3.27.2004



Well! Last night was one of the most enjoyable, most exciting and most educational experiences of my career as a volunteer EMT.

The weather was delicious. I arrived to find J2 hanging outside the station with Old P. Old P is a retiree in his late 50's who still runs on the squad and drives tiller on the truck. He used to be a diver and very much enjoys the firehouse. He's the one who recruited me to this station and I like him a lot. J2 has some shopping that needs to be done before she heads to Iraq for 3 weeks. She asks me to ride 2nd so she can take the ambulance. Sure.

Sick baby:

On our way out of the parking lot of the store we get a call. Sick or hurt infant, not sure which. ZOOOM! we take off. At one particularly full intersection, J2 goes against the flow of traffic and cuts straight through the intersection. Wheee!! I'm more comfortable talking on the air now. I get address confirmation from dispatch and keep them informed of our status.

I'm on maps and I nail the coordinates perfect. 50 yard dash, 3 flights of stairs, bang on the door. Mom opens the door with a beautiful, and I mean beautiful, baby girl on her arm. She's alert, good color and very interested in this new person. Mom states that she turned for a second on the phone and heard a "thump." Baby had rolled off the 2 foot high bed onto the floor. Mom got scared and called us. We get mom to sit. Baby's got a strong, steady pulse at 100 bpm and clear lungs with regular rhythm. No signs of injury or trauma. No guarding either. I give her a full check for injuries or tenderness. Nothing. The whole while she's oriented and interested. Sparkly eyes and perfect features. The baby doesn't protest to anything until J2 starts to speak.

You see, J2 has no volume control. When children are present, she has no pitch control either. She does the coo coo baby thing and Mom, baby and I all wince in unison. Baby starts to cry. J2 keeps going! WTF? I had a calm, compliant baby here and J2's making her crazy! *Sigh!*

On our way back, we discuss Dinner. We decide we want to eat from the Italian place nearby. It was where I had my first job and I had worked there for 5 years before heading off to sea. Good place. Since I was planning on doing a 10 mile training run on Saturday, a big mess of pasta would be perfect. We get back to the station to see if anyone else wants to get in on the "food run" and I discover that J1, my favorite hotshot ambulance driver, was on duty and had actually signed up earlier as the duty ambulance driver. It appears that J2 came in, without signing on and just took over. I convince her to join us on the run. I kind of needed her to be there as a buffer between me and J2 and I was hoping that J2 might decide to head out early. She's driving me nuts.

There seems to be some bad blood between the Js. Partly due to J2's lack of a filter between her brain and mouth and partly because of J1's tendency to hold a grudge. J2 is one of those people who lack in social skills to a degree that you begin to wonder if there's something wrong with her. She's extremely loud and enthusiastic. She's very knowledgeable about her work but she cannot pickup any cues from anyone. She seems to not even pay attention to what anyone else is doing. It's horrible to have someone like that as an EMS partner. You have to be so direct with her that you have to constantly choose between her yelling in your ear while you're listening to breath sounds or risking offending her to the point where she'll sulk and throw tantrums all night. Too much drama.

Well, J1 and I couldn't shake her from the ambulance even though she's leaving for a combat zone in 2 days and claims she has a billion things to do. Well, J1 and I decide we're not going to let that ruin our fun and we promise each other that we're going to be nice. We grit our teeth, make those rictus-like grins and say "Be nice!" at each other in a snarl. HA! Turns out we had fun. We took our dinners to a park near the firehouse and ate at a picnic table. Afterwards, the Js rode the swings while I cracked jokes about making our own patients. "Only one of you is allowed to get hurt so we have a driver and an EMT for the transport, OK?" The weather was warm and breezy but the radio reminded us that the night held promise. Personal injury/assault, personal injury/MVA, unresponsive person, EMS to assist PD. It's going in all around us as the night gets ready to swing. A citizen stops her car.

"Is everything OK?"

"Yes, ma'am. If the EMTs in your community are bored, that's a good thing, right?"

Big smile and a nod of the head, "Right!"

Back at the firehouse it's a soccer ball in the back parking lot. We're all working up a sweat and having fun. "Don't hit my car!" We've all got an ear out to the dispatch feed. It's like we have a sense of something looming. There's a pressure building and it's about to burst. Nobody wants to miss it.

Then it comes. Motor vehicle accident, one car on fire, injured person in car, off duty FF on scene. Squad and Ambulance roll. I'm thinking burns, BSI, working the maps, but I'm focused. I'm ready for the worst. I'm also calm. There's a little kernel of absolute peace inside me. It's the same feeling I used to get before I went into the boxing ring or before I walk on stage opening night. I'm ready. J2 is driving, J1 is riding 3rd. Our chief gets on scene way ahead of us and radios back that the injured person is NOT in the burning car and then he directs us where to stage. we pass a sedan fully involved in flames. The headlights are the only part that is not actually burning as it sits on the shoulder. The trees above it are catching fire and there is a perfect circle of fire around the car in the grass.

We stage, I hop out, put on my turn out gear and get to work. J2 has already pulled our trauma and extrication bags. We head over to the car with the patient in it. The rescue squad has already started setting up and they're going to work on taking the roof off the big american sedan. The volunteer FF is in the car holding cervical spinal immobilization for the driver. J1 goes in and takes over for him. She had to work hard to convince him to leave and only after the rescue crew hollered at him did he get out of the way. C'mon man, you got no protective gear, you're already the hero, let us work.

J1 calls back for stretcher and backboard. I join J2 to help. Back at the ambulance she tells me "You shouldn't have left your patient!" she's in her tizzy mode: moving too fast, too emotional, caught up in the drama of the moment. I put my hand on her arm, "I've NEVER worked an extrication, J1 has the patient and we're all a team. Got it?" J2 gives me a sulky look and we get back to work. I hate drama.

Back at the car, the patient's in and out of consciousness. I'm trying to get in and help J1 but I'm also getting shoved and knocked about by the extrication crew. I don't know the dance yet. Medic's on the way. Roof comes off in a flash (our rescue squad rocks!) and we get her boarded, on the cot an headed to the medic unit that is arriving. The medics ask J1 and I to stay and J2 to drive the unit to the landing site for the helo that's been called in. Clothes cut off, take vitals, Medics start an IV. The patient is starting to come around and become combative. She's oriented somewhat and is responding to verbal commands. She complains of pain only in her face which is bloodied and a little bashed up. Oh, did I mention she's drunk? You probably already guessed that. Seems she rear-ended the currently burning car at a pretty fast clip. Amazingly enough, the driver of the Sedan-flambé was totally uninjured and refused treatment.

The patient is stable and the helo is 10 minutes out. She's breathing without assistance and her vitals are stable and within norms. At one point earlier one of the medics asked me to help him set up the IV and I told him I didn't know how. Now that we had some time, I asked him to show me. He was more than happy and our wait for the helo turned into a sociable instruction session for J1 and I. I think the medics enjoyed teaching us as much as we enjoyed learning. We talked about drugs, IVs, what their thinking and diagnoses were and more. The helo arrived and their medics took over. I helped carry the patient to the helicopter and off she went. It was a little nostalgic as this service uses the same model of helicopter the Coast Guard uses. We helped the medics clean their unit and we went back in service right away.

On our way back, we get called again. MVA on the highway north of us. Then another! We're screaming down the road with sirens wailing. J2 is in full "tizzy-mode." She's distracted, talking from one subject to another and can't focus. I notice this guy in a souped up honda is not getting out of our way, We surge ahead and cut him off to get to the exit ramp and he's screaming at us. That's when I notice that our siren's wailing but our lights are not on! J2 notices this as well and promptly turns them on.

"Switch must be broken!"

"Hm."

Our chief gets to the scene first and, discovering it to be a minor fender- bender with no injuries, puts us back in service.

Back at the station, J2 is over my shoulder telling my how to fill out my paperwork but she had refused to do the paperwork herself. My restraint only goes so far and I shoo her away. Strangely, this is what offends her the most. She goes off to sulk in the other room. I look over to J1 and she's grinning that rictus-grin, "Be nice!" I love her!

We got together with all the squad team for a debrief. J2 did not deign to attend. I candidly asked these guys what I should have done and how I should go about balancing the needs of the patient and the need to stay out of their way. They were candid, fair and helpful. We all reviewed and worked on figuring out how to do it better. I don't feel the outsider any more. My chief called me by my first name and consulted with me about the patient disposition. The squad crew greet me when I come and go. Good. I'm a sociable creature and if I get along with these men and women well, there's more opportunity to learn for me.

The night did not stop for the rest of the area. Calls were going out all over the radio but none for our ambulance. Our rescue squad went on a call for a MVA where they had to cut out the dead one to get to the live one. I stayed at the station to provide staffing for the Ambulance. I could hear the ambulances for every other neighboring jurisdiction go out. Personal Injury/assault, scene not secure; Personal Injury accident; trouble breathing; unresponsive; the night was hopping but my ambulance was not. At 4 in the morning, I went home.

Hell of a duty night! Too busy to write!

Sick Kids

Flaming Car-becue!

Another accident! No....wait! Go home....

More later

--maddog

3.25.2004


Magical powers!!!!

Well, it seems that no sooner do I type out my woes that they quickly go away! I had griped that blogroll was down. I even spent some time poking around and waiting before I posted a gripe and apology(to my readers). HA! Now it's up, and I'm sure it's only up to spite me.

The fine computers at blogroll were only waiting until I publicly complained before they booted themselves back up again to prove me wrong. There were times when I worked as a network administrator that my own servers and workstations would do the same thing. It did not make me feel very good about my skills. Then again, everything I worked on was Micro(the European Union thinks your evil too)soft and frustrating me was merely a "feature" according to technical support.

Serves me right for whining, I suppose. If any of you have a technical problem, I'd be more than glad to do my part to make it go away by complaining in my public blog. Of course there will be a nominal fee......

--maddog

%$#@!&%R$#@! Blogroll is down.

Sorry about that. I've come to depend on that blogroll quite a bit as it's a hell of a lot easier and faster than putting in the HTML by hand.

I guess I'll wait and see if it comes back up again. I can't even connect to their site.

Apologies.

--maddog

3.24.2004

Update on the Vomit Comet:

I'm all better now. Sunday was a daze of fever and weakness. I watched two movies I had been meaning to see for a while and only regretted one of them. The Transporter was a little too over the top and Hong-Kong-esqe but I finally saw Bringing Out The Dead. I'm glad I did. Generally, Scorcese had not failed to please me.

Those of you that enjoyed the transformation that Nicholas Cage's character went through in that movie would also enjoy Matchstick Men. I saw that on Monday while I was still weak and wobbly but much improved from Sunday. Today, Tuesday, I'm back in form and might even try working out again tomorrow. I tell you, that food poisoning (for that's what I'm convinced it was) really kicked my teeth in. I'm usually not that incapacitated by illness. I think of myself as able to "push through" any discomfort such as root canals and the like, but this thing knocked me out! I know this is not very EMS related but I thought I'd give an update and mention the EMS movie I saw.

Thanks for reading and your concerned comments. I'll write about guts and gore or EMS vs. Fire controversy soon. I promise!

OK. See you all later. Duty either Thursday or Friday night. I'll keep you posted.

--maddog

3.21.2004

I got to the station to discover J was standing duty as the driver for the ambulance that night. Cool! We hung out while the squad and the truck went out to various calls to be put back in service halfway there.

I was delighted to find out that J is going to go to Paramedic school starting in the summer. I thought that was pretty cool. We talked about this and about how we both feel when working with J2 and with each other. We both agreed that J2, while knowledgeable, is not really good at picking up on what her partner's doing. There are other issues that have created animosity between J and J2 as well. For dinner we took the ambulance to a local chain place to get some salads. I got a vegetable panini sandwich that was pretty good. At least I thought so at first.

Unfortunately, the only patient I dealt with last night was myself. About 30 minutes after eating the sandwich, I started to get shivery and chilled like I had a fever. This got worse and worse and I could not get warm. I checked out with the chief and went home. My shivers were so bad It took a conscious effort of will to drive my car in one lane.

At home, I got a bucket for the bedside and bundled myself up in bed. I wasn't feeling nauseous but I had visions of whatever toxin was in my sandwich leaching through my stomach wall and into my body. Eventually, the idea of it got me up and I "emptied" myself. I felt considerably better after that and slept for most of the night.

Today, I feel like someone has lit into me with a baseball bat. All of my muscles are sore and feel bruised. I have a nasty headache and I don't think I've entirely shaken the fever. Fortunately, my stomach is OK and coffee is staying down. I'm operating at about half speed and standing up straight is a painful experience. I've been stretching and trying to get the hurt out of my muscles but it's going to take a while. No running for me today.

Sorry I don't have anything too exciting to write. Hopefully I won't be as disappointing next time.

--maddog
In order to go out with some friends last night, I have changed my duty night to tonight!! I'm just about to get dressed and head on over. I'm looking forward to a good time. The weather is nice (for around here) and the evening holds promise.

I love EMS!

--maddog

3.20.2004

I've been reading over some of my blogs and, UGH!, I need to proofread! I'm seeing some awful and obviouse mistakes. Verb tense, for example: I start the sentence in past tense and then describe what's going on in present. I also see where I've left out a few key letters that change the meaning of a word.

The funny thing is I scorn people that rely on spellcheck too much. Then I go and see my own writings with "there" instead of "their" and "move" instead of "moved." All perfectly correct words but totally inapplicable in context. Spell check only works for spelling, not context. I guess that makes me a lazy, sloppy hypocrite, no? HA!

I suppose I'll have to be more careful in the future about my writing. It certainly doesn't help that most of the time I write it's something done between other obligations and crammed into a short time limit. Writing well is almost never done in a hurry.

Duty tomorrow night. Saturday. Perhaps we'll have some fun.

--maddog

3.15.2004

Last Friday:

Got there early, hoping to get some calls in and I was not disappointed. At around 6:00pm, we got a call of a woman fallen on the platform of a local commuter rail station with a hurt leg. Oh boy, I had visions of a 300+ lb woman lying on the tile of the platform calling out for the baby Jesus to save her.

Well, it was a normal sized, embarrassed, professional looking woman in a considerable amount of pain with a very swollen ankle. She was on the landing in the middle of a set of stone steps leading from the platform down to ground level. It seems she rolled her ankle on a step and went down. No other trauma and she didn't hit her head or any other part of her body. She was extremely polite and kind as we move her from the ground to a stair chair to the stretcher to the ambulance.

(I know I have some non-EMS readers. For those of you who read this and don't understand the terms I use, email me or leave a comment and I'll fill you in)

I stabilized her ankle in the ambulance (it was cold outside & she was chilly), put an ice pack on and we had an uneventful transport to the local Emergency Department. An ED that was full of low priority patients. A hurt ankle with good vital signs and no extreme pain is an even lower priority. We had to put her in a wheelchair and set her out in the general waiting room to wait forever. Purgatory can't be any worse. Bleah. To her credit, she took it all with grace. We, on the other hand, exited with grace and got something to eat on the way back.

I had brought my sewing machine and sewing kit to the firehouse that night and there were a couple folks that needed some work. I had seen some people going around in un-hemmed pants and without patches on their shirts before and so I took to emailing everyone before I came in for a duty night to let them know I'd do some sewing for free. Some of the people there have been paying $20 per pair of pants for the worst hem jobs I've ever seen.

I had a few takers that night. One of them, B, had a crappy hem job that I'd seen before, with a small tear in it. I unstitched and re-sewed both cuffs of his pants properly, with the edge rolled into the hem. I just couldn't stand to see them all raggedy. He asked me, with a skeptical "are you a sissy boy?" look on his face, "How come you know how to sew?"

"Four years of sea-time." I said and and kept sewing.

"Right, of course, Duh!" said B.

I imagined scenes of salty old sailors with tattoos and grizzly beards bent over needle and thread making a new mainsail or foretopgallant. I tried to restrain myself from squinting one side of my face and saying "ARRRR!"

Then I went ahead and said it anyway.

3 pairs of pants hemmed and a few patches later the bell goes off again. 13 month old having seizures. I'm riding second and, J#2 (we'll call her J2 from now on) was driving. In the apartments again and I had to make a decision to try to get the ambulance in the back way since the map showed a hell of a long walk to get to the front. Fortunately, there was an easy way to the apartment from the back and we only had to run up a hill with steps. I'm the marathon runner at the firehouse and J2 is not exactly Cathy Decker. I think she was about to pop a gasket by the time we made it to the door. Me, not even winded.

We find a naked infant unresponsive and breathing through his mouth, in the arms of his grandmother. The place smells like pee. He's hot to the touch and I get a response from him when I tap the bottoms of his feet. Wicked fast pulse, clear lungs, lethargic movement. Mom is hovering, sisters, aunts and other female members of this huge West African family are pouring through the door. I let Grandmom hold the baby and enlist her help holding a non-rebreather mask to the child while we get some good O2 going.

The medics show up and one of them was on the GSW call before. I say "Hello" and she recognizes me. "Good to see ya!"

The baby is responding very well to the O2 and almost immediately wakes up and cools off. Mom says he's been sick since Monday with a cough. He's still breathing through his mouth and there's a lot of dried mucus in his nostrils. Looks like he got too hot and started to seize. Mom and Grandmom took all his clothes off to help him cool and called us. I think that's when the little guy tinkled on the carpet. I know because I managed to kneel in it when I was getting down low for a better look at him. BLEAH!

When some Africans get very dry skin it develops a scaly appearance. I can tell this little guy is super active. He's got patches of dry scaly skin from just above his knees to the midpoint of his shins. He's a crawler and sure enough, once he become alert he starts to wiggle around to look at everyone and take it all in with his big brown eyes.

One of the medics goes to listen to lung sound and, apparently, she doesn't warm up her stethoscope first. The cold of it surprises the kid and he starts to holler and cry. All of us, Medics, EMTs and relatives visibly relax. His condition is consistently improving and my blood pressure returns to normal.

We load him up and he and mom take a ride to the now-quiet Emergency Department. He was so interested in everything I was doing and he looked at the world like he was eating it with his eyes. I love children but they scare the hell out of me when they're sick.

The only other call that night was us and the rescue squad on an MVA. By the time we got there, both drivers are out and one of them is surrounded by cops. The cop-free driver refuses transport and the cop-laden one is obviously getting a ride to lockup rather than the ED. I'm standing by while J2 gets a patient refusal form signed and I can smell the booze when the wind shifts. Yep, he's going to a nice warm cell tonight.

The cars are a sight to see. Near as I can tell the drunk guy came surging out of a parking lot and hit the sober one so hard in the rear bumper that it spun his big sedan around 180 degrees and the drunk guy's airbags went off.

Dang! I'm glad nobody was hurt. My patience for drunk drivers is no more than drunk boaters.

Thanks for reading. I'll see you all next week.

--maddog

3.13.2004

Whirring sewing machines.

Woman falls down stairs into ER wait purgatory

Febrile seizures in a 13 Month old

Drunks, cars, cops and crashes.

Friday nights are fun!

More after I sleep......

--maddog

3.12.2004

Duty tonight.

Windy day, clear skies, cool but not cold, Friday night.

Stay tuned, kids. I got a feeling tonight's gonna boogie!

--maddog

3.10.2004

I got a phone call today.

I was at school working on a paper when my phone rang. It was J, my favorite driver on my ambulance. She was calling to let me know she was standing duty tonight and to find out if I was going to too. I told her that Fridays were my duty night now as I couldn't get out of class in time to be there on Tuesdays. In any case I had a date with 2 ladies for dinner tonight and I'm not breaking that for the world! Especially since one of them is buying me dinner! She alternated between razzing me for not pulling duty on her night and trying to convince me to come in tonight.

Wow! That's cool! I got the feeling that she LIKES running calls with me. I had said in my last post that I think she's warming up to me but I didn't even know she had my number. At first I didn't know how to feel but as I thought about it, I got pretty excited. I finally feel like I'm really a member at my station. I have voting rights in the volunteer organization and I'm a recognized officer in my jurisdiction now. That's all good and fine but to have another member call and, for all intents and purposes, request my presence on her duty night is pretty reassuring.

I don't think I'm any great shakes at EMS and I certainly don't have any high opinion of my interpersonal skills at that station. To hear from J, whom I hold in pretty high regard in both EMS and socially, was extremely self-affirming. To tell you the truth, I like running calls with J quite a bit. She and I seem to work together well. There's no personality conflicts and we both see eye to eye when it comes to the "Patient First" attitude. I ended the call with the feeling that she's thinking about coming in on Friday nights to run calls with the "maddog."

Wow!

--maddog

3.04.2004

Pulled duty last Tuesday night.

I got my official approval as Senior Ambulance Technician and I can ride the officer seat in our Ambulance now. Yay! J was there that night as it was the monthly meeting night. She's warming to me. She teases me a lot more and it's a friendly way.

After the meeting, she was going to leave. I told her she couldn't. Who was going to drive the ambulance in that special way she does if she leaves?? (see last post below). J griped and moaned but opted to stay for "Frasier" and "Scrubs," two TV shows she likes.

Sure enough! Within the first 10 minutes of "Scrubs" we got a call. Female at local restaurant who collapsed and complained of dizziness. History of heart failure. Us and an ALS unit are dispatched.

The restaurant is also a popular bar in the area and local PD has taken to stationing someone there at all times. One of the officers, W, volunteers at our station as an EMT/FF. Cool, he's already got the patient in a stable position, getting SAMPLE history and vitals when we show up. J takes the lead as she's in the door first. She's breaking out gear and W is really running the patient care at that point.

J to me: "ETA for ALS, backboard and stretcher!" and she sets up O2 via NRB and starts talking to the patient. Out the door to the ambulance for the stretcher and one of the other cops there comes right along to help. Right on! Our local PD has never failed to be fantastic and at least 3 of them volunteer at my firehouse.

Back inside: her vitals are normal and she's responsive and oriented. Hyperventilating a little bit and obviously distressed. We get her on the backboard then on the stretcher. When we go to raise the stretcher, a rather immense woman seated in a booth next to me goes to stand up. She's been watching all the goings on and if she did get up, she'd topple the stretcher, me and just about anyone nearby. I've got both hands full of stretcher and I'm lifting so, I tell her, "Do not stand up ma'am." Clear instructions, firm voice direct delivery. I call it my "cop voice."

"Can I go in the ambulance?" She asks

"No." Delivered in the same clear, no-argument tone. She becomes meek and sits right down.

As it was there wouldn't have been any room for her. We got the patient, her husband myself and J in the back of the ambulance when the medics arrived and took over. I've heard a lot of stories of snotty medics, uncaring medics, incompetent medics and medics who think that EMT-Bs are the bane of their existence. These two medics were great! Both were calm, professional, caring and courteous to the patient and to us. They talked to the patient, shifted her off the backboard, had her sit up, got a 12 lead hooked up, BP, pulse, listened to lung sounds and checked her from head to toe. All vitals within norms.

The patient is now looking very, very embarrassed. She refuses transport and the medics urge her to go to the hospital. We encourage the husband to take her there and he pulls his truck right up to the door of the ambulance. She leaves under her own power and off she goes.

I help the medics stow their gear and they seem pleasantly surprised that an EMT-B is doing so. It makes me think that the stories of rude medics have some origin in the teller. One of them asks me what I do for a living and I tell her I'm going to school to be a paramedic. She smiles, shakes my hand and wishes me luck. The other medic, tells me and J that we did a good job getting her on the board, stretcher and in the back of the ambulance. They then spent a couple minutes giving us feedback and answering questions about why they did what they did.

I was delighted for the learning opportunity and I sensed that they were pleased to find volunteers that were interested in more than burning buildings.

Panic attack was the general consensus for the patient's incident. I feel bad for her. It must have been extremely embarrassing and I wouldn't be surprised if she's hesitant about going out in public again any time soon.

Well, no duty this Friday. Going out of town. Thanks for reading and keep me updated on what you think.

--maddog