In this business it can very much be feast or famine. What I mean by that is that you can go for weeks without doing seeing any acutely ill pts or even mildly ill patients. On my current flight rotation I seem to be getting stuck with all the crappy weather days. Sure, it gives me time to do homework, but I don't really want to just sit around all day. I would like to actually do something. Don't get me wrong, it is nice from time to time but I would much rather have it be the exception and not the rule.
Anyway, my latest shift had not allowed for any type of altitude due to the weather. So I will have to dig up a story or two from the "archives" and post it up here as soon as I have some free time.
Friday, February 21, 2014
Friday, January 3, 2014
One thing lead to another...
I know it has been a while since my last post on here. It has not been for lack of interesting situations, but rather due to lack of time to adequately document them. The last semester took a lot of my time and required me to put my blogging on the back burner for a bit. This was a call when I was working the ground in the mitten. Anyways...
So there I was right...working a shift up in Michigan with a buddy of mine on one of the MICU trucks. We started the day with a ventilator wait and return type of call. Those are my favorite calls said no medic ever! So the call went fine with no real story worthy details to add here and we return out pt with no issues back to a facility that we frequent.
So we are cleaning up our truck when we see the local PD/PSO show up. I go over and ask the officer what was the story was and before I could get the words out of my mouth he says "Are you guys able to take this one?" ...I respond with a VERY confident "Sure. I guess. What's going on?" he points to what I can only describe as a very angry looking Santa wearing a Red Wings jersey. The officer says he has been angry and aggressive with the staff and this call is going to be a committal. He also informs us that they have been here before for this individual and they have never given them a problem in the past. He is just pissed off at the staff. And apparently he is very hard of hearing.
So I gesture to this guy to follow me and he complies and provides no resistance at all. He knew the drill and was cool with it. We get him strapped in on the gurney and start our usual assessments and questions. "How are you feeling?", Do you have any pain?", "What happened?" The usual questions. He really doesn't give us much of an answer, but doesn't give us much of a hassle either. Ok, we can deal with that. I won't be the first time we transport an angry pt and it certainly won't be the last.
Well the snowball started rolling just after my partner asks me a question about the status of the receiving hospital while having a smile on his face. The pt immediately changes his mood and starts yelling at him. So he goes from smiling to total poker face in about 0.3 seconds, apologizes to the pt and explained to the pt that he was merely asking me a question about the status of the hospital we were about to transport to. The pt snapped at him again but didn't show any further signs of aggression. I ask if we are good to go and get the thumbs up to transport.
As we start to roll priority 3 towards the mother-ship, I start to hear some more angry noises from the back of the truck a few minutes later. I ask if everything is alright and all I get back is "Pull the !@#$ truck over!" As I pull into a parking lot, I look into the rear view mirror and can make out hands moving all over the place. I flip the lights on so when help does arrive, they can find us quickly. Unfortunately, I forgot to call out on the radio to request it. My bad.
I jump out of the driver seat and run around to the back of the truck and throw the doors open and then myself into the darkness. I was half expecting to get punched in the face before my eyes could adjust to the relatively darker pt care compartment in the back of the truck. Thankfully there was no punch in the face. I'm always happy when I don't get punched in the face. As my eyes adjusted I see my partner on top of this now VERY violent pt trying his best to keep him from further assaulting him! Apparently the pt decided to undo his safety belts and lunged at my partner. No bueno!
My partner is on the upper body and I am on the lower body making sure to protect ourselves as best we can. So we have our pt somewhat subdued...now what? We can't reach the locked drug box in an attempt to sedate this pt and we can't reach the radio to call for PD. Welcome to that lovely piece of real estate located on the corner of Rock and Hard Place. But what it the key to success? Flexibility and dynamic or out of the box thinking. We were able to grab our cell phones but thanks to the endogenous catecholamines coursing through our veins we were not able to remember the number for dispatch. What we did remember was 911.
Now I have to admit it was a bit odd being on the other end of the 911 call requesting help. And right on pain in the ass Que, our pt starts yelling every obscene and foul word he can think of. I am sure the dispatcher that answered the phone wasn't expected to be verbally assaulted when they answered. So this means I have to try and yell over the sea of profanity to get our location to the other end of the phone line. The only thing I can see out of the back of the truck was a local Mexican restaurant. However, I was able to recall the closest intersection to give them an idea of where we were. As soon as that information was given the call ends and we are left hoping for help to arrive soon.
It was probably only a few minutes between the call and the arrival of the first PD unit on scene. However, when your adrenalin is going it seems to take forever. It was a huge relief to see the flashing blue lights. Yet it seemed as though it took the officer way longer to get out of the car and into our little box of advanced life support chaos. He pulls out his tazer as what I can only assume was a show of force and says something to the effect of "I'm only going to ask you once, calm down, sir". And of course there is a slew of obscenities towards the officer which he doesn't take kindly to. He tells us to jump off of him and applies the tazer directly to his chest! CLACK CLACK CLACK CLACK! Goes 10,000 volts of justice. Apparently he initially had good contact but lost it because the pt was able to swat it way. Unfortunately, this did not work in his favor as the officer swung it around again to regain contact and hopefully control but the pt swatted it away again. However, this time it landed on his nuts. That's not the medical term for it, but still...OUCH!
Now there is another officer that has arrived to the party with more toys in the form of hand cuffs. FINALLY! We have the situation under control. I ask my partner about sedation and he was OK with just restraining the pt. He said he could take the abuse, as long as it was verbal only.
So we transport our crazy, electrocuted, and now secured pt to the mother-ship I realize that I never told dispatch about our little "situation". I call over the radio to ask and I can only describe the response as a long drawn out question mark.
As we pull into the hospital, we are met at the door by a couple of security guards that are way too excited to do their job. I kept thinking that a whistle would be blown soon for unnecessary roughness. But they played nice and provided a spit shield. After all, no one likes getting punched in the face AND spit on. It just goes to show you that you never really know what is going to happen. Just add it to the list of WTFs that occur every day on this job.
So there I was right...working a shift up in Michigan with a buddy of mine on one of the MICU trucks. We started the day with a ventilator wait and return type of call. Those are my favorite calls said no medic ever! So the call went fine with no real story worthy details to add here and we return out pt with no issues back to a facility that we frequent.
So we are cleaning up our truck when we see the local PD/PSO show up. I go over and ask the officer what was the story was and before I could get the words out of my mouth he says "Are you guys able to take this one?" ...I respond with a VERY confident "Sure. I guess. What's going on?" he points to what I can only describe as a very angry looking Santa wearing a Red Wings jersey. The officer says he has been angry and aggressive with the staff and this call is going to be a committal. He also informs us that they have been here before for this individual and they have never given them a problem in the past. He is just pissed off at the staff. And apparently he is very hard of hearing.
So I gesture to this guy to follow me and he complies and provides no resistance at all. He knew the drill and was cool with it. We get him strapped in on the gurney and start our usual assessments and questions. "How are you feeling?", Do you have any pain?", "What happened?" The usual questions. He really doesn't give us much of an answer, but doesn't give us much of a hassle either. Ok, we can deal with that. I won't be the first time we transport an angry pt and it certainly won't be the last.
Well the snowball started rolling just after my partner asks me a question about the status of the receiving hospital while having a smile on his face. The pt immediately changes his mood and starts yelling at him. So he goes from smiling to total poker face in about 0.3 seconds, apologizes to the pt and explained to the pt that he was merely asking me a question about the status of the hospital we were about to transport to. The pt snapped at him again but didn't show any further signs of aggression. I ask if we are good to go and get the thumbs up to transport.
As we start to roll priority 3 towards the mother-ship, I start to hear some more angry noises from the back of the truck a few minutes later. I ask if everything is alright and all I get back is "Pull the !@#$ truck over!" As I pull into a parking lot, I look into the rear view mirror and can make out hands moving all over the place. I flip the lights on so when help does arrive, they can find us quickly. Unfortunately, I forgot to call out on the radio to request it. My bad.
I jump out of the driver seat and run around to the back of the truck and throw the doors open and then myself into the darkness. I was half expecting to get punched in the face before my eyes could adjust to the relatively darker pt care compartment in the back of the truck. Thankfully there was no punch in the face. I'm always happy when I don't get punched in the face. As my eyes adjusted I see my partner on top of this now VERY violent pt trying his best to keep him from further assaulting him! Apparently the pt decided to undo his safety belts and lunged at my partner. No bueno!
My partner is on the upper body and I am on the lower body making sure to protect ourselves as best we can. So we have our pt somewhat subdued...now what? We can't reach the locked drug box in an attempt to sedate this pt and we can't reach the radio to call for PD. Welcome to that lovely piece of real estate located on the corner of Rock and Hard Place. But what it the key to success? Flexibility and dynamic or out of the box thinking. We were able to grab our cell phones but thanks to the endogenous catecholamines coursing through our veins we were not able to remember the number for dispatch. What we did remember was 911.
Now I have to admit it was a bit odd being on the other end of the 911 call requesting help. And right on pain in the ass Que, our pt starts yelling every obscene and foul word he can think of. I am sure the dispatcher that answered the phone wasn't expected to be verbally assaulted when they answered. So this means I have to try and yell over the sea of profanity to get our location to the other end of the phone line. The only thing I can see out of the back of the truck was a local Mexican restaurant. However, I was able to recall the closest intersection to give them an idea of where we were. As soon as that information was given the call ends and we are left hoping for help to arrive soon.
It was probably only a few minutes between the call and the arrival of the first PD unit on scene. However, when your adrenalin is going it seems to take forever. It was a huge relief to see the flashing blue lights. Yet it seemed as though it took the officer way longer to get out of the car and into our little box of advanced life support chaos. He pulls out his tazer as what I can only assume was a show of force and says something to the effect of "I'm only going to ask you once, calm down, sir". And of course there is a slew of obscenities towards the officer which he doesn't take kindly to. He tells us to jump off of him and applies the tazer directly to his chest! CLACK CLACK CLACK CLACK! Goes 10,000 volts of justice. Apparently he initially had good contact but lost it because the pt was able to swat it way. Unfortunately, this did not work in his favor as the officer swung it around again to regain contact and hopefully control but the pt swatted it away again. However, this time it landed on his nuts. That's not the medical term for it, but still...OUCH!
Now there is another officer that has arrived to the party with more toys in the form of hand cuffs. FINALLY! We have the situation under control. I ask my partner about sedation and he was OK with just restraining the pt. He said he could take the abuse, as long as it was verbal only.
So we transport our crazy, electrocuted, and now secured pt to the mother-ship I realize that I never told dispatch about our little "situation". I call over the radio to ask and I can only describe the response as a long drawn out question mark.
As we pull into the hospital, we are met at the door by a couple of security guards that are way too excited to do their job. I kept thinking that a whistle would be blown soon for unnecessary roughness. But they played nice and provided a spit shield. After all, no one likes getting punched in the face AND spit on. It just goes to show you that you never really know what is going to happen. Just add it to the list of WTFs that occur every day on this job.
Thursday, August 8, 2013
First flight!
So it has been a few weeks as part of a the flight crew at the new job. It actually wasn't anything super exciting or really critical. Just a lot of policy and procedure. However, I was able to get my first flight! It wasn't a super crazy scene call that involved RSI and landing on the interstate, but it also wasn't a dialysis transfer either. What it was, was an opportunity to break the seal and apply what I have learned thus far. After all, you have to crawl before you can walk and walk before you can run. Oh, I have to admit that it was pretty cool to be able to do so in a brand new aircraft but man did it take forever to get that first flight out of the way.
At any rate, we took a very stable pt from one of our out lying facilities to the "mother ship" for further evaluation of a DVT. Nothing ground shattering or mind blowing. It was an easy call. I have done calls like this dozens of times on the ground but this time I happen to have a much cooler ride. Thankfully the flight went fine without any issues or concerns by anyone involved. It was nice to reach a goal and check it off of my life's list of things to do. Or as some of you would put it, the bucket list.
But now is not the time to get comfortable or cocky. Now is the time for learning, growth, and observation. Onward and upward! Hopefully this particular chapter in the adventure that is my life will allow me to add a few more interesting stories to my collection.
At any rate, we took a very stable pt from one of our out lying facilities to the "mother ship" for further evaluation of a DVT. Nothing ground shattering or mind blowing. It was an easy call. I have done calls like this dozens of times on the ground but this time I happen to have a much cooler ride. Thankfully the flight went fine without any issues or concerns by anyone involved. It was nice to reach a goal and check it off of my life's list of things to do. Or as some of you would put it, the bucket list.
But now is not the time to get comfortable or cocky. Now is the time for learning, growth, and observation. Onward and upward! Hopefully this particular chapter in the adventure that is my life will allow me to add a few more interesting stories to my collection.
Wednesday, June 19, 2013
Things that make you go "Huh?"
From time to time in this line of work you mutter the words "really?" or "are you blind?" or simply "huh?". I had one of those situations a while back at one of the super hospitals in the area.
My partner and I were transferring a pt from the hospital we were stationed out of about 30 miles away from this particular super hospital. It was an easy transfer that didn't require lights and sirens. It was a BLS call. The transfer itself went fine. It was when we arrived at the hospital was when we experienced that "huh?" moment.
We park at the hospital and are wheeling in our pt through the ER to their destination when we encounter a rather large and worried looking group of medical professionals near the resus/trauma room. I think we all just stopped and looked at each other for a minute until someone from with in the resus crowd asked "Is that the flight crew?" I have to say, I was a bit taken back by that. I wanted to ask this particular resident/intern/person who should know better "really?" but instead all that came out was a very confused "huh?" Our gray uniforms don't exactly look like flight suits. As the awkwardness of the situation lifted we slowly moved away from the trauma hungry mass to drop our pt off at their room.
After the call, my partner and I just shared a confused looked and muttered "really?" We then shrugged it off and went back in service for our next call. Just another thing that makes you go "huh?"
My partner and I were transferring a pt from the hospital we were stationed out of about 30 miles away from this particular super hospital. It was an easy transfer that didn't require lights and sirens. It was a BLS call. The transfer itself went fine. It was when we arrived at the hospital was when we experienced that "huh?" moment.
We park at the hospital and are wheeling in our pt through the ER to their destination when we encounter a rather large and worried looking group of medical professionals near the resus/trauma room. I think we all just stopped and looked at each other for a minute until someone from with in the resus crowd asked "Is that the flight crew?" I have to say, I was a bit taken back by that. I wanted to ask this particular resident/intern/person who should know better "really?" but instead all that came out was a very confused "huh?" Our gray uniforms don't exactly look like flight suits. As the awkwardness of the situation lifted we slowly moved away from the trauma hungry mass to drop our pt off at their room.
After the call, my partner and I just shared a confused looked and muttered "really?" We then shrugged it off and went back in service for our next call. Just another thing that makes you go "huh?"
Monday, June 17, 2013
Movin' on up!
Recently I completed my first flight as a new crew member for my new job as a flight paramedic! It was not a scene call. It wasn't even a transfer. It was just a training flight. Still, it was pretty sweet. I had to do my check/cert ride to be NVG qualified. That's right, night vision, goggles. How cool is that? We flew around for about an hour and landed at one of the hospitals, did some failure drills, and worked on communications. It was a great training exercise and I look forward to writing more and more about my experiences on this new job/adventure. Stay tuned.
Friday, May 17, 2013
A story from back in the day: First arrest...ever!
A story from way back when...
So I have a paramedic for all of about 3 months and have not had anything too crazy yet. Sure, in the ER I have seen it all and done it all (or that is how I felt at the time) but out on the road as the lone ALS provider, I was still very green around the gills. I'm not sure where that analogy came from, but it is still applicable. At any rate, I am working my second job for the local ambulance company down in Mississippi. We did a few transfers and maybe a rescue or two but the day wasn't super exciting. Until we get the call "Control to 99. Priority 1. Details on the way". OK, so we put the info into our GPS and head on out that way. Since we are covering most of what seems like the southern most portion of the state, it was a bit of a drive to get there. While enroute, dispatch calls to tell us "CPR in progress". Great. This is going to be a lot of work AND it's my first arrest ever as a medic.
This was it. This was a big stepping stone from student, to third rider, to new employee. Getting your first arrest ever as a medic is a big deal and can really be a bit unnerving. You want to do the best job you can, not screw up, and hopefully get a pulse back. Unfortunately, that last part doesn't always happen and new medics tend to take that personally. I don't feel I did, but anyway, back to the story.
As we arrive on scene after what felt like an eternity, my partner and I see one of the local deputies doing CPR in the passenger seat of a parked car. The seat was at about a 45 degree angle and he was pounding away at her chest. Not the greatest position for such maneuvers. So in a very hurried manner, my partner and I pull out all the equipment and place the gurney next to the car where our pt is then promptly placed on gurney, secured, and CPR continued.
Now let me try and paint a slightly better picture of the situation. When we arrived, our pt was in the passenger seat of a four door sedan when she arrested. She was in her early 90s and was about to go to the store with one of her family members when she suddenly collapsed. The family then called 911, started CPR, and when the Sheriff's deputy arrived, took over CPR. Our pt was all of 90 lbs if she was soaking wet with change in her pockets.
Thanks to my endogenous catecholamines that were circulating, I was very much thinking from my brain stem. I thew on the defib pads and immediately forgot how to work the monitor. $#@! Thankfully I had a spasm of lucidity and was able to get to the pads view to see what was going on. And in true mega code fashion, it was course VF. Very course VF. We deliver our first shock. POW! 360J of Mississippi power go coursing through this poor pt and her arms and legs go flailing all over. Actually I was almost hit in the face due to poorly securing her to the gurney. A total rookie maneuver, I know.
And to continue the trend of rookie moves, I hastily attempted to intubate my pt right there in the chaos of this rural MS drive way. So between my blade placement, probably rocking back the blade and just not being an expert on laryngoscopy, I could not see !@#$. So in true protocol driven medicine I reach for the combi tube. They are OK airways when they work, but they do not protect from aspiration and are actually pretty rough on the soft structures of the airway. This is especially true when you have a new guy jamming it in with all of his might. So push, push, push and the tube goes into place. And I am sure we bagged WAY TOO FAST as well. But we load up the pt into the waiting ambulance and I ask who is coming with me, the fire fighter or the deputy? Both look at each other as though they had an unspoken game of "1,2,3 Not it!". Then the good o'l boy fire fighter begrudgingly hoped into the truck and took over CPR. The doors then close and we are off like a shot.
I opted to start an IV enroute since enough time was taken on scene. I tried for an EJ on the right side but it infiltrated. Great! Now what? I can't drop drugs down this monstrosity of an airway that I have in place. Is her face getting bigger? Anyway, I have to get an IV...and bag...and watch the monitor...and not fall on my ass. I thought to myself, are all arrests like this? So I opted to try the other EJ since I would allow me to do the least amount of moving around the cabin and not interrupt CPR. Oh BTW, CLEAR! POW! Shock delivered at 360j the pt has been in course VF this whole time too.
At this point, I am able to calm down ever so slightly and reassessed the situation. I have good compressions going, an airway in place, and an IV. Is her face getting bigger? Anyway, I am glad I had the fire guy with me, because he did CPR for me while we transported priority 1 to the closest hospital. His CPR seemed almost lazy because of the little amount of effort he had to put into it due to how big he was and how tiny the pt was. BTW, this hospital was about 20 minutes away going priority 1. Great.
Now I may be new, but I knew my ACLS protocols inside and out and was doing my best to follow them as closely as possible. I just kept grabbing boxes of drugs every few minutes and pushing them though my one good line. Everything is going well so far on my end...well maybe.
Her face IS getting bigger. One of her eyes is bulging and her face and neck appear swollen. When I reach down to touch it, she feels as though she has rice krispies under her skin. Apparently when I went all KER-SMASH with the combitube and tear went the trachea. No bueno! I can't take out the tube to reattempt intubation, and I don't have an airway alternative. Oh sorry, clear! SHOCK! And CPR continues.
I am sure I repeated myself multiple times when I called report and sounded a bit shaken. Hopefully they cut me some slack. I doubt that they did though. After I hang up the phone and continue to multitask between airway and drug therapy, I look at my jump bag and see that I am running out of just about everything. We better be at the hospital soon! My partner yells back from the front "2 minutes out!" and I am slightly relieved. However, that last 2 minutes felt like an eternity.
When we get there I scream out my report to the staff in this tiny little back country ER. I probably didn't need to do that. Damn adrenalin! My fire fighter rider is drenched in sweat, the staff gives bicarb and calcium, and I have no idea what to do next. They pronounce the pt a few minutes later and disconnect her from the monitor.
Unfortunately for everyone there, another arrest rolls into the ER 5 minutes after we get there. Good it won't me just me that has to do a mountain of paperwork. The arrest that followed mine was an intentional OD that was rearresting and coming back every few minutes. So it was a bit more of a challenging call than my arrest.
Thankfully the staff was good to me and didn't bite my head off for anything. They asked me what I had given for documentation purposes and I realized we gave 8 epi, 3 lido, fluids, and about 8 or 9 defibs. I am surprised that this LOL who CTD didn't just disintegrate.
Everyone remembers their first arrest or first really bad call. They usually don't go as well as planned and even can get screwed up more often than not. It is a right of passage and mine was no different.
So I have a paramedic for all of about 3 months and have not had anything too crazy yet. Sure, in the ER I have seen it all and done it all (or that is how I felt at the time) but out on the road as the lone ALS provider, I was still very green around the gills. I'm not sure where that analogy came from, but it is still applicable. At any rate, I am working my second job for the local ambulance company down in Mississippi. We did a few transfers and maybe a rescue or two but the day wasn't super exciting. Until we get the call "Control to 99. Priority 1. Details on the way". OK, so we put the info into our GPS and head on out that way. Since we are covering most of what seems like the southern most portion of the state, it was a bit of a drive to get there. While enroute, dispatch calls to tell us "CPR in progress". Great. This is going to be a lot of work AND it's my first arrest ever as a medic.
This was it. This was a big stepping stone from student, to third rider, to new employee. Getting your first arrest ever as a medic is a big deal and can really be a bit unnerving. You want to do the best job you can, not screw up, and hopefully get a pulse back. Unfortunately, that last part doesn't always happen and new medics tend to take that personally. I don't feel I did, but anyway, back to the story.
As we arrive on scene after what felt like an eternity, my partner and I see one of the local deputies doing CPR in the passenger seat of a parked car. The seat was at about a 45 degree angle and he was pounding away at her chest. Not the greatest position for such maneuvers. So in a very hurried manner, my partner and I pull out all the equipment and place the gurney next to the car where our pt is then promptly placed on gurney, secured, and CPR continued.
Now let me try and paint a slightly better picture of the situation. When we arrived, our pt was in the passenger seat of a four door sedan when she arrested. She was in her early 90s and was about to go to the store with one of her family members when she suddenly collapsed. The family then called 911, started CPR, and when the Sheriff's deputy arrived, took over CPR. Our pt was all of 90 lbs if she was soaking wet with change in her pockets.
Thanks to my endogenous catecholamines that were circulating, I was very much thinking from my brain stem. I thew on the defib pads and immediately forgot how to work the monitor. $#@! Thankfully I had a spasm of lucidity and was able to get to the pads view to see what was going on. And in true mega code fashion, it was course VF. Very course VF. We deliver our first shock. POW! 360J of Mississippi power go coursing through this poor pt and her arms and legs go flailing all over. Actually I was almost hit in the face due to poorly securing her to the gurney. A total rookie maneuver, I know.
And to continue the trend of rookie moves, I hastily attempted to intubate my pt right there in the chaos of this rural MS drive way. So between my blade placement, probably rocking back the blade and just not being an expert on laryngoscopy, I could not see !@#$. So in true protocol driven medicine I reach for the combi tube. They are OK airways when they work, but they do not protect from aspiration and are actually pretty rough on the soft structures of the airway. This is especially true when you have a new guy jamming it in with all of his might. So push, push, push and the tube goes into place. And I am sure we bagged WAY TOO FAST as well. But we load up the pt into the waiting ambulance and I ask who is coming with me, the fire fighter or the deputy? Both look at each other as though they had an unspoken game of "1,2,3 Not it!". Then the good o'l boy fire fighter begrudgingly hoped into the truck and took over CPR. The doors then close and we are off like a shot.
I opted to start an IV enroute since enough time was taken on scene. I tried for an EJ on the right side but it infiltrated. Great! Now what? I can't drop drugs down this monstrosity of an airway that I have in place. Is her face getting bigger? Anyway, I have to get an IV...and bag...and watch the monitor...and not fall on my ass. I thought to myself, are all arrests like this? So I opted to try the other EJ since I would allow me to do the least amount of moving around the cabin and not interrupt CPR. Oh BTW, CLEAR! POW! Shock delivered at 360j the pt has been in course VF this whole time too.
At this point, I am able to calm down ever so slightly and reassessed the situation. I have good compressions going, an airway in place, and an IV. Is her face getting bigger? Anyway, I am glad I had the fire guy with me, because he did CPR for me while we transported priority 1 to the closest hospital. His CPR seemed almost lazy because of the little amount of effort he had to put into it due to how big he was and how tiny the pt was. BTW, this hospital was about 20 minutes away going priority 1. Great.
Now I may be new, but I knew my ACLS protocols inside and out and was doing my best to follow them as closely as possible. I just kept grabbing boxes of drugs every few minutes and pushing them though my one good line. Everything is going well so far on my end...well maybe.
Her face IS getting bigger. One of her eyes is bulging and her face and neck appear swollen. When I reach down to touch it, she feels as though she has rice krispies under her skin. Apparently when I went all KER-SMASH with the combitube and tear went the trachea. No bueno! I can't take out the tube to reattempt intubation, and I don't have an airway alternative. Oh sorry, clear! SHOCK! And CPR continues.
I am sure I repeated myself multiple times when I called report and sounded a bit shaken. Hopefully they cut me some slack. I doubt that they did though. After I hang up the phone and continue to multitask between airway and drug therapy, I look at my jump bag and see that I am running out of just about everything. We better be at the hospital soon! My partner yells back from the front "2 minutes out!" and I am slightly relieved. However, that last 2 minutes felt like an eternity.
When we get there I scream out my report to the staff in this tiny little back country ER. I probably didn't need to do that. Damn adrenalin! My fire fighter rider is drenched in sweat, the staff gives bicarb and calcium, and I have no idea what to do next. They pronounce the pt a few minutes later and disconnect her from the monitor.
Unfortunately for everyone there, another arrest rolls into the ER 5 minutes after we get there. Good it won't me just me that has to do a mountain of paperwork. The arrest that followed mine was an intentional OD that was rearresting and coming back every few minutes. So it was a bit more of a challenging call than my arrest.
Thankfully the staff was good to me and didn't bite my head off for anything. They asked me what I had given for documentation purposes and I realized we gave 8 epi, 3 lido, fluids, and about 8 or 9 defibs. I am surprised that this LOL who CTD didn't just disintegrate.
Everyone remembers their first arrest or first really bad call. They usually don't go as well as planned and even can get screwed up more often than not. It is a right of passage and mine was no different.
Thursday, May 2, 2013
Soon..
I started the new job and will be on orientation for what seems like forever. I will be doing the ground rotations for the next few weeks then it will be on to the helicopter for a while. It should provide for some interesting stories. Until then I will have to stick to old stories I haven't shared yet.
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