higher rate of speed, weaving through traffic... most often with other drivers competing with us for the lane, the right of way, whatever which puts our lives and other drivers' lives in danger for your call. Now if its a true life or death I have absolutely NO problem at all with this risk. Its a weighed risk, a risk of helping someone who without our skills or equipment would otherwise be in more pain, more distress, whatever. Time of day shouldn't matter, and in a true emergency it doesn't matter at all. But these abuse calls, at 0300am tend to add insult to injury.
Ok.. now on to the 2 examples that just took place.
We get dispatched to a severe respiratory distress. Generally implies Asthma, COPD, CHF or a cardiac event. Any of these can be deadly so we are on the ball, out the door, and down the street. Imagine, at 12M, you get such a call. You pull up to the residence, grab your gear and head to the door when you see a gentleman in the driveway who says, "Whoa... hey, thanx for coming... I really just need a jump for my car." E....Ex....Excuse me?????? Your kidding right? "No, I just needed a jump for my car and called 911" So, you're not having any respiratory problems? "Well, I was about 15 min ago, but I'm fine now" AAGHH #^%&#&^!!!!
I want to know who raises folks to believe that 911 is the end all be all of anything you need whether it be shoe polish, a jump for your car or your pooch. Speaking of pooch.....
The next call, about 2 hours later... yes 0200am was from a guy who locked his dog in the car. Now, middle of summer, 12N, 100 degrees outside... fine, I'll grant some leeway. We're still just gonna break your window. But its 60 degrees and.... and.... there is a 1/4" opening in the window and his sister could be on her way with a spare key, but he didn't feel like waiting that long. So he calls 911. If only he could really grasp the thought that you,his neighbor down the street, who's just been shot or is having a heart attack is going to have to wait for responders from 2 territories away because we're on this call. But I doubt he ever will.
I, as well as any other public safety professional, could go on and on. I would love to create a PSA. To try and educate our general public and remind them what 911 (& an EMERGENCY room) is there for. And that there is now 311, 411, 511... the phone book and the Internet to get information that is not an emergency.
As for the calls we ran tonight... we ran an OB call in the local WalMart. We all talked about the movie where the girl gives birth in Walmart on the way there. Our pt's water had broken in a grocery aisle .... "clean up on aisle 11"... Anyways. Whew.... hhhmmmmm... she's 26 years old. 7th pregnancy. Yes, 7th. 28 weeks with no contractions, last pregnancy was 11 months ago. She's used to the drill. All vitals were good, so we helped load her into the rescue and off they went. I'm gonna try and get some sleep while I can. Stay safe out there.
Friday, November 21, 2008
Attacked by a naked woman
Well I have finally caught the cold that my husband and son have been battling for the past 3 weeks. Its a nasty chest cold and this is probably the only day that I don't want to be on the engine and fighting fire. My chest hurts to breathe, and I'm taching away at 145. Yuck.... but when you love the job this much.... the second the bell rings with a structure fire... its all adrenaline and you cant wait to do the dance.
But no such luck. We started the day with a 3-alarm fire in progress on the opposite side of the county. And all day... we would get dispatched to an Alpha/Non-emergency/Butt-Ache call and the very next dispatch would be a working fire in our immediate or the next territory over. AARRGHH!!! We worked a call for a couple of hours on a gas leak. The guy operating the backhoe... next to the 3" gas line that was severed... it was his first time. He was trying, but he was making me nervous with all his second guessing his actions.
Then comes Dorothy. Dispatched for a diabetic problem, it could be either to high or to low. Well... she was a bit to low. So low that when we get to her home and her sister lets us in, we find an early-50's woman, butt-naked and running around the bounce bouncing off the walls... literally. You know how pinball machine ball bounces in a zig-zag fashion coming down the lane, yeah...that was her. I coaxed her to let us in her room and let me take her sugar. 41. The 2 guys on my engine crew are just around the corner to my side since she once she saw them she freaked again. Laughing in that psycho laugh that some people have. So I've now coaxed her into sitting on the bed so we can get her some D50. And in just a hair of a second, she has jumped up, slammed the door shut (blocking my exit) and is coming at me trying to hug me with this insane laugh and her tongue hanging out the side of her mouth. UGH!!!!!
I almost knee her to get he off when E comes in and pulls her off. She then literally falls onto the bed and bounces off the other side, head first, with naked butt and legs up in the air. Wow.... just wow. Her sugar must have dropped enough to mellow her out a bit and once she had the D50 in her she was as laid back and sweet as Aunt Jemimah.
We ran a little kitchen fire at 5am.... that's the only real fire we got. Oh well... just as well. Now I'm gonna Vicks up and try to fast forward this chest cold. Stay safe out there.
But no such luck. We started the day with a 3-alarm fire in progress on the opposite side of the county. And all day... we would get dispatched to an Alpha/Non-emergency/Butt-Ache call and the very next dispatch would be a working fire in our immediate or the next territory over. AARRGHH!!! We worked a call for a couple of hours on a gas leak. The guy operating the backhoe... next to the 3" gas line that was severed... it was his first time. He was trying, but he was making me nervous with all his second guessing his actions.
Then comes Dorothy. Dispatched for a diabetic problem, it could be either to high or to low. Well... she was a bit to low. So low that when we get to her home and her sister lets us in, we find an early-50's woman, butt-naked and running around the bounce bouncing off the walls... literally. You know how pinball machine ball bounces in a zig-zag fashion coming down the lane, yeah...that was her. I coaxed her to let us in her room and let me take her sugar. 41. The 2 guys on my engine crew are just around the corner to my side since she once she saw them she freaked again. Laughing in that psycho laugh that some people have. So I've now coaxed her into sitting on the bed so we can get her some D50. And in just a hair of a second, she has jumped up, slammed the door shut (blocking my exit) and is coming at me trying to hug me with this insane laugh and her tongue hanging out the side of her mouth. UGH!!!!!
I almost knee her to get he off when E comes in and pulls her off. She then literally falls onto the bed and bounces off the other side, head first, with naked butt and legs up in the air. Wow.... just wow. Her sugar must have dropped enough to mellow her out a bit and once she had the D50 in her she was as laid back and sweet as Aunt Jemimah.
We ran a little kitchen fire at 5am.... that's the only real fire we got. Oh well... just as well. Now I'm gonna Vicks up and try to fast forward this chest cold. Stay safe out there.
Friday, October 31, 2008
Know your meds
Perfect shift yesterday. Ran a full day with 2 fires and then slept all night. How much better can it get? Medically we ran a cardiac arrest then the typical sick kid calls. I have been running into a lot of Lisinopril reaction calls.
Lisinopril is an ACE-inhibitor medication used to treat hypertension, and post heart-attack patients. Some people, whether they've been on the medication for 5 days or 5 years will just one day have a severely swollen tongue. There are generally no other symptoms but it is considered life-threatening as their tongue can swell so much it can occlude their airway. While we treat it as an allergic reaction and admin Benadryl per protocol, Benadryl doesn't reverse the reaction as in normal allergic reaction patients. All we can do is manage their airway and admin fluids and wait til the residual Lisinopril filters from their system. It never ceases to amaze me how many MD's do NOT talk with their patients about this common and dangerous side effect. There have been many patients who have died because they couldn't breath. As am I'm always carrying on about... PLEASE.... question your doctors. About everything! Do some of your own research. While you may think your MD is great, he still may have only gotten a 70 on his final exam.
So, Halloween is here. We are heading over to a friends house for a Halloween party. Dont want to scare the baby so I'm making it easy. I'm dressing as a hippie and Aiden will be my hippie baby. Hope you have a safe and happy night tonight with your kids and families.
Lisinopril is an ACE-inhibitor medication used to treat hypertension, and post heart-attack patients. Some people, whether they've been on the medication for 5 days or 5 years will just one day have a severely swollen tongue. There are generally no other symptoms but it is considered life-threatening as their tongue can swell so much it can occlude their airway. While we treat it as an allergic reaction and admin Benadryl per protocol, Benadryl doesn't reverse the reaction as in normal allergic reaction patients. All we can do is manage their airway and admin fluids and wait til the residual Lisinopril filters from their system. It never ceases to amaze me how many MD's do NOT talk with their patients about this common and dangerous side effect. There have been many patients who have died because they couldn't breath. As am I'm always carrying on about... PLEASE.... question your doctors. About everything! Do some of your own research. While you may think your MD is great, he still may have only gotten a 70 on his final exam.
So, Halloween is here. We are heading over to a friends house for a Halloween party. Dont want to scare the baby so I'm making it easy. I'm dressing as a hippie and Aiden will be my hippie baby. Hope you have a safe and happy night tonight with your kids and families.
Thursday, October 23, 2008
Respond to a....
I had hoped to keep up with this thing a bit better since being back... but oh well. An 8-month old will do that to you.
I am now on the other side of the burn-out phase and most of the time can simply acknowledge that for the territory I work in.... it just is what it is. 80% of the time, its the stereotypical butt-ache call that if the person had an ounce of common sense or had been taking their meds as prescribed, we wouldn't have needed to have been called.
Ran a call for a possible broken arm on a 7-yr old. When we get there the Mom is on the belligerent side of making a scene. The kid had gotten hurt on the playground and was already wrapped in a sling by the school. I wont get into the conversation I had with Mom, lets just say it wasn't pretty. We call for a basic and dispatch tells us to stay in the area, we'll be waiting for PD to clear a scene for a person shot. It's 3 buildings away. We didn't hear any gunshots while we were with the angry mom outside.
PD clears the scene and we enter with 2 kids in custody and a third on the floor unresponsive. Its a crappy call. Anything that occurs where a kid gets hurt sucks. Lots of details I cant share here, right now, but lets just say it did not end well. After 3 1/2 hours of de-coning the truck and us, we were back in service. 2 minutes later we get called back to the SAME address for a..... 7-yr old with a broken arm. Yep... same woman as before. I am quite livid as we are enroute. (by the way.. its not broken, the poor little thing has a sprained arm that mom has no OTC meds to help relieve her child's pain, she just wants to make a scene about it)
We get there and I ask why she didn't go to the hospital with the other ambulance we called in for her. She says, "they said I didn't need to go". I'm thinking... I told you you didn't need to go. I call the basic unit and inquire as to what happened. They advised that the woman signed 2 refusal forms and didn't want to go then since there was a shooting happening in her apartment complex and wanted to know what was going on. GGGrRRrrrrrrrrr. So.... NOW she's ready for us to transport her daughter (who is in pain) to the hospital. Ma'am.... we are NOT your taxi service!!!!!
We ran a call on Arthur, a frequent caller who is homeless and when its just to cold or he's just tired of being chased from the front slabs at convenience stores, he calls 911 for a warm bed and a meal in the ER. This time he is complaining of difficulty breathing and chest pain, albeit from the coughing he's presenting to us. He says he was at the Er last month, diagnosed with pneumonia. I ask if he finished his antibiotics. He says no... he threw them in the bushes a few days ago because he started to feel better. As we're waiting for a basic transport to come get him, I ask him his history and how he got from someone who worked and supported themselves to this. He is a friendly soul who by his eyes longs for a simple purpose in life. He tells a tale of bad choices and big plans for the future as soon as he can get around to it. We help him into the other ambulance and make our way back for shift change.
I am now on the other side of the burn-out phase and most of the time can simply acknowledge that for the territory I work in.... it just is what it is. 80% of the time, its the stereotypical butt-ache call that if the person had an ounce of common sense or had been taking their meds as prescribed, we wouldn't have needed to have been called.
Ran a call for a possible broken arm on a 7-yr old. When we get there the Mom is on the belligerent side of making a scene. The kid had gotten hurt on the playground and was already wrapped in a sling by the school. I wont get into the conversation I had with Mom, lets just say it wasn't pretty. We call for a basic and dispatch tells us to stay in the area, we'll be waiting for PD to clear a scene for a person shot. It's 3 buildings away. We didn't hear any gunshots while we were with the angry mom outside.
PD clears the scene and we enter with 2 kids in custody and a third on the floor unresponsive. Its a crappy call. Anything that occurs where a kid gets hurt sucks. Lots of details I cant share here, right now, but lets just say it did not end well. After 3 1/2 hours of de-coning the truck and us, we were back in service. 2 minutes later we get called back to the SAME address for a..... 7-yr old with a broken arm. Yep... same woman as before. I am quite livid as we are enroute. (by the way.. its not broken, the poor little thing has a sprained arm that mom has no OTC meds to help relieve her child's pain, she just wants to make a scene about it)
We get there and I ask why she didn't go to the hospital with the other ambulance we called in for her. She says, "they said I didn't need to go". I'm thinking... I told you you didn't need to go. I call the basic unit and inquire as to what happened. They advised that the woman signed 2 refusal forms and didn't want to go then since there was a shooting happening in her apartment complex and wanted to know what was going on. GGGrRRrrrrrrrrr. So.... NOW she's ready for us to transport her daughter (who is in pain) to the hospital. Ma'am.... we are NOT your taxi service!!!!!
We ran a call on Arthur, a frequent caller who is homeless and when its just to cold or he's just tired of being chased from the front slabs at convenience stores, he calls 911 for a warm bed and a meal in the ER. This time he is complaining of difficulty breathing and chest pain, albeit from the coughing he's presenting to us. He says he was at the Er last month, diagnosed with pneumonia. I ask if he finished his antibiotics. He says no... he threw them in the bushes a few days ago because he started to feel better. As we're waiting for a basic transport to come get him, I ask him his history and how he got from someone who worked and supported themselves to this. He is a friendly soul who by his eyes longs for a simple purpose in life. He tells a tale of bad choices and big plans for the future as soon as he can get around to it. We help him into the other ambulance and make our way back for shift change.
Tuesday, September 02, 2008
Getting burned out
So... I'm in a valley that has high sides all around it named frustration, anger, weariness, and fatigue. But I still have a love for the job that I have never known in any other career. I fought hard for this career. Very hard. And the station I am at is everything that you'd want. Good people who truly love each other, who work hard on every scene, & who go out together outside of work.
Now normally we have a good rotation between the engine and the rescue, but lately due to people on vacation, or whatever I have had many...MANY shifts on the rescue. And we've been getting beat on almost every shift. A couple of shifts ago we ran 23 calls in 24 hours. We only transported 3 and only 1 of those *needed* transport. I would love to do a PSA campaign on why you do/don't call 911. A lot of our territory is just so uneducated and view 911 as their personal taxi to use the ER as their primary care physician. I was brought up that you call 911 when you are DYING or close to it. NOT because you have a toothache, a headache for the last 6 hours, a stubbed toe, your kid has had a fever for the last hour, or your drunk. (Just to name a few)
Now, call me bitter, call me whining... this is my blog and I can vent all I want or need to. I understand that probably 85% of my job in my territory that I work is public education. But it never ceases to amaze me the craziness that plagues our 911 system. I've joked at the notion of recording via a pin-hole camera on my radio belt the patients we encounter in a day's work. And then broadcast a PSA. Maybe then our hospitals who are failing and bankrupt due to the overwhelming demand of non-paying patients could catch a break and get back up on their feet.
This last shift has been a little bit of a breaker for me. I've really needed these 2 days off to veg out. We ran a call for a vehicle accident with entrapment. Enroute it was a car into a house. We were the 2nd rescue in with everyone else already there. By the time we pulled up they had the roof cut off and was pulling the 1st patient out the back (our patient). 3 16-yr olds in the back, one DOA, 2 front passengers A/O x3 on the front lawn. Our pt was A/O x4. Multiple punctures, lacs, and possible broken leg. Enroute everything went unremarkable. Our pt was able to give me their name but that's it. When asked their age... "I dont know" My pt was collared/backboarded prior to us on scene and mind you this was 2am... but after arriving at the hospital and giving report... we found out she had a probable broken pelvis, GSW to the back of the head and internal bleeding. Come to find out later that the vehicle was shot at several times prior to crashing. And this is what is comes to.... teenagers (who in my opinon shouldn't have even been out at that hour) out having a good time... were executed in the back of the car. While not verifiable at this point, we believe the DOA on scene was probably shot in the head too.
I have to admit I cried most of the way home. Generally I'm able to leave work at work.... but the inundation of stupid... and I mean STUPID calls along with the senseless waste of life responses we've been getting is overwhelming. Most people get into Fire/EMS cause "they want to help people"... or .... "they want to make a difference". I'm doing neither. Maybe that's just what I need to accept. I love my job.... in its theory. I certainly love the family I have at work and the firefighting. And if the calls we ran, even if they were 23 in 24 hours were true 911 calls, I could run them all night long and not miss a beat.
But imagine if you will (for any of my non-EMS readers)... you come into work at 0600 and run calls (no problem)... and you finally catch lunch at 3:30pm after you've had diarrhea smeared on you, a drunk homeless person swearing at you.... then after missing dinner completely cause you're still running calls at 0300am.... a 24 yr old healthy woman calls 911 with 6 cars in the driveway cause her head hurts. She's taken 4 Tylenol over 2 days and done nothing else to relieve the pain except lay in bed and moan. Seriously?!?!?! You want an ambulance to cart you to the ER for a flippin headache?!?! Yes... she seriously does. Its very hard to sympathetic.
Ok.... my rant is over. I love my job and cant wait to see what I might encounter tomorrow. Hopefully something challenging. Maybe I will have an easier shift for a change.... maybe. Until then I will serve the citizens that pay my paycheck.
Now normally we have a good rotation between the engine and the rescue, but lately due to people on vacation, or whatever I have had many...MANY shifts on the rescue. And we've been getting beat on almost every shift. A couple of shifts ago we ran 23 calls in 24 hours. We only transported 3 and only 1 of those *needed* transport. I would love to do a PSA campaign on why you do/don't call 911. A lot of our territory is just so uneducated and view 911 as their personal taxi to use the ER as their primary care physician. I was brought up that you call 911 when you are DYING or close to it. NOT because you have a toothache, a headache for the last 6 hours, a stubbed toe, your kid has had a fever for the last hour, or your drunk. (Just to name a few)
Now, call me bitter, call me whining... this is my blog and I can vent all I want or need to. I understand that probably 85% of my job in my territory that I work is public education. But it never ceases to amaze me the craziness that plagues our 911 system. I've joked at the notion of recording via a pin-hole camera on my radio belt the patients we encounter in a day's work. And then broadcast a PSA. Maybe then our hospitals who are failing and bankrupt due to the overwhelming demand of non-paying patients could catch a break and get back up on their feet.
This last shift has been a little bit of a breaker for me. I've really needed these 2 days off to veg out. We ran a call for a vehicle accident with entrapment. Enroute it was a car into a house. We were the 2nd rescue in with everyone else already there. By the time we pulled up they had the roof cut off and was pulling the 1st patient out the back (our patient). 3 16-yr olds in the back, one DOA, 2 front passengers A/O x3 on the front lawn. Our pt was A/O x4. Multiple punctures, lacs, and possible broken leg. Enroute everything went unremarkable. Our pt was able to give me their name but that's it. When asked their age... "I dont know" My pt was collared/backboarded prior to us on scene and mind you this was 2am... but after arriving at the hospital and giving report... we found out she had a probable broken pelvis, GSW to the back of the head and internal bleeding. Come to find out later that the vehicle was shot at several times prior to crashing. And this is what is comes to.... teenagers (who in my opinon shouldn't have even been out at that hour) out having a good time... were executed in the back of the car. While not verifiable at this point, we believe the DOA on scene was probably shot in the head too.
I have to admit I cried most of the way home. Generally I'm able to leave work at work.... but the inundation of stupid... and I mean STUPID calls along with the senseless waste of life responses we've been getting is overwhelming. Most people get into Fire/EMS cause "they want to help people"... or .... "they want to make a difference". I'm doing neither. Maybe that's just what I need to accept. I love my job.... in its theory. I certainly love the family I have at work and the firefighting. And if the calls we ran, even if they were 23 in 24 hours were true 911 calls, I could run them all night long and not miss a beat.
But imagine if you will (for any of my non-EMS readers)... you come into work at 0600 and run calls (no problem)... and you finally catch lunch at 3:30pm after you've had diarrhea smeared on you, a drunk homeless person swearing at you.... then after missing dinner completely cause you're still running calls at 0300am.... a 24 yr old healthy woman calls 911 with 6 cars in the driveway cause her head hurts. She's taken 4 Tylenol over 2 days and done nothing else to relieve the pain except lay in bed and moan. Seriously?!?!?! You want an ambulance to cart you to the ER for a flippin headache?!?! Yes... she seriously does. Its very hard to sympathetic.
Ok.... my rant is over. I love my job and cant wait to see what I might encounter tomorrow. Hopefully something challenging. Maybe I will have an easier shift for a change.... maybe. Until then I will serve the citizens that pay my paycheck.
Tuesday, July 10, 2007
Back in the saddle
I'm been back at work for a month now and everything is going well. Initially was on the box all the time, but I asked for that as I did not want to be a liability to my crew. We've had some good calls, but the meat and potatoes of the job is still there in full force. Doing the stretcher has been a little difficult but for the most part have figured out ways to get the job done when there is no extra help around. Threading an IV hasn't been a problem with my left hand and intubating has been fine. One of my first few shifts back I had a patient who needed some calcium. When was the last time you broke out the calcium? Yeah, me too. But I had a brain fart and when doing my calculation, I calculated twice in my head and thought I had OD'd the patient. I thought, oh great, just getting back at this and here I go. Turned out to be fine, I hadn't OD'd her, and her rhythm returned to normal.
Had a GSW the other day and he was a very lucky guy. Guy was shot at point blank range to the L-mid-axillary line at about the 3rd to 4th intercostal space and exit wound was mid-scapula, 4th to 5th intercostal space.... and it never hit his lung. I was pretty impressed.
Also ran a call on a woman short of breath. Asthma history, but stating at 99% and clear, and took her in. My partner who is getting her in the back turns to me and says, "She says her finger blew up". During the last 15 minutes of talking with the patient, she never mentioned her finger, but after looking over at it, I can't imagine how she couldn't have mentioned it. It was 3x its normal size, the skin splitting in several places and oozing pus all over the place. She mentioned that she had hit it on something earlier in the week and a few days ago the nail had fallen off. She was just putting neosporin on it. For as sick as it looked, I asked her, "Jeesh, did you slam it in a car door or what?".... no, she hadn't.... just hit it on a counter or something. It was a classic diabetic response injury. I looked under her haphazard bandaid and there was a definitive hole down through the middle of her finger. IV antibiotics were definitely on the menu in hopes to stave off an amputation.
All in a day's work.
Had a GSW the other day and he was a very lucky guy. Guy was shot at point blank range to the L-mid-axillary line at about the 3rd to 4th intercostal space and exit wound was mid-scapula, 4th to 5th intercostal space.... and it never hit his lung. I was pretty impressed.
Also ran a call on a woman short of breath. Asthma history, but stating at 99% and clear, and took her in. My partner who is getting her in the back turns to me and says, "She says her finger blew up". During the last 15 minutes of talking with the patient, she never mentioned her finger, but after looking over at it, I can't imagine how she couldn't have mentioned it. It was 3x its normal size, the skin splitting in several places and oozing pus all over the place. She mentioned that she had hit it on something earlier in the week and a few days ago the nail had fallen off. She was just putting neosporin on it. For as sick as it looked, I asked her, "Jeesh, did you slam it in a car door or what?".... no, she hadn't.... just hit it on a counter or something. It was a classic diabetic response injury. I looked under her haphazard bandaid and there was a definitive hole down through the middle of her finger. IV antibiotics were definitely on the menu in hopes to stave off an amputation.
All in a day's work.
Wednesday, May 30, 2007
Next step
I finally have it in ink! I've convinced my doctor to let me go back to work! I'm so excited I'm bouncing off the walls... its kinda like being put on parole. I still have a good 4 months of therapy and doc said surgery in the future is a possibility (I sure hope not, I'm SO done with surgeries)... but at this point, the fact that I can get out of this flippin house and get part of my life back is SO WONDERFUL!
I am a good 3-4 months ahead of schedule, and while I'd love to, wont be fighting fire anytime soon. Index finger is still broken, but I can still thump on a chest, push drugs, and granny tote.There will be a few things with a learning curve as I learn to adapt and figure out new ways to do things on the job, but it will be good occupational therapy to just get out there and do it!
So next Saturday is gonna be a good day! I know for all you guys who think I'm crazy just itching to get back to work... but then again, I just love my job and have the best crew you could ever ask for.
Tried riding this past weekend. 2 months to the day I got hurt, and while I have some mental blocks to get over, its the first baby step to get back out in the dirt!! Have a great holiday weekend. If you don't have plans and you live anywhere around north GA, Durhamtown is having an awesome Pro Freestyle Bike and Quad competition this weekend. I will be down there all weekend.... watching... ha ha ha, don't worry... this girl wont be trying any freestyling. Play hard... get dirty.
I am a good 3-4 months ahead of schedule, and while I'd love to, wont be fighting fire anytime soon. Index finger is still broken, but I can still thump on a chest, push drugs, and granny tote.There will be a few things with a learning curve as I learn to adapt and figure out new ways to do things on the job, but it will be good occupational therapy to just get out there and do it!
So next Saturday is gonna be a good day! I know for all you guys who think I'm crazy just itching to get back to work... but then again, I just love my job and have the best crew you could ever ask for.
Tried riding this past weekend. 2 months to the day I got hurt, and while I have some mental blocks to get over, its the first baby step to get back out in the dirt!! Have a great holiday weekend. If you don't have plans and you live anywhere around north GA, Durhamtown is having an awesome Pro Freestyle Bike and Quad competition this weekend. I will be down there all weekend.... watching... ha ha ha, don't worry... this girl wont be trying any freestyling. Play hard... get dirty.
Tuesday, May 22, 2007
More rehab
I know some people do sustain injuries that incapacitate them life long... but working where I do, I have encountered my fair share of people milking the system. Now, after me being laid up for 2 months... I just don't know how they do it. I am going flippin NUTS sitting here at home! I want to go back to work... NOW! My therapist jokes that when I'm 50, I'm gonna wish I had taken half a year off. I severely doubt it. I don't care if I shovel shit at this point, I just need to do SOMETHING!
I feel clumsy at everything I do. This past weekend I went out to Durhamtown since my accident. Hung out with some friends and we planned on riding the quad, the bike and doing some fishing... mmmm... and maybe a little drinking. LOL. Lets just say that I had a good time fishing. I need to learn patience with myself. But I guess I had talked myself up in my head so much and being back out there... it was not fun.
I feel like the part of my spirit that was so "balls to the wall" wasn't there. Granted, the quad I was riding is 4x bigger than what I'm used to riding, but I felt like it was taking ME for a ride. The next day I rode the dirt bike and really didn't have a good time. Falling just simply was NOT an option that day. I felt out of control. I know a lot of that comes from my index finger still being broken and everything else on my hand being hyper-sensitive... but... BUT... I want to ride! I want my life back, dammit!
I've been thinking a lot over the last couple of days about being so skittish this past weekend. Ya know, before this accident, broken bones, sprains, abrasions.. whatever... yeah they hurt... but they HEAL. And since I wasn't doing anything spectacular when I crashed, I feel like.... crap, what happens when I fall again? Falls are just a part of the sport, they happen. Its just a mental block that I need to work through. And I just don't want to give up something that I love so much. I know... baby steps. That's like telling the Tasmanian Devil to slow down. I need to find something to be good at again! SOON! Frustration, awkwardness and clumsiness is running rampant right now. Hell it takes me 15 minutes just to put my hair in a ponytail!
If I can get back to work, even as the medic on the box, I'll be ecstatic. I can at least use my noggin and feel useful again. I am trying to talk my doctor into letting me go back to work... if I can go back soon, I'd be a good 3-4 months ahead of schedule. Therapy has been going well and almost every visit I have Dan shaking his head. LOL. Every week he creates new splints for me to improve mobility in my joints and tendons. So, we'll see.... stay tuned...
I feel clumsy at everything I do. This past weekend I went out to Durhamtown since my accident. Hung out with some friends and we planned on riding the quad, the bike and doing some fishing... mmmm... and maybe a little drinking. LOL. Lets just say that I had a good time fishing. I need to learn patience with myself. But I guess I had talked myself up in my head so much and being back out there... it was not fun.
I feel like the part of my spirit that was so "balls to the wall" wasn't there. Granted, the quad I was riding is 4x bigger than what I'm used to riding, but I felt like it was taking ME for a ride. The next day I rode the dirt bike and really didn't have a good time. Falling just simply was NOT an option that day. I felt out of control. I know a lot of that comes from my index finger still being broken and everything else on my hand being hyper-sensitive... but... BUT... I want to ride! I want my life back, dammit!
I've been thinking a lot over the last couple of days about being so skittish this past weekend. Ya know, before this accident, broken bones, sprains, abrasions.. whatever... yeah they hurt... but they HEAL. And since I wasn't doing anything spectacular when I crashed, I feel like.... crap, what happens when I fall again? Falls are just a part of the sport, they happen. Its just a mental block that I need to work through. And I just don't want to give up something that I love so much. I know... baby steps. That's like telling the Tasmanian Devil to slow down. I need to find something to be good at again! SOON! Frustration, awkwardness and clumsiness is running rampant right now. Hell it takes me 15 minutes just to put my hair in a ponytail!
If I can get back to work, even as the medic on the box, I'll be ecstatic. I can at least use my noggin and feel useful again. I am trying to talk my doctor into letting me go back to work... if I can go back soon, I'd be a good 3-4 months ahead of schedule. Therapy has been going well and almost every visit I have Dan shaking his head. LOL. Every week he creates new splints for me to improve mobility in my joints and tendons. So, we'll see.... stay tuned...
Sunday, May 06, 2007
Rehab
I am well underway into therapy and I think I have encountered almost every emotion. Since my last posting, I've seen my hand unwrapped and lost it. I've stiffened my upper lip, taken account of what I've lost, what I still have, met people who've lost more than me and have learned about true friends and what they're willing to do.
Shortly after writing my last entry, and letting the wounds start to heal from the skin graft surgery, I had my appointment to see my hand as it would be. My legs were continuing to burn and feel as if someone were stabbing me, my skin graft was not healing well and I was an all-around wreck. We added vsits to a neurologist to figure out why you couldnt even blow on my skin on my legs without me having a meltdown. Pain meds were maxed out and eating a sweet-tart had the same effect. Time is passing slowly. I oscillate pretty frequently between being all gung-ho and being frustrated and bitter.
Shortly after writing my last entry, and letting the wounds start to heal from the skin graft surgery, I had my appointment to see my hand as it would be. My legs were continuing to burn and feel as if someone were stabbing me, my skin graft was not healing well and I was an all-around wreck. We added vsits to a neurologist to figure out why you couldnt even blow on my skin on my legs without me having a meltdown. Pain meds were maxed out and eating a sweet-tart had the same effect. Time is passing slowly. I oscillate pretty frequently between being all gung-ho and being frustrated and bitter.
Tuesday, April 03, 2007
Injured
Bet you thought I'd never update this thing did you? Well neither did I for a while. Pretty much all of February I felt like everything I was running was so run of the mill. We had a few moments here and there that I wanted to jot down and right about but never did. But now its the beginning of April and so much has happened the last 3 weeks.
I was at my part time job where I work as a medic at a sportsman resort. You've read about Durhamtown and its where I have raced and ride as much as possible. Well Mark and I were out patrolling the trails and on the "B" trail there are these 2 hills/jumps that are blind doubles. They're meant for bikes, but if you're on an ATV and you hit it fast enough, you'll fly right over the 2nd one. Well, since we weren't riding hard, and when working we're on utility quads, I came over the first part and hit nose heavy in between the 1st and 2nd jumps. Instead of rolling right over the 2nd part, the quad bounced and me and the quad went rolling. After rolling about 40', and kind of taking inventory of everything, I realized my right hand was hurting.... a lot!!! I pulled my helmet off with my left and saw from the tears in my glove that my right hand was really messed up. I was able to pull my glove off (later you'll see how I don't understand how I could do this), and once my brain acknowledged that it was MY hand that I was looking at the wave of pain that washed over me was indescribable. I prayed to pass out but it never came. Mark finally realized I wasn't behind him, listened to me scream and ramble as he packaged me up, and I was off to the closest hospital which is about 50 minutes away. Unfortunately, the medic that I was with couldn't get a line so I had no pain relief while en route. The lidocaine block once in the ER was SO wonderful. They realized I need both a hand and vascular surgeon specialist, so I was shipped over to Atlanta. Thank goodness!!! I have been blessed with an amazing doctor!! So.... the outcome?
After the first surgery, which ended up being 8 hours instead of the expected 4, due to the damage and amount of dirt in the wounds, my doc grafted about 8" of veins from my forearm into my fingers in an effort to save them. After 2.5 days, and watching my middle and ring fingers turn black, they amputated them just past the last knuckle. The tip of my pinkie was lost in the incident. We're not sure what exactly crushed my fingers, but it sure was a doozy of an injury. You'll see in the xray pics that all four fingers had significant injury. But there is much to be thankful for. Even though I now only have nubs for 2 fingers, which gives me a permanent "rock on" hand sign, my thumb was not injured, my index finger was able to be saved, and the rest of me only received road rash.
My mom was able to come up for the last 2 weeks, and I've had some awesome and amazing friends by my side since minute one. My doc is stating 6-8 months for full recovery, I'm setting a personal goal of 5 months. Now that I'm not AS doped up on narcotics, its been good being at home to start setting a schedule for myself for physical therapy. My fourth surgery was yesterday, which they took skin grafts to cover my fingers and other wounds. Hopefully this will be the last one for a while. I have included pictures of the xrays, and links to the pics that are more descriptive in case those of you with weak stomachs don't want to see them. Sine I now have lots of time, I will try and keep this updated, albeit with PT stories instead of field stories for now.
I was at my part time job where I work as a medic at a sportsman resort. You've read about Durhamtown and its where I have raced and ride as much as possible. Well Mark and I were out patrolling the trails and on the "B" trail there are these 2 hills/jumps that are blind doubles. They're meant for bikes, but if you're on an ATV and you hit it fast enough, you'll fly right over the 2nd one. Well, since we weren't riding hard, and when working we're on utility quads, I came over the first part and hit nose heavy in between the 1st and 2nd jumps. Instead of rolling right over the 2nd part, the quad bounced and me and the quad went rolling. After rolling about 40', and kind of taking inventory of everything, I realized my right hand was hurting.... a lot!!! I pulled my helmet off with my left and saw from the tears in my glove that my right hand was really messed up. I was able to pull my glove off (later you'll see how I don't understand how I could do this), and once my brain acknowledged that it was MY hand that I was looking at the wave of pain that washed over me was indescribable. I prayed to pass out but it never came. Mark finally realized I wasn't behind him, listened to me scream and ramble as he packaged me up, and I was off to the closest hospital which is about 50 minutes away. Unfortunately, the medic that I was with couldn't get a line so I had no pain relief while en route. The lidocaine block once in the ER was SO wonderful. They realized I need both a hand and vascular surgeon specialist, so I was shipped over to Atlanta. Thank goodness!!! I have been blessed with an amazing doctor!! So.... the outcome?
After the first surgery, which ended up being 8 hours instead of the expected 4, due to the damage and amount of dirt in the wounds, my doc grafted about 8" of veins from my forearm into my fingers in an effort to save them. After 2.5 days, and watching my middle and ring fingers turn black, they amputated them just past the last knuckle. The tip of my pinkie was lost in the incident. We're not sure what exactly crushed my fingers, but it sure was a doozy of an injury. You'll see in the xray pics that all four fingers had significant injury. But there is much to be thankful for. Even though I now only have nubs for 2 fingers, which gives me a permanent "rock on" hand sign, my thumb was not injured, my index finger was able to be saved, and the rest of me only received road rash.
My mom was able to come up for the last 2 weeks, and I've had some awesome and amazing friends by my side since minute one. My doc is stating 6-8 months for full recovery, I'm setting a personal goal of 5 months. Now that I'm not AS doped up on narcotics, its been good being at home to start setting a schedule for myself for physical therapy. My fourth surgery was yesterday, which they took skin grafts to cover my fingers and other wounds. Hopefully this will be the last one for a while. I have included pictures of the xrays, and links to the pics that are more descriptive in case those of you with weak stomachs don't want to see them. Sine I now have lots of time, I will try and keep this updated, albeit with PT stories instead of field stories for now.
Here are the links to some pictures that I took once I had the lidocaine block as well as some the medic took for on my way to Atlanta. *** WARNING *** they're graphic.
http://i64.photobucket.com/albums/h183/gaffmedic/injury015.jpg , http://i64.photobucket.com/albums/h183/gaffmedic/injury013.jpg , http://i64.photobucket.com/albums/h183/gaffmedic/injury014.jpg , http://i64.photobucket.com/albums/h183/gaffmedic/pre-surgery.jpg , http://i64.photobucket.com/albums/h183/gaffmedic/pre-surgery2.jpg , http://i64.photobucket.com/albums/h183/gaffmedic/pre-surgery3.jpg , http://i64.photobucket.com/albums/h183/gaffmedic/injury3003.jpg
So.... while this is definitely a challenge for me for the next few months, I'm up for it. So, play hard, and get dirty.
***** Update*****
Here are some pictures from the "now".... still getting used to it. Have good days and bad. Now that the weather is getting colder... you know how your extremities hurt when they're cold and you hit them on something. Yeah... it hurts even more when I hit my nubs on something. Have 2 more surgeries next year that we know for sure. Life has been busy with a baby on the way, so my concentration on my hand has been diverted, which is a good thing.
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