Sunday, December 31, 2006
In some hospitals (such as Little Company of Mary's in Torrance) a lullaby is played over the PA every time a baby is born. One day I was working with a new EMT who asked me about the music. After the explanation I added that he should hear what they play when they have a person die. It took him about 15 seconds before he realized that I was only joking!
Saturday, December 23, 2006
By the time that we got to the ER our patient had a good strong pulse. Two saves in a row.
In the ER they pushed two more rounds of drugs and got him back! I couldn't believe it. His heart had changed rhythms 5 different times! He had no other medical problems, took no medications, and was in decent physical shape. Makes me wonder if drugs were involved.
Tuesday, November 21, 2006
We quickly take cervical spinal precautions and strap him onto a backboard. During transport I do a fast assessment (the patient only spoke Spanish so I took the lead on this one). He was panicked and had a bad headache but that's it, no chest pain or trouble breathing. He has a history of high blood pressure but that all. He is taking no medications.
We wheel him into the ER and drop him in bed 6. The ER tech comes in and does a 12 lead ECG which shoes that our patient is having a heart attack on the backside of his heart. I think to myself, "what a bummer. A stroke and an MI at the same time!" About then the ER doc calls me and the other medic over to him and tells us that this is a once in 20 year call. A patient exhibiting these signs and symptoms together is suffering from a dissecting thoracic aortic aneurysm or in plain English, the largest artery in his body was slowly tearing itself in half.
I know that he was in surgery real fast but I never found out if he made it. If he did I wonder what permanent disabilities he will have.
Saturday, November 18, 2006
The title of this post comes from one of the firefighters who, after hearing the security guards questions, said to me, "I feel safer already, don't you?"
The call came out as a hit and run auto vs pedestrian with major bleeding from the head. We arrive on scene to find TFD performing CPR on a woman. From the neck down there didn't seem to be anything wrong with her. Her head however had been crushed by the wheel of a truck (from which she was evidently just pushed). It was really strange being able to watch the bones in her skull move around as we tried to breathe for her. Everyone on the scene agreed that it was one of the worst trauma they had seen. We transported her to the local ER about 2 minutes away where she was pronounced dead about fifteen minutes later. We found out later that the male party turned himself in after about an hour. He is facing several felony charges.
Monday, October 2, 2006
Thursday, September 28, 2006
I'm just glad that we didn't have to go rescue someone in that rain.
Monday, September 11, 2006
In the back of the ambulance I was setting up to start an IV and my EMT was putting the girl on the ECG monitor when he said, "I think she's not breathing." I did a quick check and sure enough, she wasn't breathing! I told Brian to get the BVM (bag-valve-mask) and to start breathing for her while I checked for a pulse. I also asked Dan to get going code 3 to the hospital and to let them know we were coming in with a pediatric respiratory arrest. It was about this time that I noticed she was having another focal seizure. I gave her a quick shot of Versed to stop the seizure and then she started breathing again. She stopped breathing one more time before we got to the hospital but we got her breathing again just as we arrived.
After transferring care to the hospital we talked to the mother. She then told us that her daughter frequently stops breathing when she is having a seizure. Somehow she forgot to mention that when we were at her house! The nurse told us that the girl did the same thing to a different paramedic 6 weeks before and he intubated her. In the end all was ok with the little girl.
Thursday, September 7, 2006
Saturday, September 2, 2006
Tuesday, August 29, 2006
Wednesday, August 23, 2006
My paramedic went in to assess the situation while they were working on tearing apart the car. The woman was alert, but her injuries were severe. She had deep cuts and crush wounds everywhere. She broke the shin bones on both legs and her femur on one leg. She also had a hip fracture and probable damage to her internal organs. Her femur fracture was so bad that her thigh had swollen to 3 or 4 times its normal size. He started an i.v. on her and had a cop standing nearby hold the bags of fluid in the air while the fire department continued to extricate her.
They got her out, c-spined her as well as the baby, and put them on backboards. The injuries were bad enough that they called for the medical helicopter to transport. (My paramedic didn't get to go on the helicopter; the hospital sends a crew over with it.)
Here's the painful part of the whole situation - with an accident that bad, my paramedic can't give ANY pain medication to the patient! The hospital has to be able to ask her where it hurts to get an accurate assessment.
Thursday, August 10, 2006
Wednesday, August 9, 2006
The bad - the other day after work, some guy ran a red light and pulled out right in front of my paramedic, causing him to rear-end the guy.
The ugly - my paramedic wasn't driving our car; he was driving our friends' car. They let us borrow it for the internship to save on gas.
More good - they're still our friends, lol. Both my paramedic and our friends have full-coverage insurance so at least the car will get fixed. And, no one was hurt.
More ugly - the driver who ran the red light tried to run. my paramedic chased him down and he finally stopped. When my paramedic got out of the car, in his uniform which looks a lot like a cop's uniform, the guy was suddenly very scared and very cooperative. The driver didn't have a driver's license on him, and the insurance information in his van was old. At least it was a van for a company, so the company and the employer can be traced.
More good - my paramedic talked to a cop right after it happened, and the cop said that he would give my paramedic a hit and run report against the driver if he needs it.
Saturday, August 5, 2006
Here's a funny little story. One slow day, my paramedic and his partners went to the hospital to help out. My paramedic was starting an iv on a patient and the nurse asked him how his skills were. When he said they were fine, she said 'oh yeah, you're a paramedic.' Then she grabbed the arm of the patient and started shaking it. When the patient wanted to know what the heck she was doing, she said that since paramedics are used to starting iv's in the back of a shaky ambulance, they're not used to hitting a stationary target.
Wednesday, July 19, 2006
The answer is a fork lift with a sheet of plywood across the prongs for him to lay on.
Tuesday, July 18, 2006
1 - Prepare the arm to be stuck.
2 - With the free hand, find the vein that's gonna get poked.
3 - Stand up and balance yourself leaning the hand that is holding the needle against the far side of the ambulance.
4 - Open the needle.
5 - Watch out the front of the ambulance for a stretch of road that Dan might drive smoothly on.
6 - Jab quickly! And hopefully, accurately!
7 - Repeat as needed.
Wednesday, July 12, 2006
What, besides seeing, are a frog's eyes used for?
10 points to the first person to guess this one!
Friday, July 7, 2006
The call came in about 1615 hours to respond to a man that can't breathe. As we enter the house the wife lets us know that her husband was just seen by the doctor this morning and was diagnosed with sever bronchitis and possible pneumonia. When we get to the bedroom we see a 51 year old man that looks like death warmed over. He's only breathing about 8 times a minute, is pale, cool to the touch, sweating profusely, and only responsive to painful stimulus. Not good. We quickly get him on oxygen and check his oxygen saturation level.
As I try to get an IV started in an arm the wife tells me that no one can ever get one. As I search in vain my partner looks at his neck and says "he's got great jugulars." I decide to try once to get the IV in the arm and then go for the jugular. Of course I missed the IV in the arm! At this point we load him up on the gurney and take him out to the ambulance. As we're loading him up my preceptor noticed something I missed. Our patient is taking Methadone, a narcotic pain reliever. Once we're in the rig I start my IV...in his neck (more correctly his External Jugular veins or EJ's)! That was a cool procedure. I then grab the Narcan (used to reverse narcotic effects such as in an overdose) and give him 1mg. Enroute to the hospital we give him another breathing treatment. The Narcan did its job and our patient started coming around. We asked him if he took more than the normal amount of his Methadone today. He affirms that he did.
By the time that I finished the paperwork at the hospital he was looking almost normal again. It was nice to be able to tell have a good day and to have him thank us for helping him. I have to admit though; I was still jazzed about getting to start an IV in someone's neck!
Saturday, July 1, 2006
As we approached we noticed that the police had the entire street cordoned off. As we got closer to the scene we saw that our 'man down' was really a TC (traffic collision) where a compact sedan had run into a telephone pole. The car sheared off the pole and moved it 6 feet. It was still dangling from the wires. Our patient, a 16 year old girl, was sitting in the grass with the firefighters trying to refuse any care. Her father on the other hand (who had time to get there since we went to the wrong location) was demanding that we take her to the hospital. Since she's a minor she had very little choice in the matter. We would have taken her to the hospital anyways, because of her age, but it's a little frustrating to have an overly concerned parent there to second guessing your every move. The father also wanted us to wait there on scene until his wife could show up. We drew a line there and told him he could meet his daughter at the hospital. If he had followed us he probably would have said that we should have gone a different route.
Oh well. You just never know what you're going to get when you're dispatched to a 'man down.'
He said, "I woke up this morning and my arm was numb. There were also some red lines on it here" as he motioned across his bicep.
From this point on it was a little difficult to keep a straight face but I performed a thorough assessment.
I asked if it was still numb.
"How long was it numb?"
"About 30 seconds."
I then checked to see if he had good sensation, equal pulses and movement in his hands and wrist. All was good so far.
While the firefighters got me a set of vitals (pulse rate, respiratory rate, blood pressure, skins signs) and my partner hooked him up to the ECG (heart monitor), I continued my questioning.
"Do you have a headache, weakness, blurred/double vision, ringing in the ears, chest pain, shortness of breath, abdominal pain, N/V/D (nausea, vomiting, diarrhea)...?"
"Do you have any medical conditions such as high blood pressure, diabetes, heart problems, hepatitis, strokes, seizures...?"
"Are you taking any medications?"
"Are you allergic to any medications?"
I then informed him that his vitals were all normal and his ECG was fine. I finally asked the question that I wanted to ask first.
"Sir, is it possible that you just slept on your arm wrong and it went to sleep?"
"Yeah, I guess so. I never thought of that."
"Do you want to go to the hospital to get checked out?"
"Sign here...Have a good day."
Sometimes I think that Darwin must be wrong because so many stupid people survive. I guess I should just look at it as job security.
Tuesday, June 27, 2006
"HOLY SH**!!! You just passed your internship!"
A mushy aside - a special thanks to all of our friends and family who are making this internship process easier. We really appreciate all of your various forms of help!
Saturday, June 24, 2006
Brian's new game is 'stump the Mount S.A.C. graduate'. Apparently, my paramedic's school has a reputation as being the most difficult paramedic program. Brian asks every paramedic they meet to try to come up with a question that my paramedic can't answer so that he can make him write a paper about it. I'm just waiting for Brian to come across another Mount S.A.C. grad to face off against my paramedic. I think Brian's going about it all wrong. He keeps asking medical questions. I could give Brian some GREAT questions to ask my paramedic that he can't answer (like what he wants to name this baby). I'd love to get a paper written on that one!! Maybe we can name him Sugar.
Thursday, June 22, 2006
Saturday, June 17, 2006
Friday, June 16, 2006
"Do you know what time it is?"
"About 1400 hours."
"Do you know where you are?"
"Yes. I'm strapped to your f****** backboard!"
Yep, alert and oriented.
Thursday, June 15, 2006
Tuesday, June 13, 2006
"Then what's it for?"
"To make you forget the pain you're about to feel."
He then pulled while Brian popped the hip back into place and they transported her to the hospital.