27 March 2005

Hyperglycemia!

Not a patient's hyperglycemia, silly, mine! Wheeee! It is Easter Sunday and following my annual Lenten venture of giving up sweets of all kinds, I've embarked on my traditional sugary goodness binge. There's nothing like starting the day with marshmallow peeps, rounding out the afternoon with no less than 1 million Cadbury mini eggs, and finishing up the day with a large chunk of angel food cake. Ah, heaven. This year I have a practical use for the sugar, to inspire me to finish up a paper and presentation due tomorrow. (A project due on the Monday after spring break?! I can’t believe it either. It should be against the law. I’m going to fine my teacher for messing with spring break. I think $300 should do it.)
Break was pretty nice. At my home station I taught my first 2 CPR classes. It was pretty fun and those mannequins sure do come in handy. I sent one to a boring meeting dressed in my clothes, another one to the dentist, used one to get me into the HOV lane, and got to play some pretty funny practical jokes with them.
I enjoyed visiting my niece and nephews (all of whom are adorable, and getting so smart, if I do say so myself). I also had fun shopping with my mom for new Easter clothes. Me enjoy shopping? That’s impossible! I was happy to catch up with my two best friends as well. All the planets must have been in alignment or something; all three of us available at the same time, on the same day, in the same year, amazing!
Well, I suppose it’s time for work, and more candy! Wheeee!

21 March 2005

Flash = happy dance

There are few things more satisfying than seeing the flash when starting an IV. Every time I see it, I want to jump up and do a dance, but I manage restrain myself. I don't like to show my craziness to patients...at least not while I have a needle in their arm.
I had a city shift last weekend. It was my first day shift and I think I liked it better. I was lost slightly less than 100% of the time, which was nice. I can't stand not knowing where I am, and it was easier to keep track in the daylight.
I started a record two IVs, and gave glucagon, my first real drug. This was a pretty harrowing experience. Glucagon has to be reconstituted and, of course, we were already rolling when I started, so I got to almost stick myself about 4 times. There is definitely an art to wielding a needle in the back of a moving ambulance. I also got my first call for a violent crime, a cutting. I was bandaging this while my patient was sitting on the marble steps of a formstone house in the heart of Baltimore. For the first time I felt Baltimorean, it was pretty cool.
So, now it's spring break (and there is much rejoicing). I'm thoroughly enjoying doing very little. Next, next weekend is another busy one, with at least one city and one ER shift.
Have a happy whatever it is you may be celebrating this time of year!

13 March 2005

Me? I can't believe it!!

Last night was less craptacular (fewer drunks) but more downtime, which always has me on edge for some reason. I got two IV attempts (1 success), an EKG, and a neb.
Maybe the funniest bit of the night was when my nalgene bottle which was sitting in the 'action area' was launched into the oxygen compartment when OGM hit the brakes. I felt like an idiot, but when I went to retrieve it, it fell out of the ambulance onto the parking lot, and came through its adventure unscathed. Now I'm a nalgene believer.
On my second IV of the night the patient noted that she was a difficult stick. My preceptor said: "Oh, don't worry, Ellie here was the 2004 phlebotomist of the year." The patient replied: "Oh, good!" and I thought: "Oh crap!" because he was totally making that up. No matter, I got the IV, and can therefore retain my title. I will be passing on the crown and the needle shaped scepter soon though. I've been formulating my retirement speech for my adoring public. "I'm so happy I had this year to support world peace through the successful cannulation of every vein, and seamless blood draws for everyone." how touching, I know.
Well, hopefully more excitement next weekend. I have one city shift and then back to my hometown for some ambulance-129 fury and spring break! yay!

12 March 2005

I am not a white cloud!

I’m whatever color cloud that reaps crappy calls all shift. My preceptor suggested I get a talisman of some sort and pray to it for better calls, either that, or never come back because I’m bad luck. If a Baltimore City police officer had to spell my night they would say: Bob, Uncle, Lincoln, Log, Charlie, Rash, Apple, Pencil.
You can get this great romantic feeling riding in the back of a Baltimore city medic unit. The BELIEVE sticker in the window, siren wailing at traffic, the lights reflecting off of store fronts and residences as you fly by on your way to heal and help people. I’ve learned that romantic feeling dissolves quickly when you realize you could get a buzz from your patients’ vodka flavored breath.
Last night was my first real experience with drunks (I’m a medium town girl). I hope that I never find them anything but amusing.
Envision pulling up behind a police car in an alley. The officer is standing on the sidewalk looking down at a guy who is half under the car, just behind the front tire. That's what we pulled up to. From any angle it looked like the guy had been run over by the police. But it turned out that the patient had put himself under the car for reasons unknown.
Another call was for a guy who had ‘cut his wrists’ although, it hardly amounted to anything. This guys inane ramblings about God knows what made me almost burst with laughter, but I managed to keep it in. This was mostly due to the fact that I could feel OGMs rage toward him from across the ambulance.
But, the night was not a complete lesson in drinking to excess. I did get my first field IV on a guy who had heart palpitations. I’ve never seen so many fantastic veins on one person, it was great. I love my preceptor and OGM, they practically forced the guy to go to the hospital so that I could get an IV and an EKG, awesome!
Well, I’m off to get ready for another shift tonight. I’ll bring my trolls, lighters, a rabbit's foot, lucky pennies, and the just plain luck of the Irish. Hopefully that will get me something fun. (disclaimer: EMS personnel do not wish death or injury on anyone, just for a good shift: )

10 March 2005

Wave and snap, wave and snap....

I love my hospital ID badge (even though it says I'm an EMT student). It opens almost everything, and it's on one of those retractable ID holders with the string for extra fun. I can wave it at doors, staff elevators, children, refrigerators, supply closets, the elderly, and at the parking garage. It's great fun to walk down the hall unlocking all the doors with just a wave of the ID badge. And it's so easy, just wave and snap!....But I digress.

Last night was my first ER clinical. It was pretty cool. I did about four 12 lead EKGs, all unremarkable, took a ton of vitals, and showed a strong 100% IV success rate (1/1 counts, right?)
I also got to watch a spinal tap. Now, there's an unnatural procedure. I was glad I was wearing a mask, especially when I realized my mouth was hanging open. I looked from the patient to the cerebrospinal fluid and back again thinking: "That's your CSF! That's not supposed to be out here!"
Later, after a couple of failed IV attempts by an unnamed student, and the charge nurse, I watched an ultrasound IV placement, which was pretty cool too.
On the same veinless patient (whose tongue was swollen to at least twice its normal size) the ear nose and throat doc put a bronchoscope down her throat (via nares) to monitor the swelling there. This was almost torturous to watch, but he let us sneak a peek, which made it worthwhile.
So, all in all, I enjoyed the ER shift. After envisioning burned out nurses bossing us around forcing us to do foleys, walking into a nice ED to eventually get to know some good people, and practice skills was a relief.

Oh! I almost forgot, the drunk and disorderly people. How could I forget these vitamin 'A' and 'H' deficient people? (A and H refer to a sedative and an antipsychotic med, respectively.)
Both patients could be heard before they were seen, but one was making an unusual noise. The sound of his teeth grinding together resembled that of a cricket, and was just as loud. I found this so disturbing, I wanted to believe he had a cricket in his pocket and it was not his teeth constantly grinding, ew! The other student there had just been assigned to get a glucose stick on him. As he gathered the equipment, the patient was seen walking across the nurse station and out the door. (he was later brought back, and settled down for his long drug induced winters’ nap.)
The other patient was a fiery million year old lady who insisted upon calling every unsuspecting person into her room to try and help her out of bed (she was being mechanically held there). I told her that what was keeping her in the bed was a very complicated device that I didn't have the expertise to figure out. One of the techs sat at the computer telling her she was researching how to help her. This patient mercifully took a little nap for a while, too.

My next ER shift isn't until sometime next month but this weekend I have two city shifts, I'll keep you posted.