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Sunday, June 29, 2008

Long Night

Friday night at about midnight we got toned out for a medical aid, a person having trouble breathing. On call that seem likely to not need a paramedic I let my firefighter/emt do the assessment. This time Eric asked if he could do it. He is in paramedic school now and wants to get in practice doing ALS assessments. He performs the assessment and anytime that there is an ALS skill that needs to get done he delegates that to me. He did a good job. The patient was in mild distress. She had clear but diminished lung sounds. She was 96 so getting her medical history was a challenge. While we were searching for her medications we started her on a breathing treatment. After finding her medications we discovered that she has CHF. We checked her lung sounds again but there was no fluid in there. I started an IV and let Eric finish the assessment. When MBA showed up Eric gave the patient report to the paramedic intern.

Time to go back to bed.

Two hours later we got toned out for a person having chest pain. As we pulled up to the house we saw MBA pulling up from the other direction. They just happened to be passing by the area when they got the call. We let them go in first and do the assessment since they have an intern. The patient informed us that she was having chest pain but it went away as soon as she got on the phone with the 911 operator. The operator thought that it would be a good idea to have us come out and check on the patient anyways. The patient checked out fine and she decided to sign out AMA.

Time to go back to bed, again

A little more than two hours after that we got toned out for another person with chest pain. This gentleman has chest pain every couple of months and is pretty well known to us and the MBA paramedics. He does have a fairly significant cardiac history so you never know what you're going to get. Eric did this assessment to. The pain started last night while he was laying in bed. The patient described it as a pressure more than a pain at an 8 out of 10 on the pain scale. He was nauseous and had vomited several times. The pain also radiated to his left arm. On the heart monitor he had a normal sinus rhythm with occasional PVC's. Not anything to get too concerned about. We put him on oxygen, gave him some Aspirin and Nitroglycerin, and started an IV. At this point MBA showed up and we sent him on his way.

Time to go back to bed, again. Oh wait, it's now morning and time to get up. Eric and I later had our Osha safety nap.


Tom said...

I've seen the phrase several times, but don't know what you mean when you say "signed out AMA)

Firefighter/Paramedic said...

Signing out AMA means they don't want to do what we suggest (AMA means Against Medical Advice) so we have them sign a waiver releasing us of liability. Usually this happens when the patient doesn't want to go to the hospital. It can happen if the patient wants to refuse a certain treatment, like not wanting an IV, but that is rare. I had it happen once when a parent wanted to pass up the three closest hospitals for their kid that was having seizures.

Anonymous said...

the nice thing about retirement is that you don't need OSHA to tell you when to take a nap.

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