Tagged: CMTSU

Just ducky

It’s a relatively normal morning. We get our first call before coffee. She’s a regular chest pain patient; an uncontrolled angina. Oxygen, IV, monitor; 12-lead ECG and nitroglycerin. The only hitch is with the aspirin. She doesn’t like the taste and refuses to swallow it.

The early morning traffic is light, and we make easy work of the dance.

As I turn into the driveway of Local Suburban Hospital, I am greeted by a duck. A lone mallard stands authoritatively in the middle of my path. He’s a beautiful specimen with shiny green plumage on his head.

Spring is finally here, and I’m glad to see the birds returning. I don’t have time to admire this one though. He refuses to move. I creep up with the ambulance; he stands his ground.  I consider the siren. It would be reasonable, but I’m reluctant to use it on hospital grounds. It’s just poor form.

The standoff lasts a few seconds. I creep forward. He stands his ground. He knows I won’t hit him.

I blink first. I put a wheel over the curb and creep into the bark mulch, silently praying that the ground is solid enough to hold a Ford. I don’t want to have to explain this to the men from the Motor Squad.

As I pass, the duck turns his head to watch. In my mirror I see him waddle (saunter?) off in the direction of the retention pond.

Muerte

A sunny Sunday morning. A crowded neighborhood; the closest thing we have to tenements, filled to the brim with people seeking the American dream and finding everything but. Paramedic 9’s diesel screams at the curb, nose to nose with a fire engine in the tiny one way street. They will have to back out.

We charge up the stairs with bags, oxygen, Autopulse, cardiac monitor, and the virtual suitcase that is our drug box. The firemen follow with a backboard, and the stair chair in case we are wrong.

We aren’t.

Grandma sits at the kitchen table, slumped over into her Cheerios, not breathing. The apartment is a beehive of activity and unintelligible chatter, but no-one does anything to help her. That’s our job.

Police officers corral the family to one side, quizzing them in Spanish and relaying the answers to us. We pull her down to the floor, start CPR. Push hard, push fast.

The ballet rolls on, each of us dancing his assigned part. Airway, IV access, drugs, electricity. The Autopulse does its job without fanfare, filling the now quiet room with its rhythmic VOOMPA-VOOMPA sound. Clear a path, prepare a way downstairs to the ambulance.

Partner hands an oxygen tank to the firemen. “Here, can you get me another? This one’s dead.”

A wail goes up; the room is filled with sound and fury.

I only know about 4 words of Spanish, but muerte is one of them.

Oops.

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.

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.

 

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*

Written by Comments Off on Overheard in the Emergency Department Posted in EMS Tagged with ,

Not clear on the subject

Overheard in the medic truck:

Medic 505: “So I see you’re allergic to Penncillin. What happens when you take it?”
Patient Experiencing Allergic Reaction: “I don’t take it, I’m allergic.”
M505: “But how do you know you’re allergic?”
PEAR: “My doctor said so.”
M505: “And how does he know?”
PEAR: “I had a reaction.”
M505: “Uh-huh. What kind of reaction?”
PEAR: “An allergic reaction.”

*facepalm*

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.

Tired

 

“Medic 9, respond for the unresponsive male. . .”

 

A BLS ambulance arrives before us and begins doing their thing. He has a pulse but isn't breathing. Oxygen and a BVM will take care of that for the moment. His environment suggests heroin overdose; his pinpoint pupils and track marks scream it. The Narcan performs its miracle and soon he's awake and talking to us.

 

Of course he denies using anything illicit. When asked if he realizes he wasn't breathing, he insists that “I'm just really tired.”

 

——–

 

“Medic 9, respond for the shortness of breath. . .”

 

We arrive to find a befuddled fire crew staring at our patient, who sits on the edge of her bed waving a CPAP mask. “It's not working,” she says. “I can't go to sleep; I'll DIE!” As paramedic and resident sleep apneic, I am the appointed expert.

 

I really don't know much about anyone's machine other than my own, so I deploy my best cable company troubleshooting skills: unplug, wait 30 seconds, plug in. The machine beeps once, blinks twice, and begins doing its thing.

 

——–

 

“Medic 9, respond for the unresponsive male with CPR in progress. . .”

 

We arrive in a perfect storm of fire engines, ambulances, and police all converging on one dilapidated apartment building. No one is doing CPR, but it isn't necessary. This looks familiar: environment, pupils, track marks. The treatment becomes routine: BVM, Narcan. Shortly he's awake and claiming, “I was just really tired.”

 

Intermission

Two police cruisers idle in the cul-de-sac, lights off, projecting calm authority. Nothing to see here. Move along. An apologetic looking sergeant steps from his air conditioned refuge as we arrive. “She's off her medications again,” he tells us. “I've spoken to her doctor, and the paperwork is on its way.”

But of course it isn't here yet. We take a moment to discuss the situation and opt to wait. The officers say she won't go voluntarily, and there is no point in escalating the situation until we have all our tools in place.

She has different plans, however. Suddenly she materializes on the front lawn and walks to the side door of our truck, bemused police officer in tow. My first impression is of someone my age trying to look like an 80's pop star. Somehow I don't find that strange on this day, in this city. Her left hand clutches a half-empty iced coffee with which she gestures for effect. “Let's go.” She points at the ambulance with her straw.

Inside, I try to be nice. “So what's going on this afternoon, Ms. Lauper? Why am I here?” The response is vulgar and not informative. I try again, but now she feels my family and lineage are somehow relevant to her situation.

OK then.

I sit on the bench and initiate the Stare of Life. I have nothing to treat and she won't talk to me, so I sit quietly and watch. She alternates her time between looking out the back window at traffic and shooting confused glances at me. I'm not going to play the game.

I have seven minutes of intermission before Act Two will begin at the Emergency Department.

Rain delay

A mild summer afternoon has turned to a muggy evening. The June storms have arrived, bringing a paradoxical increase in the temperature. We stand in the open garage bay facing south as lightning illuminates the clouds above, each flash forming shadow images on the horizon.

The minor league ball game across the street has called a rain delay. Neil Diamond blares “Raindrops Keep Falling on my Head” as the crowd thins out. The bravest souls move up in the stands seeking shelter under the overhanging roof.

One by one, heavy jetliners appear over my left shoulder seemingly just beyond arm’s reach. They drone onward below the storm clouds on final approach to Big City International Airport. Occasionally the storm will silhouette one against the sky, burning its image into my memory.

Gunshots ring out across the city, faint but too irregular to be fireworks. We turn up the police radio and wait, as the ball field begins to play “Here Comes the Sun.”