I went out for a run today.
So did 30,000 other people.
26.2 miles later, I completed the 30th annual Marine Corps Marathon.
At mile 23, someone handed me a beer.
I love that man.
I walk past the car that's resting gently in the ditch with water up to the doors.
"What happened?" I ask the driver, who's standing on the shoulder looking at his sinking car.
"I fell asleep." He says. "And I woke up in the ditch."
"Were you wearing your seatbelt?"
"Do you hurt anywhere?"
He checks out as perfectly fine. Answers my questions appropriately and doesn't want to go to the hospital.
"Where were you going?"
"Where do you live?"
"****Town? The exit for that is 5 miles back!" Exclaim I.
"Yep, I fell asleep."
Posted by --maddog at 22:52
She's 80 years old but looks like she's 60. Doris just had her knee replaced a month before. She takes medicine for high blood pressure. She was wearing her seatbelt. The airbag blew. The front of the minivan is metallic and rubber hamburger. The engine is 2 feet away from where it should be.
I gently take her head in my hands with my thumbs along her jawline. "Doris, I want you to keep your head still, Ok?"
She nods. "No, Doris, you need to relax and keep your head still."
Collar, headroll, backboard, straps, into the Medic unit. Once inside I do a full assessment. for any trauma and get a better idea of her mental status. Biggest complaint is the knee she had replaced. Hit it on the dashboard. She also has pain from the seatbelt in her chest, neck pain, back pain and her wrist hurts too. The whole time I'm talking to her to reassure her. I tell her everything that I'm going to do and I'm honest if something's going to hurt.
She's lucid and with it. No loss of consciousness, pupils are equal and reactive, no signs of head trauma. I get a good IV started and run a 12-lead to get a look at her heart to rule out any cardiac problems. Her EKG looks better than mine!
All of these procedures are difficult in a moving ambulance. (My preceptor is driving because he trusts me enough to run the call!!!!) but I also have to do them all one handed. Doris will not let go of my hand. I can get her to switch hands from time to time but, for the most part, she's hanging on to me.
I think all of the medical interventions I perform don't do as much for her as holding my hand.
Into the crowded hospital. We're in line. A doctor comes out to check out Doris's neck. He directs us to X-ray right away. I give my report to the receiving nurse and assure Doris that she's in good hands.
With a strength that surprises me and the nurse, Doris reaches up, grabs me by the neck and pulls me down for a big smooch on my cheek.
I'm almost skipping when I leave the ER.
Later, on my evaluation form, my preceptor writes, "EXCELLENT bedside manner!"
Posted by --maddog at 17:40
I've been doing some of sailing. I've also run a lot of calls, gone running a lot and have no internet access at my house. (bleah!)
I know, I know. I have NOT been writing as much as I should. I shall endeavor to write entries daily but they seem to pile up. I look at the pile and I say, "Feh! I'm going sailing!"
I'll try to publish more, I promise.
Posted by --maddog at 06:26
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!"
Posted by --maddog at 21:17