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Tuesday, March 29, 2011

Closest I've Come To Passing Out

A few weeks ago my wife pointed out that my blog doesn't have any stories in it before my paramedic internship started. For good reason. She started it for me as a way to document my internship and to share some of my stories with my family. I've since taken it over (cue evil laughter). So every once in a while I'm going to start sharing stories of when I was an EMT. This one comes from my clinical rotation during medic school.

I walked into one of the busiest trauma centers in Los Angeles county (and probably the world). It was my very first shift as a paramedic intern. I had to put in 240 hours in the ER and do several rotations through other specialties (OR, OB, Peds...). I was assigned to an RN and was basically told that I would be assisting her the entire shift. She gave me a quick tour of the ER and then showed me where the supplies were that I might be using. She then tossed me into the proverbial water so I could learn how to swim. She asked me to go start an IV on the woman in bed 23.

Up until this point all of my IV starts had been on mannequins. Not the ones you see in the department stores. These had simulated veins and were supposed to prepare us pretty well for the real thing. Most paramedic programs have you practice on each other (which seems like some breach of the 8th amendment) but ours didn't citing that their insurance wouldn't let them. I didn't complain while I was in class but now that I was about to start my first IV and it was on an actual patient I wasn't very happy about it.

I was a nervous wreck. I went to the supply room and slowly gathered everything that I thought I'd need including lots of 4x4's. I then stalled by double checking that I had everything. I was mildly freaking out.

As I walked up to bed 23 I noticed that my patient was a black woman, in her 50's and she was overweight. Quite a bit overweight. I walked up to her side, introduced myself and confidently told her that I was there to start her IV. She could obviously tell that I was anxious because she informed me that she had been a heroine addict for 30 years so needles didn't bother one bit.

I fumbled around and got the tourniquet on her arm. I then went to the antecubital spot on her right arm and started searching, in vain, for a vein. I then tore open the alcohol wipe and proceeded to wipe down the area hoping that a blood vessel would magically pop up.

It was then that my patient did it. She grabbed my hand, the one with the needle in it, and said that I had to get in there and just dig around. As she was telling me this she forced me to plunge the needle into her arm. She then started moving it around deeper and deeper as if the vein were hiding behind her bones. After what seemed like an eternity she stopped and directed me to the other arm. The scenario played out the same with no luck starting the IV.

By now I was sweaty, pale and defeated. I went and found my RN and told her that I was unable to start the IV. The only thing that makes the whole experience sting a little less is that 3 nurses could start the IV either. Eventually the MD had to come in and do a surgical cut down to get vascular access.


Silliyak said...

50 ml humility bed 23 STAT!

Firefighter/Paramedic said...

My friends will tell you that humility is a short lasting drug on me!

jackie25remi said...

I like hearing your stories, im in training right now, and at times feel overwealmed, then read your stories and know that im not theonly one. :)

Firefighter/Paramedic said...

Jackie- Oh no, you aren't the only one. Good luck! There's no better job.

Sandra said...

Oh puleeeeze, look at you digging around. I'm a student nurse. I'm supposed to be proficient in phlobotomy. But I can tell you, there's not way I'd be "digging around" for nothing. Nowhere! Good for you for doing what you had to, and good for that patient for being such a trooper!

Warren Baldwin said...

Stories like this is why I did not go into the medial field! But I'm thankful for all of you that have.

Firefighter/Paramedic said...

Warren- It got a lot easier.

Sandra- Good luck in school. Now I have no problem digging for my IV.

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