Flying off the building

This is my dumbass sliding down a rope from 5 stories up. I really enjoy my job. We had TRMT (rope team) training the other day. We spend the day building a sloping highline using a flying W. What fun. It's like a giant zip line like we used to play on at the river. I was also issued my gear for the team. with my compentancies done I am now an active member, no longer in training staus. Which is cool cause now I get to go on call outs. They mostly consist of calls at the ports and shipyards. We do more confined spance than high angle, seeing that there isn't too many high structures in The City. I also spend last shift with my "angry" partner. He was in a bitchy mood all shift. But I am learning to embrace his bitchiness and just take him with a grain of salt, since we do get along so well. I think if I was not friends with him to begin with I would have to stab him in the throat sometimes. Today is also Inservice day. I would just skip it because I worked last night, but alas it's a mandatory HAZMAT inservice. We get to sit through hours of fun learning the same bullshit we learned at last year's HAZMAT inservice. WIth one diffrence. The City Police department is going to build a meth lab in the county building and teach us all about reconizing a meth lab. You would think this to be an easy task, however we had a lab bust a few years back in a very afluent part of town. We were called to a Shortness of Breath and stumbled upon a Meth lab put together by several medical students from the local med school. So it just goes to show you anybody can whip up a batch of Meth in their own homes.

For the most part it's been business as usual. Asthma attacks, old people falling, and psych patients trying to leap from bridges. One of our local Psychotics tried that yesterday. She tends to jump from smaller bridges, not to kill herself, but for the thrill of tying up several local resources for her own entertainment. However she threated yesterday to toss herself off the Big new bridge. We were called, but were cancelled when the police tased her dumbass and pulled her from the edge. I know several of them just wanted her to jump and get it over with. She is violent, a spitter, has psudo seizures (so she can get Ativan), attacked several EMS workers and has the life span of a cat. She is not welcome at at least 2 of the ERs because she escaped from one, ran into the woods, shot herself with a crossbow in the stomach. Where she got a crossbow is beyond me. It's not like she could sneak in into an ER. The other she assaulted several nurses and tried to stab them with hyperdermics. She's a pleasure.

I love my job...I love my job...I love my job

You ask...I answer

I got two questions in the comment section of my last post and I was going to answer them in the comments section but it is kinda a long expliantion so I will make a post of it. The first one hase to do with response codes that we use in my system. We have six diffrent response code that we use. The response designations are used for what we were told is "priority dispatching". Apparently when the 911 call comes in the dispatchers ask certian questions pertaning to what ever the call is about. Like for instance a MVA call they (the caller) would get asked "how many vehicles involved "is there anyone trapped in the vehicle" and "is the patient awake" And how the questions are answered is how they designate the response code. Alpha is for very minor things they we would not run code to like a lac or sick party with no prioridy symptoms. Bravo and Charlie are for like minor MVAs with injuries and ABD pains. These we run code to. Delta is stuff like unreponsives, entraptments, SOB and CP, these are most likely a bit more serious. And Echo is for like cardiac arrest or uncertian breathing type of situations. CAT one type of things. The only diffrence we see on the streets is Alpha which we dont run hot to and Bravo,Charlie ect...which we do. there is also an Omega reponse, which is hardly used it kind like an Ultra Alpha call, public assist kind of thing So it's more for the dispatchers and their record keeping and helps them deterime if say fire or police need to be dispatched with us. It does kinda let the street people know how serious the call could potentially be. you could have a bravo reponse CP, which is not as serious according to thier questionaire as say a Delta reponse CP. Now of course this all depends on how the caller answeres the questions. They might know the rules of the game and know the right answeres to get a bus there quicker. ..or so they think. Some of our county is also cover by QRVs or Quick response vehicles. These are SUVs that are not transport units. There a manned with one paramedic crew cheif. Some of the popluation referes to it the as "The No Go Truck" as in you ain't going nowhere. They are used either as a first reponder for bad calls, or as a medic called to basiclly bullshit Alpha calls that doesn't need transport. It helps keep the transport unit 10-8 for potentially real calls.

As for the second question....It has to do with our shifts. We have 15 transport units that cover our entire county. Of the 15, 7 are 12 hour trucks, 7a-7p and 7p-7a. These are the busy trucks that cover the city and north area. Their call volume can shift from 5 calls in 12 hours to as many as 15+. The Downtown truck is the busiest, I have run 15 calls in a night a few times. The shifts are like Sat, Sun, Mon your work your12 the off Tues, Weds, then work Thurs Fri. The next week it swtiches. You have 12 hours off between your shift days working. The other 8 trucks are 24 hour shifts. You work 24, off 48. These are the outlying, slower trucks. Some won't turn a wheel all shift and some might run 10 or 12 in 24 hours. Really depends on where you are. The colser to the city the more calls you run. As for what makes a 12 hour truck depends on call volume. They count how many calls you run during your shift in a 6 month period. If you run more than a certian number consistanyl for severl 6 month periods the truck goes from a 24hour truck to a 12. This dosn't happen very offen. All but 2 trucks have a station. We have 2 roaming trucks that cover all over. Like if the three north area trucks so out the they send one of the roamers there same goes for the south districts and so forth. The stations are all like mini apartments with kitches and bedrooms and we are allowed to asleep on duty. To help with fatugue on duty sometime crews can switch out with slower trucks so that they can rest. Like if you crew member worked 24 hours on a faster truck and then picked up a 12 OT shift they can go out to the islands and sleep for a couple hours. We cannot work more than 48 hours on a slow truck or 36 on a fast one. and you have to have at least 12 off between each stretch. Like I just got off a 36 hour shift today. I can't be forced back in until tommorow morning. And being Forced is a whole other monster of it's own. That would take me another whole page to explain. But basiclly it's foced overtime. We can get called back into work. And there is 12 pages on it in the policy manual. Lists and rules and all kinds of shit. Too much to try and explain here. So thare you have it. The answers.

The flowerpot's revenge

Once again it's early AM and I can't sleep. It most likely because I slept until late this afternoon finally waking up for good at around 1500. I woke up to no water in the house due to a busted water mane at the corner. We were up all night last night running calls. Sometimes I really hate 24 hour shifts. In fact the only reason I didn't stay on 12hour nights was because I like my partner. I told the supervisor in charge of schedules that I would rather work a truck I don't really like but have a fantastic partner that I get along With than the other way around. I have worked trucks that I love, but had shitty partners and it sucks. Anyways we were up all day running calls and changing out of trucks. The off going crew got into a new truck but according to them were to busy to check it off so that job was put on my partner and I. Half the shit was missing and what wasn't;t missing was expired. It was a good three hour check off. Then we had calls all day then after 1900 radio check the radio in the unit decided it would be a good time to quit working. And it being 1900 the radio shop was closed so we had to change out of that truck and into another one. And then this truck was also missing all kinds of crap from Adenocard to a BVM. And then there was a whole nother list of expired shit. When did everyone in the system stop doing a blue book check off? So that was fun. Then we had about a two hour down time until about 2300 then the calls started. Now for the most part all the calls were BS, except for our 0230 call. Assault via flowerpot. Now the call came out as bravo response. (for those not familiar with the response levels there is omega, witch is complete and udder bullshit, Alpha, code 8 bullshit, bravo, the first level of code 7 calls, like fender benders and sick parties, Charlie, delta, and echo. Echo being the most urgent, like cardiac arrest. It more for the dispatchers. But it helps up out sometimes because it can tell us how sick out patient could potentially be.) So this came out as Assault, bravo response...Possible dangerous body area. Pt struck in head with flowerpot. So my partner and I were expecting a woman struck with like a plastic flowerpot and had like a small lac and lots of drama. The fire department assn;t even dispatched with us. So we pull up and there are about five six police officers standing over this woman laying supine in the street. There is thick terra cotta pieces all over the place along with lots of potting soil and one lone geranium. As were approach the patient we come to realize that she is actually hurt. Her face is all bloody and what looks to be a large skull fracture in the side of her head. She is unresponsive but combative as hell. Before we get to her she has struck her head several times on the asphalt. The police know her and are yelling her name. She smells strongly of alcohol and has rows of track marks up her arms. So the unresponsiveness is due partly to the ETOH and partly to the large dent on the left side of her head. My partner and the police hold her arms and head so she will stop fighting and I gather the Long spine board and collar. We get her packaged and in the back of the truck and off we go. I get my secondary survey done during the ride. Unreactive, unequal pupils. I get my bilateral lines. I suction blood out of her airway. We most likely would have RSIed her had we not been 6 blocks from the hospital. I encode the trauma center. I swear sometimes that don;t listen to us. I told them I have a "Trauma Alert. Unresponsive, very combative Assault. Looks to be a skull fracture GCS less than 8. I'm working on IV access and vitals See you in three" The MD gets on the radio and asked "What is the patients mental status?" What did I just tell you? Do you not listen? "UNRESPONSIVE. ETA less than 3." I hang up the radio and finish with the second line. I have made a mess in the back of the box. My partner opens the back doors and sees me in a mess of wires and oxygen tubing and other medical detritus. He just groans and says "I can;t leave you alone for five minutes can I, before you completely destroy the back? You're like a distructive puppy" I just smile, detangle myself from the monitor wires and hop out of the truck "Have we met? How long have you know me. I'm like Pigpen from the peanut's gang"

Response to Stupid Medic Tricks

So like most bloggers, I use my little space as a sort of public online journal. Its a place to ramble on about my life as a medic and a place to show off some of my photographs. I write about the ups and downs of my job, my life. I also encourage people to post comments. Now Today while I was flipping through some old posts that had new comments and I was shocked at one of the comments I received. Now I made a comment to this one in the comments list however I felt I needed to say some more. I normally would ignore such ignorance, but I wanted to show this in all it's arrogant glory. This is a comment from either one of those medics who scare us all, the ones who think they know everything, one who will eventually kill a patient because they refuse to learn from what they do wrong or someone who is not a medic at all and does not truly know what goes on in the back of an ambulance.

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.

5:42 PM

I posted several weeks ago about a call in which I screwed up. It was a bad call with a sick CHFer. I forgot we had CPAP on the truck and I got flustered. It was a very short transport so I put her on albuterol for her wheezing and encoded the hospital a second too soon before I had all the vital information. So when the hospital kept yelling at me for BPs and asking me if I had any IV assess I got overwhelmed. I should have put the radio down and thought more thoroughly about what I was dealing with. I basically pulled a rookie medic mistake. It was not really a mistake per say, I didn't give say Lidocaine to a heart block or Mag Sulfate to a trauma victim. I just didn't treat my patient completely. Had I had a eight minute transport intead of a two minute transport I would have worked everything out in my head. My hands would have caught up with my brain. Now most medics know what I am talking about, especially the new ones. You're screaming down bumpy roads with your driver throwing you about the back of the box. You're trying to hold on and treat your patient at the same time. A good medic takes that whoops and turns it into a learning experience. Every call when go on is practice for the next patient we encounter. My next CHFer I get I will now reach for the CPAP and Nitro before I reach for the radio.
I never claim to know everything. Nor will I know everything. I will be the first person to admit my mistakes. I will speak to the MD after a bad call and ask what else could I have done to make the call run better. I am forever learning. I speak with my coworkers. I post on my blog to learn from the other medics who read and comment on my blog.

sorry so long

Mailboxes on the island

Well I know it's been a while since my last post. And too be quite honest I really have nothing to post. Except for some photographs. I have been playing with my new camera every day I'm off. I have filled up three memory cards with images. Work has been very busy. But busy with stupid bullshit. No life saving. No putting into practice the new AHA's CPR guidelines. I haven't even started a line in the new year. I have however put more insurance seeking people on backboards from lame MVAs. I did make the call to cut up a beautiful brand new Mustang. A Brand new Mustange with ZERO damage. All because the bitch driving it was SCREAMING like a FUCKING banchee that her back hurt everytime she moved. We could not get her out of the car other wise. So not only did I make the call to pop the door off, we rolled the roof too. I never felt such satifaction as I did watching rescue demolish that car. The look of horror on the police officers' faces when I said "I need the door and roof gone" I think spoke for every male on that scene.


Scone



Pirate's Courtyard