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Tuesday, August 28, 2007

911= Anger Management?

We had a call a few days ago at a convalescent home for a woman with an altered level of consciousness. When we arrived we found the patient relaxing in her bed watching TV. We asked her if there was anything wring and she said no. She wanted to know who called us so we went and got the "nurse" (I use this term loosely since the quality of tends to drop quite a bit in facilities like this) . The RN told us that she called because the patient wasn't acting normal. We probed further to find out that the patient was just grumpy so she called the paramedics. The patient ended up going to the hospital just so that she could get away from the staff at her home.

Thursday, August 23, 2007

Pit Bull 1: Mailman 0

The call came out as a dog bite to the face of a mailman. The first thing that the captain asked dispatch was if the dog was contained (smart captain). Dispatch informed us that the dog was contained and the PD and animal control were on the way.

We arrived on scene just after the rescue. We were on a narrow street and we had a large SUV following us. I'm not sure what the lady was thinking but when we stopped it became clear to her that she as not going to get by us. She then did what, sadly, most people do. She put her vehicle in reverse and backed up without looking. Unfortunately for her the animal control truck was right behind her. As I was getting the gurney out of our rig I was startled by the crunch of her SUV hitting the truck.

Our patient was found laying on his right side with a fair amount of blood all over the sidewalk. He had a puncture wound below his left eye and his lower lip was torn in half. There was enough blood that it was difficult to tell if there were any more punctures in his scalp but I think that there were a couple. We quickly got him onto a backboard laying on his right side so that the blood form his injuries would not choke him. We loaded him up and provided suctioning for the blood so that he could breathe a little better.

Our patient was in surgery not too long after getting to the hospital.

Wednesday, August 15, 2007

Honorary Stories...

This happened to a new EMT about a month ago.

The call was for a woman with general flu like symptoms. While in the back of the ambulance she had a bout of diarrhea. The paramedic in back asked the EMT to cover it up with a blanket so the smell would not become overpowering. As the EMT did this he started gaging. He then proceeded to throw up all over the drivers side of the compartment. This started a chain reaction. The sight of the EMT vomiting caused the paramedic to start dry heaving. The smell and sounds of both of them caused the patient to start vomiting as well. It all came full circle when the EMT (still sitting at the head of the patient) turned his head the other way, towards the open drug box and the ECG monitor, and threw up!

Just so that you don't think that the driver got off without any fun...the driver is responsible for cleaning up the rig while the attendant does paperwork. The cleanup took hours and both EMTs helped.

Monday, August 13, 2007

Honorary Stories...

Honorary Stories are stories that happened to someone else at work. Since they didn't happen to me I wasn't going to post them but some of the stories are just too funny not to post.

A pair of our EMTs responded to a in call Santa Monica for a woman with nausea, vomiting and diarrhea. She was too weak to walk down the stairs herself so they got out the stair chair (the stair chair is a collapsible chair with handles designed to make it easier for EMS personal to carry a person down stairs). Just as they had descended about a third of the way the patient had an explosive bout of diarrhea. This might not have been as bad as it sounds if she was wearing pants. Unfortunately for the EMT on the bottom, she was wearing a miniskirt. Unable to move for fear of dropping the patient the EMT got covered in liquefied fecal matter from his chest down to his boots. Once down on the street he quickly stripped off all his clothes.

One of the interesting things about relating this story are peoples reactions. Most people ave commented that they feel sorry for the young woman that just had the most embarrassing moment in her life. I don't feel half as bad for her as I do for him.

Friday, August 10, 2007

Fall with injuries

A call came out today for a fall with injuries. Dispatch also let us know that our patient was unconscious. We arrived on scene just in time to see Engine 95 start breathing for the patient with a BVM (bag valve mask). The patient was found laying on his back next to a brick planter on the grass. There was a ladder leading to the roof where he was painting about 14 feet up. We quickly c-spined the patient and loaded him up. He had a normal sinus rhythm on the monitor at 84 (without ectopy for all you medical buffs) and his sugar was 117. His initial blood pressure was 198/p. After several minutes of rescue breathing he started to breathe on his own so we put him on an oxygen mask. The only trauma that we could see was an abrasion to the left cheek and another to the lateral portion of the thigh.

With the lack of serious trauma we began to think that he may have had a medical problem that preceded the fall. As he started to come around we noted that there was no movement of the left leg and that his grips were weaker on the left side. By the time that we got him to the trauma center his blood pressure was up to 220/120. He was able to squeeze with his right hand and that was about it. Our theory was that he felt himself start to stroked out and climbed down to the ladder to the grass where he fell and scraped his arm and leg on the planter. We are going to try to follow up but sometimes we never get a chance to find out exactly what went wrong. One thing that went right for the patient was the response time. It only took 24 minutes from the time that someone called 911 to the patient being seen by a doctor at the trauma center.

King Drew Closes

Just a couple of days after my tirade we got word at work that MLK (King Drew Medical Center) was going to close. On the Redinet (a computer program that lets us know the status of area hospitals such as closed to ALS runs, or closed to trauma runs) MLK posted themselves as closed to internal disaster. This means that they are closed to all ambulance traffic with no exceptions. They are doing this so that they can start to close the hospital without more patients coming in. I don't know hat they are planning to do with the walk-in patients. The downside is that it will be a little bit busier at other local hospitals.

Wednesday, August 8, 2007

King Harbor Medical Center

Formerly known as King Drew Medical Center and still known in EMS as killer king, King Harbor Medical Center uses surprisingly out of date equipment for a trauma center.

We picked up a patient today from King Harbor Medical Center ER that had two IVs. The amazing part was that the IV locks and tubing were the old school type that require you to use needles around the patient whenever you administer a drug. This creates a much larger chance of an accidental needle stick for the health care professional. The sad part is that because the rest of the county has switched over to the needless system the patient, upon arriving at the hospital she was going to be staying at for observation, the first thing they were going to do is discontinue the old IVs and start new ones. The poor patient ad to be stuck again because King Harbor Medical Center is behind the times.

Tuesday, August 7, 2007

When it rains....

Today the flavor of the day for EMS calls was what we call in Los Angeles county an EH. EH is the abbreviation used on the county run form to indicate a person that is having behavioral problems. It could be a psych patient or drunk, a nut or a depressed person.

Our first patient came the closest to being a real call. It was for an elderly woman with supposed shortness of breath. In reality she was more worried about where her husband was, how he was going to get to the hospital, who was going to lock the door, etc. These sound like legitimate concerns from an elderly person but when you are flat out panicky about them there are issues. I did hold her hand all the way to the ER and that seemed to make it all better.

Our second patient just wanted to get out of work so he hyperventilated causing his fingers to go all tingly (yes that is a medical term). Amazing how he felt better once he got away from work.

The last one was a whopper. He was a 34 year old male that showed up at a doctors office (not his) with lacerations all over his arms and head (problem #1). His systolic blood pressure was in the low 80's (problem #2). He admitted to us that he drank a 12 pack of beer (problem #3). Because of this and the head injury he was a little altered (he didn't know what month we were in) (problem #4). He was a diabetic that was not keeping track of his blood sugar and so when we checked it his sugar was almost 400 (problem #5). So it turns out he needed a little insulin, some stitches, some IV fluids, and AA to make him whole.

Friday, August 3, 2007

Can you send another unit?

This didn't happen to me but to one of the other crews at work. The crew had just found the address and was doing a three point turn so that they would be facing the right direction to get to the hospital. As they were in the middle of the turn (blocking the street) the drive shaft to the ambulance came off and started to roll away. A rather distressed EMT called into the office asking if we could send another unit. This story just makes me laugh.
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