Wednesday, December 12, 2007

Finally, a funny story...

So, we're standing around the ER, finishing up paperwork and generally bullshitting.

My partner takes off his glasses and makes some comment about it being hard to write out his patient report.

Somebody else says, "You think that's hard? Wait till you're wearing bi-focals!" That person turns to the ER doctor and says, "Right, Doc?"

He very seriously replies, "Yeah, they're a real pain," demonstrating how he peers over the top of his glasses. He continues, without realizing what he is saying, "Especially when intubating... or doing a pelvic exam!" He's leaning forward, still demonstrating the head tilt and peering over the glasses.

The room goes quiet. Furtive glances are exchanged. Smiles start to break out.

The doctor looks around, "What!?" Then he realizes what he said and turns beet red. The room breaks out in laughter. Then we leave to go get another patient...

Wednesday, December 5, 2007

One that went well

It was dispatched as an unconscious patient. They almost always regain consciousness while we are on the way. The common phrase is "syncopal episode" - a fainting spell. So when the notes on the MDT were updated while in route with "PATIENT STILL UNCONSCIOUS," we knew it was probably serious.

We were on our way to sit point for area coverage, so our response time was faster than normal. As we pulled up, a sheriff's deputy car was outside the house, with the sheriff inside. We grabbed all our gear and loaded up the cot.

The sheriff met us at the door and said, "He's in the bathroom. He's still breathing."

My partner led the way and took one look at him - an elderly man on the floor, leaning against the tub. He was gray and dusty in color. "He's not breathing right. He's breathing like a fish out of water. Let's get him out of the bathroom."

We dragged him out and, suddenly, the training kicked in, and it was all asses and elbows, equipment flying everywhere.

While my partner prepared to intubate, I started pulling out everything we needed from the Lifepak monitor: blood pressure cuff, oxygen/pulse fingertip clip, heart monitor leads, etc.

While I was getting him hooked up, my partner successfully tubed him and started bagging him with the bag-valve mask (BVM). At this point, the fire fighters arrived and since the call was in my fire department's area, I knew them both.

"What do you need?" they asked. I tossed Jim the BP cuff and told Cupcake (Dave) to go get the backboard and straps from our ambulance.

By now, the patient had regained some consciousness and was looking at us, obviously unhappy about the tube down the throat.

"Sir! Don't fight the tube. It's helping you breath. I had to put a tube in your throat to help you breathe," my partner loudly told the patient, and surprisingly, he understood her and stopped fighting. She said to me, "I'm gonna give him some medication to help him tolerate the tube."

Once we got him stabilized, we slipped the backboard underneath, strapped him down, and lifted him to the cot. We found out from his girlfriend that he had COPD (chronic obstructive pulmonary disorder) and had not taken his breathing treatment that day.

In the ambulance, my partner asked fire to drive as she wanted me to help on the way. With lights flashing and sirens blaring, we took off down the road, things looking good.

Suddenly, he made a noise. We looked at each other, and it happened. He vomited. What looked like recently eaten chicken noodle soup came welling up, past the tube, running down his face, into his nose and eyes. I grabbed towels and started wiping, while my partner grabbed the suction and started suctioning. The guy was understandably freaking out and reaching for the tube.

"Sir! Sir! It's OK! You can breathe through the tube. Don't worry about vomiting!" Again, surprisingly, he understood us and stopped reaching for the tube. He crossed his hands on his chest and just looked at us.

At the hospital, we hustled the patient into the ER, and the staff burst into action. We quickly transferred him to the hospital bed and thankfully handed him off to the nurses and doctor.

It took us quite awhile to clean up the cot and the back of the ambulance, reviewing the call and what went right and wrong. While it had been stressful and physically demanding, it had gone well, and we felt we had been able to use our skills to truly help someone.

This was the type of call that make up for all the ones that are less than satisfying...

Tuesday, December 4, 2007

Third Time's The Charm

Black ice all over the county. Car crashes happening everywhere. Over the radio, dispatch sent probably 30 ambulances in 30 minutes to accidents - lots of rollovers.

Then we got one. Lights and sirens down icy roads. Luckily we got canceled by PD (police) - no injuries. Back to the station to catch breakfast. Radio pager goes off again, and we get dispatched to the same road, same intersection. "Probably the same car in the ditch, and the caller didn't bother to stop," my partner said knowingly. Yep, about five minutes down the road, we get canceled again.

Dispatch, not known for making jokes, sent us a text message on the MDT (the computer system in the ambulance that provides most of the call information), "Perhaps I should just stage you in the area." We have a good laugh and head back to finish breakfast.

After eating, I'm just about to finish some station duties when we get another call. Same road, same intersection. "Oh, come on..." we said as we started down the road, "Not again!"

My partner picked up the radio to ask dispatch if this is, yet again, the same accident. She glanced at the MDT and read the notes. "NOT THE SAME ACCIDENT. THIS IS A SEPARATE ACCIDENT!"

Whoa! So off we went to save the day. Lady lost control on the same stretch of ice, spun out, and hit a tree. Probable broken wrist. Lucky.

We had to backboard her and carry her out of the woods to the stretcher on the side of the road.

Be careful out there when you drive. Icy roads can be very deceptive and really dangerous.

Saturday, December 1, 2007

The Old Timers were right

When I first joined the fire department, I was all geeked up about running out there and saving lives. Who doesn't want to rush in and save the day?

And then the classes and training, all geared towards these worse case scenarios: mass casualty incidents, gun shot wounds, motorcycle versus deer. It gets you all fired up for the big one.

We'd get a call that sounded good. Alright, here's the chance to practice everything we'd trained for!

And we get there, and it's nothing. A mere flesh wound. A "oh help, I've fallen, and I can't get up," kind of thing... Or worse, we get canceled mid-route. That is so insulting... The old timers would say, "Those are the best kind of calls."

I would be disappointed if we didn't get to do something. I mean, really, we train and train and train, and we get called out for this?

Then we got a real one. I don't remember if my first real emergency was a car crash or a cardiac arrest or something else. Whatever it was - it sucked. It sucked big time. It was not fun. And it was definitely not cool. The young girl screaming as we struggled to pull her shattered feet and ankles out from under the crumpled dashboard. The guy gurgling in his own vomit as we preformed chest compressions and tried to ventilate him.

It is not a good time in that situation. You feel sick. You feel like you could cry. You wish you were somewhere else. You wish the ambulance would get here quicker. You wish the paramedic would take over and be responsible. But you can't, and you don't, and you won't. You do the best you can and hope for the best.

When it was all over, it feels exhilarating, and we discuss it in detail. What did we do right? What did we do wrong? Did you see it when...?

And now I realize that the old timers were right.