Monday, December 8, 2008

Busy night in the city

I usually work the ambulances in my county; they are close to home, and the call volume is low due to its rural nature. However, I needed some hours, and the schedule gets really tight before the holidays. So when one on the EMTs in Jackson sent out a message on the text pagers asking for for a sub on Friday night, I said what the heck... It was from noon to midnight, and I had not worked a weekend night shift in the city before. Time for the country mouse EMT to see the big city bright lights...

Bobby, a paramedic new to me, and I started the shift and drove out into the cold. When it was all said and done, we ended up with nine calls, a pretty busy shift - two of them refusals with no transport and three of them interfacility transports with no lights/sirens/drama.

We often go to the scene with lights and sirens but usually transport the patient without them. Having to go to the hospital with the lights and siren on is a BAD thing. I've had to do it a couple of times (cardiac arrest, difficultly breathing, pregnant lady), either driving or with a firefighter driving while I help my partner in the back. I tell people that when you see an ambulance flashing and wailing by with a driver and a passenger, think good thoughts because they are on the way to help. If you see an ambulance with lights and siren and only a driver, send your prayers because it means that someone in the back is in a serous way.

As for the other four calls, I can honestly only remember three as of right now. They often all blend into one generic call. Unless there is something of note, it will fade away, even during the same shift as we try to remember earlier calls.

The first one was a sick elderly lady with emphasyma and a two-pack a day smoking habit. She was uncharacteristically weak and lethargic and had been vomiting. We loaded her in the ambulance, took her vitals, set up an IV, and away we went to the hospital.

Later that evening, with an outside temperature of 14 degrees, we got a call for a man down in a parking lot of a commercial area town. The police had been driving by and had seen him lying in a decorative garden bed. When we got there, the officer and two fire men had assessed him and figured out he was drunk as a skunk. I've seen some drunk people (yeah, college!), but this guy was wasted. He was able to walk with assistance and sit on the cot but that was it. If I hadn't found his wallet in his coat pocket, we wouldn't have known a thing about him.

The most interesting call of the night was to an elderly gentleman's apartment for difficulty breathing. We took the elevator with our cot and gear up to the fourth floor and knocked loudly on the door. We heard him shuffling and saying, "Just a minute!"

Once inside, we tried to figure out what was going on, asking all the questions we normally do. No medical history, no medications, NOTHING. He was walking around with his cane, saying, "Whew! I'm so weak. I feel so strange. I don't know what's going on here." So he agreed to go to the hospital to get checked out.

We loaded him up on the cot and wheeled him out to the ambulance where we got him hooked up to the monitor. I placed the blood pressure cuff, the pulse oxymeter, and started putting the heart leads on his chest. As I pulled down the collar of his shirt to put a lead on his right collar bone area, I felt a distinctive lump under his skin. So I casually asked, "What's this thing on your chest, under your skin?"

He answered, "Oh, that? That's my pace maker!" My partner and I looked at each other - "No medical history, huh?" More questions revealed he had an extensive heart history.

So on the way to the hospital, I was filling in the data fields of the patient care report on the laptop, asking and answering the patient. He was a talker; we got along just fine. Then suddenly he started talking about booze. Wait a minute...

"Sir, have you been drinking?" I asked him in a sort of shocked tone. "Why yes, I have," he replied, "Whiskey!" That might explain why he was feeling so strange.

I enjoyed giving my report to the ER staff at the hospital. They all rolled their eyes and had a good laugh. You just never know...

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