Tuesday, December 09, 2008

Well people, two things today. Did you know that one can shear the ENTIRE IV cath off? Not a peice, the WHOLE DAMN THING. Me neither. But it happened. I saw it, I was witness to it. My trainee for the day did it. I was on the radio, encoding, forgeting that I still had the radio keyed up, when he told me what happened, I went over the channel "You did what...fuck." Then cussed again when I relized that I had dropped the F-bomb over the radio. I apologized, then told the hospital they were not gonna believe what happed and I will explain when we get there. That was impressive. I have never seen anything like that, and apparently, it has never happened before with a peripheral INT; at least not where we could find over the internets. Centeral lines, sure. But not peripheral sites. But everything worked out, and the pt was turned over to the hospitals staff with a slightly brusied arm and a missing Cath tip. The hospital is still trying to find it.

2nd thing...I got my acceptance letter to school....and my loan approved. So I am now $27000 in debt. But I'm gonna learn me somthing. I am still working full time for a while at least. So I will still be posting as my paramedic self. With school updates thrown in. And more photography, of course.

Thursday, November 27, 2008

Well I have decised to go back to school. These past few weeks at work have made me rethinking paramedicine and the reason I'm in it. The cincher was after I got moved out of a district I love, away from a partner I get along with, and am not longer under the supervison of Supervisors that have grown to trust me. And they did it at the holidays, which has me working on every holiday but Thanksgiving day. I had my whole holidays planned. But because I am single with no kids, the holidays apparently mean nothing to me. The move was caused by something that didn't even involve me either. This among many other things have been leading me to this conclusion of going back to school to finish my BFA in photography. This job has gone away from Emergency Medicine and has turned into a "let us hold your hand and sing fucking Kumbaya" with the so called sick and dying. I am now forced to be nice. If I don't coddle my patients I may get a complaint and then I'm called into the principle's office for an ass chewing. Now I am normally kind to my patients, but then I have a patient throw a stack of Medicaid cards at my feet telling me "If you want it, you can pick it up and find it" I have a hard time biting my tounge and continuting to play nice. It's the ones that demand respect, but refuse to give it to me that piss me off. They feel that I am there to service them, not care for them. They talk down to me. That I am below them on the social ladders. So to them I say "I am here to save your ass, not kiss it"

I have grown tired of this. I am burned out and all thats left is a broken medic with a broken spirit. So When I walked into Art School, I could feel the energy in the halls. The creativity came back. I walkedd the halls of that place and I felt alive again, amoung the creative misfits. I had forgotton that feeling. I used to get it getting on the ambulance and running the lights. Not anymore, so I now think my lifespan as a medic is coming to an end. Art is calling me home. So now, a year shy of 30. I am going back to school. I can now see the light at the end of the tunnel.

Thursday, November 13, 2008

Today's horoscope

I'm not one to put a whole lot of thought into horoscopes, but this was mine for today

Scorpio (October 23-November 21)
11/13/2008
You may not be willing to accept the advice of someone else today if you don't think that he or she has enough information to form a clear opinion. It seems to you that others are willing to oversimplify the situation for the sake of expediency while you would rather delve into the complexity, even if you can't decide what to do. Be patient; solutions will continue to surface over the days ahead.

I'm dealing with a problem at work right now that I don't really have a solution for. Well, I do...but it includes explitive ladden phone call and a possible day off without pay. Not really a solution. I want a REAL answer. A fix. So I shall be patient. Let some of the feelings settle. Form actual thoughts, and maybe get something done

Wednesday, November 05, 2008

Lesson learned

So I along with most of America voted yesterday. I am not stating here on my blog who I did or did not vote, nor my veiws on, well anything, as this is not a political blog. If you want that go read Slate or something. I am just a paramedic and this is my blog. So Back to my adventures in voting. I had just got off work, after working all night. I didn't even go home to change out of my uniform. My back hurt from lifting patients up off the floor. I had been puked on and had just gotten off the phone with the coroner 20 mins prior. (I had a woke-up dead) I was tired. I was ready to just go to bed. But I am an American, and this is just something I had to do. So I drive to my voting place ( a local Elementary school) and the parking lot was packed. I had to park a few blocks away in someones front yard. I walk in and get into the line. I'm there for an hour. I'm playing a game on my iPhone, listening to music. Blurring out the maddness, the bitching about the lines, the politcal bickering. I'm in my own world. until I feel a tap on my shoulder. I pull the ear buds out of my ears just in time to hear "She's done caught herself a seizure!"

Sure enough, next to my, across the hall, an elderly woman had passed out in line. Her neice thought she had a seizure. So I go over, and see if I could be an assistance. (I'm still in uniform, remember) The woman was out cold for a few seconds but was coming back around by the time i got down on the floor to her level. Someone screaming about Seizures and "Sugar". I block them out for a minute
"You Okay?"
"Yes. I think so."
You hurting anywhere?"
"No."
"You have Sugar?"
"No, but I didn't eat breakfast."
"Well you fell out, Sit here for a second, Whats your name and how old are you?" She told me and I called my dispatchers. As I'm doing that I get pushed out of the way by some woman screaming about "Is there a doctor in the house!" and "Does any one have a BGL machine" I get off the phone. And in my head...Who is this woman ( she never idenified herself as any sort of medical person) and what the fuck, Lady, you are in an ELEMENTARY SCHOOL, who do you think has a freaking BGL machine? I lean back down and continue speaking with my now patient. and this woman continues to yell. "she has no radial pulses!. She severaly hypotensive!" she has no radials" Good Greif. "Mrs. M? do you think If I get some helf you can make it over to that bench so we can get you up off this floor?" She said "I can, I'm just a little weak"
"Well lets get you up."
Screaming lady-"You can't get her up she has no radial pulse she will pass out again, she is severly hypotensive"
Me-"Then we will deal with that, But I would like to get her up off the dirty floor, out of the crowd. I already called an ambulance. I work for EMS."
Screaming lady-"Well I ..." and she walked off. well damn if I knew it was that easy I would have said that 10 mins ago. I got some help to get her up and we when to sit down. We got her taken care of. She got to vote. When I went back in I had lost my place in line. I stood there for a second, contemplating what to do. The people running the polls were no help. I didn't want to get back in line a wait 4 more hours, but I still wanted to vote. It wasn;t until a young woman about my age holding a 6 month old infant said "You missed the riot".
"Did I? was there Bloodshed, I hate it when I miss bloodshed."
"Na, you helped that woman?"
"Yep, and now I've lost my place in line"
"Here jump in front of me, you were here at least as long as I have if not longer I saw you." Now she had been holding this kid for god knows how long
"I can't do that, you have you son with you and have been waiting too."
"Don't worry about it, jump in."
So I did. We talked for a few minutes and her little one kept babbling at me and pulling at my hair. I asked her if he would let me hold him. Since she let my cut the line. I held the little one for a while. we had a very deep conversation about the economy ( a little one sided) and health care. Then he napped on my shoulder. Mom and I chatted with the others in line. The rest of the voting was uneventful. No more falling out or seizures.

So I voted. My patient voted. And I learned not to wear my uniform to the voting booth if you have been up all night.

Sunday, October 26, 2008

Competition

These are photos from this years Competition. Link to my Flickr Page.

This Competition was in Charleston SC this year. It is a competition open the EMS systems in North and South Carolina. This years winner was Greenville County EMS. Congrats to them.

Senerios were: an explosion at a camp site. One DOA, One with 2nd and 3rd degree burns with Airway involvement, the ambulatory pt who was deafened by the blast, and the "distracter patient" an unresponsive, apenic pediatric with airway obstruction.

The 2nd one was: A pair on a motorcycle rear-ended a construction truck full of rebar. Several impalements, that make C-spining somewhat creative. The critical go unresponsive and vomits (I will never look at pea soup the same again) The "distracter patient" was the driver, who was having CP, now collaspes and codes.

So here are the photos...
http://www.flickr.com/photos/strangelittlegirl190/sets/72157608361515378/

Saturday, September 27, 2008

The Innocents

Again, It's been a while since my last post. Had a few calls that made me want to walk out and take a long needed vaction, one that made me sad, one that made me angry, both Pediatrics. First. I had my first pediatric arrest. We, as paramedics, dread this call. We train over and over for it. We run the drug calculations in our heads, the tube sizes, the algorythms, so that when that day comes and a screaming mother hands you that limp, not breathing child, you don't freak and fumble your way through. And yes, your first you will freak and you will fumble, but do it on the inside. The ET tube was too big, I needed the smaller one, shit! it's not ready, what the dose for the epi again? how many doses was that? is it time for another? Is that IO still flowing?....Watch the fucking turns, I just got the fucking tube!... Are those readings right on the end title CO2. Keep up the CPR...FUCK! I gotta encode the hospital! All on the inside. On the outside, we worked like a machine, nobody screaming, everyone doing the task at hand. Except the Fucking turns remark, I did scream that. But despite all the good we did, the airway, the drugs, the CPR, the child had been down too long, the tiny heart had been still for too long.

We work for peds. We want them so badly to live, even though we know, in that paramedic part of our brain, that there is no hope. They are so young, they haven't had time to play, time to learn. So we fight for them. We get thrust into these calls, and this for me was my nightmare call, tiny little baby in cardiac arrest, but we get thrust into it, the parents looking at you with such hope. Hope that you can perform some miracle and breath life back into this child. I still have the mother's screaming in my head. When We got to the hospital, I could barely give turnover to the hospital before I fell apart. Even though I knew there was nothing we could have done for this child, this child had been down way too long, You cry for these tiny little patients. You pray to whatever Higher Power you pray to....then for the next few days you play the call over and over in your head until you are satified that everything that could be done was done. And you are still sad. I didn;t sleep for several days. But you call your support system, those other paramedics that you call after calls like this and you lose it. If they are good, they will talk you back from the edge and back onto the truck so that you can help the next one.

My next one came yesterday, We rescued a 6 year old and 9 month old sibling, who had been abandoned...for 8 days. The 6 year old kept as good of care of the infant as a 6 year old could. Fed the infant a bottle twice a day and also made toast and jelly for himself (he was covered in strawberry jelly). When asked how he knew how to make the bottle, he answered very matter-a-factly "You just mix the powder and water together in the bottle and shake it up" and looked up at me like DUH, don't you know anything? You ARE a grown-up. The I asked if if he changed the baby's diaper, "No, I don't know how. I'm only Six!" But because he took good care as he could of his brother, this had a good outcome. I wasn't working two sick children. Other than a severe case of diaper rash, a snotty nose and a slight fever the baby was really okay. The little one when I held him just curled up close to me and slept. (not lethargic, limp sick baby sleep, but normal baby sleep) The six year old was very active, totally obvious to why the Police and Paramedics were there. He was just so excited to ride in the ambulance. He played with all the switches. He really like turing the suction on and off. I think it was because it was loud and we picked up band-aids with "Magic" We also like the stethescope. We listened to his heart then his brother's and it sounded like a drum!

I wanted to take them both home with me and watch Disney movies on my sofa. I wanted to show them what it was like to be loved and wanted. Then the anger came. Not toward these two children, but that mother who left them alone for so long. I had never wanted to cause physical violence to anyone. How dare she leave. I'm almost happy she was not found before we left, nor was grandmother. I would have gotten a complaint. I would not have held my tounge. I held both those kids all the way to the hospital. We played and sang. The baby looked at me like who is this crazy woman, singing with my brother. But he still giggled when I tickled his little round belly. They probally got a warm bath and the best sleep that night.

These innocents, We care for them, we fight for them. We want to love the unloved. It was hard to give them over to the hospital. But they now are getting cared for. And that is the best outcome.

Sunday, August 24, 2008

Thanks

I want to thank my boys in blue today. My system gets along very well with the other public servents. Fire gets along with police, police gets along with EMS, EMS gets along with Fire and the circle goes round and round. We all take care of each other. It's like we all know we are here for the same job, to make sure that the public of our coastal city stays safe. Even if the person we are taking care of is a violent crack dealer. I had a very large, potental violent patient today that was tased. He had been using cocaine all day. Possibly injested another couple grams more of crack, then was tased several times to be controlled. We were called for a posted tasing exam, as per protocol, we placed him on an EKG and her was extreamly tachy, in the 150s. But The Cops, because of the patient's violent potential and his size (he was a BIG BOY) did not want to put him in the box with two female medics. "I know you girls can hold your own back there, but he tried to kick MY ass and I have a gun AND a Taser, I AM NOT putting him back there with you two." I explained to the cop that he needed to go to the hospital, his heart could explode due to the tasing and the coke. The cop offered to take him the hospital in his crusier, which was a great. In the same breath I also wanted the best for my what was now my patient. A cop, even on the way to the hospital has little medical training. If he was to arrest in the back of his crusier the cop would be in a world of hurt. So For the good of all invovled I convinced the cop to let me ride with him. With my partner driving behind us in the ambulance. That way if anything happened I could work the patient, the cop would stay out of trouble because he did all he could to keep us, the medics safe, and the patient under medical care. And Pateint care was not compromised or discontinued. It was in the best intreast of all parties involed. So we look out for everyone. Not just the sick and Stupid.

Friday, August 22, 2008

Zebras

Weird medical calls. That seems to be my specialty. Think is psych, wrong answer. It was a bi polar trying to make the manic thoughts go away took to many of the friend's medications. Ended up with the body eating it's own muscles and kidney failure...oh and hallucinations of spiders, lots and lots of spiders. Next one...Panic Attack. No way. The EKG showed a strange narrow complex bigemeny and ecscape PVCs. I did 5 12 leads because the rhythm kept changing. One did show a type 2 AV block, but then the heart onverted itself back into the odd sinus arrhythmia I started with. I looked it up in one of my cardiology textbooks. Escape-capture bigeminy (ectopic atrial escape, sinis beats with prolonged P-R) apparently. It was in the chapter of Blocks. Turned out pt had infarcted several days ago. An Inferior MI. Makes sense, inferiors tend to have strange blocks and such. How about a drunk homeless frequent-flyer. The last time he was in my truck he spit at me, then proceeded to urinate all over the back of the box. The only reason cops won't take him in is because he refuses to ambulate, so they call us to "check him out" so they can arrest him. Only this time he has a BP of 70. Goddamnit. Turns out he has been drinking and doing herion all day.

This is why I am a good medic. I tend to be overly cautious. I have come across to many strange "zebras" to think otherwise. Like my young patient who stated it hurt to breath "right here", but whose vitals were all normal. He ended up with a spontanous Pneumo. Found that with a stethescope. I do 12 leads on just about everyone. But I have found more MIs on Pts with NO Chest pain , than pt with classic signs of Heart attack. Old lady vomiting...Huge Head bleed. Middle age SZ...brain tumor. Athlete in training has abdminal pain...Aortic anyrism. Young woman violent and hallucinating...bacterial menigitis. No wonder I'm a hypocondriac. I think everyone is sick and dying. Good thing I guess in a medic. You don't want a medic who thinks everything is bullshit. But sometimes the hoofbeats are just horses, just not with me. It's always a puzzle. The EMS gods playing little games with me. Like they sit up there in their ambulance in the clouds going "Let's see if she can figure this one out..."

Thursday, August 07, 2008

My Reality In B&W

http://www.youtube.com/watch?v=AOsGIE56g5M

A YouTube video of stunning B&W photos. This is my reality.

Enjoy the Ride. I do.

(I believe this is somewhere in South Africa)

Saturday, July 26, 2008

Some needs to call the paramedics, Oh crap I am the Paramedic

So this morning I was sitting at the light in front of my house, waiting for it to turn green. Which sometimes it doesn't because it sucks and it stays red for ever and I have to call The Voices, who then call the city police voices, who then call traffic, who then fix the light. Well this particular morning, I was waiting for the light to turn, enjoyin my morning coffee an the new Death Cab for Cutie album, when I heard sirens and lots of them. I first think, how odd, I don't remeber Sirens in this song, them it dawns on me, its coming from outside. I see a fire truck, then another, then a ladder, the two squad cars. Phew, something big is going down. I cut off the car in front of my that won't turn and continue on my way. I find out when they were going in such a hurry.
I turn down the road on mu normal route and they are all clutered in front of the school with a bunch of cop cars, but no medic unit. I see the vehilce smashed all to hell and a man with all the fire guys franticly doing stuff over a man with lots of blood around the head area. I fly past all the chaos, and pull into the school parking lot, jump out of my car, barely remembering to put the damn thing into park and rush over. I am stopped by a police officer, mind you I am in uniform. "Can I help you?" He asked in that I'm a bad ass cop voice, even though he looked like my seventeen year old cousin. I look at him thn look down at myself, and go "Well I thought I might be able to help you, I'm a medic"
"Oh...OH....yeah...YEAH, go see what the fire guys need!"
I go walking over. "Hey yall, I was on my way in to work, thought you might need some help." I hear from behind me someone yell "Hey capt, he's CAT 1!" (Damn near dead) I turn around and he is guppy breathing, clamped down, blood everywhere. One of the fire guys, goes "We got a medic!, She needs a pair of gloves!" I get a pair of XL gloves thrusted at me from somewhere (I wear a small normally) And right at that moment I had a oh fuck moment. I was the only Paramedic. With nothing but a BVM and a pair of gloves. No drugs, no ambulance, no monitor. And at least six men turn to ME (gulp!) and go "What do YOU need us to do?" WHAT THE FUCK DO YOU MEAN "WHAT DO I NEED YOU TO DO" Oh Jesus Christ and all that is holy, I am now in charge. I am the senior Medic on this scene now. And All I could do was Bag this man. Breath for him. He still had pulses. We did have CSpine stuff, so we were starting to CSpine him when the medic unit pulled up. And never in my life have I been so happy as to see an ambulance. That 3-5 mins it took the medic unit to get there felt like an eternity. But when it did show up. I was happy to turn over care.

But I did have a Oh Fuck Me moment. A someone needs to call a paramedic, Oh shit! I am the Paramedic moment. When everyone, even though they were completly able and competent, turned to you. Because You have Paramedic in front of your name and goes, "Hey, what do you need?" I was alot of responsiblity that hit me all at once. I wanted to run away. But of course didn't. I had My fire guys taking care of me. And they did a wonderful job. So again I thank them too.

Friday, July 04, 2008

Gut feelings

My last post was about assessment. This one is about gut feelings. I get them. I know when I'm about to walk into something bad. And it's usually when I get it, very bad. I got it on the way to the Airport and when we walked in to a cluster of a cardiac arrest. (We brought him back, not only brought him back, but had him walking and talking, CAOx3 by the time we got to the hospital, they were doing CPR when we got there, he was D-E-D dead. and very much alive when we dropped him off at the hospital) I got one when we forced entry into a house and found a pt laying prone on the floor who looked up at us and took her last breath. I got one when I listened to that kids lung sounds from the last post. And most recently got one with a pt who called us after a syncople episode in his backyard. Pt was SOB and passed out. Even out in the heat pt was pale, cool and diaphoretic. You know how they teach that kis are either sick or not sick. Well this works on adults too. They are either sick or not sick. And this pt was very much sick. S-I-C-K. Cardiac sick. Pt had that look. Had a gut feeling. So pt got high flow O2, and a 12 lead. which came back normal. So pt got two more 12 leads 5 mins apart. Also normal. But something was not right. Pt was sick. Pt was hypoxic, fighting to breath. SPO2 was normal. But Pt was fighting the mask, and skin condiction never improved. Then as we were pulling into the hospital, pt respiration increased from 26 to 38. SPO2 dropped and near syncope. One more 12 lead. HUGE ST elevation in inferior and anterior leads with some slight elevation in lateral leads. The pt infarcted right in front of me. nearly arresting. I RAN him into the ER waving 4 12 leads in my hands. "Doctor! Doctor!, you need to come with me, He's literally infarcting right now! right as we pulled in. the bottom two are the first ones I did, the top one is the one I did right now like 30 seconds ago"

So gut feelings. Listen to them. They are normally right

Tuesday, July 01, 2008

Assessment

Don't you love it when nothing else is wrong, but there is one thing, one symptom, one minut finding that make you sit back and go, "Self, something is totally fucked up about this." You look at your patient, who looks fine, whose vitals are stable, but that one finding, that one thing is signifigant enough that your gut is screaming at you. I had that the other day. A young pt who had pain in inspiration "right here" and he pointed to a point on his chest on his right side. "A rubbing sharp pain?" I ask. "
"Yep. Excatly."
Pluresy. His vitals are ALL stable. Normal Sinus on the EKG, 99% SPO2 on room air, I put him on a canulla. respirations 16 non labored. Not fighting for oxygen at all. I listen to his lungs with my handy dandy stethescope. High tech little tool we have, not really, but very important peice of equiptement on the ambulance. So I instruct him to take a deep breath and hear very clearly breath sounds on the Left, but nothing on the right. Whaaayayayyttt? Okay do it again dude, Deep breath. And again, nothing on the Right. I look at the monitor and everything is normal. So ONE more time, deep breath, and once more....nothing on the right. But still vitals stable and pt not working to breath. I ask again any shortness of breath. No. None. Just a sharp pain and he can put his finger on it. He doesnt want to go to the hospital. I explain that I can't hear air moving on the right side, thats strange. I have a gut feeling that something is funky. But how do you explain to someone about gut feelings? I convince him to go. and we take a easy ride to the hospital.
When we get there, I tell the staff. "I know I sound like a crazy person, his vitals a completly stable, SOP2 is 99-100%, respirations are 16, and he denies SOB. But I swaer his has almost no lung sounds on the right. I know all I have in the feild is a stethescope, not exactly a chest xray. But I swear, I listened 8 times, my partner listened. neither of us could hear. So we brought him to ya'll. So you tell me...can this be a spontanous pnuemo even though no other signs and symptoms piont to one?"
The doc told me that I was thinking the more deadly Tension Pneumo, a small bleb wouldn't show up so seriously. SO I did what I could do in the feild and brought him to the hospital. So good job. They would do a chest xray and figure it out. He wouldn;t try an diagnose a pneumo in the feild.
Yesterday, I stopped by the ER, it was not only a pnemo, but a big one. Needing a chest tube.
This my friends is what you find when you do a good assessment.
Listen to Lungs, know what the sounds mean, do the 12 lead on that 78 year old whose only complaint is weakness ( I found a huge anterior MI once that way, again, pt was very stable, vitals, only complaint was weakness x 3 days, but there it was staring back at me plain as day). I have had several medical mysteries recently, where the patient was absolutly stable, but something told me, put them on the monitor and then caught the 2 degree heart block or the stable Vtach (yep, had that too) don;t put them with you EMT basic partner, as competent as he is, he can't give amiodarone or interpert a 12 lead. CHeck the drunks BGL. Oh shit it's 567. Thats why he altered. Yes there are times that sometimes a fall is just a slip and fall. Listen to your patient. They can tell you many things. And also listen to what they are NOT telling you. Sometimes that can tell you more.

Wednesday, June 25, 2008

Losing at dodgeball sucks

I'm getting lazy with my posts I know. Been busy, life takes over...blah...blah...blah and all. Getting settled into the new place. Work is work. Did ya'll know that losing at dodgeball warrants EMS being called. Neither did I. But when the player that gets tagged out refuses to speak and gets upset because they lost, EMS gets called. As does mom. Mom being no dummy realized what was wrong with dear sweet child, and kindly waved away the ambulance. Next time, she tells the kid, suck it up, we all lose at dodgeball every now and again. Today was calls like this all day. People who didn't call, third party callers. And also your typical hot weather calls. Faintings, falls at pools, jellyfish stings...the normal summertime on the islands calls. Not too bad of a day. At least it didn't storm today and flood downtown. Our fair city has terrible draining. Especially at high tide after a terential downpour. It tends to flood really bad over by the hospitals and on most of the normal routes to the hospitals. What should have been a 8 minute transport, turned into a 35 min roundabout tour of the city because the city was at a standstill because to the water. Glad it was only a broken ankle and not something life threating. Then when we left we run into a huge flooded area with a local news crew filming. I have learned from personal experience if you have to debate if you can make it or not, you probally can;t make it so dont try it, especially when a news crew is pointing a camera at you and your ambulance.

The new apartment is nice. The pool is even nicer. My days off spent by the pool.

Saturday, May 24, 2008

back.

Yes, I know its been a while. But before you all go yelling and hollaring, I do have a very good reason for no posts. NO INTERNETS. My internet has been down since the crazy hobbit med student moved out of the apartment. But I am now in my own place, complete with TV and cable internets. So I am now setting up my new place, with a short break to type this post. Other than moving haven't been too busy. Work is still the same. Actually our system has had a few bumps, but nothing I want to comment on really. We all have our problems. So we will leave it at that. But in my work life, everything is smooth. I work hard. No death, but now extreme life saving either. I haven't shocked anyone back to life in recent weeks. And the most notiable thing that has happened was I got threated by a drunk, mentally hadicapped man who told me "Unhand me you crazy woman or else I will fuck you up!" But my partner and the cops kept any fucking up from happening. But not before he let loose a lugie the size of my fist in my general direction and then he just cackled at me. Oh well it happens. well I will make this short a sweet as I have more boxes to unpack.

Monday, April 21, 2008

Okay here it is a new post

Phew, I know I know I know. Been a long time. But I have good reason I promise. Had a bout of writer's block. Then I found out my lease is up alot sooner than I thought so I had to find a place to live otherwise I was gonna be living at the women's shelter that I have grown to know and love. But I have found a wonderful place to live. A place that is ALL my own. My first place that is mine all mine. I don't have to share with anybody. More rent and I have to work a little harder to actually afford it, but a space that is all your own is worth that extra two shifts a month I think. And it has a pool. So seriously, yeah, two extra shifts is worth a pool.

Man, yall...we were crazy busy this weekend too. That full moon thing is so true, and all but one was some BULL-shit. The one was one of our frequent flyers that everytime you see she is actully sick, but because of crack. You just go "Goddamnit!, You were doing so good! What the hell happened?!" and she shruggs, all while fighting to breath. You CPAP her, load her up with NTG and haul ass to the hospital, go any slower and you will be tubing her. You just pray the whole way that she didn't wait too long to call you, because you can't get a line so you can't RSI her and you for damn sure don;t want to nasally tube her, she doesn't care for the CPAP, so you know she ain't gonna like that tube shoved down her nose.

The rest were all just alot of uncooraperative people who thought that EMS were either taxis to downtown or "unresponsive" who were gonna "faint" everytime we tried to stand them up. And every one of our "fainters" were a good 3 bills give or take. i've already has back surgery once, I'm not having it again. so I' not gonna catch you. You can faint. Not one of our "fainters" hit the ground. They all somehow made it to either a sofa or a chair or somewhere soft. One even made it clear across the room to the sofa. It was a fucking miracle.

Then there was the drunk college kids. How do you drink that much? No Seriously? How? I've been drunk, really drunk. I broke my foot in five places I was so drunk. But I have never been so drunk that I was unresponsive and EMS had to suction vomit out of my airway.

Wednesday, March 05, 2008

Holy Crap Batman! I can raise the dead

So I thought that my streak of death was still following me. But apprently the EMS gods had other plans for me today. We get called to a near syncope...oh and can you also first respond to the Seizure too, it's at the same place, we have another unit coming, they are just 20 minutes out. Sure thing my dear dispatchers.
Medic on scene...Are you fucking kidding me, you didn't tell me the seizure was in fact in cardiac arrest! I can't give too many details about the call because this being the internet, a a very public forum and I would like to keep writing and this is the kind of call that walks the line of "can I write about it without reveling too much in this kind of setting" but I can say the pt was in fact in cardiac arrest, meaning he was not breathing, nor did have a pulse, he was...in not so many words...Dead when we got there, but my dear readers, do not fear, by the time we dropped him off at the hospital, not only did he have a pulse, not only was he breathing on his own...but he was sitting up, talking, conscious, alert and orenited x3 and holding a conversation with us. And when we left him at the hospital, he was on a nasal cannula, and they were trying to find a reason for why he went into cardiac arrest in the first place. Yes...We did some "Third Watch", "Emergency", "Baywatch", "only shit you see on TV" kind of Paramedic Magic today.

I have no idea what happened to the near syncope, the other unit came...nor frankly do I care. I was to busy saving a man's life. With a little help from my friends.

I would also like to say a BIG thank you to the First Responders. Without them sometimes our patient would not walk out of the hospital, like our cardiac arrest today. They started CPR right after he dropped and frankly, played the biggest part in saving their friend's life. So thank you. Without them we'd have nothing to work with. Just want you guys to know that the Paramedics, we do apprciate what you do. We may not say thank you all the time. But here's mine.

THANK YOU FOR ALL YOUR HARD WORK GUYS.

Thursday, February 28, 2008

Sick and Tired of the BS

Now we all should know by now I am a very laid back medic. Rarely getting worked up over much of anything. Sure, my hands tend to shake through bad calls, not out of nervousness, but because the adrenaline makes me. I can usually work through it by just sitting back for half a second and saying to myself "Self...Honey...It' ain't your emergency" On the outside I'm cool medic. I'm Eh...It's just VTach Medic. On the inside I'm going "Someone should really call the paramedics... oh crap I am the paramedic." But Thats another post on another day. Today, whoa, was let's see what else we can find to bitch about day. And to top it off I have whatever the respiratory crud from hell is going around. I bought my partner three bottles of cucumber foaming hand sanitizer and a tube of Airboure and a can of Lysol that I made him use every hour today because damnit if he's gonna get sick too. Anyways, Bitch at the Medic day...good Lord, seriously. I have other things, more important things to worry about than where my partner's name plate is. Like where are the Narc Keys and are they still attached to my hip? Seriously we have already discussed that fact that it is missing and that it is getting remade. I sometimes feel like I'm in the movie Office Space...Yes, I have seen the memo on the TPS reports and no... I don't need another copy. I have 8 bosses, Bob...EIGHT. Okay, so we are out of 20 gauge INTs. I didn't;t get by our supply cabinet this morning. It's cool really. Everyone will either get an 18 Gauge or a 22 gauge or just won't get an IV. The world is not crumbling or coming to an end. Chicken Little, my friend, the sky is not, in fact, falling. We have plenty of oxygen and all the ways to deliver it, drugs and all the ways to give them, and the monitor/difibrillator is still sitting on the bench seat so I'm cool. I have all I need. My boots are a bit scuffed and my uniform shirt has a few drops of coffee on it leftover from a little spillage when we hit that bump at 45mph, but I still am ever the professional. I still speak to you, my patients with kindness and confidence. I may have no idea what's wrong with you (as what was the case the other night with my actually unconscious/ unresponsive 18 year old with perfect vitals and no reason to unconscious) but I will treat you as to the best of my ability and haul ass to the hospital if needed. So With all that being said...Very few things piss me off or get me worked up as rudeness. Don't yell at me unnecessarily. Don't speak to me like a child. Don't hang up on me. And don't EVER call a supervisor without talking to ME about what I did wrong first. It's childish and like tattling. I hate getting a phone call at home several hours or even days later from a white shirt bitching...er, discussing... that I am not allowed to be at a station when the other crew is home when I have forgotten all about staying that extra ten minutes at a station because I was shooting the shit the with crew and fire guys. I'm very respectful to you on the phone, I expect the same respect to be shown to me thank you very much. I state again, Chicken Little about the sky..NOT falling. We can all get along. Just show me the same kindness, patience, and respect I show you and we will have no problems.

Tuesday, February 26, 2008

Thursday, February 21, 2008

Distract and play

We as paramedics get caught up sometimes in the swirling around us. Lots of people yelling at you from all directions from your 2 year old patient to the patient's freaking out mother to the fire/ medic first resonders who were on scene first to the other kids who saw the patient fall and then subsequently started seizing. HOLY SHIT PEOPLE QUIT YELLING AT ME! Okay one at a time. FIrst Thing...Mom... your little one is alert, awake and now telling me that she is two years old and her favorite color is pink. I can't go anywhere until I find out what happened. Quit yelling at me to start driving I have a Fireman hanging on to my bumper. Quit freaking out because when she sees you freaking out...she freaks out...now hold this oxygen mask right here.
Now...Fire Guy...Give me the short story...
Now Partner...Drive before this mom starts to yell at me some more that I'm not moving fast enough.
Phew...
This is what I had to deal with today. This 2 year old fell and hit head...HARD on the concrete driveway. Had what sounded like a seizure following fall and breif LOC. But on arrival of us, kid was CAO to normal mental for age. ANd did tell me she was 2 years old and in fact her favorite color was pink. She did not like me for about 30 seconds following a BGL check until I redememed myself with Elmo stickers, which she kept a death grip on in her little hand for the rest of the trip. Mom at one point asked why I wasn't doing anything "You know? medical?" Thats when I looked at her and go "I know it looks like I'm doing nothing, singing and talking and asking your daughter stupid questions like what color is my stethescope, But as I ask them I'm checking her mental status. She has no idea what day it is or who the president is. But she know who Elmo and Big Bird is and that who on these stickers. And she know who you are. And she knows her favorite color is pink. So if she answers those questions, she has a normal mental status for a 2 year old. And that is a very good thing. Means that there is a a very slim chance of a head injury. Also her Heart rate is right where it should be and her pupils are equal and reactive. I'm doing more things "medical" singing with her than you think. I can't do a exam with her screaming crying now can I?" That got mom to shut up. I was more than just an "Ambulance Driver" at that point. We got the child to the hospital. Gave turnover to the nurses.

You have to learn that with kids...distract. Play. Sing. Clap. Anything to get thier minds off the fact that you have needles. I particularly like stickers. Elmo Stickers are a huge hit with the under 5 set.

Tuesday, February 19, 2008

roamers

System Status Management. I haven't decided if I like it or not. I'm on one of our three "roaming" trucks. Meaning I have gotten to know alot of parking lots and street corners. Now I don't mind the street corners. In fact, if it keeps the non roaming trucks in their station instead of driving around and out of parking lots...I say...Send me to the parking lot of the WalMart on Main, I'll sit. I've got an iPod with the entire second season of No Reservations and the seventh season of The First 48. Plug that bitch in the cigarette lighter and I'm good. Thats what I'm here for. I'll even pick up the radio and remind dispatch that "Hey Y'all, we are right here!" when they lose track of where they put us and sends the downtown truck to the island we are sitting on. But what I don't get is they whole we can't be at the station when the truck that is STATIONED at that station is home. Take today for instance...We were sent to way out there..then that truck came home. The dispatcher called the station and goes..."Is the roamer there? If they are tell them they have to leave." When the crew asked where to send us, the reply was..."Anywhere in your district is fine but just not your station." Are you kidding me? Really? So we left, and went two blocks away to the local pizza joint and got a couple slices and cherry cokes. Its ridiculuas really. But So goes it.

Other than that one issue though...I think I do like it. We drive around. I've seen alot of the city that I might normally miss because I'm stuck at a station all day. Last shift we drove to the waterfront and sat and ate lunch there. You just don't do stuff like that when you work at a station. So its not so bad I guess. Could be worse...I could be working INSIDE. ::shudder::

oh and PS...

Steve Berry thinks I'm Cool.

Love your stuff. You are one sick medic and I respect that
Best Regards,
Steve Berry

4:13 PM

Tuesday, February 05, 2008

did nothing

So I was back to the streets today. The back problem was short lived, fixed with a couple of flexarils and lortabs. Thank God for that. Not too busy today, just one call. A seizure at a local supermarket resulting in a calm ride to the hospital with a postictal man who kept repeating himself. The rest of the day was spent sitting on various street corners discussing with my partner, who eats more discusting stuff, Andrew Zimmer or Anthony Bourdain. (I prefer Tony B. to the other but I just happen to like his crass, cynical attitude towards everything) Everyday can't be filled with lifesaving shocks to the heart. So there we sat for 12 hours, breathing disiel fuel, talking about fermented shark, pig entrails, and slaughtering goats and how I would never put half that stuff anywhere near my mouth. (I have been watching WAY too much of Anthony Bourdain's show on the Travel channel) Boring day really. One needs days like this though. You can't have balls to the walls days every shift, or else one would go nuts in this line of work. You gotta have sparatic do nothing days. Where you sit. And do nothing. And talk about...well...fermented shark, and pig entrails, and goat sluaghtering

Friday, February 01, 2008

oh crap

"Are you fucking kidding me!" Was the thought that went through my head as I paced outside the hospital. Over and over that one phrase. I had just got done moving over this fat ass bullshit "I got rear ended because I was talking on my cell phone, wasn't paying attention, had to slam on breaks so in turn caused the car behind to do them same and they still hit me but now I have bullshit neck/back pain, so I'm now going to sue the ass off those poor college kids who hit me" MVA patient from my stretcher to the hospital bed. Now as many of my faithful readers know, I am very conscious of my body movements because of my history (I have had back surgery at the ripe old age of 27). Well, this time even though I was very aware of what I was doing, I still strained my back. I knew it the second I did it. I felt that pain. That pain I was once very familar with. Now thank God it was not pain the shot down my leg. Thats Disc, you need surgery pain. This was muscle tighting and screaming at me pain. So I took the stretcher outside and paced. And this is where we came in "Are you fucking kidding me?" So I called my supervisor and Safety officer. And went in to get seen by the county doc. I'm getting better the Flexaril has helped ALOT, which is a very good sign. That means its muscle, not disc or nerve. So I get a couple days off rest the old back. I have the spine of a 60 year old. So I sit and I rest and I enjoy the drugs. Until monday when I go back to the Doc and hopefully get cleared to go back to work.

Saturday, January 26, 2008

We rock.

I was a good little paramedic today. Actually, make that a damn good paramedic today. I saved a life. Yep, my friends, I, The Angel o' Death, saved one. Really and truly saved 'em. I pulled some great paramedic magic outta my ass and brought one back. So here's the story. Got called to a chest pain. Pt was sitting up, Talking, CAOx3. Looked fine, skin pink, warm and dry (we are all about skin condition). Tachy at 140s was our guesstimation. not working hard to breath, lungs clear, BP at 130/88. Got [the pt] out to the truck put [pt] on the 12 lead EKG (was c/o of CP pain earlier, now only generalized weakness). The EKG showed....VTach. The pt was so very stable, had a great blood pressure, no SOB, and was still sitting up talking. So I moved the 12 Lead stickers and started putting the defibrillator pads on [the pt] And started explaining that the heart was doing some funky things and that we are doing everything, but its going to be alot of stuff all at once....and that we might have to shock [pt]. I was gonna try to aviod the whole shocking thing and go with anti-arrythmics, but Versed and Cardioversion could work too. anyways... My partner starts working on an IV line and I hop over to the O2 cabinet to get a non-rebreather mask on [pt] As I'm doing that I'm also getting the hospital on the radio to let them know we are coming with a very stable but very much in VTach pt that I'm about to give Amniodarone to. Because at this point with [the pt] as stable as [pt] is, cardioversion is not first line. Until [the pt] looks at my partner and goes "I'm going to go unconscious" to which my partner responds "Are you really now?" Just as the pt flutters and in fact goes unresponsive. To which we both look up and see that [the pt] is now in V Fib. I now throw the radio mic down, mid sentance, grabed a BVM, threw that to my partner and then leaped over the pt, landing on the bench seat next to the monitor. I hit the charge button, looked up, CLEAR! and lit em' up. and then quietly prayed....please don't go into Asystole please don't go into asystole please don't go into asystole. Not Asystole...don;t know what it was...strange looking rhythm, but not asystole. [The pt] then opens eyes looks up and goes "I blacked out there for a second" Ah, no... darling you just DIED there for a second. But we saved you. The rest of the ride was uneventful. No more shocks, no more "I'm going unresponsive"s I made sure of it. [Pt] closed eyes for a second and I yelled, "Don't you be closing your eyes, you keep talking to me [M.P]!" Oh and hile all this is going on, I had forgtton all about the hospital I had on the radio, so I kept hearing "Last unit...advise...Last unit?" Sorry, Miracle Hospital, we were busy shocking our pt back to life. We got 'em back we are stable again. Here's what we have. ETA's less than 5mins. Any more questions/ orders?

So we rock today. My first day back after an 11 day vacation and my first call had to do actual paramedic work. Thinking like a real paramedic is hard. I love my job. I saved someone. We so rock.

Thursday, January 03, 2008

Chaos and assholes

Do ER Docs go to special classes to learn how to be pricks to the medics? I think some do. I think some forget what we have to work with on the streets. I think some forget that we are not glorified taxi drivers and most important I think some forget that not all of us are paragod idiots. Some of us do in fact know what we are doing. I am in fact a good medic, despite my faults (I can't add and I can come off as a dingbat sometimes) but I am, so I've been told, a good medic. I have even been told by a seasoned ER nurse who I have known for a very long time and love and respect that I am a VERY good medic. So when I have an asshole doc tell me during a hectic call over the radio in a very condecending tone "Did you think to give your unconscious, only breathing 4 times a min Pt that you're are assisting ventalations with a BVM with Narcan?" It makes me want to be a total smart-ass back. Which I kinda was. My response was "I would be glad to give my unconscious only breathing 4 times a min Pt Narcan, do you have any other obvoious orders for me Doc? I am 3 mins away from you guys I was trying to encode you before we got there since I am assisting ventilations, We actually just got the line" ASS.

What these ER docs Have to remember is this...I am working in a 4x6 closet on wheels with an EMT Basic who may be a very good Basic, but they can only do BLS. Meaning no Lines, no drugs, no intubations. Thats all on me and me alone. And I may have Fire too...but again...BLS...If I'm lucky I might have another Medic, but usually just one. So One more pair of ALS hands so four ALS hands. I'm doing the same job that the ER doc is doing with several veteran RNs, a respiratory thereapist, an ER tech or two, maybe a resident, a PA maybe all in a cloest with deisel engine. Going down the road at 60 MPH. Do you know how hard it is to hear lung sounds with a crappy stethescope with a siren going and a turbo desiel going at the same time? It's tough. I have even had a ER doc tell me "I don't know how you people get anything done in the back of those things." I just laughed and said "That's why you're a doctor and I'm the kick ass paramedic"
"That you are my dear, you fixed the Patient, now can you take him back to the shelter?"
"Nope, I am 911, strickly one way babe, he belongs to you now"
That happened to be one of the ER docs I like. One who understands what we do. What truly goes on in the back of a truck. That is really is oranized chaos.