The other day I was working with a friend of mine when we recieved a 911 call not very far from our station and the hospital for that matter, for a person that fell c/o ankle pain. From the place (in the middle of the road) where this guy was lying to the hospital property was probably about 500 ft. However, to the ER was about a mile. At any rate, it is about 20 degrees outside and it was snowing lightly. My partner was not exactly enthusiastic about this call because it was late and she wanted to go to bed.
So we roll up to see just about ever vehile with lights on top of it in that town on scene. Just so we are all clear here, this guy was breathing, had a heart beat, and was totally conscious. However, he was lying on the ground with his knee pulled up to his chest yelling. It sounded very formiliar. Walking up I could hear all sorts of "y'alls" and "dag gums" and "do what nows". This was a good o'l boy from the deep south. Apparently "Bubba" as we will call him was visiting the Great Lakes State on business and decided to visit one of the local watering holes. This particular place has been known to attract the "biker crowd" and has the reputation for be a bit of a hole in the wall. Although in this particular area of the county, you get more of the "Wild Hogs" types than a hells angel. Anyway, as I digress...this poor fellow is lying on the ground, in the street, in the slush, and has a foot that is flopping around like wet noodle. I ask this gentleman what happened, and he proceeds to tell me in what sounded like something out of a Larry the cable guy bit. He says things like "I'm not from here" and "I been drinkin'" and "Man, you yankees got some slippery ass roads! I mean your ice is slippery!" ... ok...
Nothing for nothing, but I am not about to start treatment in the middle of the road while it is snowing and it is 20 degrees out. So we get him in the back of the truck and get his history, vitals, and so on. And then we are off to the ER. I call ahead just for a quick heads up. Mean while, Bubba proceeds to tell me how awesome he is and that how he is not used to "nice yankees" and that his wake boarding skills boarder on legendary. Oh yeah, he also keeps mentioning that Michigan has some "Slippery ass ice". Thank god for him, because I would have totally forgot. He also proceeds to tell me that he has great insurance but they won't cover his visit if they know he has smoked pot. Well what he actually said was something to the effect of "Buddy, I gots great insurance. Don't you worry meow. But they won't pay if they know I's was [makes hand gestures pertaining to smoking something illegal]". I respond with a very professional "totally...". And then his looped and very drunk story starts again.
Once we get to the hospital and roll by the nursing station, he promply gives a very southern fried "Hello ladies. How you derrin" and tells me you have to give'em a little some'em some'em. I'm sure everyone within earshot rolled their eyes. I give report to the RN and immediately appologize for any misbehaving he will do and turn over care.
I have to say that taking care of drunk people is a pain in the ass. Especially the ones that are mean, rude, or covered with vomit. This guy was the kind of drunk person that you want to respond to. Alert, quirky, funny, and other than the pain of his injury, in good spirits. You just gotta look out for that slippery ass Michgain ice.
Thursday, January 27, 2011
Wednesday, January 12, 2011
Preemptive Karma...
Just the other day I was working a rescue shift. Nothing too exciting so far that morning. Just a chest painer and a dead guy. So we get sent to go to post because everyone else was busy. Well, except for one of the MICU trucks which was at the same post. As my partner and I drive up, we notice that both people in the vehicle are asleep. Obviously, the first thing that pops into my head was "how can I mess with these two"?
So I do the logical/mature/smart thing and decide to drive right up next to them and blast the siren. This apparently was more of a problem than I thought it would be. Now before I go any further, let me paint you a better picture of the area. The other (larger) ambulance is parked in a small parking lot next to a curb and a tree with enough space to drive my ambulance between the two. I obviously miss judged the turning radius of my vehicle and as I am pulling next to the other truck I look in my mirrors just in time to have the back bumper of their vehicle "kiss" my left rear wheel well. This promptly wakes up the other crew who for some reason decide to back up their truck. Don't ask me. I was driving the other truck. So I actually have to get over the PA system and tell them to stop moving. From all the grinding, rubbing, and all around bad sounds that came from the contact of these two mobile infirmaries, I thought the damage would be pretty bad.
Much to my surprise, the larger ambulance didn't have a scratch on its bumper ( the area I came into contact with). However, my vehicle now as a 9 inch by 3 inch "beauty mark" on the rear driver side wheel well. Every one was OK and after much moaning and groaning I give the supervisor a call to tell him what happened. He wasn't exactly enthusiastic about what I had just told him, but he was professional and gave me clear instructions on what to do from there. Basically it involved me not driving for a week and everyone writing an incident report.
Moral of the story? Being a smart ass can be fun, but it can and will bite you in the ass. Am I still going to be a smart ass? Am I still going to try and pull a prank or two from time to time. Absolutely. However, I not going to do so with company equipment. Now I have to take CEVO...again. For the third time in less than a year. This is why I need a flight job.
So I do the logical/mature/smart thing and decide to drive right up next to them and blast the siren. This apparently was more of a problem than I thought it would be. Now before I go any further, let me paint you a better picture of the area. The other (larger) ambulance is parked in a small parking lot next to a curb and a tree with enough space to drive my ambulance between the two. I obviously miss judged the turning radius of my vehicle and as I am pulling next to the other truck I look in my mirrors just in time to have the back bumper of their vehicle "kiss" my left rear wheel well. This promptly wakes up the other crew who for some reason decide to back up their truck. Don't ask me. I was driving the other truck. So I actually have to get over the PA system and tell them to stop moving. From all the grinding, rubbing, and all around bad sounds that came from the contact of these two mobile infirmaries, I thought the damage would be pretty bad.
Much to my surprise, the larger ambulance didn't have a scratch on its bumper ( the area I came into contact with). However, my vehicle now as a 9 inch by 3 inch "beauty mark" on the rear driver side wheel well. Every one was OK and after much moaning and groaning I give the supervisor a call to tell him what happened. He wasn't exactly enthusiastic about what I had just told him, but he was professional and gave me clear instructions on what to do from there. Basically it involved me not driving for a week and everyone writing an incident report.
Moral of the story? Being a smart ass can be fun, but it can and will bite you in the ass. Am I still going to be a smart ass? Am I still going to try and pull a prank or two from time to time. Absolutely. However, I not going to do so with company equipment. Now I have to take CEVO...again. For the third time in less than a year. This is why I need a flight job.
Friday, January 7, 2011
96 hours, an I/O, and a full arrest. What could be more fun?
This week was a very busy [EMS] week for me. Meaning that we had a ton of calls. I worked new years eve day and new years followed by 4-6 12 hour shifts after that...I think. It has been kind of a blur. Either way, we were hammered with calls. On the "holidays" we did 16 calls, and up until today every shift had an average of 7 calls. Ugh. Busy stuff.
Most of the past week has been stuck in what I am sure have mentioned before as "priority 3 purgatory". However, today we recieved a call for pt in their 60s who was having trouble breating. So much trouble in fact that this person's heart stopped beating. So it's a CPR in progress kind of day. It was a bit of a unique code situation. Our patient had a trach which made the "A" part of airway, breathing, and circulation much easier. The staff at this menagerie of tirtiary care was performing good compressions but bagging like hyperventilation was going to bring them back. The first few things we did was confirm the arrest, place the defib pads, and check a rhythm which turned out to be PEA. The staff was told to slow their bagging down to about 12 times a minute and we then looked to gain vascular access. This particular pt was a...um...vascular challenge to say the very least. My partner and I didn't even try to start an IV. We just popped in an IO in the right tibia. It was super easy and was the first state side IO I have done in a while.
Then the strangest thing happend. Before we gave any drugs, fluid, or electrical therapy, we achieved ROSC (return of spontaneous cirulation). The pt had a pulse again. So we took the opportunity to switch the pt on to our ventilator and transported priority one to the area's only trauma center for further care. The BP was still low, but the pt was perfusing.
On our way to the ER, the pt decides to throw me a curve ball and codes again. Just so everyone is aware, doing CPR in the back of an ambulance is not easy, fun, or comfortable. Plus, its very traumatic to the pt. In this case, I am pretty sure the pt had a floating sternum, meaning the sternum detatched from the ribs and was basiclly floating around the chest. Not a very nice feeling or sound. So I start CPR again and reach for an amp of epi, since the pt was still in PEA (sinus tach was the underlying rhythm). I push the meds just as we roll up to the ER.
As we roll through the doors of the resusitation room, I give my report. One of the ER residents was ready and very willing to intubate this pt, but I kind of stole her thunder when I told her she has a trach in place. She looked alittle disappointed. Oh well, so we get the pt over to the bed and again we get ROSC.
Once that whole tornado of ACLS is brought under control, the doctor mixes a neosynepherine drip. That's right, the doctor. You don't see that very often. He said he wanted to make sure we kept this pt alive until family can show up to say "good bye". So we clean up, do our paperwork, and clear. Before I leave, I ask one of the nurses if the new registration girl is single or not. Haha.
Several hours later, we return to the area's only trauma center to find that our pt is still with us. Surviving the night is another story. But as much work as we did this week, it was good to use our skills and critical thinking again. Gotta love life on the MICU.
Most of the past week has been stuck in what I am sure have mentioned before as "priority 3 purgatory". However, today we recieved a call for pt in their 60s who was having trouble breating. So much trouble in fact that this person's heart stopped beating. So it's a CPR in progress kind of day. It was a bit of a unique code situation. Our patient had a trach which made the "A" part of airway, breathing, and circulation much easier. The staff at this menagerie of tirtiary care was performing good compressions but bagging like hyperventilation was going to bring them back. The first few things we did was confirm the arrest, place the defib pads, and check a rhythm which turned out to be PEA. The staff was told to slow their bagging down to about 12 times a minute and we then looked to gain vascular access. This particular pt was a...um...vascular challenge to say the very least. My partner and I didn't even try to start an IV. We just popped in an IO in the right tibia. It was super easy and was the first state side IO I have done in a while.
Then the strangest thing happend. Before we gave any drugs, fluid, or electrical therapy, we achieved ROSC (return of spontaneous cirulation). The pt had a pulse again. So we took the opportunity to switch the pt on to our ventilator and transported priority one to the area's only trauma center for further care. The BP was still low, but the pt was perfusing.
On our way to the ER, the pt decides to throw me a curve ball and codes again. Just so everyone is aware, doing CPR in the back of an ambulance is not easy, fun, or comfortable. Plus, its very traumatic to the pt. In this case, I am pretty sure the pt had a floating sternum, meaning the sternum detatched from the ribs and was basiclly floating around the chest. Not a very nice feeling or sound. So I start CPR again and reach for an amp of epi, since the pt was still in PEA (sinus tach was the underlying rhythm). I push the meds just as we roll up to the ER.
As we roll through the doors of the resusitation room, I give my report. One of the ER residents was ready and very willing to intubate this pt, but I kind of stole her thunder when I told her she has a trach in place. She looked alittle disappointed. Oh well, so we get the pt over to the bed and again we get ROSC.
Once that whole tornado of ACLS is brought under control, the doctor mixes a neosynepherine drip. That's right, the doctor. You don't see that very often. He said he wanted to make sure we kept this pt alive until family can show up to say "good bye". So we clean up, do our paperwork, and clear. Before I leave, I ask one of the nurses if the new registration girl is single or not. Haha.
Several hours later, we return to the area's only trauma center to find that our pt is still with us. Surviving the night is another story. But as much work as we did this week, it was good to use our skills and critical thinking again. Gotta love life on the MICU.
Monday, January 3, 2011
The "hype-no-tensive" pirate!
So in the not so distant past, I was working a MICU shift where we responded to a 911 call for a pt with low blood pressure. This is also known as hypotension. Hypo meaning low in relation to blood pressure, as hyper means high in relation to the same function. With that being said, we will return to the story at hand.
Now my partner and I arrive on scene to a "handy man special" single floor ranch style house in an area that is occupied by people that are taking full advantage of that certain government program that is located between sections 7 and 9. As I am sure you are already aware, this place was about as clean as gas station bathroom and probably smelled similar to one. So we walk in with the local fire department who was actually very helpful. We find two men, on in a wheel chair and one who looks like someone just pissed in his Wheaties. Our pt was actually the one in the wheel chair. The obvious questions are asked first. What happened, what type of medical problems do you have, any allergies, and are you always in that wheel chair. The pt's brother was not happy with that last question. He immediately threw what we in the medical field call a "hissy fit" and proceeded to tell us in a very high pitched manor of the events that transpired. Apparently his brother suffers from "hype-no-tension". They will remind us of this several times over the next 30 minutes. This act of replacing the "o" in what should have been hypotension with a "no" totally threw my partner for a loop. So I had to translate white trash pirate for him into terms he could actually use.
Oh yeah! The whole pirate thing. Let me paint you a better picture. Our pt, the one in the wheel chair is something of a miracle of modern medicine. You see, he sort of drank himself into his current condition and is kept alive by medicines, medicare, and certain family members being enablers. This gentleman was probably a buck thirty soaking wet with change in his pockets, had a fairly thick beard and mustache and to top it off, had a black "pirate-esque" eye patch that he wears due to an unfortunate incident at a certain hospital with a medication he is unsure of. As you can see, he was prime material for being captain of the football team.
So we ask black beard about his medical problems and what brought us to his lovely home to assist him with. He proceeds to tell us the story of how when he stands up he gets dizzy, "hype-no-tensive" and falls down. After my eyes stopped rolling, we took him to the area's only trauma center for further care.
As we are loading him into the truck, he is still talking about his mispronounced condition. For some reason, I felt it was necessary, nay my duty to correct this one eyed pirate citizen. I tell him "Sir, you mean hypotension. Low blood pressure." He yells at me and says, "NO! Hype-no-tension! Like Hype-no-dermic needle!" I just look at him and say "Actually no. But it doesn't matter. As long as we are both on the same page that you have low blood pressure, then it will all work out". We then load the pt up and I let my partner take the call. The pt was very very done with me and what I had to say/offer. So we bring captain hook to the ER and continue back out into priority 3 purgatory.
An interesting thing to note on this call is the correlation between the amount of DVDs one owns to the total amount of productive work days in a year. I think I will deem this "Blue Rays Law". If your DVD collection exceeds either the amount of days you work per year or is greater than the number of days in a year, than you are not exactly a very productive member of society. Call it jaded, but when I came up with it, I was pretty damn proud of myself. Ha ha! That's all for now.
Now my partner and I arrive on scene to a "handy man special" single floor ranch style house in an area that is occupied by people that are taking full advantage of that certain government program that is located between sections 7 and 9. As I am sure you are already aware, this place was about as clean as gas station bathroom and probably smelled similar to one. So we walk in with the local fire department who was actually very helpful. We find two men, on in a wheel chair and one who looks like someone just pissed in his Wheaties. Our pt was actually the one in the wheel chair. The obvious questions are asked first. What happened, what type of medical problems do you have, any allergies, and are you always in that wheel chair. The pt's brother was not happy with that last question. He immediately threw what we in the medical field call a "hissy fit" and proceeded to tell us in a very high pitched manor of the events that transpired. Apparently his brother suffers from "hype-no-tension". They will remind us of this several times over the next 30 minutes. This act of replacing the "o" in what should have been hypotension with a "no" totally threw my partner for a loop. So I had to translate white trash pirate for him into terms he could actually use.
Oh yeah! The whole pirate thing. Let me paint you a better picture. Our pt, the one in the wheel chair is something of a miracle of modern medicine. You see, he sort of drank himself into his current condition and is kept alive by medicines, medicare, and certain family members being enablers. This gentleman was probably a buck thirty soaking wet with change in his pockets, had a fairly thick beard and mustache and to top it off, had a black "pirate-esque" eye patch that he wears due to an unfortunate incident at a certain hospital with a medication he is unsure of. As you can see, he was prime material for being captain of the football team.
So we ask black beard about his medical problems and what brought us to his lovely home to assist him with. He proceeds to tell us the story of how when he stands up he gets dizzy, "hype-no-tensive" and falls down. After my eyes stopped rolling, we took him to the area's only trauma center for further care.
As we are loading him into the truck, he is still talking about his mispronounced condition. For some reason, I felt it was necessary, nay my duty to correct this one eyed pirate citizen. I tell him "Sir, you mean hypotension. Low blood pressure." He yells at me and says, "NO! Hype-no-tension! Like Hype-no-dermic needle!" I just look at him and say "Actually no. But it doesn't matter. As long as we are both on the same page that you have low blood pressure, then it will all work out". We then load the pt up and I let my partner take the call. The pt was very very done with me and what I had to say/offer. So we bring captain hook to the ER and continue back out into priority 3 purgatory.
An interesting thing to note on this call is the correlation between the amount of DVDs one owns to the total amount of productive work days in a year. I think I will deem this "Blue Rays Law". If your DVD collection exceeds either the amount of days you work per year or is greater than the number of days in a year, than you are not exactly a very productive member of society. Call it jaded, but when I came up with it, I was pretty damn proud of myself. Ha ha! That's all for now.
Sunday, January 2, 2011
48 hours of Rescue
I figured it would be a good idea to get back into the swing of things after my 8 days out of town by working 48 hours straight. I was able to "sleep" but enough for it to be rejuvinating. Sleeping while at the same time waiting for the radio to go off or the phone to ring is something that I am still not all that used to yet. I still think 12 hour shifts are better than 24s.
This period of time at work was pretty busy. Nothing too exciting, just alot of people calling 911. I think over the two days, we did 16 911 calls. It is picking up in the area(s) where I am running 911. I was surprised when we didn't have to respond to a single assault or ETOH related incident. Especially on New Year's Eve. It was alot of chest pain/shortness of breath. Basiclly everyone recieved the usuall "IV, 02, and Monitor".
I hope 2011 will bring some new challenges, more knowledge, and a new position (Think flight job). Only time will tell. Until then, rescue and MICU shifts will have to do.
This period of time at work was pretty busy. Nothing too exciting, just alot of people calling 911. I think over the two days, we did 16 911 calls. It is picking up in the area(s) where I am running 911. I was surprised when we didn't have to respond to a single assault or ETOH related incident. Especially on New Year's Eve. It was alot of chest pain/shortness of breath. Basiclly everyone recieved the usuall "IV, 02, and Monitor".
I hope 2011 will bring some new challenges, more knowledge, and a new position (Think flight job). Only time will tell. Until then, rescue and MICU shifts will have to do.
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