More good reading

If you all enjoy reading my blog then you will love reading Confessions of A Stretcher Jockey This is one of the guys that turned me onto this whole blogging thing. You will definitely not be disappointed.

My Morning

So tired from a strange night we managed to catch one last call of the morning. And if you were wondering, yes those are feathers. My uniform looks like I just ran through a chicken coop in some twisted three stooges sort of way. So here's what happened...

18 year old driving along the road drifted into the oncoming lane, effectively bought two cars. She was awake but did not remember the accident at all but that's common in serious wrecks. Alot of confusion, metal, glass, and the unforgettable smell of airbags deployed. Her abdomen was tender and becoming larger by the minute, probably her liver but all I can go on is probably but that's all I need. We immobilize her head and hold her still while I am ding a quick head to toe assessment. Neck pain, abdominal pain, pelvic pain upon palpation, and a strong urge to pee were her primary complaints. She was wearing a Fubu jacket, it actually made me sweat looking at it as it had been so nice out the past few days. I take no pleasure in ruining someones favorite jacket, pants, shirt etc. But on the same token I don't hesitate to cut them off a patient. Unfortunately as I began cutting the jacket to clear it from around her neck I realized it was a down jacket. What can you do though? I had already committed and besides, there was no way in hell we were getting the jacket off of her without cutting it. So we get her into the ambulance and I position equipment and begin to finish what I started and clear the jacket from her arm. I must say they are well made and there is alot of down in those jackets. So now the feathers are flying as I am getting her on the monitor and getting her vitals and I have to brush them off my face once or twice. I get her name and she denies any history of medical problems. So another more detailed head to toe while I am waiting for the blood pressure to cycle. She screams at me and keeps telling me how her belly hurts and I try my best to calm her down as we are only a minute or two away from the hospital. So then I drop a 14 gauge in her arm and now she has something else to yell at me about as I flush it and secure the line. My Observer Paramedic Partner hangs a bag of saline and then sets up the med patch for me. I give them the info, letting them decide whether to call a trauma alert on it. We are backing into the ambulance dock as I am trying to get another 14 gauge in her other arm but it won't advance so I pull the line and patch it up with gauze and tape. We open the back doors and it looks like a herd of chickens floating out. We wheel her into the ER and they have called a trauma alert due to hypo tension and the possible belly bleed. I give my story to the doctor and charge nurse as the ER staff works like a well oiled machine, stripping her the rest of the way, inserting a Foley catheter into her bladder, and doing ultrasound and x-rays, as well as drawing labs and a 12 lead EKG. I go out to the ambulance, have a cigarette and laugh as I look into the back and see the mess I made. It took an extra hour to get all the feathers out.

This is my life and I am loving every minute of it

This ones for you Jamie

Nothing breaks up the monotony of work sometimes than when you get an extraordinarily strange call. So with that said I will relate a call that happened to a co worker of mine last night.

Kind of a busy night, moon is waning, weather is nice and mild. Rode with the windows down for a while.

We get sent out to take a psych or two to the Behavioral Health Institutes (I love that title but I do prefer looney repositories)

Our first sign that something was in the air was brought into focus when we get called to the local Holiday Inn for an intoxicated person. Now let me say that I have been drunk once or twice. You can kind of rate the degrees of severity by the actions that signalled the end of the evening like hugging the throne, waking up half naked in the hallway right before you reach your door, waking up in the shower, or the classic waking up with one foot on the floor because the night before you thought it was a very clever and logical idea that if you put one foot on the floor it would stop the rest of the room from spinning. And yes, it does work.

So we find this guy, sitting in the middle of the parking lot, covered in feces. I won't go into too much detail but I had not been so happy it was my turn to drive this much for a while. So we transport him in, and while my partner did turnover to a nurse who was probably imagining creative ways to torture us at the next group party, I was compelled to ask the guy how he got all the crap on him. I mean I was not even sure if it was his. That being said my opening remark was the bizarro polite thing to say which was

"So um is that YOUR crap on your all over you?" Lets define the situation here man

"Yeah"

"How did you get crap all over you?" Now that the source had been established

"Well I tried to take a crap outside and did not have any toilet paper" A problem many of us have faced even if we do not all admit it

"So you used your shorts?" I had to bring this into perspective here

"Kind of" Kind of does not validate this situation in the least

"And your shoes?" for they were covered as well tops and the bottoms

"WHAT? my shoes? I got crap on my shoes...Dammit!" Does this make sense to anyone?

So he was more worried about the crap on his shes than the 3 foot smear down his back and leg

But wait...thats not the actually bizarre call for the night.

After relating this to my coworkers as walking out to my ambulance, another ambulance pulled in beside us and the medic got out, saw me and handed two handfuls of pill bottles ranging from barbituates to muscle relaxers and ask me to follow him into the ER with is patient, whom I notice is sitting straight up but wiggling and trying to step off the stretcher while still strapped on. She is covered in vomit and making noises the likes of I have only heard on discovery channel. We get her into the room and my friend starts giving turnover to the nurse.

Are you ready for this one?

Her boyfriend had called 911 because she had taken unknown quantities of a myriad of pills and had been acting strange. EMS gets there, fire had gotten there a few moments before only to find this woman in a squatting position on the floor near her couch retching and wiggling around making afore mentioned animal planet noises. The couch was next to her and the arm of the couch was tattered and appeared the dog had been chewing on it. The thing is, the dog had not been chewing on it. Actually I am not sure they even had a dog. The story goes she had been eating the arm of the couch and had managed to consume a respectable amount of the arm of the couch. Now normally when dogs do this they spit the pieces o the floor, but not this woman, she was a champ, she had not been spitting the pieces out but had been actually eating the couch.

"So did she have any cuts on her mouth from the wood and the staples?"

"I aint putting my fingers near her mouth...Bitch ate a couch!"

God I love my job sometimes.

Apparently after we left the ER she began mooing incessantly

Thoughts

So tonight I am starting my ride time for the last portion of
Paramedic School. I get to put all the things I have learned during
the past year and a half to the test and see how it works out. Kind
of nervous but thats to be expected.

First call is to a 89 year old womans house due to a change in mental
status. Now a "Change in Mental Status" can mean a multitude of
things and be caused by an equal multitude of things.

So we get to the residence and we are greeted by a very sweet elderly
lady. I'll never get used to the fact that my patients remind me of
family members, friends, and other people I have met over the years.
Sweet Elderly women always make me think of my Grandmothers.

The house looked neat and tidy apart from the smell of feces coming
from the living room. While my preceptor was getting basic
information from her I stayed within earshot to listen but also wanted
to observe the living room. There was a parakeet in a cage next to
the sofa chirping loudly probably due to the strangers in its home.
There were several stains on the carpet, a large one near the front
door, and a few in various stages of being cleaned up.

"Do you have a dog Mam?" I asked

She looked at me puzzled and said "No, why do you ask?"

Not wanting to point out that I had noticed the state of her carpet
due to the embarrassment it might cause her I replied.

"Just asking because I noticed the bird you have and was wondering if
you had any other pets" I smiled and made eye contact with my
preceptor who had understood why I asked the question. So I made the
mental notes and went back to the patient.

She had not eaten in three days and had called her friend because she
had just had a period of delirium in which she thought she was being
attacked and killed in the living room. She denied any previous
incidents but told us she had been having increased difficulty
remembering things and generally taking care of herself.

This had to be a very difficult and frightening feeling and I
sympathized with her. So we obtained our vital signs which appeared
to be within normal limits, collected her medication, and carefully
walked her out to the waiting stretcher. So we got her into the
ambulance, did an EKG, BGL, IV, and got her to the ER.

The elderly in general are not as willing to volunteer information if
they think it might prolong their hospital stay. the old "If it ain't
broke or hurting, it must be working right" Many times when we ask
them if they have any health problems they will tell us no but then
give us a laundry list of medications.

"Why do you take a high blood pressure medication? Do you have high
blood pressure?"

"Nope. I used to though but I take a pill for it now"

Its all a matter of perspective.

So our next call is for a 28 year old man, having a seizure. We
arrive with the fire department and go inside to find his girlfriend
quite distraught describing what sounds like a classic seizure. The
patient is diabetic and has not checked his sugar since this morning
so I do it while I am talking to him. As we are waiting for the
results he keeps telling us he is fine and all he needs is to take his
insulin and rest. His results come back as 429. Normal sugar range
is usually 80 to 120 so needless to say this was concerning.

Now what many people don't understand is that we don't necessarily
like to take people to the hospital. Meaning if we don't think you
are really in need of an ambulance or a trip to the ER we will not try
and convince you to go to the hospital if you tell us you do not want
to go. We advise you of the possible consequences, obtain some legal
signatures and we are on our way. Thats not to say we would ever
refuse to take anyone to the hospital. I could hate you as a person
and I would still do everything I can to get you to the hospital
stable, comfortable, and safe while doing anything in my power to help
you. Be it breathe or pump your heart for you as well. What I am
saying is this. If we are trying to convince you and recommending you
go to the hospital to get checked out then you should take our advice.

He was conscious, alert, oriented and able to make a sound decision so
we obtained the paperwork and info we needed and told him to call if
he needs us again.

We were back there an hour and a half later, he was more than happy to
go with us this time.

I'm telling you folks. We do have an idea what we are talking about

Another Night Shift

Another night shift. Last one on my rotation. Its always easiest to
stay awake and alert on the third one. I mean your body has gotten
used to the time shift so you aren't dragging as much but you also
know that after the last one you just have to get back into day mode.
Won't have to worry about that for a few days at least.

Tonight started off slow enough. Get called to a 15 year old girl
hanging outside one of the local Ice Cream Shoppe in need of a
psychiatric evaluation.

Before starting this job I had no idea how well adjusted I actually
was as a child. Nowadays I find many of our psychs are young kids,
having trouble relating to their parents and likewise their parents to
them.

This girl was no different. She was very manic and happy to get into
the ambulance. It was a short ride to the ER but more than enough
time for her to tell me an abbreviated life story filled with strife
and fights with her mother. Tonight it had escalated to "I wish you
were dead" statements. The girl had tried to cut her wrist with a
pair of scissors. I looked at it and thought to myself that I could
probably do a better job with a McDonalds straw. She did not want to
die. She was just looking for someone to actually pay attention to
her and listen to her story. More often than not thats what we end up
dealing with. Of course some people are a little more aggressive and
successful with their attempts but some of these people have years of
practice trying this. So I lent an ear and noted everything, giving
the nurse a good report as I turned this girl over to her care.

Later I met the girls mother, she refused to take her home and when it
was explained to her she would be charged with neglect she said a few
choice words and walked out of the ER, refusing to take her daughter
home.

Our next call was for a complaint of chest pains. A sweet little lady
of 93, lives alone, and who was just about to go to sleep after
letting her cat in and felt pain on the left side of her chest, she
thought it was just gas pains but it is best to get checked out. Many
elderly are afraid to actually go to the hospital. In their later
years they value their independence more than anything. So following
the chest pain protocol, Oxygen, Baby Aspirin, Nitroglycerin, and a 12
lead EKG and a short 5 minute drive to the ER, we turn her over to the
night staff.

Then it is off to grab coffee, straighten up the ambulance and be
ready for the next call. This is life.