With folks like him riding ambulances and being members of our community, we will improve.
Jolly and I are on night shift at the main clinic when we get a call for a security guard who's collapsed at a facility about 45 minutes away.
On the way, we're advised that the patient has been loaded into a security vehicle and they are racing to rendezvous with us. We meet on the dusty shoulder of a desert highway. A panic-eyed security guard opens the back door of the SUV and I see our patient.
He's blue. It's been at least 20 minutes since we got the call.
That's not so good.
BVM, good air movement. I holler over my shoulder to Jolly. He slides in and we quickly transfer our patient to the ambulance. No pulse, no respirations.
Load and go, pump and blow!
The drivers hired by our company for the ambulances are not medical personnel. They are local employees who are sliding towards retirement. They have NO training in emergency vehicle operations and no concept of what it's like to be in the back of an ambulance. They also drive like locals.
Our particular driver has been infected by the urgent panic of our patient's colleagues. He goes screaming down the highway, around corners and over speed-bumps in such a way that Jolly and I can barely keep up CPR, much less attach a monitor, intubate or start an IV.
Jolly is alternating between chest compressions and bracing himself against the movement of the ambulance. I'm doing my best to manage the airway with basic adjuncts while screaming "Schweiah, Shcweiah, F*****g Schweiah, already!!!" Over my shoulder. ("Schweiah" means "Slow") The panic makes the driver deaf.
At the ER, we work the code with the rest of the staff, most of whom were my students in an ACLS class I had taught 3 days before.
Asystole on the monitor.
Tubed with a 7.0. Bilateral 16s, wide open. Enough Epi to make a sloth break a 4-minute mile.
We call it after about 30 minutes of working. We went that long mostly for the benefit of the patient's coworkers who were looming outside the door.
51 years old. This was only the second time he's ever seen a doctor. Also the last. His previous visit was 7 years ago and it ended with a prescription for cholesterol and blood pressure meds that he never filled.
We did our best but there's always that let down. Maybe it's the adrenaline wearing off, maybe it's the obvious grief on the faces of his friends.
It's late. I clean up and hurry over to the commissary next door to grab a missed dinner before they close.
The Indian guy at the checkout looks at my name tag. He pronounces my last name carefully.
"Do you know what your name means in my language?"
I shake my head. I'm really tired.
He wears a big grin. "Murderer!"
Great. Just great!
Wow! What an amazing time I had at the 2011 EMSToday conference. I learned a lot, met some amazing people and have been re-energized to make this blog fly.
There's so much to write on but I've got 90 minutes until hotel checkout and too much knocking around in my head. I'll be with family for the next day or so then I have about 24 hours of plane and car travel to get me back to my tiny desert town.
I want to write about the people I met and the impact of social media on blogging. I've seen a DRAMATIC change over the last 2-3 years. I want to discuss that.
The recent protests in the Middle East merit mention considering where I live and work.
Give me a few days to get all these thoughts organized and I'll be pushing out some posts over the next few days.
While at the EMS Today conference in Baltimore, I popped by the EMS blogger party hosted by Zoll. (Thanks, Charlotte!).
What an amazing time. What an amazing group of people! I met some of the brightest, sincerest and funniest bloggers out there. I realized that my recent inactivity and general decline of blogging has led me to miss the boat. Social media, facebook, twitter and the increased interconnectedness that we get from that has transformed EMS blogging.
I started it as a diary of sorts of my times and efforts becoming and then working as a paramedic. Now, these amazing professionals share information, teach each other, engage in collaborative learning that would not have been possible 10 years ago and would have been unusual 5 years ago.
I feel like I took a long nap and then woke up to find my house full of the smartest, most motivated people I've ever met and they're all clamoring to do cool stuff.
People like Tom Bouthillet, the Happy Medic and so many others were there last night and I have to say to all of you, thanks. You have made me feel welcome again into this growing community of blogging EMS providers and I'm really glad to be back. You have inspired me.