29 April 2004

Just Under the Wire

29 April 2004

"Just Under the Wire"

Have you ever been to a casino?  In a hotel adjacent to the facilties, they normally hand out brochures of the games that are played explaining the basic concept of the game, how to properly wager a bet, and most importantly, your odds on winning. Depending on how well you know the game and do your homework, you can manipulate the house into tens of dollars or more, or you can end up with less money than you walked in with.

Today, we will play a similar game. The "Will they get a call game?"  It is quite simple actually (getting your hopes up). I will detail a few clues as to the situation, and you guess the outcome. I will even provide odds for you. We can then gauge on how well you will do in Vegas.

DISCLAMIER ( the small print)

This is not an actual game and should only be intended for the sole purpose of the participant's enjoyment. Any or all winnings that can occur from enrollment into the game played, is not responsible for payment by said facility and participation is sole based on a volunteer stature. All participants should be of legal age and advised some working knowledge of EMS. Always wear your seatbelt. Some assembly may be required.

Okay, here is the senerio:

You are in a Three (3) truck rotation. Right now, you are averaging a call every 90 minutes. At 2230 (10:30PM for those who didn't study) you are required to do a trip that brings you back into your service area at 0000 (midnight..sheesh).  Theoretically, you should be the next one out on a call. But as you return, yo ufind that neither of the other trucks have gone out yet. Keep in mind that it is now after midnight where call volume usually triples in the last eight hours of a shift. 

Right now your odds are 1:3 that you will go out within the next 60 minutes.

As you tuck yourself away to sleep, you kind of tread lightly on falling all way down, knowing that you will go out soon.

An hour has passed, no more calls..your odds are 1:6. You fall asleep.

You awake to hear your partner stirring in the room gathering his things to put away. You look at the alarm clock and notice it is 0730. Did the other truck go out? did we miss it? Will I make it to the promised land.

Right now you are running 25:1 because you don't know the status of the other truck. You hit the snooze bar.

0800

Time to get up. We are in the red zone now. The red zone is defined as the final half hour of your shift where tensions tighten a bit because you have absolutely no idea what is about to happen. The new crews will be in in roughly 15 minutes. They will usually take a call for you (usually...hmmp) and  let you wind down your day with your daily chores and a cup of coffee.

Odds now are 10:1 (only because you have no status of the other truck, and you slept all night long.)

The other crews start to arrive. The time now is 0810. Almost home free.

Odds are a whopping 50:1.

The phone rings.

NNNOOOOOOOOOOOOOOOOOOOOOOOOOOO!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Is the call for you or is it for the other truck, will the new crew take it, or have they not arrived yet?  You are staring at a 4:1 now...ewww.

Your pager goes off.

Paying out....50:1. Paying an additional 4:1 if you picked you are going.

Thank you all for playing. Please come back.

My partner makes sure I am awake as I am strapping my boots on. No relief in sight. Sigh.

EMS is like jello. There is always room for one more.

Coming out of the bedroom (which has no windows so it is dark as the bottom of my wallet), I made it into the all glass bay area. The doors face the east and the sun was just over the buildings at this point.

Trying to recover from my retinal blindness, I found what felt like a passenger door to the squad. I pulled it opened and felt the seat. (wanna play odds if someone is in it....if you do, you need counselling).

Empty.

WOO HOO!!!

I climbed in and we took off faster than a launch off an aircraft carrier.

I looked at the screen on the MDT to see that it was for a general weakness call. Hmm..going awfully fast for that, are we.  As we were off and acknolwedged by dispatch, we found that fire was not going to help us on this call. (Their crews changed at 0700...slackers)

Okay boss, John Wayne time.

We are on our own for this one.

Turning down the street, I noticed that a construction crew was blocking the road...right where we needed to go. Um..okay..what do we do now? We NEED to get to the other side. A side that is blocked and will take a few minutes to get to. I was just about to jump out, grab the bag and monitor, and walk over to the house while we found access when a foreman stopped construction (it was cement repair actually) and ordered his cement truck to back up allowing us access to the call.

Well, that is something you don't see everyday.

We clicked on scene, walked into the house and found our patient sitting there...this was not good.

Our Patient, a female of actually relatively young age, looked gray. She was sweaty, cold, clammy to the touch. She was clutching her chest and leaning to one side in a fair amount of pain. 

Okay...GO Mode!!!

My partner and I kicked it up a bit and interviewed tha patient to find out specifics...we did not like the results.

First of all, the patient denied a medical history. This could be good OR bad.

Second, she stated the pain started 2 days ago. The fact that she was still alive was good, but the critical hour is now WAY gone.

Next,she stated she took some Pepcid AC because she thought it was heartburn, but it did not relieve it.

Then she decribed her pain as "when you eat ice cream and it freezes your body". Also, she said her pain was a "5" on a 1 to 10 scale. Okay, this is good. But then added, I have not expirienced pain before so I really don't know what to tell you about the number. Hmm..an honest answer.

I took her blood pressure and she was hypertensive (above normal ranges).

Bottom line, she was not looking good. My partner and I ran to get the cot. (Yes, we ran) and he looked and said "I think she is having an MI (myocardial infarction...a heart attack). I concurred going slightly down the stroke scale myself because she had leaning and some slurred speech.

We took the cot inside and helped her get onto it. Secured her and moved to the squad.

Inside, We gave her more oxygen than what we did in the house and began a quick check and followed our algorhythms to give appropriate care.  I hooked up the cardiac monitor and turned it on..hoping for the best.  She showed a regular sinus rhythm without any wierd ectopy (injury to heart). I wasn't satisfied. While my partner started an IV line, I changed the leads on th monitor.

Quick lesson, different leads show different angles of the heart and help to determine where the injury may be in the heart. We normally run through lead II (2...but there are 12 different angles to take a picture of the heart with). This normally shows the inferior wall. We have 3 lead capability, but leads II and III measure the same lateral angle. Lead I does an anterior angle.

There it was!!! a VERY profound elevated ST segment on the monitor. (Indicitive to a acute injury to the heart...in other words..she was having a very bad heart attack).

Time to shit and get. (sorry for the french there). leaving the back of the truck, I asked my partner if he wanted to go in hot (with the lights and sirens) and he said, "yeah, we better, the nito didn't relieve her pain). Whoa boy..this is bad.

Normally, we go to the hospital in the city with a patient "cold or with normal traffic without lights and sirens. We are so close that we really don't need to expidite if the patient is stable. It cuts down on the patient's anxiety, and it is safer for all because not everyone likes to obey the traffic rules and pull over anyways. I think in 15 percent of our total calls, we will go to the hospital "Hot" because time is money..or tissue in this case.  This was one of those time.

With the weather as nice as it was, that acted as a factor in our favor. Traffic was light seeing everyone was at work already. Our trip to the hospital took just under 5 minutes.  We unloaded the patient and gave report. Seeing I drove, my job was to put the truck back together. While I was doing this, the nurses started a 12 lead ECG (electrocardiogram) which shows all sides of the heart and injury that may have occurred.

Getting the cot back together, I hear the loud tones of the overhead intercom calling a "code purple" which means that someone is having a massive heart attack. I walked back in to see the doctor, three nurses, a pharmacist, a respiratory tech, and my partner in the room, working on the patient. She was still awake but now it was time for aggressive treatment.  Cutting through the chaos, I heard one of the nurses telling my partner, "She is having an acute MI right now". Hmm..good call by my partner.

We drove back to the station, with a mild sense of gratification knowing that the call and the choice of care plans was correct.

I don't know the patient's outcome to this point but I will let you know when I find out info.  My girlfriend is a nurse in the ER there so I will ask her to find out for me later.

0900

I was off a half hour ago. I better go home now before someone calls off sick.

My fellow readers, in today's society, we tend to be more self sufficient as to our own medical needs. With advancements in medicine, we tend to think if we take a pill that we will be fine. This is not always the case in this matter.  I have no doubt that if this patient would have waited and not called the ambulance, she would have died probably later in that day.

My message to you is, if you think your pain is something that is non-serious but is keeping you up at night or excruciating. Call 9-1-1. Let US be the judge of that. Otherwise, the next trip you might take, could be your last.

Be safe and wear your seat belt.

Rounding Third and heading home,

M-

 

 

26 April 2004

A Call from the Archives

25 April 2004

"A Call from the Archives"

Sundays are supposed to be boring.  It is God's day of worship and rest.  People head to church, visit family and friends, and lose their sancutary graces by cussing while trying to find a parking space at the local Bob Evans which triples its business on the final day of the weekend.  (I think Bob is lacing his buscuits and gravy).

For us in our little corner of the globe in EMS, Sunday is for one of three things or any combo of the three.

First, grilling outside.  Taking your chicken halves and marinading them for a good portion of the shift in order to place on the hickory sticks that will bring out a flavorable mesquite taste more enjoyable than any KFC can provide.

Second is sports. Whether it is footbal or NASCAR, Ohio Revised code reads this.

ORC 3421.9

In the profession of Emergency Medical Services, it is set forth that on the holy day of Sunday, that no fewer than a minimum of one (1) television within the residential quarters of those whom operate and function as Emergency Medical Technicians have their receivers set on such channel to broadcast program(s) from said National Football League, National Association of Stock Car Auto Racing, or said athletic events designated by mandate.

Finally, a more simple plan for the third reason for Sundays...

Sleep!!!

Time to play catch up with the Sandman.

Well, pull some jiffy pop out of the cupboard, grab a Pepsi (the choice of a new generation), and kick back...

and relax...yes, take a snooze, root for the number 8 car, and pull out the Ms. Dash's seasoning. Nothing exciting happened today.

But as to not leave you on a dry note, I am going into my memory archives and telling you about a story that I have never lived down and has made me popular in some sorts.

 

04 March 2002

"The home version of "Jackass"

3:30 AM

"93..I need you to head out to GCI for an inmate with chest pain."

Man..not again!!! This is the third shift in a row. And why does everyone get sick AFTER midnight? Yawn!!!!!

"Donna, get up!!! we have a call."

"Where we going?"

"Don't ask, I don't wanna ruin it for ya."

Climbing out of bed at the butt crack of dawn has some routines that are essential to get mastered before you go out on the road.

First is just getting up. Some of the crews have not mastered that yet.

Next, is getting dressed. You would be suprised on how many crews still need their mommies. C'mon..tie your shoe...over...under...through.

Finally, we have 3 minutes to get en route after midnight. An acceptable practice seeing that most volunteer departments take an average of 5 minutes to get TO the station. So, if you have to relinquish bodily fluids, you must so really quick.  I was about 2 seconds behind my partner becasue I had the extra obsticle of climbing down from the top bunk.

What I saw next can only happen with a female partner. (No you sickos..nothing like that).

She was in the bathroom, making sure her hair was perfect.

WHAT?!?!?!??! C'mon..it is zero dark thirty. Put a hat on and shake a tail feather little girl.

Getting to the squad, I usually drove so it took me a breif second on how to turn the squad on. (cut me some slack..I am dead tired). Within a few seconds, we were on our way.

Sirens cutting through the night, and the strobes reflecting off of anything that came within range, we tore through the late winter morning and approached our scene...a prision....sigh.

Okay, going into the prision with a female is like walking into the lion's den with porterhouses tied on you.

My partner, a rather attractive female, just put the A1 sauce on the steak. Here is the twist....

It is the GUARDS that we have to worry about, not the inmates. They are very..um..what is the word....piggish...full of themselves...does that sum it up?

Within a few minutes, we reached the sally port. The portal to condemption. Once inside, there was no way out except the way we came. We were doomed.

Here is where it gets funny.

The guard at the enrty point kinda reminded me of Cartman from South Park. A bit on the plump side but very full of himself (if only he had the voice too). Rolling down the window to talk and get our clearance, the guard who had the voice of "this is what you are gonna do and you will like it" got about 3 words out when he made eye contact with my partner. Hello???? sir???? you there...I was obvious, he was making himself out to be robocop.

Sucking in his gut (which he did), he walked around the front of the squad as if here were checking it out. He came up to my partner's side and "instructed" her to roll the window down.  Following his "order", she did so. He then sucked up his voice to sound more masculine (I am not sure he was to begin with).

(takes a deep breath) "I am gonna ride in with you and show you where to go!"

First of all, I already KNEW that. They ALWAYS ride with us to secure the truck.

Second, this isn't my first time here, Kojack. I know where I am going.

But not to steal his thunder, I obliged him of his request. Then, he did the unthinkable.

Normally, the guards proceed to get into the back of the squad and sit on the jump seat. Sometimes making conversation, sometimes not. Either way, they are inside.

Evil Kenevil had to be different.

I think he was REALLY trying to impress my partner..the key word being "trying."

So what does he do? He stands on the running board of the passsenger side.

WHAT ARE YOU DOING??? Do you have a screw loose?

The running board is no bigger than 6 inches deep and maybe 2 feet long. It is designed to be a step, not a floor.

This is not a SWAT truck. We don't ride on the rails and spring into action when we get to the scene. If we did, we would have a stunt double and a bigger paycheck.

"Um, what are you doing?" I asked him.

"I will ride here." He said looking at her giving her that wink that makes you want to puke.

All he needed was his hair slicked back, a leisure suit, and a scotch and water in his hands.

"Sir, that is not secure and it is not safe."

"Just go!!! I am fine." he commanded.

Are you? We will see!!!!<insert evil laugh>

I rolled up the window, looked at my partner, and with an astounded look on my face, I said,

"Dude, he is gonna fall. Watch this..I am gonna dump him."

My partner looked at me with a very fast glance, looked in a suprised look at me, started to laugh, and sank in her seat.

Don't tell ME what to do when it comes to safety of my truck if you are not in the field.  Those who are late, do not get fruit cup.

OOOOOkkkkay, here we go.

I started to drive really slow and around the first corner. As I watched the guard, it was apparent on his face, he made the wrong choice. The temperature was below 20 degrees outside, the air was very brisk, and the ground was very hard and covered with frost.  "I'll take 'Stupid Ways to Impress a Girl" for 1000, Alex."

Here came the next curve..the pivotal moment..the spot of redemption.  Even the empire stuck back...heh heh heh heh heh

At the curve, I added a little gas to the accelerator and created an increased G-force to the truck. The truck turned left..the guard went straight.

My partner started shreking at the top of her lungs in a pitch I have only heard in operas.

"OH MY GOD, YOU DUMPED HIM!!!!" She yelled.

Tears of laughter are free flowing from her face at this point. I glance in the rear view mirror to see the guard doing his best bowling ball impression tumbling in the grass and finally coming to a stop.

Stopping, My partner was concerned that sniper fire was imminent  now. This wasn't Vietnam..no snipers. My partner is uncontrollable now with the hysteria she is in laughing beyond the point of making sound. But here is where it gets better.

The guard got up, dusted himself off, retrieved his equipment...then got BACK on the running board as if he was determined to impress my partner.

I looked in the mirror to check to see if his brains are still on the frosted turf because only an IDIOT would get back up and do it all over again. Oh, did I mention that I did this in front of the security hut so all his friends saw him?

Looking in the hut, I see guards in hysterical laughter pointing (better than shooting) almost on the floor at the sheer stupidity of this co-worker.

Rolling down the window, I asked him "Are you okay?"

"Yeah, I am fine, let's just go." he said in a much quieter voice this time.

"Are you gonna stand there again?"

"Yeah, I am fine..let's go" he said.

By this time, he knew and I knew who was in control. Donna, my partner is practically sitting on the floor board laughing, she is red now and I am in fear her breathing will stop with the amount of humor she found in this.

"Hey, Nash Bridges..get in the back!!!" I yelled at him.

Without incident, he got off, got in, and proceeded to sit in the furtherest and darkest part of the squad.

What a moron!! I am SURE she will go out with you now.

I got out, once we got to medical, and made sure he was fine. Without making eye contact, he just nodded in a disgusted manner and secured the truck.

"Oh, can you check the oil while you are here." I thought I would put the nail in the coffin.  The other guards, by this time, have lost total control of their composure and have joined my partner in laughter.

Moving on, we loaded the patient and were on our way. As, I looked in the back, I noticed that both my partner and the other corrections officer were sharing the memory of the oscillating officer. I had to call in the report because my partner was toatlly gone..STILL laughing after 20 minutes. I bet she needed a diaper after that.

Two weeks later, we went back to the prision. Immediately upon arrival, a guard looked at us with a highlight on his face.

"You are the 2 that dumped Frank (I don't remember his name)!!!"

"That is us" I told him.

"Wow, you guys are famous here now..no one like him, and you justified why. Everyone here (the guards) thinks you guys are great. Just wanted you to know" He told us.

Anyone seen my sharpie marker..I feel autographs.

Another day, another dollar!!!

Take care and wear yoaur seat belt.

Rounding third and heading home

M-

 

 

 

 

 

 

 

24 April 2004

A Couple More Journals

24 April 2004

Hey all.

There are a couple more journals I would like you to check out.

"LA Ambulance NightLife"  Sean is a graveyarder in LA County and has some interesting stories.

"Behind the Headset" Is Donna who is a 911 operator out here. Both are just starting up and I have placed their links to the right in my box.

Both are good reads...please check them out abd give them the great feedback you give me.

Rounding 3rd and heading home

M-

23 April 2004

Top Ten Pet Peeves in EMS

23 April 2004

"Top Ten Pet Peeves in EMS"

Today I thought I would do something a little different. To day, I thought I would share with you what fuels me...and fires me up too.  This is just a small list of what we actually go through in EMS.

This list is in really no paticular order but I WILL save some if the best for last.

From the home office in Siuox City Iowa, Heeeeeeeeeeeeeeeeeere we go!!!!:

10. The Concierge.  Okay, there is a lot we have to do as EMS providers in this city. Our job is complicated enough. But, the last time I checked, the squad didn't have "bed and breakfast" written on the side of it. Hold on, let me go check the squad...ummm....nope...doesn't say it. 

I don't really need the ambulance, but could you just bring me my water and I will be fine, Oh, and I need also...."

People,  Tuxedos and french maid outfits are not part of the job. (me in a french maids outfit might cause me to take "a trip to see the wizard") . Also, last time I checked, I didn't get paid what they got too.  Now, I don't mind helping someone in need, but to call just because they need their dog let in is not why I do this.  Oh yeah...I left a mint on your pillow.

9. The critic.  "I saw on TV where they did this." Really?!?! Are you sure?  I mean, I wouldn't want to deviate from my years of training and actually perform a procedure that may save your life. But if you saw it on TV, then it must be the real deal.

From now on "I would love to help you ma'am, but that episode on what to do comes on next week. Can you call back then?"

It must be gold what they say anyways, I mean with all the money they make, they MUST have perfected it.  Hmm. 

"Next week in 'Third Watch" ACLS has the medics dangling for life in a west side fire."

Riviting!!!

8. The EMT interviener.  Listen, I realize sometimes that an outside EMT might show up to a scene before we can come to help and hey, that is great and all, but once I am there, LET ME DO MY JOB!!!  There is absolutely nothing wrong with a little help, but when the EMT begins to act like a scene commander, THEN I have a problem.  Not to be selfish, but this isMY scene. The fire department, the police, other EMS. I work with them on a day to day basis. They have a rhythm, I have a rhythm. It is a groove that takes months, even years to achieve. They know what they need to do, we know what we need to do. Sometimes we intertwine, sometimes, we are on separate paths, but we get our jobs done.  Then, out of the sunset, comes a lone person. One who (while walking in slow motion) emerges from the horizion.  It is....da da daaaa...the lone rescuer.  Hey Poncho...this is MY show..get your own time slot.

7. The Interpreter.  Who calls the ambulance? A family member? A friend? A bystandard who is just walking by. All are potential lifesavers, all did the right thing by initiating EMS.  These people have pertininent infomation as to the care of someone that they called for. Now, I am there to help that victim, to treat their aches and pains, to provide comfort to them...so let THEM tell me what is wrong.

"Sir, tell me what your pain feels like" I might ask.

"He says it is tearing" the wife answers.

He did??? Because, it really sounded like it came from the wife. I usually will let one or two questions slide, but whem my interview with the patient becomes a barrier because of the other person speaking, my buttons get a little pushed.

Who is the ambulance for? I mean, if it IS for the one having the chest pain or the shortness of breath, let THEM tell me so I can treat THEM.  I realize you are trying to help me, but you are not part of the solution at this point, you are part of the problem.

What really gets my goat (what does that mean..getting your goat) is that they get upset with you when you tell them to stop. It is almost as if I were pulling your teeth (Ewww). 

Please...don't

6. The Ambulance Chaser.  Scanners are cheap and affordable entertainment and have a dual purpose of providing information to the lay people. You can go to almost any electronics store and purchase both scanner and frequency books and be off with a working knowledge of what is going on in your community.  They are called home scanners for a reason...to keep them at home.

If I had a dollar for everytime I run out to the truck for something and someone comes up and says:

"Hey, I heard this callon the scanner, so I came over to see if everything was alright. What is going on?"

Did you get the page for this call? No? Then I guess it is none of your business.

People, show some respect. These people are in need and if they wanted to be paraded down Main Street advertising some sort of need for help, they would have rented a float with balloons and thrown candy to the crowd.  Hey, I think a cop pulled a car over 3 blocks up. WHy don't you go see if he needs help writing the citation.

5. The procrastinator.  Simple rule here. If you need the Ambulance. Then call for it RIGHT AWAY!!!! 

"I've been short of breath for a while now, just can't get it back."

"Sir, when did this all start?"

"I dunno, I think last week."

LAST WEEK????  Well, now your little chest cold has turned into pneumonia and you just bought a ticket to ride.

I know that some of us are too proud to ask for help from family, let alone perfect strangers, but it is better we come and see for ourselves when this starts than way after the fact when a separate course of action is needed.  Tom Cruise said it best in the movie "Jerry Maguire" when he said "Help me, help you."

Call the squad folks, don't wait till you are dead to call me.

4. The Chauffer.  "Hi, I didn't mean to call y ou guys but I have been sick for a couple of days and I just need a lift to the hospital. I am really okay, just need a ride."

Well, I can see how you can misdial 9-1-1 from a local 7 digit number for a cab.  Are you serious? This is the REAL reason you called me? Do you actually NEED help or are you really just needing transport? Well, your 5 dollar cab ride just turned into a 500 dollar one.

Congrats on your Nobel peace prize for intelligence. You earned it.

3. The race car driver.  Why? This is all I ask you.  Why do you think you can beat the ambulance and that light that is green is SOOO impearative to make that you accelerate instead of pulling over for me. I know, I know. The place you are going to MUST close in 5 minutes so that is why you impede my traffic. I hope you got the videos back in time.

And I am gonna enforce this again..pull to the RIGHT. For those of you that are having trouble with that, here is a diagram:

---------------------------------------------------->

I hope that clears it up.

2. The Nurse.  Okay, so I am at the bottom of the food chain in the medical industry (right below the vending machine guy who fills the machines in the lobby) and I know my training is far less superior than your vast knowledge of medicine and paramedicine and that I am merely breathing your oxygen, but if you know more than I do and you don't need my help, don't call me then.

"Oh, I am a nurse and this is what is wrong with him. I need you to do this and this and this and he needs to go to this hospital."

WHAT?!?!?!  You need to step off there. I am here for his immediate care, THAT is why you called me.  I don't tell you how to do your job, don't tell me how to do mine.

Now for those nurses out there, I am not singling you out. For the most part, I love you all. I think you are invaluable to the field and should get more due credit. For the most part, you know what I can do and you let me do my job. That makes me respect you more. It is the very low percentage that makes us feel as if we are nothing more than...(gulp)...ambulance drivers.  Show some faith in us, please.  (Again, this is not addressed to all RN's, but you know who I am talking about.

1. The Valet.  Okay, this is my ultimate pet peeve here and it is set more specifically towards law enforcement here.  There are only so many spaces to park an ambulance once we get to the hospital. Hence the name, ambulance bay. But when I get there and there is a barroge of police cruisers that are there and they feel "above the law" and park wherever they want, I want to go postal.  Yesterday, I had to drag a patient across the parking lot, in the rain, because those who "serve and protect" didn't want to get their badges wet and parked in the emergency canopy.

Hey, Nash Bridges...MOVE YOUR CAR!!!!

I don't double park in the drive-thru at Dunkin' Donuts, don't take up MY space in the ER.

Okay, that is just a brief list. I feel better now..got it off my chest.

I hope I didn't offend anyone and if I DIDwrite about my shift last night, I wouldhave had to tell you about the cursed truck I wrecked, the patient that died, and the gaining of only 2 hours of sleep..but that would have been boring.

Take care and wear your seat belt.

Rounding Third and Heading Home

M-

 

20 April 2004

Going the Extra Mile

20 April 2004

"Going the Extra Mile"

compassion

n 1: a deep awareness of and sympathy for another's suffering  2: the humane quality of understanding the suffering of others and wanting to do something about it.

3 AM

"92, I need you to respond with Carlisle Fire Department for a  male with chest pains."

Wiping the sleep from my eyes, I struggled to comprehend on whether the voice that I had just heard is that of a real call or my subconscious subliminally telling me "You are working too much and now you are dreaming about work.." In my mind, I tried to change the dream where the outcome was a cancelled call and I can go back to dreaming about whatever it was I was dreaming.  Returning into my suspended animation, I reapplied myself to the warmth of my sleeping bag.  MMmmmm...nice.

The pager went off.

This is not a drill.

Okay, time to get up and go.  Waking up my partner can sometimes be like waking up a sleeping bear. If you are gonna do it, you better have a HUGE head start for the door.  Fortunately, my partner doesn't need poked with a stick to get him going. 

We stumbled to the squad, turned the key, pulled out of the bay, and converted into "go" mode.

"92, dispatch. We are en route with 37" (those are the miles I am starting with)

"92, you are en route to  Carlisle Township for a 62 year old male with chest pain.  Pt also complaining of Shortness of breath. Pt has taken 3 nitros without relief.  Your time out is 0306"

Carlisle Township is a area that is south of the city that has  a lot of property but very little residence not really needing full time EMS.  We are contracted with it them to run their EMS. Our response time to anywhere in their service area is under 10 minutes so the fit is perfect.

It is weird going through to Carlisle because you start out in the city and before you really realize it, you are flying down a country road. This is the case for this call.

Coming down the main road, I see the flashing red lights of the fire's rescue truck.  We backed in, got our equipment, and proceeded in to the house to check our patient out.

Our patient was sitting in a chairwith a non-rebreather mask on. The patient seemed a little anxious, but for the most part, he seemed relieved we were there.  My partner obtained a history from the patient and I talked to the wife who actually seemed to be a very good historian and comfort for the patient.  Normally, the spouse or significant other does nothing but impedes our care. You ask a question to the patient and the spouse answers it. Um..if I wanted you to answer, I would have asked you!!! In this case, I was rather glad that she was there.  A nurse (which could be doublly bad) she gave us very pertinent info that benifitted the patient and our course of action.

Moving forward, we loaded the patient into the squad to further assess and put his wife in the front. 

We found out the the patient has Congestive Heart Failure (A pump problem with the heart where fluid backs up into the lungs). I treatable disease, but deadly if caught really late.

As we further assessed the patient, I heard a faint whimpering in the front. It was the patient's wife. Apparently, the patient heard it too because he called out to her and obviously got a little nervous seeing his heart rate jumped on the monitor. My partner calmed the patient and I stuck my head up in the front.

"Ma'am. I need you to relax." I told her.

"He is doing fine and is more concerned about you than himself. It is very important that you stay strong, for his sake that is..and yours. We are taking excellent care of him and he is going to be just fine." My monolouge went.

Okay, maybe I shouldn't have given that false sense of security, but he was not in imminent danger and I was pretty sure he was still gonna be alive by the time we got to the ER.

We finished up in the back and I came around to drive.  Talking to the wife, I come to find that he is usually the care giver and that the roles have reversed in this situation. It was quite apparent to me that the love she had for this man was genuine and pure. Something we all need.

As we pulled into the hospital, I helped her out of my truck and into the hospital pointing out where she needs to go. Her eyes welted with tears as she took my hand and expressed her thanks to me. Choking back, I acknowledged her and moved to assist the patient into his room.

I went back a few hours later on a different run (to the hospital) and the patient was about to go upstairs. He looked 100% better and the sheer look of relief was about the face of the wife. Again, the thank you's poured out and a sense of "this is why I do my job" came onto me.  I wished them well, and headed to the station for a shift change.

Compassion. I kind word, A small gesture, a miniscule glance. It may be insignificant to you and me, but it can change the life of someone. I mean isn't that why we are here. To improve the quality of life for those we meet and touch the hearts to those around them?  There is no book, no person, no object that can teach us compassion. It is a skill that must be learned on one's own.

As I leave, I hope that sharing this with you today will instow some thought as to how we all carry ourselves each day. One little smile can change the life of a perfect stranger. One helping hand can show to someone that there is someone out there that cares about them and who they are. One kind word..can help to change your life.

Be safe out there.

Rounding third and heading home,

M-

 

 

 

 

17 April 2004

Things that go Bump in the Night

17 April 2004

"Things that go bump in the night"

Okay, a side note to start this all off. Never drink Moutain Dew before yougo to bed..very bad...no sleep.

It is 4 AM here EST and I am wide awake (maybe not wide, but I am sugar induced) so I thought I would put in my entry now seeing that I will be out of town the next few days and I will have no access to a computer.

I was really struggling for something to feed you all with seeing my excitement of the day was a PALS (pediatric advanced life support) class that I took and that was mediocre at best.  I got out early, went home, and put on the bat suit waiting for the commisioner to call.

My god, what a great day it was weatherwise!  75 degrees, sunny, windows down, music blairing. (I don't remember what happened after that.)  I sat out and enjoyed the sun at the station till 1630 till it was time to relieve the crew on my truck. I was in a great mood. I wanted it all...trauma...blood, guts, brains all over the place (of course I wanted them all to live). I was ready for the challenge. "Bring it on to me Ole Mighty One!! I yelled to Crashious (the God of Trauma). "Forsake me into thy depths of Hell and showeth your wrath by bestowing a poor soul into my clutches to be thine rescued!!!"

I got a transport.

Damn it!!!!!

Nothing special about that, nor was the one after that too.

Hmm...I thought I was going to dissapoint you all with nothing to tell you, my faithful readers of my meager little journal. So off to bed I went, shedding a tear for you, in whom I have found faith and solitude in, dissapointed in not only myself, but my faith in life as an EMS provider. (Okay..so I am mellodramatic)

Fasting away, tucked within my sleeping bag, I dreamt of days gone past in which rescues were the common place and I need not worry about taking care of those in need. A happy place where everyone lived and thanked us for saving their lives (this is how you know it is a dream sequence.

Then the phone rang.

"92 primary, 93 secondary. MVA with injuries, car vs. tree. Lake Ave just before Rush Street by the 911 building. Unknown number of patients." Dispatch told me over the phone..with a twist.

The dispatcher's voice seemed very urgent and solemn.  Wow..this may be "the one"

My partner and I scrambled (you scramble at 3 AM) to the truck as did the next crew going with us.

Taking a second, we run 2 trucks automatically for all MVA's. The "primary" truck goes to the call hot (or with lights and sirens) while the secondary truck truck runs cold (with traffic..you get the picture). Once we get on scene, we evaluate the situation and either A) bump up the truck to code 3 (again, lights and sirens) or B) cancel them as we can handle it on scene.

Calling in route, (our computers were down...big suprise <insert sarcasm>) the dispatcher repeated the call over the radio, adding something that flipped a switch in us.

"92, you are responding to the corner of Lake Ave and Rush Street. Lake and Rush for a single car MVA, car vs. tree with injuries. 92 be advised that PD request you expeidite. Your time out is 0216."

Request you expeidite. Whoa boy. Time to put the women and children to bed and go looking for dinner. This was a call that was gonna be real.

Driving LS&D, (Lights, siren, and diesel), it only took us a matter of 2 minutes to get there. (No, we didn't drive 88MPH back to the future). We came a round the corner to a barrosh of lights. This scene had more cops than a donut shop on free give away day.  What we saw next made our stomachs drop.....a lot!!!!!

The car was aorund an early 90's Ford Tempo. The tree was about a 60 year old oak.  Guess which one won?

This is what the car looked like:

The car hit the tree at an estimated 60 MPH WITHOUT ever braking. The front end of the car was wrapped completely around the tree. The engine block went under the car and into the driver's side floor board. The debris from the vehicle was scattered for about 75ft in FRONT of the car. The tires on the passenger side were blown out with the front tire having a hole in it the size of an index card. The front axel was broken making the passenger side front tire pointing as if it were turning right. The roof had an indentation on it from  a piece of the debris.  Inside, the floorboard broke the pedals off where the engine started to intrude and the steering wheeel had massive indentations in it from where the patient hit the steering column.  One good thing came from this, the patient had a seat belt on.

I am going to add on to Scott's message about seat belt use because I cannot emphasize this enough as to how important this is.  If it were not for her wearing the seatbelt, there is no doubt in my mind she would have been ejected from the vehicle and dead on scene. Here is something I want you to consider:

Do you know what happens in the first fatal second after a car going 55 MPH hits a solid object?

  • In the first 10th of a second, the front bumper and grille collapse.
  • The second 10th finds the hood crumbling, rising and striking the windshield as the spinning rear wheels lift from the ground. Simultaneously, fenders begin wrapping themselves around the solid object. Although the car’s frame has been halted, the rest of the car is still going 55 MPH. Instinct causes the driver to stiffen his legs against the crash, and they snap at the knee joint.
  • During the third 10th of the second, the steering wheel starts to disintegrate and the steering column aims for the driver’s chest.
  • The fourth 10th of the second finds two feet of the car’s front end wrecked, while the rear end still moves at 35 mph. The driver’s body is still traveling at 55 mph.
  • In the fifth 10th of a second, the driver is impaled on the steering column, and blood rushes into his lungs.
  • The sixth 10th of a second, the impact has built up to the point that the driver’s feet are ripped out of the tightly laced shoes. The brake pedal breaks off. The car frame buckles in the middle. The driver’s head smashes into the windshield as the rear wheels, still spinning, fall back to earth.
  • In the seventh 10th of the second, hinges rip loose, doors fly open and the seats break free, striking the driver from behind. The seat striking the driver does not bother him because he is already dead.
  • The last three 10ths of the second mean nothing to the driver

It only takes 7/10's of a second to die, and it only takes me that long to put a sheet over you at the accident scene. Don't be a statistic, buckle up.

One other thing I need to mention. (Back me up here Scott), unless the vehicle is on fire or there is immediate danger to the patient, do NOT pull them from the vehicle. Folks, we are trained to minimize risk to the patient and extrication of them. Why did I say this? Because bystandards moved her from the car.  Fortunately, someone who watches a lot of ER was holding C-spine control. Kudos to you ma'am.

The patient was a 22 year old female that responded only to verbal stimuli with an altered level of consciousness. She did no seem to have any apparent injuries, but nevertheless, I was not going to take a chance.

I called for the second truck because the fire department was walking around with thier thumbs up their ass after we asked them to get us some equipment. Come on people! I mean, I know it takes 4 people to cut a battery cable and those same 4 to put absorbent on the ground in the area of a small throw rug, but if you are not gonna do anything, then go back to bed, you do me more good there.

The bystandard holding c-spine was doing a great job...not manipulating the neck at all, she wasn't letting go for anything....even the collar I needed to put on her.

"Um, I am not letting go, don't you worry" she said.

"You are doing a fine job ma'am....now let go!" I told her

She looked at me as if I asked her to make me breakfast (you know that look women give...women, you KNOW what I am talking about).  I explained to her that I needed to put the collar on and that her big old claud hopper hands were impeading my care.  It took her a second, but she got the idea.

As my partner and I did a "strip and flip" (expose the clothes and place her on a backboard) I heard her talking to the cop with almost a superhero attitude. Okay, take your 15 minutes of fame miss, I feel a commercial coming on soon.

We loaded the patient and began to do out thing, My partner started a 16 gauge in her right arm (a rather big needle) and I was for sure she would flinch. Once again, (like I am with women), I was wrong. I grabbed vitals, placed her on some oxygen, and prepped another bag.

"MMMMMMMMM  OOoooooo" Came from the patient in soft moans (no, not THAT kind of moan)

Sleeping beauty has awoke (and no, we didn't kiss her)

"Ma'am...where do you hurt at?"

""mmmm nowhere"

"How much have you had to drink?"

Thinking for a quick second, the response was "I had too much"

At least she was honest.

We turned around and ran hot to the hospital where the ER already had a helicopter on the way.  We stuck around till the flight crew got there and helped them with the transfer.

The nurse on the chopper was one of that facilities ER nurses so it was easy to transfer the info on her. The patient, however, didn't care for it.

She started getting a bit combative on the table and was about 2 seconds away from buying some soft restraints.  As the flight nurse looked at her, she didn't even hesitate to ask for sedatives.  The flight doctor ordered 2.5 mg of Haldol, a major tranquilizer.  Here is where it got good.

The nurse started to explain what was going on when the patient who's "I don't care" attitude (typical with patients under the influence) spit at the nurse.

Whoa boy....gloves are off now.

Okay, for me, that is the ultimate sin. You did that to me in the field, I usually "miss" with IV needles on purpose or something to that effect. Bottom line is I WILL win..so don't challenge me.

Another nurse put a oxygen mask on her. Ha!! spit up now girlie. While this was going on, the flight doc, turns around while reviewing films and non-chalantly says:

"Oooooookay, give her 5 of Haldol."

Nighty night.

We watched them take off and then out adrenailin wore off. I looked at the clock and realized it was WAYYYY past nap time.  We got  back to the station and off to sleep we went.

Another save, another one that will proabaly sue fro breaking a fingernail...sigh.

Well, all. I am off. Gotta work in the ER this morning and off to meet new family in Dayton which is about 3 1/2 hours away.

Remember kids, If you see me coming with sirens and lights, please be kind and pull to the right.

Oh, and send Scott some hugs, will ya, I know I would need them after that call he had.

Take care and please buckle up.

Rounding third and heading home

M-

 

14 April 2004

"And I would drive 500 miles..."

13 April 2004

"And I would drive 500 miles..."

EMT.  Most people think it stands for "Emergency Medical Technician" (Most, because the rest have no clue as to what it  actually means and they can't spell ambulance driver).  Well, for those of us in the field, it takes on a whole new meaning. What does it stand for?

Early Morning Taxi

Yes, folks. You have all been misled.  If you are one of those many that watch "Paramedics" on Discovery Health, Monday through Friday at 7PM EST (there is a free plug for the channel and not even a stinkin' t-shirt I will get), where Sally and her partner climb up 18 flights of steps to save a 68 year old male who is in cardiac arrest, get the tube on the first try, shock him once and convert him, then pan to the ER where the doc tells the camera, Thank God for paramedics" and think "what a great job these people have"...well, toke another hit for me too.

What they DON'T show you is the transports, the "I fell and just need to get up", or the "I have had a fever for 2 weeks, I think I need to go to the hospital (morons)". Today, we are gonna show you what the cameras don't.

8:45 AM (0845)

During truck check, both my partner and I were discussing on how it would be nice to get a long trip so we could waste the day.  I think her exact words were "Man, I would not mind going to Columbus today in the morning."  Chuckling with her, I agreed. What better way than to get lost in the monotimy of the day than to do one long trip and take your time doing it.

8:45 and 30 seconds

The phone rang.

After hearing some snickering in the bays, the crew chief from the last shift puffs on his cigarette once, gives a shit-eating grin, and hollars:

"92, GCI to OSU"

<insert evil laugh>

She wanted to go to Columbus...well, she got her wish.

How does she do that?!?!?

GCI is another prision and OSU is...well OSU.

Hey, this is cool. 6 Hours round trip...see ya all 'round dinner time.  Getting in the truck, we took off for the jail to take, yet another, inmate to Columbus.

Fast forwarding a bit, we loaded up and we left. My partner had me drive which was fine for me. The guard that sat up front with me was  afemale officer and was rather pleasant and was good conversation so I thought that it would make the trip go so much quicker (which it did). 

Now, there is one catch..

The weather.

Getting to the interstate itself was rather uneventful, but once we got on, it was pretty similar to LT. Dan strapped to the mast of the shrimping boat yealling at God saying "You call this a storm!!!!" while being tossed from side to side violently without care. (And for those of you who have not seen "Forrest Gump"" to know what I am talking about, you need to A) check your calender to see what YEAR you are in. B) petition to get a Blockbuster in your neighborhood. Or C) If you are blind, disregard A and B.)

A box truck ambulance (You can see in the pics I put in the entry "Taking a step Back") rides like sitting on top of the washing machine while on the spin cycle (no, ladies..not in a good way),  corners like the Titanic, and brakes slower than trying to check out in the "express" lane at the grocery store with the 80 year old woman in front of you with 13 items, having a coupon, has to write a check, then proceeds to tell the cashier about her stupid grandchild who also works in a store mopping up bird feces in the pet section...but this has never happened to me..this is what I heard. (I also have some swampland in Florida I can sell you too if you believe that).

Anyways, the fog was a factor leaving visibility to nothing.  Looking ahead, as the cars dissappeared into the clouds, it had looked as if vehicles were falling of the face of the earth literally and God ended his creation right at that point. Hmm..maybe the world IS flat.  Battling the rain was also a chore making everyone drive just a bit slower...like 15 MPH slower...sigh.

To make a long story short (too late), there was really nothing spectacular about the trip.  It was AFTER the trip that got scarry.

Mission accomplished. Patient dropped off. Now on to a more important mission...food.

Kelly, my first partner of the day, ( will go through 3 partners...no..I don't stink) chose to go find an Arby's to dine at.  Arby's actually sounded good for a roast beef sandwich would really hit the spot. (in my stomach for you smart alecs).  So, we followed the signs off the highway, cut through the dense but lifting fog, and truged up hill in 8 feet of snow, without shoes (oh wait...that is my walking to school as a kid..no, I didn't have shoes either) and parked the squad.  The rain was picking up so this was a nice little break.  I went to the bathroom to wash up and when I came back, it was like being in the Twilight Zone <start playing music here>.

The two registers were manned by employees standing in the same position, military style with thier hands behind thier back, and the manager in the middle. (same pose). My partner had already ordered and a gentleman in front of me moved to the female employee at her register. The employee then proceeded to stick her hand out, grab her customers hand, and shake it.

"Thank you sir for stopping at Arby's, How may I be of assistance."

<insert dropped jaw>

I had to go out to the parkig lot to make sure that this was not a used car lot disguised as a fast food joint. The last thing I would need is someone to finance the squad for 4.9% with great incentives from your dealer....sorry.

Then it came....my turn.

I placed an order to a less receptive, but still pleasant gentleman who took my order and took my cash. Before he was done giving change, my COMPLETE order was on a tray in front of me..and correct too!!!

Now I am scared.

The condiments were in alphabetical order on the table behind me so those obsessive-compulsives who come in won't wig out that mustard comes before ketchup on the counter.

Kelly and I sat and ate and were carrying on our own conversation when the cheery girl who either got a raise, got lucky, or got a raise while getting lucky (I know, that is mean) came out into the dining room to see if she can clear tables for anyone. Bussing??? Man, she MUST be bored..but it gets even wierder.

Just as we were fisinhing up, this same girl comes around with a huge punch bowl filled with, Arby's mints. (no, I didn't know Arby's had mints either.)

"Would you care for a mint, take a couple, they are free." She said with an American Idol smile..you know, the real cheesy one similar to the Joker's in Batman.

We took a couple...then ran.

As we left, I looked in the rear view mirror to see if the restauraunt was still going to be there when looked. It was..this was not a dream.

Here we are on the road home. Kelly is driving, getting sleepy. Kelly tells me to take a nap for it will be a bit before we get home. Well, she won't get an argument from me.  I told her to just do the speed limit as I am in no hurry to get back.  This would put us back somewhere around 3:30 PM (1530 hours). Good enough for me.

2 PM (1400)

We are getting off the high way.

I woke up to the truck slowing down on the ramp. Noticed we were an hour AHEAD of schedule and went back to sleep with a groan knowing we would be slammed yet again with our entery into the city.

2:35 PM (1435..you getting the time thing?)

We are back in town.  Time to suck it up.

2:50

Assigned another trip.  This one was easy. A short little transfer to a neighboring hospital. 30 Minutes round trip and I will be almost home free.

Again, fast forwarding ahead, Our patient was dropped and we were ALMOST on our way back. Notice the emphasis on ALMOST.

"Dispatch to 92"

"92, Grace Hospital"

"Are you unloaded?"

Okay, now, I have the obvious two choices that I can reply with.

A NO, would mean that I am lying and would probably either delay the trip he about to give us and assign us even a worse trip, or...

A YES, would give us whatever he had in his hand wheather it was an emergency or another transfer.

Time to flip a coin.

Pulling a dime up, (we don't make enough to carry quarters) I flipped it with heads being Yes, tails being NO.

The wind up...and the pitch....

"Yes, we are unloaded" I said disgruntled looking at the shiny replica of some dead president's profile shot smirking at me saying "ha ha you schmuck."

"I have a STAT trip for you coming out of the West Campus going to EMH for Tachycardia"

OOOooo..Stat trip....Lights and sirens...now I am intrigued.

Time to Load and Go.

West Campus (CHP-West) is a bigger hospital located about 3 miles north of where we were. EMH (Elyria Memorial Hospital) was the receiving hospital in the city I work in and where my fiancee' works as an ER nurse.  The ride will be about 15 minutes going Code 3 (lights and sirens..a lesson you have learned.)

We got to the hospital in very little time, raced up to see what needed critical care transport, and almost went through the roof when we saw.

The patient was sitting in the bed with a tachy heart rate...of 120. (normal is 60-100) I am thinking to myself, "What the hell are we going code 3 for this for."  Finding out that the patient has no radial pulse (which is a true emergency) so hence the need for expiditious transport.  so far , so good...until....

I went up to the nurseto get some info on the patient. Her response was "You will have to wait a minute!!!"

OOOOookay...I will let that sneer comment slide but she is on strike one.

I gave her exactly ONE minute...then went back.

"He is going to the emergency room at EMH?" I asked because it was an odd place seeing we were IN an ER.

"Yes, that is what I told them" she snared at me.

Strike two!

"And he needs to go code three for this?" Reaffirming.

"YES!!! I told them lights and sirens so you WILL go lights and sirens!!!"

Okay, strike three.  My tolerance is now gone and she is one tai-bo lesson away from an ass-kicking.

"Really, is that what it means? You know being an ambulance driver, I am so glad a nurse of YOUR caliber is here to tell me that." I retorted seeing the gloves were off now.

An evil stare came from her as I started to play dumb just to irritate her.

At this point, the other nurse started laughing knowing what I was doing. Apparently this nurse has a known reputation for being Greater than thou.

We loaded the patient and were about to leave when the wicked witch of the west stopped the cot and told us, "He is a dialysis patient and needs a 250 cc bolus then stop it..he is a dialysis patient so...that is RIGHT HERE" she pointed to the line.

Seeing the bag had 500 cc's in it. I think a monkey could figure it out, but I was in a mood now so I was gonna put the nail in the coffin.

"Are you sure it is right there, maybe you should get the doctor to come over and confirm it." I asked sarcastically.

Before she could even make a comment, another medic that has been with the company since God created light spoke up to this nurse.

"You know, I know you think we are bottom feeders, but we DO what we are doing, we HAVE done this before. Why don't you go..I don;t know...somewhere else right now." he told her.

Stunned by all, she started to walk away. I was checking the sky to see if a house was gonna fall on her and began to take the yellow brick road to the squad. While leaving, I had to get my last word in.  heh heh heh.

"Hey Kelly, do you know how to turn the lights on on the truck...I don't know if I could figure it out." I asked Kelly as we walked away..I could feel the daggers in my back...ha ha ha ha ha.

EMS 3 RN's 2.

To be honest, the transports did not stop all through the night and the morning. When it was all said and done, I had put 648 miles on the squad...in 24 hours.

Good thing we are getting a new one.

Well, all, the sleep is catching up so I am off for now.

Until next time remember, wherever you go, there you are. If an ambulance is coming up behind you, please move over. Scott and I might run you down..and that is just more paperwork.

Here is a question to ponder. "If you melt dry ice, can you swim without getting wet?"  hmm..lol

Rounding 3rd and heading home

M-

11 April 2004

A Curse for the Worse

10 April 2004

"A Curse for the Worse"

Windows down, sun shining, blue skies all throughout the horizion. The temperature in the mid 50's for this early spring afternoon.  It was one of those days that just naturally make you feel better regardless of what mood you could possibly be in. (Unless you are in an estatic mood..then I think you have maxed out.)

Today was my late day. Going in at 1630 (4:30 PM...we'll teach you this military time) because I was in clinicals all morning to finish up my paramedic.  I decided to sneak in the back way to see which way I was going to go with my topical happiness by seeing just how many squads were still at the station.  Well, coming in the back way, I saw all the squads..in the parking lot. Hmmm..wonder what is up?  Exiting my Jeep, I walked around the corner to see 3 personal vehicles in the bays getting washes, waxes, and detailing.  It looked like a used car marathon as everyone was taking care of their own personal vehicles.  All we needed were flags, "WE FINANCE" stickers, and an obnoxious, high-decibled announcer screaming "WE'RE SLASHING PRICES...HURRY NOW!!!).

What kinda struck me in this matter is that ALL THREE crews had time to relish their cars and trucks.  This is either really good..or really bad. Now, doing clinicals in the Emergency Room, I had only seen one of the squads come in so, goin gback up into the "really good, or really bad" comment, there is a part of me (somewhere in the colon area I think) that says the latter of the two will apply.

"S'up dude" Scott, who covered for me, came up and said while offering a closed high-five.

"Hey man, thanks for covering for me."

"Hey, no problem. I am passing on the squad of 'no transports' to you.  He said

"We have not transported one person to the hosiptal today."

With that comment, I felt the sky getting black, winds picking up, and bolts of lightning striking the ground close to where I stand.  I felt a rumble as the earth moved from beneath me, and for one faint moment, I could swear I heard an evil laugh arising from the heavens.

"Well, now why did you have to tell me that! You KNOW I am going to be busy now!!!" I yelled back.

Sharing a laugh, Scott chuckled knowing he was going home and I laughed as to have mercy on his poor soul as I knew I was the recipient of the EMS curse.

The clock is ticking..now it is only a matter of time.

37 minutes later, the phone rang.

"92, I need you to head over to Harr Plaza for an unresponsive" The voice on the other line said to me.

Well, knock me down with a feather if I wasn't going to get the "big one" right out the door. 

Grabbing my partner, I cranked up the truck and happened to turn on the radio.  "Panama" from Van Halen had just started so what better way to pump yourself up for a run is to jam to a classic.  Unfortunately, it was only five blocks away so the song was not enjoyed as much as I had cared for. Pulling into the building, I noticed that someone had parked in the fire lane.  Hey moron..it is called a fire lane for a reason. It is not called a "let me leave my car here unattended while I go inside" lane.  I made sure to park bumper close as this is one of my pet peeves.  Here is where it got bad..

The manager of the building was running out to the squad...RUNNING....I hate it when they do that.

I had told my partner to take everything (meaning the jump bag, the monitor, and the suction unit).  This is how it transpired from here

"I don't know what is wrong with her. SHe is foaming at the mouth and ther breathing is funny." The Manager told us

"How long has she been like that?"

"I dunno"

"Does she have any medical history"

"I dunno"

"Well, who found her?"

"I dunno."

A wealth of knowledge the manager was. I mean she bordered Jeapordy intelligence,and the way she just knew the answers without hesitation, just put me in a factor of disbelief on her incredible receptions.....oh wait....she didn't know anything...well, that figures then.

Entering the room, I could hear gurgling respirations (not good at all) from the front room.  Entering the back bedroom, we found a 60 some female unresponsive on the bed covered in sweat, indeed foaming at the mouth. Okay...time for Go mode...

My partner went straight for an airway by placing a non-rebreather mask on the patient and giving her high flow O2.  I went looking for meds.

"Is she a diabetic?" I threw in the air hoping someone would pull it down and tell me.

From the rear of the room, I hear a faint "yes".

Okay, well, here we go again. (See entry "Daylight Savings Time")

This time there was NO light in the room other than a TV which had something about lesbians and gay love on it. Hmm...intriguing.....anyway.

I went and got a blood sugar on the patient while my partner allied a pulse oximeter to the hand.  I got a reading of 66.  Now this is not all that low, but she was a big woman and 66 is like a 14 to you and me.  This time Plan B WAS Plan A and I didn't even attempt to look for a line right off the bat. Probably becasue I wasn't going to get one.  Pulling out the Glucagon, my partner yells out "Her sats (Oxygen Saturation level..normal is 95-100%) is 80%!  I told him to try tubing her (intubation..we will have a class on EMS lingo).  I gave the patient the Glucagon and here is where the fun started.

"She is clenched. I can't get the blade in there." My partner told me.

"Then just bag her and try for a nasal trumpet (no, not the kind you play)."

Well, the bagging worked, the nasal airway didn't.

The fire department was with us which was a huge help as they usually are when we have critical runs. The went and help move her to the cot seeing she the back room (which they always are) and we had about as much room to manuever as the Titanic did to avoid the iceberg. (Okay, they had a whole ocean, but you saw the movie so work with me here).

We loaded her and started to the squad.  The elevator was not big enough for all of us.  Some of us wll have to take the stairs. Damn it..I am the odd man out.

How come the critical ones are always on the top floor?

So, running down 5 flights of steps, realizing, I am out of shape, and not really putting to mind that there is a second elevator, I made it to the squad.

We attempted to start a second IV attempt (I tried in the apartment anyways) and were unsuccessful yet again. (The curse strikes).  My partner wanted me to try to insert a nasal airway into the patient.

I grabbed the smallest trumpet I had...a 32 french. A rather big size, but the smallest I had.  Taking a tube of KY Jelly (don't even go there with your sick little minds), I inserted the tube with very little problems.  Okay...time to go.

Putting the squad in drive, It was time to drive it like you stole it. 

It didn't take long to get to the hospital and turn over care to the staff there.  The hospital wanted to intubate the patient with special drugs.  Kinda need an IV line for that..hmmm.  Well, not my problem now..I will let the "professionals" take over.

After their FOURTH attempt, the staff got a line and gave the D50.

ARISE!!!!!!!!!!!!!!!!  ..and welcome back.  Another Save.

There is one bad thing about these kinda calls.  When you drive (as I did), you have to put the truck back together.  After a call like that, it is just easier to buy a new truck or have it stolen. Any takers? huh?......no?....Damn it.

The only other calls for the shift were that of a minor motor vehicle collision, another trip to the jail, a trip to Cleveland, and the usual Saturday night drunk.

The weather has changed and has become cold yet again. (Probably from the curse). I am hoping I can get some sleep although that is overrated, or so I am told.

I will make sure to update you of anything interesting.  Until then..wear your safety belt, don't eat yellow snow, and always wash behind your ears.

Rounding Third and Heading Home.

M-

 

 

09 April 2004

God's Green Earth

07 April 2004

"God’s Green Earth"

EMS has its glamour, its perks, and its glory. Bringing someone back from the dead, Holding a child’s hand telling them that everything will be alright, or driving the wrong way down a one way street at 60 MPH. As the adrenalin flows through your body, a strong satisfaction as to why we do this job becomes apparent and a priority.

Would you like to hear about a new adventure?

Well, pull up a chair, get comfortable, grab your popcorn...and turn on Third Watch.

Today, is not one of those days.

Nope, no guts, no glory today. In fact, this day is rather boring.

Waking up, a dense fog covered the ground making visibility almost absent. Putting on some cool weather gear seeing living on the lake, the temperature varies slightly (okay, like 10 degrees which is not "slight" but we are not jumping over the equator). and I don’t expect it to get a whole lot warmer as the day goes on.

Arriving at station, I saw two good things right off the bat.

First, 92, my regular squad, is back in the bay. Returned from the repair shop for some minor repairs and preventative maintenance. Sitting there in all its glory, it illuminates a bask of glory shining off its body waiting to go into glory. Choirs of angels vocalize in the distance chanting "aaahhhhhh" with high pitched voices filling the air. Or was it that the truck was waxed and someone left the radio on.

Next is more simple. The fact that the truck was still there, in itself, was enough to make me happy.

Getting coffee, (and we know how important that is to me) I started getting ready for another long day of tossed all over God’s Green Earth.

My first call was for a transport from a home to a hospice center on the Eastside of Cleveland.

It took us awhile to find the address because of an error from dispatch as to what Elm street we were actually going to. You see, in smaller townships, their mailing address is listed as in one of the bigger villages or cities. I.E. Eaton Township has a city listing of Grafton, a bigger village in which it incorporates its mailing radius.

Good thing we have GPS (Global Positioning System) which can accurately pinpoint a location within a few feet. We have satellite images of the surrounding areas so we can see terrain as it affects us when we approach on a call. We also can type in an address and get cross streets for almost any location.

Why is this a good thing?

I don’t know..none of it worked.

Instead, I used a 25 cent map to find out where I was actually going and it took me less time than the CSI guys up in dispatch with around a million dollars in telemetry equipment and satellite technology. Maybe I should have a series on CBS.

We found our patient laying in bed with enough Haldol in him to put an elephant out. We transferred him to our cot, secured him, and moved him to the squad.

Now was the long trip to Euclid. From where we were, we are looking at about an hour drive time with construction and the hopes that my partner knew where we were going.

Well, we made it. Really without incident too. But there is one thing that got my goat (I don’t know what that means).

While we were walking in, an attendant from a local funeral home was wheeling a deceased female into his wagon. Okay, this is a normal occurrence, but I found one thing wrong with this picture. The head of the deceased individual was uncovered and in full view for everyone to see that walks in.

WHAT THE HELL ARE YOU DOING?!?!?

You would think that this person who recently died would have gained a little respect and dignity. Not be paraded down a hall and through a parking lot as if she were the Grand Marshall of the Macy’s Day Parade. The attendant who wasn’t much farther away from the long kiss goodnight, seemed oblivious to the situation. Knowing right off hand that we wasn’t going to hear me talk, I went right up to the body and covered her head.

"Thank you sir, I didn’t see that" he said.

Were you even looking?

I bet if he fell out of a boat, he couldn’t hit water.

Well, our drop off was uneventful and when we cleared, we were told to go to lunch.

Ummm...okay.

This was not a good sign. Only because that it meant that there was someone that needed to go somewhere that was gonna be far, far away.

"Dispatch to 92" came over the radio.

"92, go ahead"

"I need you to go to LCI for a patient transfer to CMC with O2, no precautions...time out 1300."

Here is a break down of what is about to come..you do the math.

LCI (Lorain Correctional Institution) is a medium security prision that has all sorts of fun people from burglars to rapist.  We have a contract with the prision systems in the county to transfer all their medical needs.

CMC is a prision hospital based in Columbus that houses all inmates that need acute and ongoing medical care.

Elyria....Columbus....Elyria...Columbus...

To give you an idea, it is about 7 inches from Elyria to Columbus....on the map. This translates into about 150 miles...one way.

Now, getting into the place is a complete joke but I know is routine, just without consistency.

We got to the sallyport, handed over our ID's, trauma sheers, and cell phones to the guard at the gate.  After the anal exams were finished (no, not really), we finally got to see our patient.  A gentleman who is going for obstructive sleep apnea.  Loading him up, we gave a little oxygen and were preparing to leave.

As I was walking to the front of the truck, I was met by a female corrections officer that said this to me:

"Are you driving?" she said

"Yeah, why?" I replied

"Well, good luck." she stated.

Good Luck? Why? the prisioner was in cuffs and I was in front.

"He is really cranky today." She told me pointing to the corrections guard that will be riding with us.

"Don't worry, I can handle him." I assured her.

The guard that rode with us reminded me of ED Crankshaft from the comic strip "Crankshaft" and almost looked the same too. A guard in his late 50's who thinks he is Columbo, Ponch & Jon, Starsky & Hutch, AND all of the Law and Order guys all wrapped up into one.  I thought he was somewhere between Roscoe P. Coltraine (Dukes of Hazard for those of you too young) and Barney Fife (everyone knows Barney..if you don't, watch TVLand on cable).

This is a "Crankshaft" Comic for those who are not familiar.

Not even out of the gate yet, The guard tried to impress me with stories that I cannot even remember now trying to talk himself up into a good game.

If I wanted his life story, I will by the book.

Man, just be quiet. It is a 2 hour ride and I am running with very little sleep.  I have killed people for less. (No I haven't for those of you at AOL and the FCC).

Actually, the ride went pretty uneventful other than the sun came out and I left my sunglasses at the station. Sigh.  A couple of calls on my cell kept me awake and entertained and before long, we were at our destination.  Taking about 20 minutes to transfer care, we were shortly on our way back to the promised land.

12 hours in, 500 miles logged. 

We took the scenic route back by driving through the university's main drag. (Ohio State BTW) The sun was out, the windows were down, it was 71 degrees and there were 2 guys in an ambulance.  Women everywhere!!! (But I wasn't looking, honey) {that is added in case my fiancee` reads this...xoxox dear}.  Grabbing a quick bite to eat, we journied back home to where we could do some more damage.

We arrived back in town at around 2045 (8:45 EST) to fuel up and go to sleep.  Being in a truck for 13 hours can kill the joints. (Also, I had to pee).

Sleep time was pretty uneventful except for an abdominal pain at 1 AM and a transfer to Cleveland at 6.  All in all, I did 700 miles in my 24 hour shift.  I think my truck is gonna cal in sick tomorrow. If it does, it deserves it.

Hope to see ya'll soon.

M-

08 April 2004

Daylight Savings Time..The sequel

Must read first part..well...first..hence "The Sequal"

"Daylight Savings Time..The Sequel"

There she is..laying on the bed, alert and a little confused but able to recall events. While beginning to assess he, my spider senses tell me "I bet she is a diabetic." Am I right? Is she a diabetic and this is not stroke?  The wind up...and the pitch...

"Ma'am, are you a diabetic?" I asked

"Yes, but I haven't taken my medicine or eaten yet" is the reply.

Hitting this one out of the park, I began to check her sugar to see how low she really was. The envelope please...<insert drum roll>.....The winning number for lowest sugar in the room by a patient is....35.

Normal blood glucose levels are 60-120. So, now comes the easy part. Start and IV line, give some D50 (simple sugar), recheck, and if the patient is well enough, go on home. C'mon..if this was easy, do you think I would write about it.

First, the room was lit with a single 40 watt light bulb which made the darkness illuminate with shadows.

Second, the patient. Seeing she has a bit of dehydration, her veins will be a bit tougher to find than normal. Placing the tourniquet on, not one vein protruded to mark the spot. I guess if I knew a sharp, blunt object was gonna enter me, I would hide too.

Finally, her skin was like leather which meant that putting the cathether in was gonna be like putting the circle peg in the square hole..eventually, it will go (with some help of course).

I let my partner try but she kept shaking her head. That was not a good thing. Sugar was fading fast. Time for plan "B" which quickly came into plan "A".

Glucagon is a sugar that we can give into the muscle to do the same work. Good news, it is easy to administer. The bad news is that it takes 20 minutes to work.  Robbing Peter to pay Paul, I mixed the drug and handed it to my partner to give.  Now we wait.

And wait...

And wait some more...

The minutes seemed like hours (No, we didn't wait all 20 minutes) so I decided to press my Catholic fortune on the Holy Day and ask the man upstairs to allow me access to the Cantus Findem (latin for hidden veins).  Grabbing a needle, I went to attempt my line in the forearm.  Here goes....<sounds of a heart beat here>...

Eureka!! Houston, the eagle has landed. Secured with the line and administered the drug D50.

Now, for those who have never seen it work, it is quite amazing. You can have a person unconscious on the floor barely able to talk and suddenly come back as if they were touched by God himself (through a TV evangelist of course) and arises from the hounds of Hell.  This happened here too.

Rechecking the sugar, she was now at 251.  <plays "We are the Champions" in backround and runs in slow motion waving hands in air>.

"Ma'am. Do you want to go to the hospital now?"

"No, I am MUCH better thanks. I promise I will eat something."

Good enough for me...sigh here.

Two minutes later, we were on a more desperate mission...COFFEE!!!

The rest of the dull with some fear of the night seeing it was a full moon. Sigh..I better sleep now why I can.  1 sheep....2 sheep...3 sh....zzzzzzz

rounding third and heading home

M-

06 April 2004

Daylight Savings Time

04 April 2004

"Daylight Savings Time"

"Lorain County 911, attention Elyria Township Fire Department, request for the ambulance on West Ridge Road for a possible DOA. 911 clear @ 0802."

Okay, what do you think is the most pertinent part of this call? Is it the "possible DOA" in which a rescue actually becomes a recovery?  Is it the fact that the Fire Dept (which I also work for) is needed. No...it is the 0802 part. 8:02 AM and I am STILL in bed. Damn it!!!

I TOTALLY forgot to set my clock up an hour before bed...and my shift starts in 28 minutes.  Time to switch to "go" mode. Cliffnotes version, I made it to work with 4 minutes to spare.  Good thing I had everything out or I would have been bummin' bad.

My next challenge is to check the squad.  Before I make it over to my bay, I notice that today I will be in 91...the back-up squad. Sigh.  This squad is old, smells of diesel, and I am afraid that I will have to push it back to station someday soon.  I can see me asking a patient now, "before we transport you, do you think you can give us a jump?"  I will just make the most of it I guess.

Before I even ATTEMPTED to get my morning coffee, a call came in for a woman who had a "possible stroke" and was on the floor. Sigh again...must...have...coffee.

We arrived with the fire department to find an 81 year old female in bed alert but confused not really remembering what happened. Oh, there is one twist, at 81 years old, she is the YOUNGEST in this house of 4. <shakes head>

More to come...stay tuned.