Tagged: EMS

Earth-bound misfit

Into the distance, a ribbon of black

stretched to the point of no turning back

a flight of fancy on a windswept field

standing alone, my senses reel. . .

A shift swap has brought me back to the Witch City for the afternoon.  My old shift is now occupied by new medics.  I roll south along the straight gray ribbon of Route 1, under an overcast sky with the sunroof open and Pink Floyd blasting from the MP3 player.

Something in my soul loves coming back to this city.  I don’t know why.

—–

I sit in traffic behind a Slow Down for Allie bumper sticker.

I was working that night.  I wasn’t on the call, but I watched the helicopter take off, and I saw the looks on the faces of the two medics who were.

We talk more now about PTSD and the toll this job takes on a person.  Every time I see one of those stickers part of me goes back to that night, and I say a silent prayer for those medics. (Thinking of you, guys.)

Tongue tied and twisted, just an earth-bound misfit, I. . .

Edit 11/2/15:  I changed the YouTube link.  While I love the song, the Official Video is a wondrous piece of 1980’s horribleness which I prefer not to showcase.

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Week 20 – Surprise!

While I was awaiting the return of my slides from the lab, I grabbed my Polaroid Spectra for a few quick shots.  It had a pack of Impossible B&W which I needed to finish.

Imagine my surprise when these popped out.  I really shouldn’t let cameras sit around with film in them for so long.

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.

What were you thinking?

Coming up on today's episode of What Were You Thinking? EMS Edition:

  • A dispatcher confuses the medic crews,
  • A diabetic takes his insulin and goes out for the day without eating,
  • Texting and driving almost kills a man,
  • A coworker loses his temper,
  • And I make a poor first impression.

Stay tuned!

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Memory

There is a memorial plaque in town. I pass it regularly. I remember.

I remember a sunny Saturday morning drilling at the firehouse.

I remember swearing loudly and running to the engine when the tones dropped.

I remember almost overshooting the address, and I remember the horrid moaning sound the engine's radial tires made as we literally skidded to a stop.

I remember leaping from the still-moving engine.

I remember the Doppler effect as the following ambulance shot past us, siren wailing, unable to stop in time.

 

I remember a tall staircase, narrow but straight.

I remember a tiny bedroom with too many rescuers in it.

I remember compressions, and ventilations, and “No shock advised.”

I remember an ambulance disappearing over the horizon.

 

I remember futility.

I remember we were too late.

I remember.

 

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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