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.

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.