I've taken a two week hiatus from my main EMS job, to sit back and finish up med school apps. Worst decision ever.
I essentially fell into this slump, where I caught up on sleep, let my family know I'm still kickin', and became homeless for a week (interesting story there). However, I did not get any work done, other than surf a crap-ton of medblogs on a wild-goose chase for any advice on how to wrestle with my apps.
Only when I jumped a call this morning did I realize I've been floating along, only half awake. I will hopefully be back in action tomorrow. For now, I am running Incident Command for the C-USA baseball regionals. The cot I set up next to my laptop is starting to smell like burgers and fries. Mmm yum. No patients, please.
You are a Sock. A funky personally quiz declared my existence as 100% cotton-weave. I thought it was an appropriate name for this blog. Socks go in haphazardly into my drawer, which is also a place for me to stick stuff. Dr Au describes it best:
Because your your underwear drawer is where you stash all your demons. All the private stuff that you don't want your parents to find. All the embarassing stuff that you jam all the way to the bottom right before your new boyfriend comes to visit. All the private valuables from your adolescence that you might find years later (tucked away under that dingy pair of granny panties that you never wear but keep around for contingency), the significance of which, years later, you can barely remember.
"http://theunderweardrawer.homestead.com/files/00-10-27.html"
Agh. Do you see how I've fallen into the dark side?
Friday, May 30, 2008
Saturday, May 24, 2008
Code Blue
Well. Last post up until now, the volunteer ambulance service I ride with fielded fairly routine calls, more medical cases than anything. Nothing really exciting or crazy.
I was waiting for a chance to...do something crazy. Save someone's life. Work a code.
Earlier this morning, I got my wish. Damn it...I wish it never happened.
It was actually a light Friday night, with several refusals and nothing close to my usual weekend crap-fest of calls slammed right after each other. I had dinner with the rest of the firemen, and relaxed while the others moved the ambulance and fire engine out into the street in order to play street hockey in the bay.
A nice normal night.
At 0145, we had a call for respiratory distress. Again, still normal considering the change in humidity and weather lately. Wooweewoowee bright flashing lights, zooming down the narrow road dodging idiot drivers.
We get on scene to find a gentleman with a mouth and tongue swollen up to Jabba-the-Hut size. He could still talk, with a odd high pitched tone. None of the firemen or us EMT's did anything on scene; instead, we walked him over to the ambulance.
Mr W, my paramedic supervisor asked me if I could handle this call. (Usually the supervisor can jet in their Crown-Vic responder cars, in order to be ready for the next call if he felt the two EMT's could transport a non-emergent patient without any complication.) I thought about it for a second. For the last couple of shifts I had always asked the paramedic to ride in since I am normally very over caution about everything. I looked at the pt, who was settling into the stretcher, who didn't look too agitated. Maybe I can finally just own up and take care of patients myself instead of defaulting to a superior. Maybe I could grow some balls.
"I've got this one, W. Don't worry about it." Mr. W looked at me, then back to patient. Our student was hooking the gentleman up to reserve oxygen, while my partner jumped into the driver's seat.
"I don't know. He is having a bit of respiratory trouble. I'll ride in," Mr W decided. I hook our pt onto the cardiac monitor, and tried to help Mr W start a IV.
Everything started to go downhill.
Mr W. couldn't get a line going. Our gentleman started to flail about. It took me absolutely too long to realize what was going on.
I looked at the monitor to see our pt's oxygen saturation drop. Drop. Drop. 95-100% is great. 90-95% Means something is seriously wrong. Any thing less means I get to shove a tube down your throat to force air into you. Your fickle body will probably be unconscious as well.
82%
63%
Our patient was flailing because his throat had swelled shut with his tongue so huge it was choking him.
We didn't have a line in. No IV benadryl or epi to slow down the reaction. I threw a dose of benadryl to Mr W, who stabbed the patient with a IM needle to deliver the drug into the muscles in his shoulder. Piss poor absorption. This man is going to die soon if we didn't do anything.
Our patient went limp. Blood oxygen saturation at 20%. His heart threw in the towel and the monitor flatlined.
Our student looked at me, then at Mr. W, unsure of what to do.
"START CPR NOW. FORGET THE DIVERSION, MR G YOU ARE TURNING THIS AMBULANCE AROUND NOW." Instead of heading to a hospital across town because they had our patient's records, we now were ripping down a sleepy road to the nearest hospital that was already on diversion for critical ER saturation. Our patient's life was literally draining out of our hands with every second we wasted on the road and NOT in a ER.
I frantically tore open compartments, looking for a bag to force air into my patient's lungs. WHY WAS EVERY BAG-VALVE-MASK PEDIATRIC SIZED?!?! The flustered student was pumping down on the patient's chest entirely too fast and too shallow, while I finally slapped together an adult BVM. I threw an Epi-Pen at MR W, who struggled to cut open the pt's pants, then stabbed the Pen in.
My God.
Thank goodness we were only several minutes away from the closest hospital. Those minutes were the most agonizing of my entire life. I tried so hard to bag our patient with one hand, but the whole endeavor was like trying to drive 80 mph down a freeway with one foot on the pedal and the attached knee steering. I am not joking. You need at least four hands to successfully bag a patient, I only had myself.
I felt like an utter failure.
We flew into the ambulance bay, and of course, the stretcher just HAD TO RUN OUT OF POWER as we tried to unload the patient. God damn battery powered stretcher. It saves us from breaking our backs trying to carry a 600 pound patient, but tonight my student STOPPED CPR in order to unjam the stretcher. ARGHHHHH NOOOOOOOOOOOO.
We finally wheeled our patient into the hands of a waiting ER team, and the began to do real CPR and pump the gentleman full of drugs. Maxed out on Epi. Threw in bicarb and D50.
During the entire scene described above, I was not scared nor freaked out. A weird detached calm blanketed me, my body was in automatic mode. Well, at least until I saw the patient's brother, sitting in a chair around the corner. Scared, uncertain eyes locked mine, until I forced my self to look away. Suddenly a flood of emotion rocked my body, all the way through my sweat-filled gloves. If the ER doc running the code didn't succeed, this man was going to lose a family member.
With the ER team in controlled chaos trying to save the gentleman's life, we EMT's were suddenly useless, so I waited outside while Mr W transferred the last of our patient data to the scribe. I stood outside with Mr G (my partner and driver for this night) and our student. After a minute I couldn't take it, and peeked back into the room. Seconds later, the nurse pounding the CPR stopped, and everyone relaxed a notch. Spontaneous heartbeat. Soon the gentleman was breathing on his own again.
Everyone involved was credited with a CPR save. "We" all worked together to save his life.
I don't know any more.
I was waiting for a chance to...do something crazy. Save someone's life. Work a code.
Earlier this morning, I got my wish. Damn it...I wish it never happened.
It was actually a light Friday night, with several refusals and nothing close to my usual weekend crap-fest of calls slammed right after each other. I had dinner with the rest of the firemen, and relaxed while the others moved the ambulance and fire engine out into the street in order to play street hockey in the bay.
A nice normal night.
At 0145, we had a call for respiratory distress. Again, still normal considering the change in humidity and weather lately. Wooweewoowee bright flashing lights, zooming down the narrow road dodging idiot drivers.
We get on scene to find a gentleman with a mouth and tongue swollen up to Jabba-the-Hut size. He could still talk, with a odd high pitched tone. None of the firemen or us EMT's did anything on scene; instead, we walked him over to the ambulance.
Mr W, my paramedic supervisor asked me if I could handle this call. (Usually the supervisor can jet in their Crown-Vic responder cars, in order to be ready for the next call if he felt the two EMT's could transport a non-emergent patient without any complication.) I thought about it for a second. For the last couple of shifts I had always asked the paramedic to ride in since I am normally very over caution about everything. I looked at the pt, who was settling into the stretcher, who didn't look too agitated. Maybe I can finally just own up and take care of patients myself instead of defaulting to a superior. Maybe I could grow some balls.
"I've got this one, W. Don't worry about it." Mr. W looked at me, then back to patient. Our student was hooking the gentleman up to reserve oxygen, while my partner jumped into the driver's seat.
"I don't know. He is having a bit of respiratory trouble. I'll ride in," Mr W decided. I hook our pt onto the cardiac monitor, and tried to help Mr W start a IV.
Everything started to go downhill.
Mr W. couldn't get a line going. Our gentleman started to flail about. It took me absolutely too long to realize what was going on.
I looked at the monitor to see our pt's oxygen saturation drop. Drop. Drop. 95-100% is great. 90-95% Means something is seriously wrong. Any thing less means I get to shove a tube down your throat to force air into you. Your fickle body will probably be unconscious as well.
82%
63%
Our patient was flailing because his throat had swelled shut with his tongue so huge it was choking him.
We didn't have a line in. No IV benadryl or epi to slow down the reaction. I threw a dose of benadryl to Mr W, who stabbed the patient with a IM needle to deliver the drug into the muscles in his shoulder. Piss poor absorption. This man is going to die soon if we didn't do anything.
Our patient went limp. Blood oxygen saturation at 20%. His heart threw in the towel and the monitor flatlined.
Our student looked at me, then at Mr. W, unsure of what to do.
"START CPR NOW. FORGET THE DIVERSION, MR G YOU ARE TURNING THIS AMBULANCE AROUND NOW." Instead of heading to a hospital across town because they had our patient's records, we now were ripping down a sleepy road to the nearest hospital that was already on diversion for critical ER saturation. Our patient's life was literally draining out of our hands with every second we wasted on the road and NOT in a ER.
I frantically tore open compartments, looking for a bag to force air into my patient's lungs. WHY WAS EVERY BAG-VALVE-MASK PEDIATRIC SIZED?!?! The flustered student was pumping down on the patient's chest entirely too fast and too shallow, while I finally slapped together an adult BVM. I threw an Epi-Pen at MR W, who struggled to cut open the pt's pants, then stabbed the Pen in.
My God.
Thank goodness we were only several minutes away from the closest hospital. Those minutes were the most agonizing of my entire life. I tried so hard to bag our patient with one hand, but the whole endeavor was like trying to drive 80 mph down a freeway with one foot on the pedal and the attached knee steering. I am not joking. You need at least four hands to successfully bag a patient, I only had myself.
I felt like an utter failure.
We flew into the ambulance bay, and of course, the stretcher just HAD TO RUN OUT OF POWER as we tried to unload the patient. God damn battery powered stretcher. It saves us from breaking our backs trying to carry a 600 pound patient, but tonight my student STOPPED CPR in order to unjam the stretcher. ARGHHHHH NOOOOOOOOOOOO.
We finally wheeled our patient into the hands of a waiting ER team, and the began to do real CPR and pump the gentleman full of drugs. Maxed out on Epi. Threw in bicarb and D50.
During the entire scene described above, I was not scared nor freaked out. A weird detached calm blanketed me, my body was in automatic mode. Well, at least until I saw the patient's brother, sitting in a chair around the corner. Scared, uncertain eyes locked mine, until I forced my self to look away. Suddenly a flood of emotion rocked my body, all the way through my sweat-filled gloves. If the ER doc running the code didn't succeed, this man was going to lose a family member.
With the ER team in controlled chaos trying to save the gentleman's life, we EMT's were suddenly useless, so I waited outside while Mr W transferred the last of our patient data to the scribe. I stood outside with Mr G (my partner and driver for this night) and our student. After a minute I couldn't take it, and peeked back into the room. Seconds later, the nurse pounding the CPR stopped, and everyone relaxed a notch. Spontaneous heartbeat. Soon the gentleman was breathing on his own again.
Everyone involved was credited with a CPR save. "We" all worked together to save his life.
I don't know any more.
Wednesday, December 26, 2007
I am completely bored, the day after Christmas, stuck in my dorm room. I made the trek back on the hopes of getting some work done...but after watching a movie and aimless websurfing, I know that it is hopeless. I guess some rambling wouldn't hurt.
So on my last ambulance shift for the class, I had a good time with a long time preceptor. We were out in the country for one of the last calls of the night, and I actually saw STARS in the sky.
It was amazing. My preceptor stated that he regularly sees shooting stars. I had no idea they actually existed. We were called into the backwoods, almost exactly like the home of the poor but smart kid from October Sky. I mean even the lights and crumbling steps mirrored the movie.
Through out that day we transported to a hospital that had the coolest nurses. There was one I just instantly had a crush on for the day (don't worry I don't normally do this). She was so...spunky. Looked just like Liv Taylor, but a lot funnier. I normally take a while to get used to people and places, but man, with her it was hard not to flirt back...
Anyway. Okay calls that day. Pretty crazy calls with this new service I'm hoping to volunteer for permanently...a kid with o2 sats at 45%, a couple of seizures here and there, mvc's...
The only sucky part is the ever present call at 4 am, and the last call 5 minutes before your shift is over. Oh and last shift, just when I take that last call guaranteed to make me home late by an hour, a Code Blue call goes out. AHHHHHHHHHHHHHHH WHHHHHHHHHHYYYYYYYY...
So on my last ambulance shift for the class, I had a good time with a long time preceptor. We were out in the country for one of the last calls of the night, and I actually saw STARS in the sky.
It was amazing. My preceptor stated that he regularly sees shooting stars. I had no idea they actually existed. We were called into the backwoods, almost exactly like the home of the poor but smart kid from October Sky. I mean even the lights and crumbling steps mirrored the movie.
Through out that day we transported to a hospital that had the coolest nurses. There was one I just instantly had a crush on for the day (don't worry I don't normally do this). She was so...spunky. Looked just like Liv Taylor, but a lot funnier. I normally take a while to get used to people and places, but man, with her it was hard not to flirt back...
Anyway. Okay calls that day. Pretty crazy calls with this new service I'm hoping to volunteer for permanently...a kid with o2 sats at 45%, a couple of seizures here and there, mvc's...
The only sucky part is the ever present call at 4 am, and the last call 5 minutes before your shift is over. Oh and last shift, just when I take that last call guaranteed to make me home late by an hour, a Code Blue call goes out. AHHHHHHHHHHHHHHH WHHHHHHHHHHYYYYYYYY...
Thursday, November 15, 2007
Finally, a decent call.
My supervisor, another emt, and I were watching a sweet musical (Jesus Christ Superstar) when our pagers went off. Good timing, right during the final song. It was a weird moment, when all of us jerk up when the vibrating pager went off.
"Head Injury. No detail."
Oh crap.
All three of us start jogging out to the truck parked in the driveway, then halfway there we sprinted for it.
Lights and some sirens, speeding down a lane in 5 seconds that normally takes me a minute to bike.
The guy looked fine, but had blacked out. Crap.
A car full of guys had driven up to him, rushed him, mugged him, and popped him on the head with....something....then drove away.
After awhile, we finally convinced the guy to go to the hospital. I was frozen by now, since my friend who wasn't on duty needed my official EMS hoodie...to look official...
Things are getting pretty nasty.
College isn't safe. Be careful guys and girls.
My supervisor, another emt, and I were watching a sweet musical (Jesus Christ Superstar) when our pagers went off. Good timing, right during the final song. It was a weird moment, when all of us jerk up when the vibrating pager went off.
"Head Injury. No detail."
Oh crap.
All three of us start jogging out to the truck parked in the driveway, then halfway there we sprinted for it.
Lights and some sirens, speeding down a lane in 5 seconds that normally takes me a minute to bike.
The guy looked fine, but had blacked out. Crap.
A car full of guys had driven up to him, rushed him, mugged him, and popped him on the head with....something....then drove away.
After awhile, we finally convinced the guy to go to the hospital. I was frozen by now, since my friend who wasn't on duty needed my official EMS hoodie...to look official...
Things are getting pretty nasty.
College isn't safe. Be careful guys and girls.
Friday, November 9, 2007
Wow that was a hectic month. Combine living at the ER on the weekends with crazy biochemistry studying and epi lectures to give...
I am going to miss my ER rotations. A lot. The one particular hospital I spend every weekend at, a county hospital level one trauma center, has basically been my new home this semester.
I am going to miss:
On a related note, I started an IV on myself the other night. Sweet. Now I just need to keep the ingredients for an banana bag in my room for those pesky hangovers =)
More on my first ambulance shifts later on.
I am going to miss my ER rotations. A lot. The one particular hospital I spend every weekend at, a county hospital level one trauma center, has basically been my new home this semester.
I am going to miss:
- The really nice pediatric trauma fellow who loved to let us do cool things like hold a screaming kid while he stitched up a 8 inch laceration while thoroughly explaining everything he was doing as he was doing it. First of all, pediatric trauma? Wow. Second, a really really nice guy/doctor in a super busy ER who obviously has better things to do than show EMT students cool random things on the xray scans? Now that's rare.
- The smell of vomit, feces, urine, sweat, blood, rotting flesh, cleaning solution. Oh wait, never mind, I have a weak sense of smell =)
- The helicopter pad. I swear if I find a really cool girlfriend, I am going to bring her to the top. On a clear night. Yes.
- One word: nurses.
- Please please keep extra gloves in your pocket.
- DO NOT BE A WALLFLOWER. Seriously. That is the only thing separating our class from all of the normal paramedic students.
- Stop with the AC IV's.
On a related note, I started an IV on myself the other night. Sweet. Now I just need to keep the ingredients for an banana bag in my room for those pesky hangovers =)
More on my first ambulance shifts later on.
Friday, October 12, 2007
Oh here we go
I have no idea why I am doing this. It's not like I have anything in particular I need to tell/whine about.
Life is fine. I am happy, well fed, but sleep deprived.
I just got back from a clinical at a local trauma center earlier, and I immediately thought about this quote:
'True heroism is remarkably sober, very undramatic. It is not the urge to surpass all others at whatever the cost, but the urge to serve others, at whatever the cost.'
-Arthur Ashe
My last patient had been in and out with the law. She was reading one of those thick romance novels when I approached her, and I couldn't help blurting out "Oh Nora Roberts is SO much better."
She was one of my favorite patients. Rehab is so lonely, so we just had fun talking about...stuff. It's so weird how I barely know the people living on my floor, but I got to know her really well in a 5 minute conversation.
Emergency medicine is a oxymoron. Spinal taps hurt. Like Hell. Oh god.
I just love patients leaving Against Medical Advice. Just love it.
That is all. I would like some sleep this weekend.
Life is fine. I am happy, well fed, but sleep deprived.
I just got back from a clinical at a local trauma center earlier, and I immediately thought about this quote:
'True heroism is remarkably sober, very undramatic. It is not the urge to surpass all others at whatever the cost, but the urge to serve others, at whatever the cost.'
-Arthur Ashe
My last patient had been in and out with the law. She was reading one of those thick romance novels when I approached her, and I couldn't help blurting out "Oh Nora Roberts is SO much better."
She was one of my favorite patients. Rehab is so lonely, so we just had fun talking about...stuff. It's so weird how I barely know the people living on my floor, but I got to know her really well in a 5 minute conversation.
Emergency medicine is a oxymoron. Spinal taps hurt. Like Hell. Oh god.
I just love patients leaving Against Medical Advice. Just love it.
That is all. I would like some sleep this weekend.
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