Bouncing Babies, Bleeding heads

The voting's done and #4 has squeaked by so, here we go:

Dinner's interrupted by an ambulance call. All I hear on the radio is my ambulance number and the number of the Medic unit. Out the door, I call in as "responding" and ask for the address again. Usually dispatch repeats the nature of the call and address once or twice as they tone it out again. This time the airwaves are particularly busy with dispatch toning out other calls. Basically, I'm going into a call knowing only that it's a medical call and dispatch thinks it's worth a Medic unit too.

I've got two people riding with me as observers tonight. Tootsie is a 21 year old local kid who's trying to decide what the hell she wants to do with herself. I've known her since she was about 13 when she auditioned for a play I was directing. She's joined the fire department after going on a ride-along with me. She's decided that she LOVES EMS. Goody! She's just waiting for her paperwork to clear before she signs up for EMT school.

The other ride-along tonight is Bean. She's another one I know through the theater. Her brother and I worked on A Midsummer's Night Dream together a couple years ago and I know her whole family. Bean, at 19 years old, is as tall and slender as Tootsie is short and curvy. I really like having them on board. They're both enthusiastic and helpful. All the rest of the clowns at the firehouse think I'm a pimp. HA!

We get on scene. As I hop out, "Tootsie, bring the O2 and suction. Bean, AED, I've go the Aide bag." I lead the way into the apartment building and am met by a 13 year old kid who's trying to hurriedly lead me to an apartment.

"Hold up, man. What happened?" I ask. I don't know what's going on and I want to find out a lot before I go in. Scene safety is first, right? The kid mumbles something and heads to the door. He's a little worked up.

"Stop!" That old authority voice works wonders. "What's going on?" From his mumblings I get that his 5 year old cousin fell and cut her head and she's bleeding all over the place.

Into the apartment, "Any pets in here?" No. I round the corner to find an extremely frightened young woman holding a little girl in her arms. There's drops of blood all over the floor, blood on her hands and blood on the head of a bright eyed little girl in the woman's lap.

I get right down on the floor with them and start talking to the little girl. I smile, she smiles back. I ask her her name, she tells me. I ask her if she hurts anywhere and she shakes her head. The young woman holding the girl looks like she doesn't know what the hell to do. She tells me that the girl tripped on her way into the kitchen and cut her head on one of the barrettes in her hair.

I sit cross-legged across from her and put out my arms for the little girl. The little girl gets up and sits right down in my lap with her back to me. This allows me to assess her very easily and look at the cut on her head. From the minute, I saw the kid, I'm using an assessment tool called the Pediatric Assessment Triangle (PAT). This triangle is made up of 3 factors, Airway & Appearance: which I assess by looking at muscle tone, activity level, mental status and whether the kid's breathing or not, Circulation: where I look at skin color, lips and fingers for cyanosis, obvious bleeding, capillary refill, skin temperature, pulse rate and quality and blood pressure. The final side of the PAT is Work of Breathing: Here I look at breathing effort, sounds, rate and depth. A quick assessment of these three factors can tell me if this kid's in trouble or not. With my little patient, she scores very high on all three.

The cut on her head is no longer bleeding. Again, I ask her if her head hurts and, again, she tells me, "No." I ask her to tell me what happened and she tells me a surprisingly clear, articulate and detailed account of her tumble.

The responding medic unit arrives to find a house full of volunteers, a pair of extremely frightened babysitters and a big, bald EMT sitting on a bloody kitchen floor with a giggling kid in his lap. I give them my report and ask them if they want to do any more assessment. One of them talks with the little girl for a bit and then pats me on the shoulder.

"Good job man. See you later tonight, I'm sure."

We leave about 5 minutes after mom shows up. On our way out of the apartment the little girl gives us a hearty, "Bye bye Fireman! Bye Bye!"


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