Category: EMS

Take your dog to work

So the internet has decreed that today was Take Your Dog to Work Day. At first I thought it wouldn't work, then I reconsidered.

  • Long stretches on the couch.
  • Blasting across town, head out the open window, tongue lolling in the wind.
  • Howling along with the siren.

Yeah, Cricket might enjoy it too. 🙂

 

 

 

Stay safe out there, folks.

 

Scenes from an ED

The helicopter crew turns the corner ahead of us in their blue jumpsuits. Their patient doesn't look too bad. She's awake, sitting up on their stretcher. I cannot see a heart monitor or any IVs, and I wonder what she did to warrant flying.

We roll together into the Acute area of Big City Trauma Center. The sickest people in three states all congregate here. The triage nurse asks, “Who's got the pediatric trauma?” I raise my hand like a school kid, and we are ushered past the healthier helicopter patient into our own room. The trauma team pounces.

Two doors down, we pass a Thumper machine doing CPR. The team is calm and organized, but outside I can hear a doctor having the “His prognosis is very poor” conversation with a distraught-looking family member.

Two doors in the other direction, my coworkers arrive with an unconscious three year old on a backboard. The trauma team is briefly disturbed, but like an amoeba they split, reform, and begin to do twice as much work.

We gather our equipment and pass yet another helicopter crew on the way out. These medics are dressed in green from head to toe. I ponder where they might have parked.

Restock the truck, refill my tea, sync the report to the server, and we are off into the night again. Summer has begun.

Adventures in babysitting

“Medic 9, umm, check your CAD notes.”

I flip the Toughbook screen open as my partner scowls from the driver’s seat.

Response to the clinic. Non emergency, but bring up your equipment as the staff is having trouble.

Uhhhh. . .

After a quick consultation with the dispatcher we decide this sounds like an emergency. No one can define what ‘having trouble’ means. Off we go with a cacophony of sirens and diesel clatter.

We find a stable patient. The only trouble consists of the clinic’s inability to procure a medication from their pharmacy. It’s a med we carry handily but also one the patient doesn’t need.

We extricate her from the clutches of the clinic and take her to the real hospital who can fix her problem.

—-

“Medic 9, the overdose. . .”

The city is blowing up this afternoon. We’re coming from an absurd distance, but BLS and the engine are ahead of us. They will do what needs doing and keep the patient alive until we can get there.

The radio sounds ominous. Confirmed overdose, CPR instruction over the phone, the engine asking how far away we are.

We arrive to find the crew loading her in the other ambulance, awake and talking. She hasn’t needed any medications; she’s just a bit sleepy.

I ride in with her just in case. We talk, and that is enough to keep her awake.

—-
“Medic 9, the ALS transfer, no equipment requested.“

A first grader, going from the local children’s hospital to the big city one. She doesn’t really need paramedics; we are there to make a nervous mother and a nervous doctor feel better. If Bad Things happen, we can deal with them. She smiles and cracks jokes as we roll into the warm evening, the perfect antidote to the day.

More than a job

More than a job?
More than a job?

I received this in the mail yesterday. I’m not sure of AFSCME’s audience or intent here. The photo jumped out at me though. Untucked shirts? Improperly sized gloves? A rat’s nest of ECG cables?!

This is an organization which wants to represent us professionally? It’s “more than a job?” Obviously it wasn’t more than just a job to the marketing people who created the brochure.

Sorry guys, it gets a FAIL. I never got beyond the cover.

Things I’ve learned on the transfer truck

The transfer truck. Jack of all trades. Cath lab heroes, the vent squad. We burn a full tank of Diesel every shift. We run emergencies across 5 cities, transfers to and from every hospital in two counties, and backup for the other division. We see the sickest patients, sometimes more than once; and we have more chances to follow up on their outcomes.

Some days are heavy with 911 calls; others are mostly inter-facility work. All have their share of strangeness. It's a great place for a new medic to learn the trade or for an older one to stay sharp.

  • For every night you sleep, there is at least one when you don't.
  • Smoking and oxygen don't mix. Really. This is not just a PSA. It's not pretty and it is very painful.
  • Stacking calls doesn't work. Patient from A to B, patient from B to C, patient from C to A, etc. it looks good on paper, but something will inevitably go wrong. Someone will get sicker and be diverted to Point D, or the crew will stumble upon a car crash at Point E. Just don't do it; everyone will be happier.
  • No one likes the MRI trailer.
  • A patient can elope from a locked psych facility. Sometimes this means someone let them out to smoke and forgot about them. When they return, the facility will send them to a local ER for “evaluation” since they have been outside of their control. The police will come to watch you place the harmless depressed person on your stretcher, just in case.
  • Dinner is never when or what you expect it to be.
  • The EMS gods do believe in karma. They may not reward you for doing the right thing, but they will punish you if you don't.
  • An ALS transfer for IV fluids or antibiotics, isn't. By the time you get there, the infusion will be finished and the call will be BLS. The facility will insist you take it anyway. Just in case.
  • Sometimes doctors will surprise you. Occasionally this will be in a good way.
  • You can cram a lot of sleep into 3 hours.
  • The only thing worse than a given piece of broken equipment is the spare that replaces it.
  • The sickest patients will present with less than an hour left in your shift.
  • What may seem clinically obvious to you was not obvious to the crew that brought the patient in. The alternative to this belief is believing that the other crews are lazy and/or idiots. I prefer to think better of them.
  • There is a parking space at the local trauma center with your name on it. Mine is third from the left.
  • If you can't say something nice, punch out and go home. Or to the gym, or something.
  • Whatever it is, somebody has to do it. This usually falls to us.
  • With great power comes great responsibility. All dispatchers know this. Some appreciate it more than others.
  • Shut up and do your job
  • Don't make plans. Your shift may end on time for 51 weeks in a row, but if you book an early vacation flight on the 52nd week the proverbial bus load of hemophiliacs will hit the proverbial plate glass truck with 10 minutes left in your shift. Your relief will be stuck in the resulting traffic backup.
  • Smile, it can always be worse!
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Normandy

He sits in his hospital chair, staring out past an uneaten breakfast at the city skyline beyond. Frank starts slightly as we enter the room, then turns and smiles. Our routine has begun for the day.

He's a slight wisp of a man, now. Twice my age and half my size, time and disease have not been kind to his body. And yet. . .

Newspaper clippings decorate the cork board in his room, illustrated by recent photos of life in the senior center with his old army buddies. They never speak of what they had to do, yet somehow a reporter found out. Pieces of official records tell the story. D-day, machine gun nests, a silver star. Survival against all odds, one of only a handful. General Patton's Third Army, right until the end.

My brain has trouble shifting gears. George's army liberated my grandfather from a German POW camp. Frank may not have been there in person, but he's the closest I've ever come.

There will be time for a heartfelt thank you later. We have an appointment to keep. Let's go kick this cancer's ass.

 

Grinch

It hasn’t been a great week. We ran all the usual EMS annoyances, from truck swaps through ignorant hospital staff to late calls. I’m still adjusting to my new schedule, and my family is having a harder time than I. They’ve all managed to contract the flu.

Yesterday we were reminded that sometimes Evil truly walks the earth, this time in the form of one young man in a small town a mere 180 miles from here. A small town very like this one. . .

Add in early orthodonture and the intricate ballet that is Christmas with three different sets of grandparents, and you can see that I wasn’t spreading much holiday cheer this morning.

And what happened, then? Well, in Whoville they say – that the Grinch’s small heart grew three sizes that day.

Thank you, Random Jeep Lady. It was a simple gesture, and I surely can afford my own drive-thru order. Your random act reminded me that there are still Good and Nice in the world and came at a time when I really needed it.

Pay it forward, folks. You never know.

Overheard in the Emergency Department

From the adjacent curtain bay:

“Good afternoon, sir. I’m Doctor Attending. What brings you in to see us this afternoon?”

“Well, back on March 15th. . .”

*sigh*

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Bert

The door rolls up as I approach, and I hear the Powerstroke cough to life. I’m not on the clock for another ten minutes, but I’ll do the right thing and relieve the overnight crew. Regular Partner arrives as I take the reins, and we are off into the crisp fall morning.

“Medic 9, be advised we’re giving pre-arrival instructions. Ambulance 9 is coming in behind you.”

My luck has run out. I haven’t had a cardiac arrest in ages. I got to bed late last night and was up an hour early. I’m still getting over a cold and feel exhausted already. I haven’t had my tea, haven’t checked the equipment, and I’m not even officially here yet. It’s not about me, though. Someone has stopped breathing; bring it on.

And so the day goes. Pulses return, are lost, and return again. Chest pain, overdose, morbid obesity, Jaws of Life; our routine is shot but we’re rockin’ & rollin’ & Making a Difference. Seventeen hours later we sit in the parking lot of the downtown Dunkin Donuts, exhausted and four reports behind in our documentation. I finally have my tea in hand, girding myself for another hour’s worth of writing, as Bert the Muppet cruises past on a moped.

Welcome to October in the Witch City.