The night of insanity, Part One!

What a night!

I arrived about 45 minutes early to the Firehouse to get dinner set up. I have a gallon and a half of venison chili in a pot on the front seat of my car and all the fixin's in the trunk. I'm opening the trunk of my car when the bell for the ambulance goes off.

Out the door I go! Rear-end collision on the Major Interstate. I arrive as the rescue squad from my old station is preparing to extricate the driver. I pop into the car to check her out briefly. She's in a good mental state, denies loss of consciousness and her main complaint is neck and back pain. The squaddies have things well in hand so I get out of the way until the driver's out of the car.

Backboard, straps, immobilize the head, into the ambulance. Police take a report while I do a quick trauma assessment. Nothing noted but tenderness. I check the status of the area hospitals and am told by communications that the nearest hospital is open and ready to receive patients. Ok! off we go.

Unbeknownst to me, about 5 miles away was a 5-car pileup. I arrive in the ER with my patient at the end of a line of 6 other car accident victims. The nearby trauma center has been overwhelmed from previous incidents and is on re-route. Suddenly, I'm in for a long wait.

An hour later, I'm still waiting for my patient to be triaged and to hand over care. I call the Firehouse. Herself was going to meet me there to dine with us. Sure enough, she's there. I ask her to get dinner set up and start the rice. She proceeds to not only do that but to feed everyone, thereby earning the undying love and adoration of every firefighter there.

Back in the hospital, I still had a long wait before I could transfer my patient to a cot next to the nurse's station and head on out. I have to say, I was quite annoyed at the other ambulance crews that were there. One crew kept harassing the nurses for a bed for their patient when it was clear there were none. Meanwhile, one member of this crew tells me their patient has an altered mental status (AMS) so goes ahead of mine who only has pain. We're having this conversation about 15 feet away from their patient.

"AMS, Eh? When was the last time you took vitals?" asks the maddog.

"Uh, when we transported her." says the mouth-breathing dork who transported her. That would have been about an hour ago.

"Unstable patient gets vitals every 5 minutes and, unless I'm mistaken, she's still your patient." replies the maddog.

"Uh. Oh. Right!" Off dashes the mouth-breather for a stethoscope and blood pressure cuff. Meanwhile I strike up a conversation with their patient. She's doesn't have an altered mental status, she just doesn't speak English. A few sentences later, I discover she's mostly complaining because her necklace is caught in the collar and is pinching her really bad. A few adjustments later, the patient is much quieter and the crew who brought her is much meeker.

Meanwhile, my patient is becoming more agitated. She's in a lot of pain, strapped to an unforgiving and rigid backboard and unable to move anything except her hands and arms. Her head hurts. I raise her cot a bit to take some blood pressure from her head. that helps a little bit.

"I have to pee!"

"I'm sorry, Ma'am, I can't take you off the board until you've been x-rayed. We're worried about your spine and neck."

"My head hurts and I'm uncomfortable."

"Yes, I know. I'm sorry but it's for the best. I don't want you to hurt your spine." I see this isn't working so I get personal. "Ma'am, if you were my sister or mother, I would do the same thing. I'm worried that you may have injured your spine and we have to keep you from moving until we can find out what's wrong. Please don't try to move."

"This thing is uncomfortable!" She digs at the collar and tries to twist her head. Out comes my 'cop voice.'

"STOP MOVING. STOP MOVING YOUR HEAD NOW!" No shouting but firm and clear. The whole ER gets quieter. I get my face right over hers so she has no choice to look at me.

"Do not move. Do not move your head. Do not move your feet. I don't care how much it hurts. Do! Not! Move!" I stare her down.

She grows meek. "Can I hold your hand?"

"Of course you can." She does.

I find myself managing and triaging 5 patients and getting the admittance paperwork started for the nurses. All the while holding my patient's hand. As a result, things move a smidgen more quickly and I finally leave an hour and a half after I got to the hospital.

Back at the station: I manage to finish my paperwork, wave to Herself and put one spoonful of chili into a bowl when the bell rings again. 27 year old Male with Chest pains. No medics available.


I'll write about that one next.


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