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.
Saturday, December 20, 2008
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.
Subscribe to:
Comments (Atom)
