A Work in Progress

The greatest call of the day/week/month came out as chest pain. We arrived to find our patient who only spoke Spanish with no translator in sight. Oh yeah, what made it a pretty hilarious call as well was the fact that I had a paramedic student with me. So, the student started to attempt doing his thing, although none of us spoke comprehensible Spanish, while the firefighters went to get the stair chair. When they returned, one of them for some reason inquired “Why is she on a nasal cannula?” Although I’m sure that some of my colleagues would point to the paramedic patch on their left shoulder and say “That’s why!” I, however merely attempted to explain that I believe a nasal cannula has more uses than for tying things together. Where a mask can feel constricting, a nasal cannula can deliver oxygen without raising the anxiety of the patient, the patient can still get a relatively high concentration of oxygen, and although you think she appears to be ‘gasping for breath,’ I think ...

When I got to work, I stepped up into the back of the ambulance and rammed the top of my head right into the doorway. I wasn’t sure which hurt worse, the top of my head, or my neck where it got hyperextended. Oh, it was throbbing. I stood there in the truck, blinded by my trauma, and thinking I had broken my neck. I wondered if my ear was leaking fluids, if my pupils were equal, and if I was bleeding. In a few minutes I could clear my own c-spine, but I continued to damn the tones, sirens, peoples voices, and any movement that caused me to feel my pulse in the growing goose egg on my head. It’s better now, although I had to comb my hair very gingerly today. Our first call was to assist the police with an unknown problem. They were trying to serve a warrant and the arrestee was claiming that her doctor told her not to leave the house. So, they called us to check it out. We walked in and a spry looking woman was sitting there, smoking a cigarette and yelling about going. She kind...

After a long dry spell of interesting things to blog, it seems that in one day I’ve had at least a months worth of excitement. I can barely handle it! So. I’m going to start from the beginning (of my day that is). Around 130 am today, Andy woke me up, and said “There’s smoke in the house.” What! I am not the easiest person to wake up, but I think I am getting better and faster at going from zero to competent, thanks to work. I threw on a coat and opened the door to the hall and was met with this horrid, acrid smell of some sort of burning substance. Hey, I’m no firefighter. So, Andy was sniffing around the house trying to find the source of it. He was already up because he is a responsible volunteer type and was going to go to a real call that had come out a few minutes before he stepped into the hallway and smelled this smell. Instead of going to the original call, he decided to have some more firefighter types come over and check it out. So as the emergency apparatus came...

Last week after a day at work, I got up early and flew home, amazingly cheaper and much faster than driving. It only took me about an hour of flying time to get to the Baltimore area. From there, the parents found me and we went directly to the fair in my hometown. We are crazy about the fair in my family. Relatives come from even farther away than NH to enjoy it. There’s something about it that entices us back; the food, the entertainment, the nostalgia. Because the fair has such a draw, I saw a great many of my family members, almost as many as Christmas time brings. The fair is never complete without corn dogs, laughing hysterically during a wild ride on the tilt-a-whirl, getting heckled by carnies, running into about 50 people you know, petting some cows, posing with a tractor, and doing some serious people watching. We also got to enjoy the annual demolition derby. Hilarious and awesome as usual and hopefully next year my cousin will get a few more hits in before his car d...

A proper update very soon, until then, a nutshell. Smashed up cars, whiny patients, the family, life long friends, air travel is brilliant, great food (corn dogs, hot turkey, funnel cakes, cotton candy, and pretzels), and being on vacation in my own house is straight up weird.

Since last we met: Um, a 10 month old w/febrile seizures, an increasingly crazy lady, a car accident with 3 refusals, one girl in big trouble, a guy who put his hand though a window (unfortunately a window that had glass in it), a lady who needed to be picked up off the floor at 4am, and some other calls which I totally don’t remember. Also, I got my 90 day review (so now, they can’t fire me on a whim.) I can hardly believe it’s already been that long! I’m off to Maryland tomorrow to enjoy family, friends, cars smashing into each other, piglets, and delicious hometown fair foods. Woot!

Patient complaint of the day: “My feet are cold.” We found her sitting on the floor outside of her apartment. How she got there was a bit of a mystery. Apparently she fell down in her apartment, and found it to be a good idea to crawl outside with a blanket, her purse, and her shoes. She ‘needed’ to go to the hospital so she could get her medical records. And her feet were cold. When she started moving she writhed in pain and exclaimed “My leg’s asleep!” Between us picking her up and putting her on a chair she made the greatest decision in the history of decisions and said she’d call a cab. Then we had a call for cardiac problems. When we arrived, we found a lady looking totally fine sitting in a clinic. The doc took a 12 lead as part of a pre-op check up and found some changes indicative of a heart attack. They hadn’t done anything for her, and why? She was completely fine. Asymptomatic from the time she walked into the clinic to when we left her in the ER. The best c...

Five years. Is that long enough for television specials, dramas and documentaries, two theatrical release movies? One, “Flight 93” which made almost 31.5 million dollars in the US alone. More recently, “World Trade Center” has made 55.6 million dollars so far. 87 million dollars, for who? Were these movies made in case we forgot? To remind us of what humans are capable of? As scare tactics? I still see faded "United We Stand" stickers on cars. I think we’ve forgotten what we’re standing for. It is a day of national mourning, and five years later, those responsible still roam free. Because the president puts a wreath on ground zero we're supposed to feel safe, comforted, of one mind? I read an article in JEMS about EMS providers who are literally dying from materials they inhaled during the clean up. People who are left with 33% of their lung capacity, bills they can’t pay, rare types of lung cancer, having to quit the job they loved because of debilitating...

We’ve had a whole mess of calls where ice cream could have been realized as a powerhouse drug in the prehospital environment. Amiodarone is to cardiac problems as ice cream is to everything else. We had a call for a fall. We found an 80+ year old lady who fell from standing and broke her wrist, her pelvis, was knocked out for about a minute and ended up with a concussion as well. Osteoporosis is a harsh reality, so keep eating that ice cream! Guy having pain from his sciatic nerve. Treatment: Ice cream topped with morphine. Chest pain with sinus arrhythmia 100-160. Treatment: Ice cream with bits of nitro in it. Worked like a charm. We had a lady with more complaints that all of my previous patients put together ever. "I can't feel my legs, and my arms hurt, and I have heartburn, and yeah, now that you mention it, I am having trouble breathing. Also, my back hurts, I can't stand up, I feel tired. I'm thirsty." I said: "Here's a quart of breyers,...

It was supposed to be easy, but these things never are. When I entered the house, from downstairs I could hear the fluid in her lungs. The patient was dying. The family, initially prepared for this event, had been enduring her tortured breathing for an hour now, unsure of what to do. The daughter, who could legally decide, didn't want her transported, and only really wanted her to be comfortable, nothing invasive. I was at a bit of a loss as to what to do. Lasix would only delay the inevitable and what she really needed was intubation, among other things. With a pulse in the 40s I tried to explain to the family that it was quite serious. I realized we were treating them more so than the patient, they only wanted to know that she wasn't in pain. So, we gave her oxygen and I attempted a line, but the lighting was terrible and she had no veins. I found myself able to think about nothing other than how horrible the situation was. Midway though my IV attempt, my partner leaned ...

We had a patient who had been huffing. ”Huffing?!” I thought, “who does that these days?” But indeed the patient had been doing it, and the mother produced the can to prove it. a. you are much older than 16, the age where I thought huffing, if it were to happen, would happen. b. it is not 1995, which is when I think the last reported case of huffing occurred. A lady found a bump in the sidewalk that caused her to crash her motorized wheelchair. The second motor wheelchair wreck in my career, and in this one, the chair came off worse than the patient. She was refusing before we were over the threshold of the store she had stopped in. I wanted to slip the card of my favorite lawyer in her purse, but alas, he works out of state. I think I had my first ‘sick person’ who actually turned out to be a sick person. Lots of calls come out as ‘sick person.’ It’s like the default category for calls where dispatch may or may not know what’s going on. Usually these calls turn out to be ...

A work in progress is celebrating 150+ posts and 7100+ hits! Yay. Certainly there are blogs that get that many hits in one day, or even one hour, but hey, it took me a year and a half! I'm going to celebrate by going to bed early and working the entire weekend! Woot! (if you want to buy me gifts, I'm sure we could arrange something, for the good of the blog, of course!)

We headed to a call for seizures. We figured something else was going on when two police cars showed up too. The relatives on scene said they were worried that the patient had a seizure and was refusing to let them in the apartment. The patient had a history of being combative when postictal (the state someone is in after having a seizure, typically they are confused and out of it, occasionally to the point of being violent.) So, we headed up to the apartment which turned out to be about 400 degrees, with the patient lounging in a chair looking totally fine. The relative insisted that she go to the hospital to be checked out and the patient jumped up and appeared to ready herself for a trip to the ER. On some calls, okay, on most calls you get a vibe of some sort. Sometimes it’s nothing, or that something doesn’t add up with the patient and their situation, or my favorite, when the vibe you feel is that of crazy. Just as this particular vibe was washing over me, the patient rus...