"lub-dub, lub-dub, lub-dub, hello?, lub-dub, lub-dub, lub-dub, Hello?, lub-dub, lub-...

First night at the new firehouse:

I arrive at 7pm in uniform with the patch from my old station still on my left sleeve. I am greeted by a group of people in a friendly way. "I'm the new guy." I say.

"You're the new ambulance officer?" they ask.

"Yep, sick, bleeding, ill or injured. Bring 'em on!" I say.

"Hell!" Says one, "I'm gonna buy you dinner!"

More of the same sorts of welcomes. Nice way to start! Deputy Chief (We'll call him Jake) arrives a few minutes later and we get right to business. He gives me the written test for ambulance officer and gives it to one of the firefighters too. This one is considerably different from the test I took at my old station. For starters, there's an actual written test, it has a LOT of patient care questions and seems to be focused on ensuring the person riding the ambulance is ready to treat patients and knows where to take them.

During all this I notice how clean and orderly the ENTIRE station is. Even the crew lounge is a clean and pleasant place to be. My neighbor's son (we'll call him Zach), who lives at the station, gives me a tour of the place.

After passing my Ambulance Officer test (1 question wrong, I blanked on the normal blood pressure for an infant), I was entered into the log as approved to ride on the Ambulance. I proceeded to set up my sewing machine, remove my old patch and put on a patch from the new station on my left sleeve. Other members began to offer me money to sew their patches and hem pants. I think I earned a lot of brownie points by offering to do them all for free. I'm going to have a busy duty night next time!

First call comes not too much later. In fact, I was in the lounge talking with one of the members about my transfer and how much I like medical and trauma calls when the bell rang for the ambulance.

76 y/o Male with loss of sensation in his left hand. Call goes out as a possible CVA (stroke). The address is a managed care facility next door to the hospital. It's a recovery facility for patients released from the hospital next door. It's not our jurisdiction but, the company that covers it has no ambulance due to mechanical problems or something.

That company has dispatched their brush truck with a pair of FF/EMTs who are there when we arrive. The patient is alert and oriented X3, Hx (History) of Congestive Heart Failure (CHF) being treated for pneumonia most recently and a medication list longer than my leg. He's a good sport and responds well to my questions. The other station's people are already getting vitals so, I get some history from the nurse and the patient. His face has no droop, he speaks with no trouble, and has no other complaints except the numbness. We load him up for the 100 yard drive to the Emergency room.

My ambulance doesn't have an SaO2 meter and the one the other company brought doesn't work. I take his pulse and respirations manually and notice something I've never seen before. He's got no pulse ever 4th beat! I check his other wrist and get the same thing! Wow! 3 good, strong, steady beats and then one's missing! I note it in my patient care form and we admit him to the ER.

On my way out, I run into a medic who's restocking his ambulance and I ask him about it. No other signs, Hx of CHF, what pulse is there is steady and strong, patient has no altered mental status and complains of no pain other than the numbness in the arm.

"Secondary blockage, sounds like" he says. and then proceeds to explain how sometimes the action potential or nerve impulse cannot perfuse properly through the heart muscle and it doesn't fully contract. It was really cool of him to explain this and I could tell he's "into" the science of the medicine. The really awesome part is that we covered the science of it in my Anatomy and Physiology class the very next day! w00t!

I had another patient that I'll write about later.


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