I apologize to the readers who come back to my little corner looking for something to read and have been disappointed. With the new baby and the other two kids, the Wife, work, teaching and taking classes, I've not had that much time to write. So here is the account of my last shift...
We had a student rider to come and do his clinicals with us. Have you ever noticed that whenever a student comes, it's either feast or famine? Either you run the worst calls or absolutely nothing. Well, this student is a "white cloud", meaning that we run nothing. Every time he has showed up I can count on being able to catch up on my sleep.
I kinda hate it for the guy because my cert card is barely dry and I remember all too well what it was like to do field clinicals. I know that he wants to get out there and tube someone, push every drug we have in the box and shock people 'till all the batteries are dry. I've offered to answer any questions he has. He's asked a few, I showed him all about the monitor, CPAP, BIG gun, MAST trousers, the pressure infuser and any other piece of equipment that we have on the rig. We've went over all 42 drugs in the box and he knows them by heart. So now we just sit around and watch TV or sleep. You know, just another day in EMS.
Last shift, he had no sooner pulled his little hatch-back car with all the EMT stickers and red lights out of the parking lot than the tones went off. We didn't stop for almost 8 hours. God, I wish they'd let him ride for 24 hours instead of just 12.
First call was for a choking at a nursing home. Nothing to it, little old lady got choked up on her mystery meat and the nursing staff freaked. You shoulda seen the look on the doc's face when we brought that one in...
Next was a CVA (stroke). Middle aged man had an acute onset of right-sided paralysis with blurred vision also in his right eye. No prior history except for diabetes and migraines. His symptoms were fully resolved way before we got there, and we only had a 4 minute en route time. He's a little sweaty, but otherwise he looks fine. The first responders say that his pressure is like 280/ 140 and they took it 3 times just to make sure.
We got him in the truck and they were right on the money. IV, O2, monitor and we were on the road. I gave him 2 sub-lingual nitro's and a clonidine. We were about 40 minutes away from the hospital and I actually got to see the clonidine work. Finally got his pressure to 160/ 100 and that was good enough for me. He never had any complaints whatsoever.
The last call of the shift was for a reported unconscious. We get there and the first responders are freaking a little bit. An elderly lady is propped up in bed, unresponsive, breathing about 30+ times a minute and looked like crap. We got her out to the truck and got to work. Her O2 sat's were in the 70's and her capnography was 23mmHg. History of COPD and CHF and lung cancer that was in remission, but no wheezing and no rales. Her lungs sounded good, for the little amount of air that she was moving. She came back around before we got to the highway and stayed that way until about 5 minutes prior to pulling up at the ED. She just finally wore out. I had my intubation stuff ready, but there wasn't any time, so I got a nasal airway in and bagged her the rest of the way.
As we moved her over to the ED bed she woke back up. We waited around just to see what they would do for her. I figured about CPAP or BiPAP, my partner thought they should just tube her. I didn't think she needed it and if they did, she would probably never come off the vent. Her sats dropped to 50 by the time the doc decided to do something about it. I didn't feel like watching them let her die, so we left. Not sure what happened. We got back and slept for the few hours before the morning wake up call.
And that was just another day...