an EMT made me look good

Ok, we all know the saying Paramedics save lives, EMTs save Paramedics. Well, I always tell my EMT, you job is to make Me, your Parmedic, Look Good. Ok, well my EMT, who I had been having problems with for 4 months, did both on our last shift together. We aren't gonna go into why I had problems with them, thats not the story. The story involves a patient that presented with totally random symptoms that turned out to be a big ol' bad CAT 2. So he we go...

Get called to a "sick party" Now this could be anything, this anything turned out to be inconsolable crying. Really. Pt in a mentally handicapped pt, non verbal, who's family calls this the pt's "pain cry". Pt not eating. HX of bowel obstruction. Fever. Ear infection. Tachy at 130. Hypotensive at 90/60s, but pt is also 80lbs soaking wet. BGL at 200. But Pt is compleatly stable. skin is warm/ dry. Pt will focus on you when you speak. I felt perfectly fine putting this pt in the back with an EMT who is also a paramedic student. But then the family wanted the pt trasported to a hospital who is notorious for asking for an IV for even the most mundane of symptoms and this was a borderline BLS/ALS pt. so I said to my EMT partner "I'll ride this in, but I want you to continue to assess as if this was your pt, do a BGL, put pt on monitor, everything but the IV, oh an get a manual BP the monitor been fucking up" SO he does what I say. and as he put pt on monitor I glance up for my seat as I type my report and I see little Normal sinis complexes marching across the screen. little funning looking, but I'mm get up in a minute when we get going and really look at it when i go the start the IV. from where I'm sitting there's a P wave and an upright QRS so we are golden. I go back to typing. Just then my EMT shoves a strip in my face..."Hey!!B!! is that ST elevation?!?"

"Noooo..Thats just a funny lookin...Well fuck me...
I get up and start flipping through the leads on the monitor and get to Lead I and goddamnit if there ain't huge ST Elevation. Well...get em on the 12 lead...we have elveation in leads I, II, aVL, V2, V3,V4. And BIG elevation. And pt had pressure of 90 and can't swallow, so no Nitro, or aspirin so I just placed em on high flow O2 and high flow disel and off we went. Pt didn't like me neither I had to stick em like 6 time for an IV because {the pt} kept trying to bite me.

That just goes to show you paramedics sometimes need them lowly basics.

So I yelled again.

People never stop amazing me. I know it's human nature to gawk at an accident scene. To stare at it from the car window as you dive past and imagine the carnage that may or may not be unfolding. To be mezmerized my the flashing lights of the emergency vehicles. To watch as the Paramedics, Firefighers and Police Officers run around on scene in seemingly aimless patterns, with equiptment and notepads and oxygen tanks and stretchers. To even watch as a helicopter lands in the middle of the highway blocking traffic. I can only imagine what this looks like from the outside looking in. As opposed to being right smack in the middle of it.

So as we pull up to the scene there is a small truck, roof caved in. Looked to have rolled several times. Firefighters at the side two criticals laying in the grass. Another across the highway at the side of a family of three sitting up in the grass, not bleeding. They will be care for in a few minutes. I need to see the two laying supine bleeding all over the place first. Just as we were about to pull up a man with a Nikon around his neck leaps in front of the ambulance and snaps off a few shots. I look up and see where he came from. A goddamn fucking tour bus had stopped in the middle of my fucking accident scene. So not only did I have 5 patients (two of which who were critical) but I had a bus full of fucking tourists snapping pictures. Oh and ONE COP. Who sends ONE COP to a multi car MVA? So ever the professional, I get out of the truck and begin my triage. I go to the first patient. Severe SOB and pain on inspiration, bilat, yet dimin breath sounds, several head Lacs, crushed hand. Place him on High Flow O2, Got a trauma RN on scene to hold Manual CSpine while I go see my next patient. CAT 2, trauma center criteria. Run into some tourist who goes, "You just gonna leave him with that fireman?"
I give the stank eye and go "You gonna tell me how to do my job? Or you gonna move so I can triage all my patients? MOVE!"
Next patient...Partner's got him...Altered Mental, repeating questions, weird looking pupils, neck/back/chest pain. Also CAT 2. CSpine. High Flow 02. Trauma Center Critera. Move him to unit.
GO across highway to triage family...All CAT3 facial pain 2nd to airbag deploy. Can wait on 2nd unit. Firefighter stays with family until 2nd unit arrives.

Thats the run down. Now I walk back over to where my criticals are. Where now ALL the tourists from the bus are now off the bus and all have their cameras out and snapping pictures. I have now had it. This is not a show. This is real life. This is not entertianment. There are two people laying in the grass actually bleeding, actual blood from a actual car accident and these people are treating as if it's an episode of "Grey's Anatomy" So as I walk up, I start yelling. "ANYONE WHO IS NOT PART OF MY ACCIDENT, BACK THE HELL UP AND GET THE HELL OFF MY ACCIDENT SCENE." I then think to myself I'm gonna have to call a supervisor later. I'm gonna get complaints. But right now I don't give a damn. And I got back to my original patient. He looks up at me and says "You tell 'em girl" Then the man with the nikon that jumped in front of the ambulance as we pulled up tried to get up close to me and my patient. "If you don't get that camera out of here...you see that cop over there...I will have him cofiscate that lovely little memory card from you lovely camera because you breaking all kinds of HIPPA laws right now, BACK OFF!" I was pissed. This guy felt he had the right to barge in on the lives of my injured and bleeding patients... and on mine for that matter. But I could fight him off. My patients could not. They lay there exposed to the world, both physically and emotionally. So I was angry and I expressed it and not just at this one man, but at the whole bus load of people who treated the whole thing as entertainment. So what if I end up with several tourist complaints in my file. They acted more inapproriatly than I did.
And so we load both our critcals in the back of our unit and too off.

Our patients made it to the trauma center alive and in one peice. And I only pissed off a bus load of tourists. Welcome to our fair city.

phew glads thats over

Holy mother of god I'm tired. 48 hours on an ambulance will do that to a person. 48 hours and 22 calls later and suprisingly an Angel of Death, such as myself didn't kill any one. (Refer back to a an earlier post for how I earned that nickname) In fact, I might have very well saved one. Woman having the tingling of an Inferior MI. Just the beginings, ever so slight ST elevations in the right Leads (which are ??? my Paramedic students out there) Bradycardic and slightly hypotensive. II did have to laugh at myslef for just a second as I go "I gonna give you a spray of...wait no I'm NOT going to give you nitro, I'm going to turn you fluids up a bit more my hypotensive friend" Its so ingrained, so banged into our heads that EVERY CHEST PAIN GETS NITRO that sometimes we forget that not ALL chest pain pts should get a spray of Nitro.

I do also forget how much fun it is working when you work with someone you get along with and work well together. My partner last night, we have very diffrent styles. Very diffrent. Both of us are laid back type of medics, but I tend to be, well... very sweetly southern. He's from a whole diffrent side of the country and well isn't. He's a no bullshit do you want to do the fucking hospital get in the truck now lets go quit bleeding on my fucking boots type A, but in a way that you like. He lets me be sweet, all while pushing them out to the truck. So it works. Its gets the job done. I get to be sweet and he well...covers me when the shit hits the fan. Plus, he's a good medic with strong medicine. And doesn't look at me funny when I yell at the crackheads who complain of chest pain at 4am (QUIT FUCKING SMOKING CRACK AND YOUR CHEST WILL QUIT HURTING DUMBASS!)

But now I'm going to bed. Sleep is good. And then The Shins concert. I love The Shins. The make me happy.

Keeper of Keys

Back to nights I go. Its time for our 6 month switch, and I get my nights back. Thank god. I'm getting frustrated on these 24 hour shifts. I'm getting downright mean. Not to my patients, but to my partners. I did have a difficult partner this time around, which is why I haven't been writing as much as I used to. I am afraid of what I might type and to be quite honset I haven't been enjoying the job enough to really write. The frustration had taken over and made it difficult to find the interest to sit in front of my laptop and tap out a post. I hate the managing part of my new position. Sometimes on my 12 mile bike rides I think of ways to get demoted back down to crew member. The best solution I came up with was to look up porn while on duty. It's not hurting anyone, nobody dies and after a while everybody forgets about it. As long as you don't do it again. and you let you friends in on the secret (I'm not really a dirty girl, I'm just tired of being bitched at at 0130 because I put the patient on 12LPM as opposed to 15LPM via NRB masK, does 3 LPM really make that big a fucking diffrerance really?) Or maybe making out with that cute City officer in the back of the unit while on duty. Again...not hurting anyone, not killing anyone. But still against policy. I just want to come to work, pratice medicine and go home. I don't want to have to worry if my EMT partner is going to try and push Narcan on MY patient if I wasn;t there to stop them or writing evals or having to sit my paramedic crew member down and tell them that this is not how we write our reports here when they have been doing EMS since before I was born. But here I am in charge. Keeper of the keys, overseerer of medic units.