Sunday, November 29, 2009

100th Post

100 posts to this blog, so what should I talk about? How about the idiocy that often makes up the runs on my shift, and the good stuff that's sprinkled around?

Here's an idiot call to get us started.

I spotted this grafitti a few weeks ago and took the picture, knowing that sooner or later, I'd get the chance to use it. I'm suprised I had to wait this long.

Early 20's black male was laying on the curb, surrounded by 2 cops, wearing a wifebeater and boxers. His pants nearly to his ankles. It was pretty damn chilly out when this happened too.

There's the strong smell of puked-up booze, and it's obvious his body was pissed at the amount of alcohol it contained and tried to fight back. The officers were wearing gloves, and had stuffed the guy's ID, phone, etc, into a glove because it was all covered in vomit.

The guy's friends rolled up and tried their damndest to pull drunk guy to his feet and shove him into their car. They wanted to take him home to momma for her to deal with, afraid he was going to jail. Idiots, he already had the ticket in his pocket and wasn't under arrest. Our jail nurses would've refused him anyways, they refuse hangnails.

Finally, everyone gave up and we were able to drag him out and onto the stretcher. As we were putting on the seatbelts, drunk guy ripped one, right in my seatman's face. I looked up, then thought about laughing, and then I smelled it. I had to back off immediately. So help me god, that was the worst fart that's ever terrorized my senses.

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A BLS crew requested us out for ALS. Their patient had thrown up, and was starting to slip in and out of consciousness.

As soon as we arrived, we helped them move her to the stretcher and get her loaded. The monitor and drug box were loaded into the ambulance from our truck, and after a quick set of vitals, they took off.

The patient was complaining of a really bad headache. She didn't look like she was feeling good. It turns out, she had a massive brain bleed. If she survives this, she'll probably be a vegetable the rest of her life.

It always makes you think. This person was talking to us onscene, even if we had to get her attention, she was talking to us. Those may have been the last words she'll ever speak.
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As for some good stuff, first and foremost........

Georgia beat Georgia Tech!!!

I'll give both teams credit, it was a helluva game. It was definately a runner's game, with UGA running over 300 yards.


In other news, I got to spend some time in the mountains recently. 2 friends came back to GA for their families to throw them a baby shower. She's 7 months along now, and I haven't seen her in 6 months, so it was great to see how much she's grown.

Me and her hubby had fun geeking out with our guns in the back yard.

Ahhh, the joys of being in an area where shooting in your backyard is perfectly legal.

Every orange spot in the trees is a clay target. Since there are other houses nearby, we set targets at the base of trees, on stumps, or on knots where limbs were.

I grabbed my .223 and my buddy grabbed his .22 rifle. After the first couple of shots, her dad joined us on the deck with his 38 revolver. But, he wanted to fire my rifle. I only had a couple rounds left in the magazine, so I handed it to him, making sure he knew where the safety was, etc.

His first shot was way off, as was his 2nd. So, he turns to me and immediately complains about how I need to sight my rifle in.

How about no. Does that work for you? Oh, too bad.

It's my rifle, it's sighted in for the way I shoot. Get over it.
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As far as silly news goes.

You've never had fun until you've played christmas carols with the airhorn while responding to a call.

I was laughing, the seatman had a silly grin on his face, and the driver was oblivious.
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All in all, we were up almost all night. I came home and went to bed.

I swear, somewhere, somehow, somebody at dispatch managed to sneak those pressure sensors back into our beds. As soon as we layed down, we got right back up for another call. It happened twice in a row.

We ran more calls after midnight, than before midnight. Everyone was beat.

Friday, November 27, 2009

I hope everyone had a great thanksgiving yesterday.

I spent the first half of my day sleeping, recovering from my shift. Later, it was off to enjoy the festivities at my brother's house.

The shift started out early, and with a patient that had us wondering about the weight rating of some of our equipment. I don't think people over a certain weight, especially those with medical problems affecting their ability to walk, should be allowed to live anywhere other than the ground floor unless there's an elevator.

An extremely rare occurence happened when a frequent flier kicked us out and refused transport. Sad thing is, they probably actually needed to go this time.

Another frequent flier called and was indeed needing transport. Once on the monitor, it was very obvious that her pacemaker had a good capture and was pacing her. Her only complaint was related to breathing, even though her oxygen levels were in normal limits.

The only other call of any real interest had us awake at crazy hours. The call came in as an accident with injuries and entrapment. Strangely enough, the address was on a residential street, so we assumed it must have been where the street intersected with the main drag. We were wrong.

At retard-o'clock, a 20 year old was driving her SUV home from a party, drunk. She made it all the way into the very back of this neighborhood before jumping a curb and driving across a large front yard. But she didn't stop there. She drove through the homeowner's small sedan, spinning it over 90 degrees and sending it into a tree, then she continued across what has to be the largest cul-de-sac I've seen, jumping the curb, and finally coming to rest after striking a fire hydrant and tree.

Of course, she was fine, not a single scratch and she refused to even let us check her vitals.

The officers asked her if she'd been drinking, and she innitially lied "no". She later changed her story to say that she'd just come from a party. Here, the legal drinking limit is .08, but it's .02 for underage. With her being 20, we were positive she was screwed. We were right.

Once the DUI task force officer arrived, he chatted with her for a few minutes in front of his vehicle (camera rolling, no doubt), then hooked her up. No roadside sobriety tests, no mini-breathalyzer, not even so much as a nystagmus check. She was toasted.

Earlier, when she walked over to her car from where we were at, she tottered over to the side and nearly ran into the back corner of my ambulance. It's not like we were the least bit suprised to see the cuffs go on.


As expected, we didn't get much sleep. Our last call ensured that we'd be late getting offduty. Oh well, it happens I guess.

I'm just happy to finally be back where I want to be, and getting the experience I need (no thanks to the command staff I begged for a transfer well over 6 months ago). I have a great crew, and the guys are really settling down and starting to pick on me when we all start ragging on each other. They seemed hesitant at first, but I don't blame them, so many females are ever-ready to roll paperwork. I guess that's why I don't like working with other girls either.

I'm in a fair rotation between the engine and the ambulance. Both units usually get hammered at night, especially the ambulance. It sucks, but I don't really mind right now because this is where I'd rather be. I know the area better from working a few years there. I know what to expect from most of the patients. I know which buildings are nothing but a tinderbox, and which one's are death traps (in a few cases, even if they aren't on fire).

I still have a lot to learn, and I'm a bit rusty on the territory. I just have such a better grasp on things here and it gives me the confidence in my own knowledge that I was lacking at the station I spent the last year at.

Tuesday, November 24, 2009

CPR on dead folks

It's a necessary evil in the world of EMS. We see dead people, sometimes we can change that, most times we can't.

Let me give a little backstory first.

A few shifts ago, we responded to a hoarder house where the female is a frequent flier with breathing problems. She has a tendency to wait until she absolutely is in trouble, then call 911. About 2 months ago, she was in cardiac arrest and was one of the "lucky ones" our crews revived. Well, she was given 6 months to live because of her other medical issues.

We responded to a call at her residence because "she couldn't walk". As it turns out, her feet were dying. As in the worse of the 2 was half-dead. The dead parts were textbook, and it's the first time I've seen this outside of the pictures in those books. The dead areas were pitch black and much smaller than the rest of the foot. The skin had split in at least 1 place, and I was shocked to not see maggots.

We tried everything to convince her to be transported to the hospital. We warned her about the impending sepsis, threatened with DFACS, and called to try for orders to hold on a psych evaluation. We even offerred to carry her to a family member's car, but she refused everything and was in too good of a mental capacity to be held on a psych order. Our last resort was to have her sign a refusal of treatment/transport, and have dispatch send a police officer that has a nurse with them to try and see if the nurse would place he under psych orders (our hope was since the nurse could actually see he living conditions an the dr couldn't, that he/she would force the patient to go).

Well, 2 shifts later, we found out that she did have her feet looked at and bandaged. Her body being too weak for the surgery to remove the necrotic tissue. Unfortunately for us, we found this out when we picked her up for being in cardiac arrest.

We did all we could for her, but she was pronounced dead just minutes after arriving at the ER.

Earlier in the same shift, we went to a hospice-at-home arrest. The daughter had medical power of attorney, but couldn't find her form stating it. There was also a DNR, or do not resussitate order, but it was missing the dr's signature, so it wasn't valid.

We had to initiate CPR, and after finally giving enough drugs and attaining both a patent airway and IV, we received orders to terminate CPR from the hospital.

I didn't know it, but apparently because of the DNR (a valid one was brought to the scene by the hospice nurse), the daughter wasn't supposed to have called 911. She just freaked out when she realized the patient stopped breathing. I'd probably do the same to be honest.



Here's something I've noticed recently though, that in a way, really bothers me. Why are ER docs so ready to pronounce without hardly even assessing the patient themselves?

I realize that by the time we get there, the average patient has had 3 rounds of epi, 3 rounds of atropine, and a bicarb, but shouldn't you at least let me get them off my stretcher and get it out of the room before you call them? Is this a new trend/standard I missed another memo on?

What's it like where any of you folks that work EMS are? Do your ER docs work everybody for a few minutes, maybe just the old folks get a rapid termination, do they base it on being asystole or PEA? I'm curious.

Sunday, November 8, 2009

If the ladder goes up...

I don't know if fire season has started and I missed the memo, or if it was just a hint of what's to come, but there were quite a few fires where I work yesterday. Sadly, I only got to go on 1 of them.

We were dispatched on the 2nd alarm (staging) of an apartment fire overnight. First crews onscene reported that the building was fully involved. On the way there, the radio traffic was buzzing as crews got water supplies on 2 sides of the building and set up for aerial operations on both sides as well. They went into defensive operations, conducted a PAR, then started flowing both aerials.

After knocking down the majority of the fire, a crew was allowed into a certain area with a 2 1/2". Another crew was detailed with checking for structural stability to see if we could send crews into other areas.

We sat in staging for roughly 5 minutes before being ordered to the scene to hurry up and wait. After some intense handshaking and hugs from guys we hadn't seen in a while, we were ordered to the command post, along with other crews for an assignment.

We ended up performing a secondary on a few apartments, and were going to do a primary on a few others, but all doors were locked and chief said not to worry about it instead of forcing all of the doors.

We were released from the scene shortly after. The fire seemed to be on the 2nd story and it also burnt the roof off. I think I heard them say 25+ people were displaced.


I've worked fires in that complex before. It's not a major tinderbox, but they (the fires) can get out of hand quickly if you don't act fast. Sadly, the first crews learned the hard way that a single crosslay will not really put enough of a dent into one of these to stop it.



Somewhat offtopic, we went through training for new SCBA's many months ago, but they weren't issued to us because of some issues the manufacturer had to deal with. How sad is it that now that some units finally got the new SCBA's, many, many people have dead battery issues? I have to include myself in this group and it irritates me to no end. We aren't allowed to change the batteries, and we don't have the correct tools anyway.

It's hard enough trying to remember what we briefly learned 6+ months ago, it's even harder when the pack and/or mask have dead/low batteries.

Thursday, November 5, 2009

Another new beginning

Like I said before, sorry for the hiatus. On to the fun stuff!

After exactly 1 year to the day, I started working in a new (to me, at least) station at work. I'm back in the busier area, and even though I already miss those I worked with for the last year, I'm content.

My first shift was spent riding tailboard on the engine. It was a Sunday, and thankfully it was slow for us. My only reason for saying this is because I've been sick. We only ran a handfull of calls, and most of us relaxed once the daily chores were completed.

At night, we were sent to an apartment fire that turned out to be just a car fire. I was excited to have anything actually burning. I had all my gear on and just had to put my mask and gloves on once we got onscene. Another engine that had 2 brand new rookies asked if they could come play, so I didn't really do too much. The engine was acting up and having issues engaging the pump anyways.

Once the rookies arrived (and de-nutted enough to remember how to get all their gear on), I handed over the nozzle and helped direct them a bit. They did great backing each other on the line, and swapped out so they both had plenty of nozzle time.

They put away the trash line used for the fire, and while the tank was refilling from the hydrant, put the line away again. This time, so it would actually fit in the tray.

Some things don't work the same as what the academy teaches.

The last shift I worked, I was on the ambulance. We were up almost the entire 24 hour shift. We slept maybe 2-3 hours total. I came home and crawled into bed after putting some food in my belly, and slept for 8 or so hours.



No guarantees on catching up on the entries I've missed reading over the last month. So for those that follw me back, don't be suprised to get random comments on old posts over the next few days.