Monday, March 15, 2010

Car in brook

Amongst other calls yesterday was this one for a 'MVC rollover, car in the brook, occupant trapped'. He was indeed in the car (and still is in this picture) and couldn't get out. Electronic doors wouldn't open and the patient couldn't smash the windows. Quite an impressive launch off of the 10+ foot riverbank I would imagine. Very, very lucky not to have done any harm to himself. Score another one for seatbelts and airbags !

Friday, March 12, 2010

Cruel and unusual...

A circumstance arose today which presented us with such a challenge that we weren't sure how we'd all be able to overcome it and make it through the day. Yep, the Internet was down at the station. Now between calls we'd have to do something ELSE. Like read a book or whatever.

Turns out it wasn't going to be an issue as I spent most of the day with calls timed perfectly to allow just enough time between each one to complete my paperwork and be halfway through eating or drinking something. At one point there was a collection of coffee cups in the front of the ambulance that would have made Starbucks proud.

Still, highlights include a 60yom with chest pain. He got the full MONA workup - Morphine, Oxygen, Nitro and Aspirin. Despite the lack of findings on his EKG, I was still worried about him. He was in a lot of pain, but also seemed 'preload sensitive' - which is to say I was afraid to give him too much morphine and drop his blood pressure precipitously.

Next up was a psychotic drug addict who was in treatment but hadn't been dosed today as he managed to fall asleep at the wheel and roll his car on the highway. We didn't get called for the trauma - he'd already made it home by this point after signing out AMA - but what his counselor felt was odd behavior 'on the phone'. I love how mental health professionals can diagnose potentially life threatening conditions over the phone and use 911 to summon EMS, despite being unable or unwilling to get involved in actually COMPELLING the patient to go. Leaves us with a delicate and often lengthy negotiation with the patient to persuade them to be transported and evaluated. Then to roll into the ED after all that hard work and have the charge nurse give you that 'what the hell' look just caps it all.

Lastly a gentleman who had managed to fall on his ass. Literally. From about 3 feet up, straight onto his coccyx. Just from the howls and vomiting, he wasn't making this up and got as much in the way of narcotics as I can give him without calling in for more. It's a rare day when I get to crack the seal on the narcs box TWICE.

Thankfully no calls overnight as my work schedule is beginning to wear me down. Off to the next job....

Tuesday, March 09, 2010

Little life

Once in a while a call will come along that reinforces the great privilege it is to be a Paramedic - to be thrust into the maelstrom of terror and confusion that is someone's emergency - and to deliver compassion, hope and care. To be trusted.

Car accidents have this potential for chaos from order. One minute everybody is riding along, listening to their favorite tune on the radio, and the next their metal cocoon is reshaped and redefined as something else entirely. Bits of glass, bits of bumper, mud and grass litter the road.

Last night the damage was minor, though the potential for great harm was only inches away. Catastrophe avoided. Three lives changed but not ended.

When we roll up, the female driver is in cuffs in the back of the squad car. The backseat passenger, an equally drunk and equally stupid male, stands a few feet away attempting to console a terrified two year old girl - the third passenger in the car and instantly my focus. She had been in her car seat, the straps had been on and no harm was visible. Her cries were for her mother, face pressed against the glass of the police car, close but yet far away.

I get angry at such displays of stupidity. To drive drunk (even drinking IN the car) with your beautiful daughter riding in the back. It defies belief. I shudder at the thought that such a precious life could have been ended by selfish indulgent adults, though I know it happens sadly all too often.

Still, we do our job. It soon becomes clear that the guy charged with holding on to our tiny patient is in no way related, completely drunk and wholly incapable of anything that could be described as care. He doesn't even know the little girl's last name. Hell, he doesn't even know his GIRLFRIEND'S last name. Jackass. He boards the ambulance as we load the child into her carseat strapped to the cot, but quickly gets turned right around again and ends up back on the street.

A short ride to the hospital with our distraught young patient, and the ED staff appear a bit confounded as to what to do. No family is available. While the Police assure us that DCFS has been called, they aren't here. No relatives have been found.

I pick up the little girl, hold her like I did my own daughter when she was that little. Rock and calm her until her sobs subside and she rests her head on my shoulder. I feel protective - I'm not ready to let her go to another set of strangers. We help the ED staff get her changed, assessed and examined, all the while I'm watching over and comforting her like my own scared child. When they're done I scoop her into my lap and rest her head in the crook of my arm, singing her songs I haven't sung in years until her tired, swollen eyes close and she slips off into a restful sleep.

At this point nothing else matters. I feel a calm and a sense of love for another human being that fills me up. All the BS calls and heartache of EMS disappear in this one pure moment where I can offer my patient nothing more than a safe, comfortable place to sleep.

It takes some time to locate a relative who can come get her. I spend it watching her breathe, feeling her warm little body wrapped up on my lap and hoping that her future will be brighter. That someone will care. That someone will take this huge responsibility seriously.

When it's time to give her up, it's hard to let go. In the space of a few short hours I've become attached, my emotions bound to her well-being. It's hard to imagine her ever being put back into the arms of the people that put her, alone, into my ambulance and my care. I can only hope (and this against big odds) that this will be a wakeup call for her mother, and that she will realize that she came close to losing such a precious, wonderful life.

Safe travels, little one.

Saturday, March 06, 2010

A good day

Had one of those calls today that makes you really happy to be a medic, and leaves you feeling like you made a difference.

We had a walk in at the station for a 35 year old woman with nausea, vomiting, diarrhea. This had all started at 7am very suddenly and she had been going at one end or the other constantly for several hours. Normally not such an emergent issue, but the patient was a diabetic and multiple transplant patient, so her situation was very different. Possibly one of the harder IV sticks I've ever had to make, but clearly a patient who needed IV fluids and meds quite badly. I ended up getting a 22ga in a vein on her finger. A first for me, but it was patent and flowed well. Some zofran (love that drug), D50 and a fluid bolus got her back into a much happier place. I later found out from the ED nurse that they had continued to use my sketchy little 22ga for the rest of the day and given her another 2L of fluid through it. Nice ! After lots more antiemetics, fluid and some fentanyl she was stabilized. Her labs revealed some pretty major metabolic derangements, so she'll be admitted for IV therapy and observation.

Bummer

44 yom with hypertension and a previous history of stroke (after uncontrolled hypertension). Not much I could do for him really. What a sucky thing to deal with at that age.

29 yom with bleeding from 'down there', which in my esteemed opinion was as a result of overzealous prescription of steroids for a shoulder injury the week before. Really underscores the point how strong this type of drug can be, and while it can work wonders on some things it can also be very destructive to other parts of your body (especially the GI as in this case).

Saturday, February 27, 2010

Good Friday

Well, for me anyway. Good to be busy, not so good for my patients. Start the day with a DIB that turns out to be a rapid AF, chest discomfort. FOUR people on the ambulance today - way too many - makes us look like the Keystone Cops all piling out at the scene. Still, sometimes with larger patients more hands makes light work.

Second call for a 'suspected' untimely. Cold, very dead and asystole in two leads. I hope she went peacefully, and sometimes I wish people would call earlier and not suffer through something expecting it'll go away.

Round out the day with a pair of patients who were getting by during the snow fuelled power outages with a gas generator. Guess what ? CO of 80ppm in your house from the exhaust getting in through your vent will not have a good outcome. Fortunate that one of them got outside and passed out, prompting the other to call for help. Could have had a VERY different outcome.

Tuesday, February 23, 2010

Looooong transfer

Somehow I got roped into doing a transfer to a hospital in NYC. Left the station at 8am, drove to the hospital to get our patient and then drove 263 miles south. Fortunately the traffic gods (not to mention the 250k mile engine gods) smiled upon us, and we made good time. It's definitely a different experience navigating both the streets and the hospitals in New York City. Not one that I think I'd like to experience on a daily basis - so I take my hat off to those that do.

After spending a half an hour and several incorrect direction assists later, we finally find out where we are supposed to go and thankfully deposit our patient in his room. As we leave he gives me a pleading look and says 'Please - take me back with you..'. I'd say if I were in his position, I wouldn't have wanted to stay there either.

Anyway, no sightseeing for this crew as we get the hell out of Gotham as fast as possible with only a small delay on the Bruckner Expressway. I always breathe easier when I'm outside city limits, and even easier still once I'm north of Massachusetts.

My back was absolutely killing me after 10 hours sitting in a crappy, cramped, broken ambulance seat. Remind me never to agree to this kind of thing again.

Friday, February 19, 2010

A busier day...

Started the day right off with a call for 33yom diabetic pt, unresponsive. When we arrive on scene, turns out that (a) it's a woman (b) she's AOx3 and (c) her husband called 911 back to report her BGL was now up to 66 and we could be cancelled. Shows how often things get lost in translation.

Later in the morning dispatched to a 30yom seizing. Arrive on scene to find a guy crumped on the floor by the door, reportedly seizing for around 30 mins. No obvious IV access, so 2mg of Versed IN. Backboarded and into the ambulance, eventually get a line and off to the ED. Love the MAD !

Went to bed early since I have to work tomorrow, and sure enough get woken up around midnight to a 60yom with chest pain. Turns out he's a frequent flyer with a long med list and history whose biggest problems appear to be anxiety. A sign off.

To round out the day, called for lift assist for an elderly man who'd fallen out of his chair. Back up he goes, in time to catch the Olympics on TV. Now back to bed...

Tuesday, February 16, 2010

Day 5

Weekend 24. Not a whole heck of a lot. While everyone else is digging out from 'snowpocalypse', we have barely a flake. Just one call for an 83yo lady with possible TIA.

Hope things pick up in the spring, because the tedious monotony will kill me.

Thursday, February 11, 2010

Nada.

First 24 hour shift yesterday. I think I must be bringing my white cloud, because we didn't go anywhere. All day. All night. Nothing. There are only so many time you can wash a truck, check and stock. This makes 60 hours in a row between this and my other job without a SINGLE call. I hope and pray it changes before I go out of my mind...

Thursday, February 04, 2010

Day 3

First time on as solo Medic today. Bit nerve wracking, but I'll get over it. Yesterday was a no call today - learning that it's OK to sit around and do nothing (unlike my FD job where there's always something to do)

49yo female MVC rollover on an icy back road. Managed to take out a mailbox and roll it into a snowbank without a ton of vehicle damage. Signoff.

14 month old difficulty breathing. Cute kid - some congenital heart problems. Bit of a pucker factor on the way to the call, but he ended up being easily manageable and quite compliant.

86yo male with unilateral weakness. FAST was negative, he has alzheimers so it's kind of hard to get a good history out of him since he has lower extremity weakness to begin with. Then again he has a history of TIA so better safe than sorry.

Fairly busy day in an 8 hour shift.

Monday, February 01, 2010

Day 1

Getting to know the rigs, what is where, which ambulances work better, where all the good drugs are and how to get at them. How all the monitors work (God how I hate Zoll monitors).

Intercept for a BLS crew who thought their patient was tanking. Turned out that nothing really emergent was going on, but hey - it got us out of the station.

Call to the boonies for a 25yo female patient with psych problems who got into an argument with Mom and was afraid she'd get out of control. A long ride to the hospital.

A short and relatively mellow day that thankfully flew by.

Sunday, January 07, 2007

Return

I hadn't even looked at this blog in a very long time, so I was happily surprised when I returned to it and read my old posts.

In this day and age, the habit of keeping a diary is one that few people maintain. Reading my own thoughts as a retrospective is cathartic - it helps to put time into a measurable perspective. Maybe life isn't flowing by me at a chaotic pace, after all. Something tangible - lasting, even - happened in the months past that I thought were lost....

There once may have been an expectation of 'audience' when publishing thoughts to a public space such as this. What I realize now is that it is as much a conversation with myself in formulating a thought and expressing it in writing. That's not so bad. What I have discovered in reading these old thoughts anew, is that the audience is really ME. Kind of like talking to yourself on a crowded bus. Sort of.


(I don't really mind if anyone else happens upon it, and if you do find yourself here, feel free to leave me a comment)

Sunday, August 06, 2006

Monday, January 30, 2006

How DO you find the time ?

To all and any who care (and this list is small and limited) I have been a bit absent lately, I know. In my defense, I have been a tad busy. I have also been a tad unmotivated to put virtual pen to paper. Work, life, house, EMT class, kids, house, life, EMT class, ambulance calls and firemans balls. Busy, busy, busy.

I admire all of you who find the time and the inspiration to write something more than just a few paragraphs of drivel on a daily basis. I doff my cap to you, I do.

In big news, tomorrow is my 'naturalization' interview. It's where I get to find out if I'm eligible to join the club of American Citizens. Could be a big day. I'll let you know.

Now I'm off to be busy again.

Monday, January 16, 2006

No bones about it

I have a new found respect for all those in the medical profession.

I'm in the process of reviewing anatomy for my EMT-B Class, and let me tell you - there's a LOT to know. The amazing thing is that I'm not even scratching the surface - we're only learning the real basic stuff. My naturally inquisitive nature often wants a bit more perspective, so this handy web reference certainly gives that. It's then that you realize just how much STUFF your average med student and/or doctor has bouncing around in their noggin (and how many bits there are inside this fleshy bag we call a body).

Of course, they also have to remember all the OTHER stuff, like diseases and ailments, medications, procedures and such. It's no small wonder that medical school takes so long. It is a small wonder that so many people make it. God bless 'em.

Still, with all that knowledge it still ticks me off when I'm sick. After two weeks of suffering I finally drag myself to the doctor (or more correctly, my wife made me go). Expecting final relief after my period of stoic suffering, I'm disappointed to discover that it's probably viral and that I should 'take 4 ibuprofen' when I need them. Er, thanks - I already figured that one out.

Anyway, today is now officially 'Hug a Medical Professional Day'.

Oh, well, it's actually Martin Luther King, Jr. Day - so maybe tomorrow ?

Wednesday, January 11, 2006

Surrender

So, I gave in.

For the first time EVER, I have allowed another carpenter (dare I say a PROFESSIONAL Carpenter) to work on my house.

I think I've just reached the point where I really want stuff to get finished, and I'm tired of doing it myself. I made a valiant effort with the porch - I got the thing 80% done before snow and had a roof on. I spent countless days nailing and finishing the floor. I spent cold days up ladders nailing on trim.

I have exceeded my personal budget of enthusiasm, and when the opportunity arose for a friend of mine who is a carpenter to spend some time on it, I gave in.

Now, I can safely say that there is NOTHING quite so nice as sitting on the couch and hearing the sounds of someone else sawing, nailing and banging away.

Still, I'd better not get used to it. My wallet can't take this kind of luxury for too long....

Thursday, January 05, 2006

Nicole Kidman !

So, I did not see Nicole Kidman today. I had no brush with stardom.

I'll admit that I'm quite fond of Nicole. I think she is a very attractive woman, and a good actress to boot. I loved 'The Interpreter'.

So, I was a bit sad to hear that she was here in our teeny little town, hanging out in our teeny little coffee shop (Green Tea with Jasmine, apparently, in case you were wondering), mere yards from my upstairs office space. I missed out.

Oh well. Next time. Wonder how many Google hits I'll get from people searching for 'Naked Nicole Kidman Pictures' ? Oops.

Sunday, January 01, 2006

Happy Hangover

For all those who, unlike myself, partied long and wild. Happy New Year !

There will be a year when I stay up past 10 O'Clock. Maybe when the kids are older. Then again, maybe I'm just not cut out for the job of drunken reveler. Some of us just don't have it in us, I guess. There's always the sensible one in every crowd, and maybe I am that person.

Oh well. Happy Hangovers to all the people that carried out their duties and partied hard for the rest us.

Thursday, December 22, 2005

It's all uphill from here

The Winter Solstice is here ! Things aren't as bad in Vermont as they can be in other parts of the world, where the sun barely makes an appearance during the short winter months and people go nuts without daylight. Still, it gets pretty cold and wintry and it is nice to know that you are headed (theoretically) for Spring.

Last night some friends of ours threw their first (annual) Solstice Party, which was a lot of fun. Part of the festivities included a nighttime snow shoe hike. Since they live across the street from our neighborhood ski resort, we started off straight up one of the runs to the top of the hill. About five minutes in I wished that I hadn't started the second beer a half an hour before, and another five minutes after that I began to regret having layered up for the Arctic cold (I should point out that the windchill was forecast to be 5 degrees F or -15 celsius). Rather than suffering hypothermia, the opposite was starting to be true and I was dying of the heat. Despite all of this, I managed to drag my ass up the remainder of the hike, briefly enjoy the pristine hilltop view, and then slither back down the hill.

As a demonstration of how bad this made me feel, I wasn't able to drink another beer for at least 30 minutes.

So, a lesson learned. Don't overdress, since it's just as bad as wearing too little. I guess I could have stopped to de-layer, but once you've got your groove on (and your teeth are gritted), there's just no stopping.

Nevertheless, a great thing to do on the solstice, and hopefully a winter tradition.