Archive | May, 2010

Crashing a Wedding

25 May

My partner and I crashed a wedding on Saturday night.  We got a call for an ‘unconscious’ at a banquet hall.  Luckily for us we were on our way to get food and were one stoplight away from it. 

So we roll up (dispatch, enroute and onscene in less than 2mins!), and my partner and I go around to the back of the ambulance to pull the stretcher and jump bag out.  That’s when one of the women who works there comes rushing out saying something about ‘pronouncing’.  Both my partner and I skipped over the part where we were responding to a wedding and were freaked out that the guy was dead and that there was no way we were declaring someone dead at a banquet hall.

So we go in and sure enough, the minister had passed out but was now seated in a trandelenberg position and was finishing up the wedding ceremony.  My partner tripped on the aisle runner and fell, landing on his knees at the minister’s side.  I was trying to navigate around the back of the bride’s dress and the wedding photographer was snapping pictures the entire time. 

As it turns out, the minister just overheated in his robes and passed out – I’m willing to bet that based on his age (80+) that he’d locked his knees.  That’s almost a surefire way to guarantee that you’re gonna pass out.

We got him out on the stretcher and in some cool air he perked right back up.  Vitals came back normal, he decided he didn’t want to go to the ER.  We left him in the care of his wife who looked like she wasn’t gonna let him do much of anything.

I wonder if we’ll ever see any of the pictures from the wedding – cause I know my partner and I are definitely in a few of them!

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I is broked

24 May

Saturday night on the ambulance I hurt my ankle.  I was moving around a patient when the ambulance lurched and a slamed the right outside part of my ankle hard against the anchors that keep the stretcher in place.

I’m pretty sure it’s either a bone bruise or I chipped it.  It hurts like hell and I look like I’ve got one hell of a gangster limp when I walk. 

I’m supposed to run a 10K on Saturday. 

But here’s my problem…if I ease off of the ankle, my mental health takes a dive.  If I don’t ease up, I could injure myself far worse than where I am now. 

I don’t want to go down the  black hole of piss poor mental health but I don’t want to damage my body any more….

It was supposed to be a quiet night

24 May

Emphasis on both ‘supposed’ and ‘quiet’.  A Wednesday night before tourist season starts in a week with two crews running out of the same station.  Should mean that it’s uneventful and that I should get quality time sleeping on the couch in the day room.  For the record, we do have  a bunk room with bunks.  I refuse to sleep there because it’s the most disorienting room possible – also a bomb shelter.  I don’t need any more help waking up wondering WTF prompted Satan to flip her moodlight and set off the tones.  (we have these red lights that come on when the tones are set off when we have a call). 

So about Wednesday night…

Call 1:  Domestic at Trailer Town.  Either she hit him with a door or he hit her in the head with the door knob as he was leaving.  Never did get the story right because nobody was home when we arrived.  Good thing too as the outside motif for this particular residence was apparently ‘goblins are gargoyles’.  I didn’t want to see the inside. 

Call 2:  Fall at “If we Change Our Name, People Won’t Think We Suck So Bad” Nursing Home.  Bariatric, mentally-handicapped woman with a history of CVAs is placed in a wheelchair, and not belted in or supervised.  To nobody’s surprise, she falls out of her wheelchair.  However, no bump, bruise, laceration, abrasion, swelling, redness or any other sign of trauma is found.  The lead “nurse” already called the Default Big Hospital to let them know we were transporting.  Apparently (and not surprisingly) the paid transport company just had too long a wait.  In a desire to not be at Suck City Nursing home any longer, we take the patient to Default Big Hospital. 

Call 3: Dinner – Pizza with a side of Asthma Attack.  My partner and I are sitting at a local pizza place finishing up dinner when a heavy-set woman rushes in.  Her daughter is in the car and is having an asthma attack.  We head out and yup, patient is having an asthma attack.  She’s also 4mos pregnant and not a lithe girl and she was panicking.  She’d already taken 3 hits of her inhaler with no relief.  Start her on a NRB at 15L, get her into the ambulance.  I pull out the IV box because that’s where our breathing treatment supplies are and we start transport.  ALS meets us enroute.  The paramedic is one of my most favorite paramedics out there – DryWit-Medic.  I’ve precepted from him before and he gets in, hands me the box.  I start the nebulizer treatment, he gets the IV access.  Amazingly enough, when the patient’s momma is not in line-of-sight, the patient calms down, breathing difficulty abates a little bit.  Take her to the ER.

Call 4 – Suicide “attempt”.  16yo female has barricaded herself in her room and is a cutter.  She’s sliced at her wrists.  By the time we get there, she’s in her room but Mom is with her.  I am the only female assigned this case – all the guys – the fire fighters, the 2 cops, my partner – all do that collective step-back when one of the cops says that ‘one of you’ (refering to us ems providers) needs to go check her out.  So I head back to the bedroom and she and I have a really good conversation.  When it came time for the awkward questions – ‘is there any chance you could be pregnant’ / ‘do you want to kill yourself?’ / ‘do you want to kill anyone else’, the patient had her mom leave the room.  She invited me up on the bed and we had a really good conversation as I cleaned and bandaged her lacerations.  I really felt bad for the girl because whenever we’d talk about her family / mom / boyfriend, she’d kind of curl up inside herself but when we talked about school, life in general – just girl talk – she would light up.  Being 16 sucks – and it doesn’t get any better for a long while.  But she didn’t want to go to the hospital and the officers were comfortable with us leaving her in their care. 

Call 5: (before I start this one – I did get to lie down for a whole hour or so before this call came out.  I was so disoriented by getting up in the middle of the night that my partner had to wake me, I tried to convince him that we were ‘just for show’ after midnight and I ended up walking out to the rig carrying my boots.  My partner said if it wasn’t for my sour personality, my confused state, vacant looks and carrying my boots might have been adorable.)  Anyways – back to the call…Breathing Difficulty at ChainSmoker with Emphasyma and COPD.  I’ve been to this woman’s house before.  She’s a heavy chain smoker on 4L O2 by NC. This night had the added fun of her locking the door while forgetting to leave the key under the mat.  Her son had to come from wherever he lives to bring us the key.  Get her loaded into the back of the ambulance where I not only was able to give her her albuterol / albuterol – atrovent, but also to start her line and push Solu-Medrol.  When we take her to the ER they start her on Bi-Pap and give her some narcan….apparently this woman was sampling something other than her Marlboros and was VERY NOT HAPPY upon the administration of narcan and Bi-Pap.  But since she’d been very NOT nice to me, I figure karma came around REALLY FAST. 

So this is the part of the night where things got really interesting.  Some fool decided that 0300 on a Wednesday night / Thursday morning would be quiet enough to take down the system that my city uses to dole out the calls.  So the computers, the tones in the stations – all that stuff – no worky no more or at least not for a couple of hours.

One crew had a 30 minute lag-time between being dispatched and going enroute.  Two other crews were assigned the call before they woke up and took it.  And the only reason that they woke up is that DryWit-Medic drove to the station and woke them up.

To add to that fun, the ambulance that my partner and I had been in decided to spazz out at 0300.  I put the key in the ignition, turned the ignition one click and the airhorn went off.  Please note – the battery wasn’t engaged and my foot was no where near the airhorn.  So I took the key out, turned on the battery and the airhorn went off again.  So we put the vehicle down as 10-7 mechanical, drove 4 miles to go pick up a 2nd truck from another station. 

That’s when we were sent to another call with DryWit Medic.  This one came out as a ‘cardiac’ but it was really a kidney stone (very similar, huh?).  It was at one of the permanent beach houses but the roads are hella narrow.  Thankfully, the patient was in such pain he was doing a sprint out to the ambulance.  DryWit Medic got orders from the ER doc to give morphine and zofran and all of a sudden – patient is hella mellow.  Calm, relaxed – it was like he’d just smoked a joint. 

Took kidney stone to the ER and after cleaning up and restocking – got to drive back to both stations – one to drop off the ambulance and the other to get in our cars and go home while watching the sun rise over the ocean.

Listening to Lung Sounds

17 May

A 53 year old male sits in his family room with firefighters and EMTs buzzing around him.  He hasn’t been feeling right lately but tonight’s the worst.  He’s cold but can’t stop sweating.  He’s tired and it hurts to take a deep breath. 

His wife is panicked as he’s always been healthy.  Even as the EMTs were walking in, a neighbor stopped them and said that if the wife was too nervous to go to to the hospital via ambulance  that they would take her. 

The patient is loaded onto the stretcher, packaged and rolled out to the waiting ambulance.

Once in the ambulance, electrodes are attached from the 12-lead monitor to the patient.  The patient is sweating so much that tape has to be used to get the electrodes to stick.

There’s a paramedic off the Engine and a paramedic from a chase car in attendance.  The paramedic from the engine reads the EKG and interprets “narrow complex” tachycardia.  He recommends to the other paramedic – the one that is going to stay with the patient – that two large bore IVs get started.  He doesn’t start them, but he passes on this wisdom as he climbs out of the rig. 

The patient is pale – that unfortunate grey-pallor that people get when things ‘just aren’t right’.  He’s sweating and breathing shallowly.  When asked why he says ‘because it hurts to get a deep breath in’.  The EMT-B in the ambulance asks if anyone has listened to his lungs yet. 

The paramedic looks at her and says ‘a nice easy ride to Memorial Hospital, please’.  She looks at her partner and both of them get out of the ambulance.  One to drive the ambulance and the other to drive the chase car. 

10 minutes later the ambulance pulls into the ambulance bay and the patient has sweat pouring out of him.  One IV is established and there is an errant IV catheter just hanging out of the crook of the patient’s arm.  Placed there but not removed by the paramedic in an attempt to get IV access via the left AC. 

The patient is unable to move himself over from the stretcher to the bed.  He has a couple of syncopel episodes while sitting on the stretcher. ER RNs, a tech and the ambulance crew sheet the patient over from the stretcher to the ER bed.  The paramedic looks on from the door. 

The patient is now on the ER bed and the ambulance crew move away to get supplies and leave the hospital. 

*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*

A return to the hospital about ninety minutes later means an opportunity to check-in on the patient.  The patient is no longer at the ER.  The patient has been transferred to Big City OR via private transport group running lights-and-sirens because the patient has a hemothorax.  The paramedic wrote on the patient care report that he listened to lung sounds and determined them to be clear bi-laterally. 

A look at the CT scan shows a completely occluded right lung and the diaphragm had been pushed down into to the stomach.  The patient was in the Big City OR 10-minutes after arrival…Memorial Hospital attempted to fly him out but the weather was uncooperative. 

There’s a reason that there is an axiom “BLS before ALS”….and don’t document something you didn’t do. 

There’s a reason that brand-new EMTs are told ‘listen to lung sounds on every patient’.  Not because we’re trying to make the process of becoming an EMT harder – but so when you do listen, you can tell the difference immediately between ‘clear bilaterally’ and ‘absent’. 

Every patient that I touch, I listen to.  Regardless of chief complaint.  But now I will listen to every patient, regardless of who’s the ranking person on-scene.  I didn’t and I wish I did for this patient and for that – I’m culpable.

And the hits just keep on coming

3 May

They say that it is always darkest before the dawn.  If that’s the case, then I am hoping for one hell of a breathtaking sunrise.  Where I am is a very dark place…

I am lonely.  Heartwrenching, comprehensively lonely.  I hurt so badly inside that if I could, I would pull everything out and rinse it off because the pain seems caught on everything. 

Yesterday was my ex-husband’s birthday.  And all I could think about was things that we’d done for his birthday in years past and how last year so many things happend on birthdays.  It was a week before his birthday that I decided enough was enough.

And then it was on my birthday that the divorce was finalized.  Nothing says “Happy Birthday” quite like a gavel banging away on the paperwork of your previous life. 

To add insult to broken heart, I put on a swimsuit and went to the beach.  Cognitively I know I’m not obese but try telling that to the voices in my head.  Usually I can out-argue them and convince myself that I do not look that bad.  But yesterday – with my paleness reflecting back the sun – all I could think about was that I should get back on the treadmill and not come off until all the fat is melted away. 

I’d recieved some news on Friday night that also felt like salt being poured in an open wound regarding a guy that I had been in a relationship with.  The relationship ended becuase I know that I’m not ready for a serious relationship and that I need to take all the right steps to fixing me.  So yes, he’s single and I’m single.  But it turns out that he went home from a bar with a woman and – while they didn’t do anything sexually – they did spend the night together.  And holy hot damn if that doesn’t hurt.  I know in my head that he’s got all the rights in the world to do that – he’s unattached and I have no claim on him…but it still stings. 

So I was in my house having a Pity Party for 1 and trying all the usual tricks to get me to recognize that I have good things in my life…and nothing was working.  Not the lectures, or the change of scenery or the looking around….until I went to bed.  And right before I went to sleep I remember thinking ‘it is always darkest before the dawn…and all I have to do is get through this…”