Thursday, December 22, 2005

Stupid Medic Tricks

Wow, I had a dumb medic moment last night. Now every one of us has an off day (or night in my case). So we get called to a Severe Respiratory Distress at 0400. Not a time when I am on my A game to begin with and then walk into an actual sick patient who is really having respiratory distress. Now in the four short years I have been in EMS (less than one of them as a paramedic) one of the things I have learned is that calls at 4am are one of two things: complete and udder bullshit or fucking sick. This old woman was the latter. Now walking in the small apartment you could tell she was fighting to breath. I listened to her lungs and she was very very diminished and what I could hear was wheezes. She stated she had asthma and had been short of breath since this morning. She had been taking her Advair all day, and of course that didn;t help, as that Advair is a treatment not for acute onset. I loaded her up and she was still very short. I get her in the back of the ambulance noticing the swollen legs and the enormous bag o meds she had. One of the pill bottles had the label for furosomide (Lasix or Water pills as they are also know) Still that didn't tip me off that what was going on was not asthma. ( like I said dumb medic moment) SPO2 still in the 80s, still fighting to breath. And of all things to forget we have on the ambulance now I forget that we now have access to CPAP. Yes, I forgot. It's fairly new to us and I completely forgot. Plus I was still treating Asthma not CHF, which is what was clearly going on with this woman. However we were two minutes from the hospital, so I start a quick treatment of albuterol for the wheezes and encode the hospital. Now of course the Blood pressure monitor isn't working and she moving so much that a manual pressure is impossible. Everything I tried to hear it all I got was an earfull of diesel engine and siren. And of course the hospital keeps asking me what the pressure is and, well I don;t have one. Finally I palpate a shitty way off pressure. Give them that. And we pull into the hospital. I have no IV, given no Nitro, and forgot about the CPAP. So I felt about two inches tall. And to make it worse the MD on duty HATES medics, thinks we are all incompetent boobs. And he tell me she is in Florid CHF, which I have no ideas what that means. (it apparently means she be real full up) so then I felt really stupid. I did everything I could just to get the hell out of the hospital. I felt stupid and angry at myself that I missed it. I had suck tunnel vision that I didn't see the forest for the trees. Now I know everyone was a bad day, but being a medic your bad day can turn into a death. She didn't die, she was fine. As soon as we pulled into the ER they had the BiPAP ready and everything was good. I am not normally this retarded. I know the treatments. I know my meds. I just had a bad call, made a bad call and tow minutes from the hospital doesn't give much time to think, especially when the nurse on the other end of the radio is yelling for a pressure. I got this AM and called my mom. Being an ER nurse she understands what goes on in the streets. She knows that everyone makes mistakes, we are not always perfect. She told me, so you made a mistake and forgot something. The next time you won't make that same mistake.


Anonymous said...

Your mom had some good advice. We all make mistakes from time to time and the very best we can do is to try to avoid repeating them. I know you do your best on the job.


Anonymous said...

I think you fucked up big time and your a shit bag medic. Awesome assessment skills! Not! Ya know, some day that PT will be your mother, and I hope she gets someone with ALOT more skill and a little more compassion.

stretcherfetcher said...

Some people just have no idea what it is like to deal with patients in the back of a diesel truck with the sirens going. And your crazy partner doing their best to throw you to the floor as they race to the ER. You learned from this, go on and forget what other people think. Hindsight is always 20/20.

painter in hiding said...

I was going to erase the second comment. Then I thought why? everyone is entitled to say what ever it is that they want to say. I know I do my job well. It was one pt, one call and she was delivered to the hospital alive. I am a rookie medic, for almost a year I have had this patch on my arm, that card in my wallet. Now if I had not learned from that call, that is what whould make me a shitty medic. So call me what you like, but remember you can make mistakes too. You can miss an ST elevation because you can't read the 12 lead, you can miss the third GSW because you didnt expose the pt all the way. I wouldn't want my mother being taken care of you, from the sound of your comment you lack the compassion and skill I would want from a medic. You sound like one of those dirtbag medics who thinks everything they do is perfect and cannot see or learn from their mistakes. Medicine is not an art of perfection. There is a human quality to it. That's why it's called "Practice".

Stacey said...

I know this is an older post but I want to comment on it anyway.
It takes a huge amount of courage to admit that you screwed up. The fact that you are willing to admit it proves that you have learned from the mistake. My paramedic instructor says "The thing about mistakes is once you have made a big one you will never make that same mistake again."
So chalk it up to a lesson learned and don't let what "anonymous" said bother you. Thanks for the post. Keep up the good work.