THIS was my kind of week, chock full of flashbacks back to my fire department days. I mean, here were some of the classes I had this week:
Trauma (neurological)
Personality Disorders
Alcohol/Nicotine/Drug Abuse x2
Toxicology
Legal Issues
I easily saw all of these issues during a single shift. In particular, I saw all of these during one crazy call out to a MVC (motor vehicle collision).
It was really bad. Officers had marked off the scene by the time our bouncy box of flashing lights and sirens had painfully navigated past lines of jammed up traffic. I jumped out with my bags ready to go at the end of the scene closest to me ready to go, but instead of a car all I saw were tire tracks. They kept going for a while, then I saw a row of orange road medians destroyed as if Autobots and Decepticons had a big fight here. Finally off in the distance I saw the car with the wheels in the air, and realized what had happened.
Brakes slammed on at first, then one side of the car used the highway medians as a ramp, and rolled over in the air like a dolphin spiraling through the water as if doing tricks at Seaworld.
Coup, then contra-coup injury, when her car finally crashed into the pavement. It's French, and describes what happens to the soft squishy brain when it gets smacked around in a hard box. Coup- the front gets bashed as the body slams into the steering wheel. Contra-coup- when the BACK of the head rebounds just like a basketball off the edge of the hoop, but into more skull.
Trauma. Check.
I won't bother you too much with the boring stuff. Firefighters using Jaws of Life. Making sure the car would not blow up on us into a nice fireball. Carefully extracted a lady. Maintained c-spine. Quick trauma assessment. Load and go. Lined her up.
What was interesting was what happened in the back of the ambulance, just the two of us, flying towards the nearest trauma center. First, nothing my patient said made any sense at all. She looked like an intelligent, attractive professional, so I thought maybe it was another language. A little slurred. Leaned in and took a sniff. Yep, alcohol.
Alcohol/ Toxicology? Check. (To my med school peeps- brief Wernicke's area disruption too?)
So for the rest of the call, I did my medical thing, and kept checking in on my patient. Slowly, she seemed to come back, through the mist of all the chaos that had just happened. Then it got really strange.
Thank-you-thank-you-thank-you-thank-you-AH WHAT THE F@#$# is HAPPENING TO ME? She kept sobbing in gratitude, but then completely spaz out and open a can of whoop-ass all over me.
The only thing I can think of now that describes that is if she had a borderline personality disorder. I'm still not sure. Maybe it was the stress of, oh I don't know, launching her car into the air, seeing the world spin around her as phone flew through the air.
Personality Disorder? Maybe check.
Anyway, sorry this flashback did not end with a bang like the last post. I've got finals coming up, and I think I'm forgetting old memories to make way for all the stuff I am learning now. I assume we all made it to the hospital okay.
Oh almost forgot, as I was doing the rapid pat-down that is the focused trauma assessment earlier, I peeked into her ear and some plastic fell out. Huh. What's left of a bluetooth set. Too bad a cop was right next to me, and checked her phone. Yep. Texting right around when the crash happened.
Legal. Check.
(Some fictionalization. HIPPA. Duh.)
Friday, June 18, 2010
Thursday, June 10, 2010
Friday Flashback
I need something to keep me sane. Whenever exam week comes around, my brain does this weird paradoxical dump. The more information I shove in, the grey matter poops out weird things. Sometimes it's notes to a song, other times it is material for this blog. If it gets really bad, I start thinking of ideas for our school's-annual tradition-that-shall-not-be-named. But for now, here is what happened when I stay up past midnight reading about street drugs. I start taking some. I'm kidding. But I write as if I did:
We had a nice lecture on street drugs this week. Our professor talked about Narcan- a drug that basically brings you back to reality if you have overdosed on certain drugs. The trick is that you have to give it slowly, or else it reverses the high way too fast. Fast enough that the patient becomes a little...well annoyed is a nice word.
Three years ago...
I was scared out of my mind honestly. My patient was sitting up on the stretcher eyes wide open as if I was the devil. I had just finished my training as an EMT-I and was alone in the back of the ambulance while my paramedic partner sped our ambulance down the highway. First day on the job. What do I get? A suspected drug dealer who was probably doing some of her own goods. We found her responsive only to pain, loaded her up, and started some IV's. Without thinking I prepped the Narcan, and just popped it in. Bam. As my partner turned on the lights and sirens and started to head to the hospital, my patient started to stir.
Cool I thought. Pharmacology at work. The nerd inside me was kind of excited. Well it was excited until the patient sat up and stared at me as if she was possessed. Then she started to panic. I had no idea what I was doing by that point. "Um...you should probably relax..." I mumbled while my brain froze. Froze some more while the patient started to yell and take off all of her restraints.
"Umm...ma'am...let's not do that..." I can't remember why but I stood up in an ambulance zooming down the highway at 80 mph, and tried to push her back into the stretcher. Not a good idea to tango in the box at that speed.
Then it really went down hill. "LEMME GO YOU MUTHAFUCKAGETMEOUTTATHISSHIT-"
And that's when she actually opened up the backlatch of the ambulance, and suddenly I saw the surprised look on the driver behind us. I don't know about you, but I totally see the insides of an ambulance while it is flying down the highway everyday.
"JESUS CHRIST. What the fuck is going down back there?"
Luckily years of experience told my partner NOT to slam on the brakes. Or else I would be posting this post from a hospital bed. (But now I realize ambulances really don't have emergency lights- you know the the red triangle you push that flashes all of your blinkers. Kind of redundant, no?)
Anyway, after I nearly tackled the patient to keep her inside of the moving vehicle, we finally rolled to a stop on the side of the highway. Let's just say I learned some interesting knots that night.
Later in the hospital break room, my partner THOROUGHLY educated me. Life lesson of the day: Narcan needs to be giving SLOWLY, or else you have one pissed off druggie.
(standard fictionalization applied to protect privacy)
We had a nice lecture on street drugs this week. Our professor talked about Narcan- a drug that basically brings you back to reality if you have overdosed on certain drugs. The trick is that you have to give it slowly, or else it reverses the high way too fast. Fast enough that the patient becomes a little...well annoyed is a nice word.
Three years ago...
I was scared out of my mind honestly. My patient was sitting up on the stretcher eyes wide open as if I was the devil. I had just finished my training as an EMT-I and was alone in the back of the ambulance while my paramedic partner sped our ambulance down the highway. First day on the job. What do I get? A suspected drug dealer who was probably doing some of her own goods. We found her responsive only to pain, loaded her up, and started some IV's. Without thinking I prepped the Narcan, and just popped it in. Bam. As my partner turned on the lights and sirens and started to head to the hospital, my patient started to stir.
Cool I thought. Pharmacology at work. The nerd inside me was kind of excited. Well it was excited until the patient sat up and stared at me as if she was possessed. Then she started to panic. I had no idea what I was doing by that point. "Um...you should probably relax..." I mumbled while my brain froze. Froze some more while the patient started to yell and take off all of her restraints.
"Umm...ma'am...let's not do that..." I can't remember why but I stood up in an ambulance zooming down the highway at 80 mph, and tried to push her back into the stretcher. Not a good idea to tango in the box at that speed.
Then it really went down hill. "LEMME GO YOU MUTHAFUCKAGETMEOUTTATHISSHIT-"
And that's when she actually opened up the backlatch of the ambulance, and suddenly I saw the surprised look on the driver behind us. I don't know about you, but I totally see the insides of an ambulance while it is flying down the highway everyday.
"JESUS CHRIST. What the fuck is going down back there?"
Luckily years of experience told my partner NOT to slam on the brakes. Or else I would be posting this post from a hospital bed. (But now I realize ambulances really don't have emergency lights- you know the the red triangle you push that flashes all of your blinkers. Kind of redundant, no?)
Anyway, after I nearly tackled the patient to keep her inside of the moving vehicle, we finally rolled to a stop on the side of the highway. Let's just say I learned some interesting knots that night.
Later in the hospital break room, my partner THOROUGHLY educated me. Life lesson of the day: Narcan needs to be giving SLOWLY, or else you have one pissed off druggie.
(standard fictionalization applied to protect privacy)
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