31 July 2006

Downy Oshun!

Today I decided to find the ocean. It only took about 30 minutes of driving before the sea became an unavoidable obstacle. I was very excited, happy to prove to myself how close it really is. After dipping my feet in, I drove along most of New Hampshire’s 18 mile coastline. It was a lovely drive, I visited an adorable church, a state park, and a teeny tiny science center.
I also found a beach that has the potential for trying out surf kayaking. Almost private sandy beach, small waves, and, well that’s all really. Less people to see me mess it up, no rocks to hit my head on. I’ll put it on the “maybe later” list.

I eventually found myself in the charming town of Portsmouth. I enjoyed the ambiance here and bakery goods. I drove back home on instinct and the compass in the truck. Now, I’m waiting for the inevitable mid summer heat wave to come. It’s apparently on us tomorrow, and I know that northerners can’t handle the heat very well. Should make for an entertaining week.

Other than that, I got my diploma, ate pie, and ran out of advice.

Busy and not so busy

Thursday night allowed for no sleep. We had a call about every 2 and a half hours. For our first call we got to wander around the highway looking for a patient that didn’t exist.
We had a 14 year old mystery patient, semi-conscious for an unknown reason. Reactive pupils, clear lungs, good respiratory effort, no drug history, good blood sugar, not an alcoholic, sinus rhythm, no seizure history, well, I couldn’t figure it out, and to my satisfaction, neither could the doc. I hate mysteries that I can’t solve.
We had a quasi chest pain, that I think was actually respiratory related, a “trouble breathing” that turned out to be, well, not trouble breathing at all. Later we had a “trouble breathing” that really was trouble breathing. When we fixed him up with a little neb he decided not to go, then decided to go, then not to go, then we ran away.

On Friday I visited the Manchester mill museum. Good Lord, I’m such a nerd! It was pretty interesting, as Manchester used to produce more woven textiles than anywhere in the world. I learned that a “queen city” is a city that is the largest in the state, but not the capitol, like Manchester.
I also went to the mall of NH, where they have a Le Gourmet Chef, my favorite cooking store. It’s ironic that I like this store, given that I think gourmet cooking includes smearing peanut butter on a tortilla and microwaving it.

Saturday day was the busiest day I’d had on the transfer truck. 6 calls in 12 hours, We had two long distance calls, and in between, four other calls. We were only at the station for about an hour and a half total, and we got off an hour late. Our first call was to a rural community hospital about an hour from town. The drive over was beautiful, and enhanced with lights and sirens. Our patient was having a GI bleed, and had received whole blood and fresh frozen plasma before our arrival. When they came in initially, BP in the 70s and pulse ox in the 60s. Thankfully, much improved by the time we arrived.
Later we had a non interesting headache and an interesting leg pain. No, for real, interesting leg pain. The patient had disease where his nervous system fires pain impulses for no reason, over and over, all the time. Other than being a veritable expert on the disease, he was in general very interesting to talk to. And, considering we had about an hour and a half to hang out, it made for a nice drive. It was slightly annoying, but I liked being busy as the day went by really quickly.

Sunday day was the complete opposite of Saturday. 3 calls in 12 hours, it was great!

Google search term of the week: “break dance fair ride injuries” I don’t even know what direction to go with this one.

26 July 2006

Mini Post, aww!

I just spent 10 minutes trying to remember our first call today, turns out it was, well, forgettable. Later we had a minor car accident, which marks one of the few times I’ve used a KED (short backboardish thing that is good, albeit rarely, for extricating people from cars.)
Later we had a person who thought it might be therapeutic to carve six, two inch lines into their arm. Pretty wicked cuts that thankfully stopped bleeding easily.

Also, I got coverage for time off and booked flights to go home soon. (time out! *happy dance* time in!) I am dead excited about this!
In addition: re-strung the guitar, cooked dinner, started my work benefits, and ran lots of red lights (at work, of course).

25 July 2006

Pictures Abound!

Finally got around to taking the film somewhere to be developed! I have also recently discovered the magic of getting said film put on CD. Why didn't I think of that?!
The pictures span quite a period of time, graduation (sort of), two states, 4 bodies of water, and other random stuff.
In light of this, I have put them on the site, but I’ll give you the links to the different folders, to enhance or increase confusion (I’m not sure yet). The newer ones are first to avoid phrases such as “New pictures? But I’ve seen these!” and “Ellie is a false advertiser!”
Links as follows:

New Hampshire

Kayak Spots

Moving

The Truck

24 July 2006

Pair of Hands

So, Andy’s partner was feeling ill, so I came in on Friday night. After I arrived, nothing happened. Really. We had one call 5 hours after my arrival that was a refusal.

But, I did get paid overtime to get a fair amount of sleep. Three hours after Andy left, my real shift started and we had 2 transfer calls. One was a 6.5 hour NICU transfer. This was a little weird for me. Back in MD, for NICU calls, we’d take the team, but still have a role in the call. Here, we pick up the team, and do absolutely nothing except lug the isolette around.
It was, as many NICU calls are, a situation where I felt desperate to have my hands full of something. The need to feel useful was overwhelming. Once our destination changed from 20 minutes away to an hour and a half away, I set my mind to calculating if we had enough oxygen in the main tank to get us there. I also occupied myself remembering how pH, Co2, pulse oximetry, and breathing rate are all connected, and how the treatments they were attempting would work.
On the way to the other facility, I even rode in the front seat, which illustrated that it was so not my patient that it didn’t even matter if I recorded any vitals or even supervised care. At the beginning of paramedic school, they told me I was not yet a paramedic, but a pair-of-hands, but for this call, I wasn't even that.

Yesterday we had a normal day until the end of our shift when we got to take a 911 call in my 1 stop light town. Because it’s kind of far away, they send an interfacility truck to the 911 calls there instead of tying up a city truck. I was pretty excited, as it served as my first call with my future fire dept. I was surprised to find out that our patient had been pepper sprayed for resisting arrest. “Pepper spray, in my little town? No way!”

Since then, I enjoyed stars and seclusion, happily slept in, found some whitewater (joy!), impressed a stranger, met another snake, ate ice cream, and washed dishes.

19 July 2006

3 calls, 4 pts, 1 transport.

Pretty simple day today, a highway fender-bender, ‘trouble breathing’, and syncope.

Trying to find the accident was fun (having the right exit number helps), but once we found it, it turned out to be not a huge deal, thankfully. My patient was very ready to get rid of us.

me: “We’d just like you to sign this…”
patient: “…so I won't sue you for injuries I may have, or may develop as a result of the accident, blah, blah, blah, I know.”
me: (taken aback) “um, basically, yeah.”

I had a student for a while again today. We had a slightly more interesting call than last week. Like many EMT students, she has been disillusioned about EMS, and is finding big discrepancies between the classroom and the street. It’s hard to explain to her, given that I’ve only recently gotten over this myself. Not all patients are straight forward, none have read the textbook, and I can’t base my treatment on one vital sign.
For example, she popped the pulse ox on the pts. finger, got a reading of 93%, and took it off. I could tell that she was concerned by this, and even voiced it to me. I had to later explain maybe a few seconds’ more time on would have given a higher reading, to treat the pt. and not the reading, and that not all readings below 98% give me a reason to worry.

me: “Did you actually black out?”
wife: “He did.”
husband: (indignant groan)
wife: “…and then he threw up”
husband: “I did not!”
everyone: (uncomfortable silence)
me: “Would you like to go to the hospital?”
husband: “No.”
wife: “Well, see how you feel when you stand up”
husband: “Fine!” (stands up quickly)
wife: “Go sit in your chair in the den.”
husband: (proceeds to walk briskly through the house an around said chair in dramatic fashion)
wife: “What are you doing?”
husband: “You wanted me to walk around!”
wife: (worriedly whimpers and wrings hands)
husband: (is fine)
what would have been a more hilarious turn of events: (pt. then actually faints and/or throws up)
next thing you know: (we’re back in service)

Co-worker quote of the day: “So, you have a degree in paramedical studies or something?” Yes, with a minor in nameology.

17 July 2006

Underexcited

Today I finally had orientation for the hospital that I ‘work for.’ My ambulance company is owned by a local hospital; therefore we are all subject to this interminable orientation. Um…yawn…zzzZZZzzz…


Whoa, I just fell asleep trying to think of something to interesting to say about orientation. I won’t try again. I had been forewarned about it though. Several people recommended that I bring a book, headphones, mini-DVD player, novelty glasses with eyes drawn on them, or a mannequin in my likeness to sit there, while I do something more entertaining, like, anything else.

Some of the speakers tried to keep it interesting by getting ‘audience’ participation. One moment I particularly liked was when the lady was going on about God knows what and said: “The bottom line is that were here for the pa…” indicating that we were to fill in the blank, and at that moment, all I could think of was “paycheck.” She was going for “patient” of course.

In the end, I was grateful for air conditioning, free food, and hilarious videos about harassment, HIPAA, and cultural diversity. For example: “Can you spot the HIPAA violations?” This preceded a video where a lady learns her neighbor has HIV because she read a computer screen, a cop gets patient information on his ex-wife for his custody trial, and a guys liver gets sold on the black market. Wait. That wasn’t in there, but it should have been!
Then we watched a video about cultural differences. This highlighted the classic ‘coining’ on children, the consequences of judging a book by its cover, and that religious views can get in the way of modern medicine. Unfortunately, from what I’ve seen at work, some people need to re-visit this video and all of it’s hackneyed lessons.

I also finally signed up for benefits, learned the magic of earned time, got a pointless ID card, and ate yummy cookies.

Work this weekend was pretty good, hot, but overall not too taxing, which I appreciated as I am currently battling a summer cold. Die, cold germs, die!

15 July 2006

Overexcited

Ah, night shifts, our fickle friend. Will it be a quiet night, with calls spaced as such that we can get a few winks? Or will it be a night where every hour, on the hour the fine citizens of our town will call us to their aid?
My night was somewhere in between, as I ended up with maybe an hour and a half of real sleep. But, I must take into account the fact that I am still a little nervous and overexcited while at work, and had a hard time chillaxing enough to actually sleep. After each of the late night calls I found myself in bed lying on my back, staring at the ceiling, thinking about what I might have changed about the call, or what motivated the caller to require our services.

We started out with a classic: blood sugar of 19, splayed out on the floor. What made this one a little different was the fact that the patients relative was doing what I like to call the "price is right dance" when we arrived. FD was already on scene and with the patient who was in the basement. When I walked in the house the overexcited relative materialized out of nowhere and began shouting about him being downstairs and that I had to hurry, while rushing me down the stairs. Ellie doesn't like overexcited relatives. "Okay, please slow down, and tell me where he is." Now we're getting somewhere. I carefully went down the stairs, and was pleased to find some firefighters and a patient and not something more sinister. The relative continued to bounce around excitedly, and once we took the pts. blood sugar, immediately decided to run upstairs for some orange juice. Okay, you do that while we do something a little faster and a lot more feasible on an unconscious person. A few seconds later, the patient was totally fine, and predictably refusing transport. We left shortly after; our patient with a sandwich and his relative with a straight jacket.

Later, we had a sleepy overdose, a "panic attack" a headache, and new onset a-fib.

The OD was attempting to, um, not be alive, but 3200 mg of an anti-seizure medication later, our patient could barely keep her head up, was vomiting, and generally miserable.
The patient with the headache was walking to the hospital, got lost, and decided to call 911 instead of asking for directions.

I love to ask at 3am "What changed now that made you call us?" thinking that there must have been a catalyst of some sort to prompt the call. Unfortunately, usually this question yields uninteresting answers like: "It's just been going on for so long..." or "nothing really." But, our a-fib patient, although didn't have a good answer to my question, did have a legitimate problem.

Google search term of the week: "“work never hurt anybody" Clearly googled by someone not in EMS.

13 July 2006

Serving Since...

I got my last piece of flair the other day, my nametag and a little bar that goes with it that says “Serving Since 2006.” This makes me laugh; it should just say “Serving Since Last Week.” I think this would instill more confidence in my patients. Or, maybe “Serving Since…you don’t wanna know.”

Yesterday was my first shift on a 911 truck. A lot of firsts lately, and I’m sure that they’ll keep coming. EMS itself is inherently full of firsts. Even veterans say “I though I’d seen it all, until today.” But I guess for me in particular, everyday includes things I’ve never seen, and nearly everything has been new experience in some way. But I digress.

We had three calls, all pretty simple and straightforward, perfect for a first day. A fender bender started the day, and I was excited, because I actually knew how to get to the call! Later we had a ‘hemorrhage’. I’m never happy when the home care nurse greets us and says “I just left him on the toilet…I wasn’t sure what you guys would have wanted…” Thanks! If I could make a list of ideal positions for patients to be in, on the toilet would definitely be at the top. Above even, unconscious behind a door on the 10th floor of an apartment building with no elevators.
Our last call was for a kid who drove his bike into a parked car. What made this call fun was the fact that we had a student with us. It just so happened that she arrived just as we got the call, and hopped on. It was fine, it was her first day of riding for her EMT-B class, and she didn’t freak out or anything. Just a little ironic to have me teaching new people!

The absolute highlight of the day was getting to drive on the wrong side of the road. I couldn’t help shouting “We’re in London!”

Google search term of the week: “flash + happy dance” It still holds true that every time I get a flash for my IV I want to say “Time out!” *ellie performs break dance routine* “Time in!” and resume the call as normal.

10 July 2006

1st real shift, start to finish

Yesterday was my first real shift, with my regular partner, on my regular schedule. Speaking of schedule, mine is pretty crappy, but for a newbie it’s not too bad. My partner, on the other hand, is much cooler than my schedule. Plus, she’ll have some sympathy about it as it’s hers too.

We were on a transfer truck yesterday, like old work, basically just interfacility transfers. We had a call for a guy who had fallen off of a ladder about 25 feet onto his backside. Among other minor injuries, he broke his hip, and needed to be taken to a more specialized hospital. We got him all settled into the bus, only to discover that it wouldn’t start! Crap! Luckily we were still in town and it only took a few minutes for a new one to rescue us.
Once we got rolling the real excitement started, as I got to break the seal on the narcotics box, and give my first drug as a real paramedic. No doubt the guy was in pain, and he was being terribly stoic, but after all the bumps he admitted that it was getting to him. I was dead excited.
When we arrived to the ER, as neither of us had been there before, I had to wander a little to find a human. When I found some and explained our situation, they looked at me like I had lobsters coming out of my ears, even though I had kindly called ahead. Finally, someone noticed we were from out of state, took mercy on me and showed where I had to literally use the PA system to call someone to EMS triage.
“EMS in triage, please. Paging Mr. Herman, Mr. Herman you have a telephone call at the front desk.”
What fun! How weird! Once we got into the room, they were on our patient like white on rice, as if we had just pulled him out from under the ladder.

Oh yeah, to add to my total excitement and bewilderment, we were in Boston. The last time I was there, I was about 3, so it was a pretty new experience. After admiring the Boston EMS huge, car pushing, monster medic units, I drove back; and as we didn’t get lost or killed while I enjoyed the beautiful city and traveled under the skyline through the “big dig,” it was a successful trip.

The last patient of the day was suffering from a hemorrhagic stroke. This was a pretty exciting call as time was of the essence, which is a little more rare on the interfacility side of things. When we arrived, the ER doc pulled me aside and pretty much laid down how critical the patient was and how imperative it was that I watch the blood pressure closely, and that I could go as far as to change the drip settings if I had to. I made my face impassive to my fear and trepidation, and committed to memory or paper his every word.
We got everything switched over successfully, it was more than an hours ride to the next hospital, so I wanted to be sure it was right. The ride was pretty much uneventful, thank God, but I must admit I was a little stressed, pretty tired of taking blood pressures, and keenly aware of the differences between EMS in MD and EMS in NH by the time we arrived.
I drove back to the station feeling quite content with the world.

08 July 2006

5 days and counting...

11:00 pm yesterday: I’m so glad I’m finished with my training I stay up and waste a fair amount of time on the internet, ready to enjoy a day off or so.

7:32 am today: Why, oh why did I answer the phone? “You need to come into work today.” Wow. Thanks for the 7 am courtesy and kindness. I thought it was me doing you a favor when you called me in, silly me.

8:32 am: Arrived at work. The supervisor woke me up anyway, so I might as well get paid to be annoyed. I didn't even get my tea.

9:00 am: Got my real schedule, no more wake up calls! Shift is classic newbie shift (really horrible), in fact, I think the only reason it exists is to break in new people. Oh, great, it starts tomorrow!

5:00pm: 1st real shift over! 3 calls on a transfer truck, including one back to a house I visited yesterday during my 911 shift, weird. But at least I knew where we were going.

10:27: Going to bed.

07 July 2006

Drive with courtesy, it’s the NH way!

So, about that damn white cloud. It floated away for the last two days, giving me a good call volume and variety for my last days of orientation ride-alongs. Thursday we had, um, three calls, I think. Mostly we got to work on getting to know the city and driving the ambulance. I got my first ‘tone’ from the road safety system and it freaked me out so much that my FTO had to say: “um, you’re now going 25 with the lights and sirens on...” My emergency driving is much better, though.
The most entertaining call was a multi-car accident, that was essentially bumper v. bumper v. bumper v. bumper. A couple people got a little banged up, but it was my first MVA here. I also had my first call with a language barrier. Three semesters of Spanish were all but wasted on me. I managed to get by for the most part, but it was interesting to say the least. I definitely became a source of amusement for the patient. Especially when trying to demonstrate to her what sublingual (under the tongue) meant. When I left her at the hospital, she laughed at my seriously broken Spanish, and my big “Gracias!” at the end (one of the words I know for sure.)

My goal today was to reduce the amount and intensity of my ‘granny driving.’ Become braver about exceeding the limit, clearing intersections, splitting traffic and all that good stuff. I think I was way better today than any other. I even got to rock out the defensive driving when a guy blew a stop sign and tried to meet the side of the ambo up close. Accident evasion; good for the soul, but not the nerves!
We had four calls, including (what I hate to call) a sweet rollover accident, but it was, well, pretty sweet. On the way there I got a healthy dose of driving on the wrong side of the road and slaloming around traffic, it was awesome.
The vehicle involved clipped another car while changing lanes, causing it to roll probably 3 times before landing on it’s roof facing the wrong direction on the highway.
The patient became pinned, and it took fire about 20 min to extricate her. Basically, she should have been dead, unrestrained, high speed rollover, but something was on her side as minor injuries abounded. It was very exciting all the same.
Later I met a family member of the patient and the first thing they asked me was: “Is the car totaled?” Um, yes…soundly.

Other than that we washed the truck, cleaned the bathrooms, ate lunch, drove around a lot and enjoyed hanging out at the station. So, now I’m cleared at work, and hopefully by next week I’ll have a regular schedule.

After work I found a grocery store that stocks my favorite British tea among other authentic imported foods, what a great day!

1 year on

London, it’s people, it’s workers, LAS, LFB, MET, and LU have been in my thoughts today. I proudly wore my LAS pin to work, but I’m not sure anyone noticed. I remember watching as the day's events unfolded last year, jetlagged, shocked, helpless, and feeling it was personal. Feelings not quite resolved.

05 July 2006

Breaking News: “White cloud floats 500 miles”

Yes, believe it or not, a white cloud has traveled 500 miles and across seven states to hang over the head of one, Ellie (aka resqellie). White clouds are notorious for shutting down cities, but save ambulance services a lot of money in gas costs, as they’ll never turn a wheel. “I’d rather have a black cloud for awhile,” Ellie commented this evening, “or even a gray cloud would be nice.”

Will Ellie have to relinquish her colloquial nickname, and forever drop the “resq” because of this obvious lack of rescuing? Time will tell, as there are two more shifts this week. As always, we’ll keep you posted.

03 July 2006

Liberate your Kayak!

Let me start at the beginning for you. I used to live a posh life, in a penthouse apartment outside of Baltimore. Maybe once a week or so I got to go out and play in a great river, bay, or lake. Then, one day, everything in the apartment was gone, and I found myself being driven somewhere. I caught a last glimpse of the patapsco river on the way out of town. When we arrived, back at Ellie’s house, I realize, I’m left outside, to be subjected to the elements and unwanted inhabitants. Finally, I was carried down the driveway and into a huge truck, and subsequently forced to tolerate a bumpy and hot 10 hour drive.
Since our arrival in New Hampshire, I think, I have been cooped up in a dank basement; for nearly three weeks now! I’ve watched sunny days come and go, watched downpours outside, knowing that back in Baltimore, this would be a good indication of an impending trip. But nothing! I’ve only seen Ellie and some other people come and go, leaving me, forgotten.

Then, today I was feeling hopeful, it’s 82 degrees, not a cloud in sight (from what I can see out the basement windows) maybe today would be the day. I watched helpless as Ellie left in the truck. But, a few hours later, she returned looking victorious, and ran upstairs. Minutes later, she returned, and I caught a peek at the paddle ends sticking out of the armful of things she was carrying. I can barely believe it as I was loaded into the truck and away we went! Half way there, I realize I don’t know where we’re going, I fear that were about to have a sad “Toy Story 2” moment, as Ellie leaves me on the side of the road.
Fortunately, after a very short distance, I realized that we’re actually going out on the water. It’s a lovely place, lot’s of water vegetation, trees, fresh air, and loveliness in general. Ellie took some pictures, and I can tell she feels as happy as I do to be out on the water again. We even stopped for lunch on a little island before heading back. I know now there are plenty of waterways to explore in this state, and Ellie intends to find them all.

I'm going to go dry off in the sun for awhile and leave it up to you to figure out how an inanimate object with no limbs or proper digits publishes a post.
-Love, Kopapa
P.S. ignore where it says "posted by Ellie" it's completely untrue.

02 July 2006

This is me not freaking out

Friday was my 1st real day at work. To be honest, it was pretty stressful. Everyone was really nice and welcoming, especially my FTO, but it was like: you can drive to the call, be quizzed on the way, wax the ambulance, tech the call, do skills, patch to the hospital, hand over the patient, write the report, change the oil, make lunch, and everything in between. Trial by fire is good for the soul.
It was all a pretty scary, especially because I don’t know where anything is, and I basically have to follow my crew around like a little puppy. But, it can only get better from here. The first day is over, and that was a big hurdle. And, I got to wear my brand new obsessively pressed uniform, with newbie extra shiny shoes, and all of my shirt “flair:” collar brass, badge, UMBC pin, etc.

Driving for this company is interesting. In each truck we have a road safety system installed. To drive the trucks, for one, you have to scan in your personal key, this lets them know who’s driving. Then, the system monitors how hard you brake, accelerate, turn, if you use your turn signals, when the lights and sirens are on, and various other things.
It’s essentially a warning system, to help you to be a better, safer driver. If you go too fast, there is a tone that counts against you. If you brake too hard at a stop light; a tone, pull out too fast; a tone, turn too hard; a tone, look at the ambulance wrong; a tone. Tones are bad and you can only get one every 8 miles (I got none the whole day). Usually, before a tone sounds, the system “growls” at you to serve as an extra warning that you are about to get a tone. It’s super sensitive, and no one goes without lots of growls.
Boy that is complicated! I like it myself, I don’t mind if ‘big brother’ is watching out for my personal safety, and that of the fine citizens of Manchester. It’s a little frustrating because, for example, you can only go 65 mph in the city trucks. Getting passed while going lights and sirens seems a little silly.

But, I did get to drive which was wicked fun! Running red lights, blowing stop signs; there’s nothing like it.
We only had two calls. The first was for an assault that rivaled any I’d seen in Baltimore city, so that was pretty impressive and surprising. The second call was for a sick person and what was cool about this is what we call “alpha response.” A revolutionary idea, uncommon in the US, which recognizes that not all 911 calls are life and death emergencies. Imagine that! There is no need to go lights and sirens (risking many lives) to a situation that does not require it. I’m really excited that we have such capabilities, similar to that of my favorite EMS system in the world.

Yesterday I studied for my protocol test, finished mowing the lawn, enjoyed our expansive, yet overgrown yard, and met two snakes.
Today I studied a little more (hopefully enough), played video games, visited a friend, and met a cat.

I have updated my blogger profile and added some new and improved pics to my photo site, including ones that illustrate what it means to mow a trail into the lawn. Click here.