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I hate sports references. They’re stupid. Sorry for being a hypocrite.
Anyways… Down to 72 hours remaining. I’ve met every other “goal” of the program thus far. So, my plan is simple: survive the remaining shifts–that as of now, I don’t know when they are. One Wednesday… then was supposed to be on sat/sun, but my preceptor is gone, so trying to find new shifts, then sunday, monday, and hopefully we can work it out so Tuesday is my last day.
5a-5p followed by 4 hours home–then home till Wednesday afternoon and back at it again for my final 5 shifts!
Pretty damn exciting right now. I really can’t wait to be out on the streets full time and at this.
I’m learning a lot–from patient care to caring for myself.
Today–I had a patient in “excruciating” back pain from a MVC, who could apparently walk around just find, sitting still is what must have made it hurt–since I couldn’t get him to just sit down.
He took 6 phone calls during our load and transport. 3 from his lawyer. Let me put it bluntly–there was no damage to either vehicle. His plastic bumper had all of the paint it started with… He had no bumps, scrapes, bruises.
He’s probably gonna die. Definitely Stab Room material.
I’ve got mad skills. I couldn’t sleep worth a damn last night. Got ≤ 3 hours of sleep. Not good with a 12 hour shift ahead of you.
I fell asleep around 0930 in the truck leaving a neighboring city out of our PSA and woke up about 1030 to the doors of the truck opening. Apparently we had gotten a call–Code 3 at that, and I slept through the entire trip. Which is impressive as the airway seat(jump seat, whatever) has only a lap belt and no way of keeping my upper half upright. So the fact I didn’t bash my head into the cabinets is impressive. Oh, and there’s the matter of the lights and sirens…
Worst part–my contacts were soooooo dry. Had a fun chat with a British Gent for about 20 minutes during the transport though.
Good times. I WILL get sleep tonight.
So many of you out in the emergiblogosphere have prob seen this dandy of an article from CNN.
It documents “Five Surprising Salaries” from surprisingly high to surprisingly low–well only one remarkably low salary: Paramedics
What they do: Paramedics respond to emergency situations and attempt to provide the necessary medical care, whether it involves transporting participants to a hospital or treating them on the scene.
Surprising salary: $27,070. Seeing as paramedics have high stress jobs that require them to be on call and ready to save lives at a moment’s notice, you might expect their mean annual salary to be higher.
Don’t worry though guys… Court Reporters make double what we do and astronomers–they triple our salaries.
Thanks Digg for depressing me yet again…
So I mentioned yesterday my chest pain patient who said “I just know I’m gonna to die”… And like they told us in class–believe them, because she did.
But what class doesn’t teach us is how to deal with that. I know that I helped her– but I didn’t save her life. I have no glory story to tell around the station. But I helped her. I made her comfortable, relaxed, and even got a smile or two out of her. But she died. Something isn’t sitting right with me here.
She told me she was going to die, and really, I didn’t believe her. I’ve heard patients say it before–but they didn’t look like her. They didn’t use the voice inflection that she did. She meant it. She knew it. And there wasn’t anything I or that bunch of lollipops could do about it.
School doesn’t teach us how to cope–the real world does that. School doesn’t teach us how to treat patients with respect–the real world does that–hopefully. School doesn’t teach us how to improvise, how to juggle multiple patients in one truck(they actually teach us NOT to have more than one critical patient–but this is the real world), how to deal with shitty partners, or how to look at a family member in the eyes who is just staring at you with those “you’re here, everything will be ok” eyes–when you know that it isn’t going to be ok. That even if you get pulses back all you’ve done is created a 150 lb vegetable with a heartbeat. Crass. maybe. Reality. Yes.
School doesn’t teach us much really. Sure, we gaind a lot of “knowledge”. Pathophys, pharmacology, anatomy, drug calcs, cardiology and even some grasp at “medical” illnesses. But where in that book did it actually show me how to care for my patients?
Honestly, if it wasn’t for my wife–there isn’t any way I could do this. That little old lady yesterday wrecked my world in the same way a little boy did 3 weeks ago. People Die. It’s a fact. When you get old you’re supposed to die–often death itself is a relief. Too many times in my life I’ve seen loved ones suffer only to have death as their savior. But they aren’t supposed to tell me they’re going to die–and mean it. I don’t have anything to fix that.
If I could go back to that 23 minutes I spent with that little old lady yesterday just to make them a little better, a little more comfortable I would. Knowing they were some of her last just wreaks havoc in my little world. But, for just a few minutes, I do know that I did comfort her. I guess that’s all I have.
Since when are isolation rooms, Action Response Plans, and violent 3rd graders common fixtures in our schools?
Since when do paramedics know school staff and Resource Officers by name?
Since when is more than one(hell… Any) transport in a day out of an elementary school on a “psych” hold normal.
Every Day some little old lady, or young kid we transport asks the same question during my small-talk sessions with our patients… “so why do you want to do this? Why do you want to be a paramedic?”
Most of the time it’s a little hard to just mutter out a response that isn’t clichéd. The “I like helping people” response is pretty common.
But its a lot simpler than that. It’s who I am. It’s what I am. This is me. I’ve worked on political campaigns–big and small. I’ve spent nearly a year with a Congressman 3 foot away from me. Spent time with more Presidential candidates than you could imagine, more business moguls and old money.
But none of that matters. In the end, win or lose–and I’ve had both–it didn’t feel right. It didn’t feel anything like giving 23 minutes of comfort to a 79 year old woman who just knew she was going to die. She knew it. I couldn’t do anything for her. My med bag, my gear only does so much. But I know that for that 23 minutes she was in my truck, she was relaxed. I got her joking. We talked about her grandkids–her husband’s business, everything.
That is who I am.
I won’t get rich doing this. Unless you ask Marty.
The book linked above is a book that we were required to read in one of my more bogus classes in college. Some places use it for management and team building, some use it as a motivational tool. Most people read it because someone told them to take the time. Whatever way it is, it relates a lot to the world we live in. We are rarely thanked, often forgotten, and only appreciated when needed. But simple things can make it all worth while. Every now and then we get a save. More often than not, we spend time comforting friends and family. Remember–often everyone in the room is our patient–most of them need something we don’t carry in our trucks.
Compassion.
There are going to be countless times in my career that I will be called to act selflessly. I hope I hold true to that. I want to be able to go home at night, look my wife in the eyes and be proud of what I do. I will not turn into a lollipop!
It’s not what I DO. It’s who I AM.
Or maybe it’s the Reverse…
EE over at Backboards and Bandaids can’t seem to make her mind up! First she’s done blogging–and understandably so, and now she’s back. 8 hrs and our responses seemed to change her mind!
Hopefully she’ll stick around to give us a little bit of her antics from time to time! But we all understand that “life is what happens when you’re busy making other plans”.
So you all know my fascination with the lollipop. I have the utmost respect for good nurses–and most nurses are at least there cause they like to be there. If you don’t like your job–quit! There are plenty of “good” lollipop retirement homes out there that will take you.
Today was special. One particular private hospital in the metro area was our destination–twice today. We don’t usually have good luck there. They won’t take our STEMI diagnosis, or even CVA diagnosis. They are the only hospital that we regularly transport to that call a STEMI team upon our field recognition. So we bring in a NON-STEMI cardiac patient, SOB, pain up and down his whole left side.
Pressure was 220 on arrival, pain a 9/10. Pale, Sweaty… looks like crap. We do our thing, load up, go, run 12-lead(insignificant), throwing a few PVCs(eventually 10 a min) and do the whole cardiac workup: Nitro, Aspirin, Nitro, Etc.
Get him down to a 6/10 on pain. Pressure is 110 so we have to stop nitro now, and he doesn’t want Morpine. So we live with it.
The fun starts when I go to give report. I’ll give the highlights… It goes a little something like this:
me “He is having SOB, left sided chest pain from his shoulder to abdomen, and pain traveling through his left leg and arm.”
LOLLIPOP’S RESPONSE “He has left-sided chest pain in his leg?”
me “yup. we moved his chest”
LOLLIPOP “so why did you give nitro and aspirin?”
me “um… did you listen to the first half of report where I gave vitals, Symptoms, blah, blah…. He is also throwing about 10 pvc’s a minute now”
LOLLIPOP “ok… everyone has pvc’s….”
ME “NOT AT 10/MIN. AHA SAYS 6/MIN IS TREATABLE. WE’VE CROSSED THAT LINE. HE DOESN’T FEEL WELL AND WHY DON’T YOU ADDRESS THE OBVIOUS THINGS”
Earlier today we brought in a little old lady who was having syncopal episodes to this same facility. She had these same episodes before her last AMI about 1.5 months ago. She didn’t have many complaints, but had a very “weird feeling” and an impeding sense of doom… “I just know I’m gonna die.” So, I gave report, and including her statement. The nurse smirked. Even giggled.
When we brought our second patient back today–I found out that she had in fact had a massive MI and didn’t make it.
Fucking lollipop.
2 patients from the same PD, back to back, both in custody. Who would’ve thunk…
Had a full arrest today too. Fire converted him with one shock. Sad part–he went to a ED/Urgent care clinic(crappiest one I could think of…) this morning for “racing heart” and was discharged within an hour. Went to get some lunch with friends, walked out to his car, and had a moment with death.
I smell dollar signs….. but then again maybe I should sue because of that smell…
Like most arrest patients, he vomited when he came “around” and started fighting the OPA. My catlike reflexes saved the day though…(sorry honey… had to steal your line)
We went to my favorite nursing home ever. Remember the lollipops? Pretty sure this nurse was stealing patient meds, and taking every last one. She didn’t know–or care about her patient enough to tell us why she called today… And The damn twitching… she couldn’t stop twitching… Not to mention bloodshot eyes to envy the biggest potheads I’ve seen. Here’s how our conversation started:
Me “What is going on with Bob today?”
McSatan “It’s on the paper”
Me “So… Bob, what’s going on”
Bob Blank Stare “I’m fine, she’s the sick one”
Me “ok… So I guess that your patients must take care of you?”
McSatan “What is your problem?!?! Do your job. Just take him to the hospital.”
Me “Well, I am not going to put him in my truck till I have just a vague Idea of what’s going on today… He seems fine, he doesn’t want to go, and we can’t just take him for ‘The nurse said so’ “(I even raised my hands and did the little quote gesture…)
You can see how that went… She said she was going to call my supervisor… My preceptor said…
“Ok, he doesn’t have one, but here’s the number for mine. This is his pager if he doesn’t answer” while he hands her a card.
Apparently this isn’t the first run in with Nurse McSatan. Fucking lollipops.
The race is on… 10 shifts remaining. Seems so close, yet so far away.
During my last ten shifts I want to work on:
Easy enough… I think I’ll start with finding ways to fall asleep at a reasonable time… even if my shift isn’t until afternoon…
I’m sure I’ll have something good for ya this evening… The whack jobs round here always give me enough material to be a not-so-mediocre stand-up comedian.
So my internship has been a bit slow(today was my first day since friday… went home for the weekend, checked out a potential job, and spent lots of time with the wife!) so I’ll just skip past it(besides, we had one call today. I slept for 3 hours… out of an 8 hour day shift…)
My wife and I go to the local animal shelters once a week or so… I’m not sure why. We just love dogs(obviously…). I like going and seeing new puppies/adult dogs, but it’s heartbreaking. There are so many great dogs in shelters that may never get the chance. There are dogs in there that are better to people than a lot of people are to people…(did that make sense… please say yes).
So I just thought I’d plug some dogs that could use a good home…
www.petfinder.com has lots of dogs… everywhere. Check them out.
Maybe you could help Clifford out…
Adopt Clifford!
Take the time to READ her STORY…All too many Dogs/Cats/Bunnies/hamsters/other furry friends are euthanized every day in the United States.
I get it, we have other issues at home too. We’re fighting two wars. We have people starving to death. The economy is headed for the shitter. Real estate prices are nearly at rock bottom.
But these animals are helpless. They can’t fend for themselves. It is our responsibility to do everything we can to help protect them.
If you can’t adopt one… please consider donating to your local shelter or…
If you need help finding a shelter in your area, check here: Insider Pages
I promise you… no pet is as rewarding as a rescue/shelter dog. They will teach you more about life than you could ever imagine… They also keep you on your toes…
I’ll end with ours:
The weekend(3 days!) is winding down. I’ve had a great weekend at home and we’re ready for this to be done! This weekend the wife and I met with the Manager of a local service in the outstate area. He was nice enough to spend an hour and a half showing us around town, pointing out all the fun stuff, where NOT to live, etc… It was very nice of him to take the time.
I’m really hoping to get a position there and it looks like a great opportunity for both of us! Now just to find someone who will let us have 3 dogs… maybe we’ll just say “2″ like we do now… Maybe we’re nuts!
Anyways, my computer is all kinds of f’d up right now and it’ll be a few days before we get it fixed(hopefully). My brother was nice enough to say he’d give it a go…
Anyways, less than 120 hrs of riding left to go! I’ll get back on here soon!
Sorry it’s been a few days since I’ve posted… life is a bit hectic, I’m not sleeping well and by the time I make it home each day… I’m completely spent.
I feel like I’ve been whipped with a wet noodle.
Today we had one particularly interesting transfer… We’ll keep it short. Upon arrival at the rural ICU, our PT had 12(TWELVE, 10+2, 6×2, 8+4, get it?) drips going. He had drugs to increase his BP, that increased his HR, so he had drugs to lower his HR. It goes on like this for days.
HE also had 14 primary diagnoses on his most recent dictation from his doctor… Fantastic.
On another note, did you know the bible(or at least major portions) has been translated into 2,287 languages.
On the 5a-5p critical truck (Medic/RN) then headed home for a fantastic 3 day weekend with my wonderful wife and terrible dogs… Anyone want a little monster of their own?
douchebaggery: When everyone on your squad seems to do everything they can to be the last crew to clear the hospital so that they can be most likely to get sent out to BFE… That was the story of our day.
We ran 8 calls, all code 3, plus 3 canceled calls. We switched posts 6 times. Awesome.
Things seem to be crawling along about the same pace as rush hour traffic the last few days(which is terribly annoying. Nothing makes a 12 hour shift better than starting and ending in rush hour…)
We did run 8 calls today, one AMI, the rest… well the rest were in the “taxi” category.
My personal favorite, which ranks up their due to craziness–in one way, shape, or form–are calls from PD for ETOH “complications”.
Now, I know what happens when you drink… I spent 1.5 Freshman years and 2 Sophomore years in college doing plenty of it. You drink. You do stupid crap. You wake up, you repeat.
Some people though, think this is a huge medical emergency. Others–they just don’t want to deal with our new “patient” and decide the ED is a better home for them than Detox or… leaving them alone.
Sure, drunks can’t be all out strolling the streets, weaving in and out of traffic… But they can, and in fact should be able to stay home and waste their lives away without interrupting my nap(twice). So to all the officers out their who will never read my blog… when you get a drunk–deal with him yourself. If he isn’t bleeding(spurting… not oozing… I don’t care about oozing blood), doesn’t have chest pain(not the “I don’t want to go to jail chest pain…” the real deal), and hasn’t smashed his head up(we’re talking deformities. Not bumps and bruises), please, please just take them to detox and save the hospital the money they will never be paid by broke ass drunks and us the hassle.
You’ll thank us later when your buddy gets shot and we’re not transporting a drunk to the ED to get free food and a bed, and thus we’re available to respond to your man down call.
Just remember… If you throw enough shit at us some of it will inevitably stick…
Didn’t still miss home, you’re nuts. I made it home for about 30 hrs this weekend and it was great–just too short.
I’ll get a full fledged 3 day weekend starting Friday.
Wanna Give a Shout out to EE at Bandaids and Backboards(see link left). She’s proven to be a great resource for me and I truly appreciate any help I can get to becoming a better medic.
A drunk, a nut, a lollipop and my fav–a group home patient.
The drunk had recently moved to the metro area and couldn’t seem to find a liquor store near her home(there is one 3 blocks away…) so she went to the grocery store and bought Listerine(the grocery store is actually next to the liquor store. seriously).
She decided today she needed treatment, and like all logical people–instead of calling a taxi she called 911.
The nut. She wasn’t completely crazy. Not my kind of crazy anyways. But we did a BLS facility to facility transfer for a woman who had been couped up for about 3 months at the hospital and I think she was starting to go a little nuts. And she hated the hospital she was stuck in… Best part, the doctors dictation in her chart dated today “BLANK is a 53 year-old woman who is a 66 year-old woman”. What?!
The lollipop. This is what I refer to my favorite nurses in the world as. The group home/assisted living/blah blah nurses. Wait… LPN’s. I’ve met a decent number of great LPN’s. I’ve also managed to meet a truck load of morons. Today, they made us break protocol and risked their jobs. In this state it has to be an RN to run a vent unless medics are specially trained. This truck was not a Vent truck and they were going to send a “nurse” with us. Well, the damn vent starts going off like a car alarm and he didn’t have a clue what to do. Then again, he didn’t know anything about the patient(and he was the patient’s “favorite” “NURSE”. Well, turns out he’s an LPN, and isn’t trained in vents. So WTF are you doing in my truck?
Seriously, if something bad had happened, his career, and possible the medics on this truck could have been in danger.
Go change a diaper. Sorry… I just can’t stand people who are supposed to be patient advocates that don’t even respect their patients.
When I was younger and having trouble with “fitting in” my dad came to me and gave me a plague with a pretty famous Teddy Roosevelt quote on it. It was a plaque he had gotten some time ago from the huge corporation he worked for–when they used to care about their employees.
It always meant a lot to me, and that quote has stuck with me ever since. For many reasons–but one of them has been to prove to my friends, family, and myself that I could be that man. I don’t need or want thanks, praise or admiration. I want to do my job, and do it well. Sometimes that means holding a lonely old man’s hand and taking him in for a routine checkup, and sometimes that means telling a family that their mother/father/son/daughter have died and there just isn’t anything we can do or them. And… Every now and then we get to save a life–if only temporarily.
But on to the Roosevelt quote:
“It is not the critic who counts: not the man who points out how the strong man stumbles or where the doer of deeds could have done better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood, who strives valiantly, who errs and comes up short again and again, because there is no effort without error or shortcoming, but who knows the great enthusiasms, the great devotions, who spends himself for a worthy cause; who, at the best, knows, in the end, the triumph of high achievement, and who, at the worst, if he fails, at least he fails while daring greatly, so that his place shall never be with those cold and timid souls who knew neither victory nor defeat.”“Citizenship in a Republic,”
Speech at the Sorbonne, Paris, April 23, 1910
Thanks Dad. That has always stuck with me.
Among EMS blogs and mediblogs in general is the “you don’t need an ambulance/doctor/Rx” philosophy. And truth be told–most of the people who call 911, go the ER, the Doctor, or the pharmacy don’t need the services provided by said facilities.
But, thinking a patient doesn’t need your service and saying it are two different things. In EMS we rarely get the luxury of telling our patients off. Some Docs will do it, but rarely.
This week, I had a Doc actually stand up to a pt. We picked up a frequent flyer who knows the hospitals in this county better than we do–hell, better than docs/administrators/nurses/dispatchers know them.
He has “chronic pain” which of course, can only be cured by morphine. But morphine only works when he gets atian too.
The Doc flat out, no qualms just walks in the room. “I’m out of morphine… Wait. I have a shit-ton of morphine. I’m just not going to give you any. You should feel lucky I wrote you a prescription for tylenol. Come back here again looking for drugs you don’t need and I’ll make sure you wait in triage till the last patient in this hospital dies.”
Well. He walks out while we all stand outside the door gawking –and says… “Next time make sure to remind him what I just said. And tell the secretary that if she ever gives him a room prior to being triaged again I’ll make sure she’s the last patient to die here.”
Ok… so funny went creepy. This doc might be a bit of a dick. This is one of the much smaller facilities around. But still, Docs rarely actually tell their patients they are drug seekers. They beat around the bush. You should see some of the creative dictation they give just to make sure they don’t call their pt a drug seeker.
Fuck it. I think we should brand them.
But all those posts about not needing our services were right. You don’t need an ambulance. You need a glass of water, a bandaid, 3 tylenol, a pepto, some neosporin, a hot meal and some god damn sleep. There are other places you can get those marvelous things other than the damn hospital. But if you think you MUST go to the hospital. Call YELLOW CAB.
PS… it’s f’ing cold outside.
So the time for me to venture home again is coming up rather quickly… I should be home in something like 37 hrs. That is if I can push through the crap weather up here in the upper midwest.
Seriously. I’m about to reach into the heavens, grab Mother Nature by the throat and bitch slap her. Snow one day. 70 degrees the next. WTF?
It started today chilly, ended with freezing rain, mixed with huge wet snowflakes, and to boot… There was just thunder and lighting overhead.
How dare you Mother Nature. You will pay.
Today was real damn slow. 2 calls. 1 transport. The second was a 21 yo female who was practicing Defensive Tactics (code for despite the fact that she weighed half what I did, she scared the piss out of me) who after completing training started feeling like her heart was “going to fast”.
Well, it was. 220 bpm. SVT. Hook her up to the monitor, 12 lead, O’s, and do a quick SAMPLE. My preceptor’s partner was the “lead” on this, but I was in charge. She seems slow… I wanted to do Adenosine on scene and she kinda hesitated, so we moved her to the truck, kept trying to calm her down(a little SOB, more anxious). And then I just got the Adenosine out and prepared to have at it. I started my IV, hung a bag and attached my syringe when the partner says “are you sure that’s what you wanna do?” I look up at her, partly in amazement, partly in a I wanna slap you and push you out of the back of this truck on the freeway during rush hour… and my preceptor says “Damn straight that’s what he wants to do. How about I pace your heart at 220 and see if you’d like it slowed down a little”.
I stated that Cardioversion was NOT necessary. She was stable. She just needed someone to help pull on the breaks.
I pushed 6mg Rapid IV, flushed it, and low and behold… her rate hit 95 quick as could be. Within minutes our distraught, nervous patient was joking, laughing, and enjoying her 70 minute transfer(to the best damn hospital in the world… Free slushies, cookies, sammies, fruit and more for EMS staff!(If you didn’t know this already… the “EMS room” at your local ED was the best damn invention ever..))
Other than that, I watched a lot of Deadliest Catch and some random show on True TV. And I got a good nap. Off too bed so I can prep for my 530p to 530a shift tomorrow…. and then the trip home!
Shelly over at The Eclectic Life has proven herself an incredible person once again. Last year she started working with Share a Square with a goal of making afghans for kids. This year she wants to send 140 kids with cancer to summer camp!
Obviously with a price tag of $21,000 she can’t do it on her own. She needs our help. I’m broke as all hell. But I assure you, I’ll do a little to raise some money and we should all take the time to round up a few bucks to send to her.
She’s on the up and up. A few phone calls was all it took to confirm that. Do what you can. Send what you can. Pester your friends/family/coworkers/neighbors/postman/cashier/bartender/whatev. Just take the time to check out her work and think about doing what you can for a great cause.
Sure, there are like 234,234,235,643,123,134,642,212,352.43 Trillion “good causes” out there. But when you see kids that need help–on our own doorsteps–then you realize that maybe it’s time to actually do something about ONE of those good causes.
My few days on the streets have taught me more than I wanted to learn. The hardships that people–especially kids go throuh in our VERY OWN COUNTRY is disgusting. While we need to help people far and abroad, we need to adress some issues right her that just aren’t acceptable.
No, handouts won’t fix it. But accountability will. What will you be accountable for?
Check out her blog and take the time to consider helping her help others.
EMS is one of the few career paths where other peoples’ misery makes our day interesting. As a matter of fact, it is pretty much essential to making our days complete. If we have boring calls, we are bored. Some of us are Trauma Junkies. Some love medical calls. Me, I like crazy people. Crazy people–I can relate to them. I’m just a few clicks from being off the rocker myself so crazy people are easy for me. Plus, you can mess with them…
Today we ended our shift(literally.. we were pulling into the garage and got toned out… again) with a “psych pt on the freeway”). Yes. ON the FREEWAY. Get your attention?
Apparently our lovely 22 year old passenger had fled(ran away aimlessly) from her group home(I love group homes. They supply 40%(made up statistic) of our patients. Most of them who need an ambulance about as much as I need a meth addiction.
This girl was mildly MR, but not bad. She had some depression, which is commonly associated with mild MR young adults. She said she had thought about killing herself–this was as close to a suicide gesture as she had ever made, and I’m not so sure it was intentional. None the less, she earned herself a 72 hour stay at one of the “finest” mental health facilities in the region. By finest I mean understaffed and overworked. They aren’t bright either–their ambulance garage is 500ft of winding hallway away from the ED.
Here’s where the fun starts. She states that she is 5 months preggers and due in LATE SEPTEMBER. Wait…. I looked at my preceptor, and casually asked him: “Is my math ok?” He looks up. “You’re a friggin’ math genius”. Yup… seems that our pt has planned to carry her twins–or was it quints–a few months extra. Yup. You’re nuts.
She was also the primary care provider to 3 young children from her friend who died in a car accident–or did she kill herself? Anyways. Somehow I’m not so sure that the group home has room for the 3 youngins. Whatev. I love a good story.
At least she has an excuse. Better than the uppity people we pick up who act like they weren’t drinking when then rammed that innocent pole.
Anyways–enough about crazies… more about Craziness.
Our first call of the day was for “one down, with burns”. We hear ‘one down’ as CARDIAC ARREST. Not so much. She wasn’t burned either, but that’s neither here nor there.
Apparently our mid-forties pt had just had lunch with her friends and a nice eatery in one of the burbs. She had got into her car, started to leave and apparently lost control of the car, hit a parked car… and her foot was still on the gas. This caused the front wheels to keep going till the point of starting on fire and thus where the “burns” I mentioned earlier came into play.
A bystander punched out the window(only to get himself a trip to the ED too) and pulled her out after turning off the car.
PD and FD arrived on scene about 7 minutes before us. One of our medics just happened to be at the restaurant too. He stated her BP was 240/120, she was posturing and had lost control of her bladder. Her friends said she complained of a headache.
Upon our arrival she was no longer posturing, but her BP was still 200/100. This is a scoop and go. She responds barely to painful stimuli. Not looking good.
En Route we start two 16′s, monitor, 12 lead, blood sugar, pulse ox, blah, blah, blah. I keep trying to talk to her, occasionally getting a little grunt. 10 minutes into our transfer she starts responding with coherent phrases. Appropriate too.
She can tell me she has had a head ache for a week. She has been taking Aspirin every day for it–shit. She doesn’t remember what happened at all. She can tell me everything before it happened though.
10 minutes ago I had a tube out and ready to go, and now she is holding a bucket and wants to puke. Who woulda thunk.
At that point I was dumbfounded. She presented like a classic bleed. Her history presented that way too. But bleeds don’t wake on their own. They don’t just get better.
Wrong. Her CT showed an 11mm ACA Aneurysm near her pituitary gland. WTF. They planned on going in and coiling it(spring to open the vessel).
Yup, one of those days.
So Today was a day that I can bet won’t ever repeat itself. At least that’s what I’m hoping.
It was really a pretty slow day. 8 hrs, 4 calls, nothing serious–well, that depends on your definition of serious. Calls 1&2 were run of the mill.
Calls 3&4… Well, they make me wanna hurl.
Dispatched code 3 to an Elementary School–on a psych. 11 year old girl who wanted to kill herself. She has made suicide gestures, had a plan(posted on myspace.com) and was very, very depressed. She’s FUCKING 11 YEARS OLD! What the hell is going on here? What happened to 11 year old girls playing dress up, house, reading cute books with pink covers and harassing little neighborhood boys?
To make it better, Dad(the sperm donor) could care less and wouldn’t be coming to the Hospital. Mom–well, she’s in prison–obviously more part of the problem than the solution.
Her aunt is the only one who seems to care enough to come… So she’s getting checked into a Pediatric Psych unit on a Mental Health Hold and she’s all by herself. Why do I see this ending badly. Maybe not today, or tomorrow, or next month. Eventually though the system will be done failing her and One of us will get to scrape her off the floor somewhere.
Absolutely disgusting.
Call 4. Code 2, same god damn school. Apparently they have a hold on the niche for kids with overwhelming psychiatric issues.
This one is 10. Yeah, that’s right. 10 god damn years old. He is “diagnosed” (by an overwhelmed, over-eager family practice Doctor, no doubt–not a psychologist or psychiatrist(Don’t get me wrong. I love doctors. They are smarter than me. But Family Practice doctors have as much business diagnosing and treating mental illness as I have treating cancer)) with ADHD and Oppositional Defiant Disorder(my fav… so he doesn’t like authority… find me a kid who DOES).
He decided teacher was pissing him off, so he kicked, screamed, bit, clawed, spit and threw a chair at him. Then the principal. Then PD.
I told him he had to go with one of us. Either with us in the ambulance with cool toys or the Police car with Handcuffs and a spit hood. He calmed down(like most people do when confronted with this situation) and walked out with us. Mom was no where to be found. She is an aide at another school in the district and was on a “personal” day. PD and school staff tried to locate her at home, friends, family. No luck.
One of the more memorable parts of that call–asking if he knew what meds he took. Benedryl. Every night. What could that be for?!?!?! Hmm…. Good Night.
What are our kids being thrown into psych facilities so often now? Case 1 was legit. She needed help. Case 2 needed parents who actually parented. We are failing our kids. We’re failing the future. I’m actually scared out of my mind about it.
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Sorry I didn’t post over the weekend… Tried to enjoy the 24 hrs I was home with my wife and monsters. Today was a long day, running on about 2 hrs of sleep. We didn’t have any real “exciting” calls… but we did have one giant P.I.T.A.
Apparently this was her 3rd(THIRD) ambulance ride in less than 8 hrs. She called because she slept with her contacts in and her eyes were burning… but wouldn’t take her contacts out.
Step One: Remove contacts.
Step two: Rinse with Saline.
Step Three: Rinse more.
Step Four: Use some friggin Visine.
Or at least that’s how they do it where I’m from…
Her version:
Step One: Call 911
Step two: Scream, bitch, complain.
Step Three: Arrive at Level 1 Trauma Center–TRIAGE.
Step Four: Get Kicked out of Level 1 Trauma Center for being a PITA.
Step Five: Call 911.
Step Six: Repeat, accept this time walk out, because she had to wait too long.
Step seven: Call 911.
Step Eight: Demand to be taken to the Other Level 1–County.
Step Nine: Flip out when taken to Triage and DEMAND a “Trauma Room”.
Step Ten: Piss off triage nurse and get ignored for 5 hours.
Apparently she didn’t like that we nor the hospitals didn’t give her anything for the “pain”. She then called 911 again, but thankfully from the proper side of the street, so as to allow County to pick her up this time.
Don’t worry though. She won’t be out of her pocket for any of those Code 3 Responses… WTF was dispatch thinking? Code three–the same dispatcher toned out all 3 of them…. Hadn’t he figured it out by then. I get that CAD helps dispatchers a ton… but does that mean they can’t think on their own anymore?
Rounding down the last 3 hrs of this shift. Then, speeding home and spending the weekend with my wife.
Hopefully the puppies will allow SOME sleep.
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