A Work in Progress

Last night shift was pretty sweet. I slept in relatively uninterrupted comfort from about 0145 to 0630. We started the evening with a local student who, after playing a game of organized sports, collapsed on the sidelines. We arrived and he was pretty out there but responded to pain and us shouting his name. The coach informed us that the student is currently celebrating Ramadan, and hadn't eaten since about 5 o'clock that morning. It was about 6pm when we found him. So, we start a line and took a sugar, and it was only 44. Well, that's not normal, especially if you haven't eaten in 12 hours. So we gave him some glucose and thiamine and he perked right up. I love calls where it feels like we're actually helping people. It was my first experience with a call as a result of a religious holiday, and I was pretty fascinated. I learned a lot from the patient, that is, once he was conscious. That was pretty much the highlight of the shift as far as I remember. ...

Today started out with a chest pain call. En route it was revealed that his chest hurt only because his internal defibrillator had gone off 3 times. This call had potential. It had potential until I walked in the door, found a well dressed, reasonably healthy, asymptomatic patient. Monitor, O2, IV, and we’re off. Also, a possible broken leg, morphine for everyone! We had our first flu patient of the flu season who made my OCD flare up, forcing me to decon the whole ambulance. Whew! I felt better after ensuring that all surfaces that I regularly touch were antibacterialized. Other than that I became blissfully aware, I think I learned what being in love feels like, and decided KT Tunstall is completely right.

A cute kid who learned that grabbing a knife is not the greatest idea. Her new favorite pastime was yelling. We've visited a few public places recently. A seizure in the mall, a back pain in a bank, and a fall at the dunkin’ dounuts. We resisted playing into our stereotypes and left without coffee or doughnuts. A patient complaining of leg pain. Yes, I’d have leg pain too if my legs were as big around as my torso. I cannot even describe this patient to you; it causes me to lose my appetite. How people can treat their lives this way, I don’t know. I was thoroughly disturbed and skipped lunch. A lovers spat that ended with assault with a bottle, belt, teeth, and HIV. I did an overtime interfacility shift and we got posted to a local hospital and did nothing for several hours. I went out to the truck for a nap and I think that I got nap whiplash. I fell asleep and snapped my head back up so quickly it hurt. It didn’t stop me from more napping though. I think our most inter...

One Monday I did an overtime shift. I was pretty excited because no matter what I did, I knew I was getting paid reasonably well for it. My partner was a new medic (newer than me, believe it!) who started the evening by informing me that he has a black cloud following him. I figured together we’d make a nice gray cloud that would allow us to sleep. We had calls spaced out enough for me to be really tired Tuesday morning. The highlights included a car accident with 6 patients and a sexist firefighter whom I may later thrash. Three women were on scene from my company, and this guy managed to leave them all seething. It’s a talent, I assume he’s been perfecting it for forty years or so. Note to self: next time I see him on scene, ignore completely. Later we had a call that came out as unconscious. En route we were informed that CPR was in progress. My partner and I divvied up the skills, and the tube was mine, sweet. Just as we arrived on scene the engine company reported ‘po...

My parents came up north for a little visit, and we did all kinds of local things. On Sunday we sent to the seacoast and enjoyed hanging at the beach when no one else is around. On Monday we went to Salem, MA and burned some witches. Well, actually we didn’t because it turns out you need a permit to burn witches in Salem. But, you can put supposed witches on a large scale to see if they weigh as much as a duck. On Tuesday, we went to a shaker village in Canterbury, NH. I learned that shakers are totally weird. Weird like a highly organized pacifist cult. It is fairly amazing that they lasted so long, and had thousands of followers when their membership was based on adopting orphans and recruitment. The shakers lived in completely self sufficient communities, made their own clothes, food, buildings, etc. Okay, I’ve even bored myself at this point, so I’ll stop. Finally, on Wednesday we went to visit the LL Bean flagship store in Maine. I got a new hiking day bag, which will ...

The procession of police officers from around the state and around the country march proudly and solemnly through the streets downtown. The main roads are blocked off and I curse as I realize there’s nowhere to park and I’ll now be late for work. Then a wave of terrible guilt forces me to retract my curse. At the station, purple and black bunting has been hung carefully, the trucks are pulled outside, the crews standing in front of them as the procession passes by. A gesture of our sadness, our wish we could have done more, performed a miracle, saved his life. I miss the funeral on television as I am driving to the gravesite; we're there to represent the company, to show we care. As we wait at the cemetery, the fire department arrives and hangs an American flag from their tower truck. Marines prepare for the 21 gun salute and bugle taps. The procession arrives, and I hold my breath as the hearse and limos pass. The procession continues with what looks like the entire polic...

I tried to take a picture of the highly reflective and ridiculously large paramedic patch, but it was just too reflective!! edit 10.22.06 11:13pm: Okay, so it's not actually a picture of the vest, merely what I thought would be an amusing picture to illustrate how large and reflective the patch is. I couldn't really find the picture that I was envisioning in my mind. And, yes, a super sleuth found me out at work. Super Sleuth: "Are you 'A work in Progress?'" Ellie: "Uhhhhh...." I was a little surprised, to say the least. I guess I'll just have to stop badmouthing every one at work. And to think, I was just about to post my list of people to kill in order to get a better full time schedule, oh well. edit 10.22.06 11:16pm: I wasn't discouraged by you finding me out, I just haven't had the time to write! More to follow soon...I hope

Lack of updates to be made up for immediately. Last night started out with a diabetic problem at our local arena. Sounds simple enough, right? Well firstly, the circus is in town. We got to go in before anyone else and see them cleaning up and what not, it was cool. Also, since the arena is across the street from the station, we have had regular zebra and camel sightings. So anyway, this guy was acting pretty normal and his sugar was 67. We kicked it old school and had him force down a delicious tube of sugary gel. Well, he hated that but we figured that if his sugar went up, he could be on his way like he wanted. After finishing that, we checked again, and his sugar actually went down. Dammit! His mental status was deteriorating as well, so we went to start an IV to give him a quick solution. Four attempts later, we still don’t have a line. Dammit! So, I go out through the gathering crowd and grab the glucagon. What an annoying drug. Draw the saline up, inject it into t...

Monday I drove about 250 miles in search of foliage and crafts. Random, yes. I drove north to go to a craft show. It turned out that the craft show was sub par, but discovering this was well worth the drive. I went up to Franconia notch state park, and enjoyed ogling at the white mountains. I hadn’t been in this part of the state for probably more than ten years, when I came here on vacation with the fam. That’s when I got to see the old man in the mountain, God rest his soul. I drove for miles in the White Mountains National Forest, lost the other tourists and found Zen. I decided to get home without using the highways, so I picked my way carefully through many towns, and beautiful autumn scenes. I found lots of hikes that I’d like to do whenever I’m not alone, and eventually stumbled upon Lake Winnipesaukee. At 72 square miles, and with a shoreline of about 288 miles, it is one of the largest lakes in the country. I managed to find one of the public boat launches (thank yo...

I’ve forgotten to mention that I finally got my squirrel vest at work. Really it’s just a fleece vest to keep warm in the frigid northland, but it has my name on it and stuff, and the absolute highlight is a large and reflective patch on the back that says “Paramedic.” It is awesome. I think it could be larger and more reflective, but then it might blind people if they shine a flashlight at my back. I’ve been kayaking a lot. I went four times last week. On Monday it was wicked windy, about 10-15 mph. It was making the water really choppy and wavy. It was so much fun. I got all wet, but it was good fun. On Friday, it was really cold. I had to wear a jacket for the first time in the season, and I wished that I had invested in kayaking gloves already. But, I am working on a great callus on my right thumb which is pretty hardcore. Work wise, I have had four relatively uneventful shifts. On Wednesday we had an abdo pain who I gave phenergan so as to prevent her breaking my #1 ...

After all the excitement of my day shift, I was all hyped up for my night shift. But it turned out that they were, well, like night and day. We only had 3 calls in 14 hours! Also, my weekend shifts were pretty boring as well. I got very far into my book, watched more football than I have in my entire life, and did my favorite work pastime, got paid to sleep. This was also the weekend of the fair here. I did EMS standby for a while Thursday and Friday. I must admit, this fair is pretty cool. I watched a woodsman contest on Thursday. Here, people rolled large logs, threw axes, sawed blocks of wood, and my personal favorite, used an ax to chop a piece of wood that they were standing on. It was pretty cool, and nobody chopped their leg off by accident. I also enjoyed fried dough, apple crisp, hot cider, and a sample of maple syrup cotton candy. That’s right, maple syrup, poured into a cotton candy machine, and made into delicious clouds of diabetic ketoacidosis. It tasted awes...

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,...