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Showing posts from April, 2008

I'm feeling lucky

Thanks to this post, when you google "Ellie is super awesome" I am the first site you get! If anyone really uses other than me, that will be in the running for best search term ever.
Conversely, if you google "Ellie is annoying" I am now the #2 site.
Just thought you might be interested.

Time Machine

At the end of a long day we got called for a stroke. We arrived and the patient was already outside with a guy leading her toward the ambulance. She looked well enough. She sat on the cot as my partner went to get the story from the bystanders.
Me: "Hi, I'm Ellie, a paramedic here to help you out."
Pt. "Hi, I'm Mary Howe*, how are you?" She shook my hand. "I don't know why that guy called 911, I'm fine."
Me: "Well, he's worried about you, so we'll check you out."
We attached her to the usual equipment as I asked the usual questions.
Me: "So what's going on that led him to call 911 for you?"
Pt. "I don't really know, I don't even know that guy, and I don't know how I got here."
Me: "Here as in...?"
Pt. "This state, this house, with these people. I don't live here, I live in Georgia."
Me: "Oh, what's your address?"
Pt. (gives satisfactory answer without hesitat…

The great outdoors

And there it was, the huge osprey that I had seen earlier exiting the water clutching a fish. I had been scanning the trees in the hopes of finding the bird and found it to be as awesome as I had imagined.
It has been a good day for wildlife. I stalked about eight wood ducks for half an hour, without real photographic success. I saw a couple of blue herons, a kingfisher, and a green heron which I had never seen before (and is actually not very green at all). I also spotted a female hooded merganser; a fish eating small duck with a fro.
Early morning kayak trips are paying off. The world is waking up and I am there to witness it.

The mountains are green again, and the weather is perfect. Every few minutes I get a waft of fresh blooms. All around me I hear different bird calls. I wish I could distinguish them. I'll have to work on that but I have now learned the noise that wood ducks make, a very distinctive low whistle. I'm also working on the pictures. I have to learn not to get …

Gold Stars

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Emergency driving is one of my favorite activities. It's really a very strange state of mind to be in with the constant scan of what is happening around me, the study of who has the green light in the upcoming intersection and praying that a rogue pedestrian does not make the wrong split second decision.
I also think about how often and how long can I blow the air horn, and how often and how long I can drive on the wrong side of the road. Very important stuff. Also in my mind I have been developing a reward system for drivers I encounter on the road.
Oh so many people do the wrong thing when they encounter an emergency vehicle on the road. They panic, they don’t notice, they ignore. I think that the people who do the right thing ought to be rewarded. I am usually satisfied when people pull over and am overwhelmed with joy when, in a magnanimous gesture, they actually stop. It is pure bliss.
If you pull over and stop you receive five gold stars, a parade thrown in your honor, a…

In case you were interested

Yes, dear readers, you are subject to my random thoughts. Here are some.

Why don’t all yogurt cups have a shape that allow one to scrape all the yogurt from the bottom?

Why is it more expensive to buy stuff made out of recycled products? I mean, I recycle, so don't I already technically own some of that bag made of recycled bottles? Why do hybrid cars still cost several thousand dollars more than regular cars? It really isn't easy being green.

I hate unsynchronized traffic lights, and lights that are on timers.
I hate when I have a loose shoe.
I don't like people who call 911 at 3am for a problem that existed at 5pm, but it just didn't occur to them to call then.
I don't like driving with the windows down on the highway.
I love squeezing fresh bread.
I am uncomfortable with people who are having a fit over something I consider to be minor.

I think I am allergic to stride gum
I enjoy toast.
My electric bill last month was $2.09. Thank God for that.

I have had lucky charms f…

DOA

To work it or not to work it, that is the question.

There are several things we can look for to confirm that someone is dead. The story, coldness, stiffness, blood pooling, etc. The guy we found the other day, sitting up on bed, still holding the magazine he was reading the night before, had most of these things. The room was about 80 degrees, so no surprise that he wasn't exactly cold.
The story was kind of weird, but added up. The night before, apparently, he had called his doctor because his chronic back pain was worse. The doctor allegedly said to "double up" on his meds. This unfortunately included putting on two fentanyl patches instead of the usual one.

I'm just going to guess that this decreased his respiratory drive until he stopped breathing altogether.

The whole thing got sticky when my partner called the ER doc (We have to get permission not to start care on patients like this. Don't even get me started.) but the doc who had supposedly advised the "d…

Who's Counting?

Okay, so a little glitch with blogger is that they count draft posts as real posts, so in fact, the original "300" post was actually only 295! So, I've been working on finishing the drafts I started more than a week ago, and corrected the title of the last post. Once I discovered it, I knew it would bother me forever, so I had to sort it out. Even though no one would have noticed unless they sat down and counted them like a crazy stalker. (Um, hopefully nobody did this.)

Thanks!

300 or, uh, 295

Yesterday I learned we are getting etomidate, IO drills, and autovents with CPAP at full time work. Sweet!

Today, I slept in for the first time in, well, far too many days. It was awesome.

Today I didn't ride the bike, but finally got some cleaning done and ate way too much cereal. (No, it wasn't Hypothetic-O's.)

Today, I'm sitting at work, waiting for a call as usual. In between, I do my best to waste time.
Books, Internet, and television help. Invariably, if I don't bring a book, there will be no calls. If the blogs I read haven't been updated, there will be no calls. If I've seen that episode of "Top Chef" three times already, there will be no calls.
Eventually, the boredom will always seep through these activities.

Wait for calls; take a walk, take a nap, have a snack. (These pretzels are really good.)

I prefer the busy days. But today, it seems, will not be busy. But maybe only until "Lost" comes on or when my head hits the pillow.

Outside,…

Blank Spaces

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We arrived to find a man who wasn't well. He suddenly went unresponsive at home and he was now barely responsive, had a fixed right gaze, his blood pressure at best was 203/110, and he was in a-fib and had ST elevation pretty much everywhere. It was the first time that I had a real issue with a DNR, or lack thereof. The patients wife was yelling about how he didn't want anything done. That he wanted to die, he had seen Jesus, he had a DNR. All this made me feel horrible and yet want to inquire that if he wanted to die at home why the hell did you call 911? (I'm pretty passionate about people getting what they want at the end of their lives, and it usually doesn't include EMS.) But, people panic for very good reason, and therefore, put us in a tight spot.

And it wasn't even that she couldn't find his DNR paperwork, oh no, it was there. All filled out with the date, witness signatures, and addresses, but was missing one thing. The most important thing. His signatu…

When you need it most

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My best, worst, and only picture of a boo boo bunny. Clearly I am not an artist.

Confessions

I have three things to admit to today.

1. I was afraid of being cleared as a single provider at part time work for many reasons. (There we run alone without a partner. I think this adds several layers of vulnerability to the job, both in terms of physical safety and provider responsibility.)
2. I milked my orientation at part time work this winter to make more money. (I get paid more there as a PRN employee, and as an orientee, I could go in as often as I wanted)
3. I was terrified today on the way to my first call alone at part time work.

Now, in a lot of ways, I am very excited about this single provider thing. Yes, it does put more responsibility on me, but I like that, and it also gives me a lot of freedom. I have to make decisions and stick to them, which is pretty cool. It is just nerve wracking to know that (I can say with no ego) I arrive on scene and the BLS crew often looks to me to sort out the situation.

Terror aside, my mom reminded me of this: How many times have I g…

Understanding

We had guy who chose a strange way to commit suicide by cutting his ankles with razor blades. "I wanted to stand in the shower and bleed out." he said, and yet somehow, we found him fully clothed sitting in his living room. This was after bleeding all over the bathroom, seemingly walking circles in the kitchen, laying in bed (leaving a puddle of blood on the mattress) and then bleeding on the carpeted living room floor.

It was something that I'd never seen before, and I continue to marvel in my lack of understanding of suicide and depression. I can't understand how an attempt at suicide is a "call for help" and why suicidal people can't just literally call for help. How do people get to the point of "wanting to end it all." Especially people who seem to have it pretty good. Manchmedics recent post reiterates my confusion and frustration on this topic. And most importantly, why do people feel the need to take out not only themselves but the…

Laces

It started out as a normal day. He didn't realize that it would not end as a normal day until he bent down to tie his shoes. He learned to tie them in kindergarten, and today, 40 years later he couldn't make his hands perform this simple task. He stumbled outside for some air. Anything, he figured, to stop this strange feeling. The phone rang, but he couldn't answer it. He had to let it ring. He tried again to tie his shoes, and yet still his hands wouldn't cooperate. The phone rang again and it seemed miles away.

Long minutes passed, and he was now almost completely immobile. Not only would his right hand not tie his shoes, now his right leg wouldn't bend to bring his foot to his hands. His cell phone futilely vibrated on the counter.

Sirens penetrated his foggy mind. Paramedics arrived and recognized the symptoms of a stroke. Stroke. That word alone reverberated in his mind. They asked many questions, and he was slow to answer. He couldn't orga…

Like a band-aid

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We arrived to find a lady looking well chatting with the BLS crew. We were both fairly certain that they were going to cancel us. Then the EMT turned to me and asked if I'd ride along. Sure, it gives me something to do. So I set up for an IV and threw her on the monitor. My partner said 'You okay?' and I said 'yep', and he shut the doors and left. As I turned away from him I was distracted by this annoying beeping coming from the monitor. Oh, that's the patients' heartrate. Oh, that's the patients' heartrate at about 170. Oops. So I got cracking on the IV and made sure of her complaints. She said she felt fine except for a little tightness in her chest, and some shortness of breath. Yes, fine. She was in a-fib with RVR (or atrial fibrillation with rapid ventricular response, for all those who like it when I use big words)
So I tried to get her to vagal out of it, and she was giving it a good try, but without success. I called medical com…

You can shock that

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Yesterday we had an arrest at a local nursing home. It was witnessed and she got CPR pretty much immediately. BLS gave a shock before we got there too. We arrived and I got the tube (woot!) while my partner started the IV and checked out her rhythm. It was like her heart couldn't decide what to do. First it was asystole, then v-fib, then v-tach, then IVR, then asystole. It didn't stay in any one rhythm long enough to get very far down an algorhythm. We ended up giving her epi and atropine, and on the way to the hospital we shocked her.
In the hospital it was very strange because the doc, first spent way too much time convincing himself that the tube was in. a. there is no reason to believe it wasn't. b. if we had been bagging the stomach for 20 minutes, I like to think we would have noticed by then.
Then he gave orders for D50, calcium, and bicarb, some more epi, and then left. From there basically a nurse and I ran the arrest with the doctor coming in every few minutes to…

New Searches

Recently, the blog has had some interesting and amusing search terms. Sleuthing these is always a highlight of my time spent wasted on the internet.

"hearing aid hilarity" What? Maybe when you are changing that tiny battery and you drop it and it rolls under the table and then you crawl down to get it and get your finger caught in a mouse trap, and then bang your head on the table. Potentially humorous, but not hilarious by any stretch. But I guess on occasion...

"combivent van Tupperware" Wow, that's pretty random. I'm not quite sure how that got the searcher here, or what they were actually looking for. A van made of tupperware? An inhaler made of tupperware? Breathing treatments in a van? Burping vans? The correlation between van driving, the use of tupperware and asthma? Who knows?

"Anglophile paramedic" Ah, you've come to the right place as that would be me, me, me, and me.

"it was very obvious we both had a great time on f…

Kid tricks

The other day when I helped one of my colleagues start an IV on a two year old in the ER, I got to employ the "boo boo bunny" trick when I make a bunny face out of a band aid and a 2x2. In anticipation of crying children I had earlier stuck some lollipops in my pocket too. Once the needles were gone I pulled them out like an old west gun slinger. "Who wants to stop crying?!" Bunnies and candy equal happy kids.
It's nice to be the nice one.

Indecision

I'll start this out with a quote from my trip sheet: "Pt. very vague when describing symptoms and is slow to commit to having any." I think that is my favorite sentence ever.
The patient called when she had chest pains, or was lightheaded, or nauseas, or was short of breath. Who knew, as even she didn't. By the time we got there she really wasn't sure, and I could tell she regretted even admitting that she felt sick. I would have let her stay home except that her heartrate was 180.
We got her into the ambulance after practically having to push her onto the cot and stop her from counting her pills, going through her purse, or making her bed. She didn't understand that there were slightly more pressing matters than her now abandoned bridge game. Vagal maneuvering, 6mg, and 12mg of adenosine later her heartrate was still 180. She still couldn't decide really how she felt. Although, when we got to the hospital she broke my number one rule. I had gone throug…

Subtle Changes

While making the most of my sick day today I've been fooling around with the new layout editor from blogger. I wish the program had more customization options, but I think the blog looks a little cleaner now. Will keep tweaking as needed. I don't want to get too crazy.

A horse, of course?

In my first 24 of this week I had 6 cancellations (three MVAs, one shortness of breath, seizures, and a diabetic) 2 chest pains, 1 dead horse, and kind of caused an accident.

I wasn't feeling well at all that day. And it turned out that within about 44 hours I ate only a bagel and a cadbury cream egg. I'm not sure what it was, my tummy was saying "don't eat" and I trust my tummy implicitly. I'm only now (a day later,) feeling a little better. There have been no, what we can call "incidents" although it got close while I was starting an IV en route to the hospital on a curvy country road.

It was slow, until overnight when we had more than half of our calls. Obviously, the most interesting of which sadly involved the horse. What I can imagine happened was that an unsuspecting motorist was cruising along at 4am, probably at about 45-50 mph when he crested a hill and was suddenly was met with an unsuspecting equine who had wandered out of its pasture an…

An ounce of prevention

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Ah, so there you see I have installed a can of pepper spray onto the bike. I have taken the last few rides to practice reaching it. It turns out that carrying around some raw steaks was not as practical as I thought, because in fact, it was attracting more dogs than it was deterring. Plus, the mini fridge was throwing my balance way off.

I haven't had to use the spray yet, thankfully. And, as they say, "An ounce of prevention..." um, well I forget the rest of that adage. Either way, I've decided is better to simply avoid the house of the bad dog, which has actually been nice, as it adds about a mile to my usual loop. The loop has recently been expanded anyway, and is now just about perfect. Around my house, it is difficult to go farther without climbing a mountain or crossing a highway. I have achieved my goal distance, and it has felt awesome! I'm very happy to be going further now than I ever have and the season it just starting! "An ounce of prevent…

The Perfect Motivation

We had a guy trying to win a Darwin Award the other day. He was standing in a tree, holding a chain saw, trimming branches when he lost his balance and fell about 25 feet down. Luckily, he managed to throw the chainsaw before it sawed his head off. He also managed to delay hitting the ground by meeting a few branches on the way.

We got there with the ambulance put him on a backboard and all that. He probably broke his hip, and started getting hostile when we suggested not going to our cute community hospital and instead going to a trauma center where they could properly treat his injuries. He wasn't hearing it. He immediatly went into a tirade about how much he didn't want to go to the trauma center, and while I managed to resist yelling over him, my partner gave him a sterm talking to and he, well, at least was quiet for a minute. Basically, you're the one who fell out of a tree, we're just trying to help you. He was mitigated when we agreed to take him to our…