Honorary Stories...

A while ago there was a CPR training course at a local community college. As they were doing their scenarios a person not in the class happened to walk past. The person doing the scenario checked the mock victim for a pulse. Upon discovering that the victim had no pulse he directed the passerby to go call 911, which he actually did. The call came in for a full arrest with CPR in progress. When the paramedics got there they found a confusing situation where people were sort of doing CPR but there was none of the urgency normally associated by people in this type of situation. When it was all straightened out the CPR instructors were told to make sure that the right people were told to call 911 during their scenarios.

Intersting people

In my line of work I get to meet some interesting people. The other day we had a ride along (an EMT student that rides on the ambulance for the day) come in for her shift. She instantly started a debate among dispatchers and paramedics as to her real gender. Luckily for our argument we have to get ID for all ride alongs. When she presented her CA drivers license it was a paper license without a photo. Under gender it said female. When asked for a picture ID she presented us with a New Jersey license. The picture was of a guy with a beard. I guess that's why he/she came to Los Angeles.

Fall Victim

I picked up an extra shift this last Saturday. The only call that we had was in the afternoon for and 87 year old woman that fell out of bed. We did a quick assessment. She was ok except for a skin tear on her right leg. We bandaged her up and sent her to the hospital with AMR. It was a pretty slow Saturday.

Mutual Aid

LHHFD has a mutual aid agreement with LA County FD which means that if there is a call the is closer to us even though it's in their area we will get the call. It also means LAcoFD calls us when they are out of paramedics.

We were busy last Monday night. Our tones went off for the first time at 10:30pm. We responded on a mutual aid call into the county area for a fall victim. We arrived on scene to find an LAcoFD engine company assessing the patient. The captain asked if we were the "Heights Medics." When we said yes he informed us that the call was BLS (basic life support, or no paramedics needed) and canceled us.

About an hour later the tones went off again. We had a call in our own area this time for a 25 year old male with chest pain. Our patient met us at the top of his driveway (which is a good sign that he is fine). We discovered that he had a non-provoked non-radiating chest pressure that had been going on for an hour. All his vitals were stable. His only history was anxiety and he took medications for the same. Even though I am sure he was just having an anxiety attack we had to do a total work up because of the symptoms he was describing. We finally got to bed a little after 12:30am.

At just before 2am we got our third call of the night. We were responding to the far side of the city for a "medical aid" which means it could be anything. We arrive on scene and find a driveway that is about 400 feet long that leads to a house that is 100 feet above us in elevation. Talk about a climb! We get up to the bedroom and find a 68 year old man that had passed out in the hallway. He is now alert and oriented but wants to get checked out anyways. He has a significant cardiac history as well as blood pressure problems. He tells us that he was hospitalized a week ago for the same thing. We work him up and get him to the hospital. We got back to sleep around 3am. It was a long night but it was nice to actually run a few calls.

Vehicle vs City Hall

This last Monday we were doing some training in front of our apparatus bay behind city hall (our fire station is located directly behind city hall). As we were cleaning up we heard a small crash followed by a large boom. A firefighter and I quickly went forward to investigate and found that a Chevy Tahoe had run into the city hall multipurpose room. The firefighter, not realizing that I was with him, yelled for the medics. I informed the captain on what we had found and went to the squad. I donned my turnouts and pulled the squad around to the front of the building for better access.

The driver had been traveling northbound on Hacienda when he had a seizure. He lost control of the Tahoe and veered to his left. He ran over the City of La Habra Heights sign, missed 5 or 6 large trees, a couple of steel poles, entered the building without hitting any major structural members and came to a rest on the far end of the room. Thanks to his seat belt and airbag he was not complaining of any injuries. We put him in full spinal precautions and transported him to the ER.

After the call the Fire Chief selected me to talk to the one cameraman there. It turns out that he was an independent photographer and sells his shots to whoever will take them. I found out later that I was on the Fox 11 news at 10 pm. I'm trying the get a copy of the broadcast.

Ill Person

One of the calls that I hate the most is the call for an ill person. Most of the time they are just that, sick. They're not dying, no pneumonia, no heart attack. They just have a cold. We got a call just like this the other day. The elderly woman was complaining that she was nauseous all morning and that she still didn't feel well. She told us that she wanted to go to the ER so that they could give her some fluids. She was feeling dehydrated. I really wanted to give her a glass of water and tell her to take two Aspirin.

I've heard that a dog will start to take on the qualities of its owner over time. This lady had a Cocker Spaniel that was missing an ear and very sickly. We all thought, "like owner like pet."

Lacerated Finger

The call came out for a lacerated finger. In plain English, a cut. When we got there our patient was sitting on the curb holding half of his right thumb in his left hand. Our patient informed us that it got caught between the chain and the sprocket on his motorcycle. He also stated that he was not on very much pain so out his finger on ice (really it was a cold pack) and we transported him to the local trauma center (with his finger). The doctors said that they had a good chance at reattaching it.

I couldn't help but think to myself that he was being a wimp. My dad cut off his finger and didn't even call 911!

Special Architects

Once again I am reminded that many of the people (engineers, car designers, baby clothes designers) that create things for use by the general public don't use said item themselves. The geniuses that designed the new UCLA Santa Monica Medical Center fit well into this category. The hospital is rebuilding. They are building up one section, opening it for use, then tearing down another section. The problem comes in how they numbered the new floors. What was once the first floor in the old building is now A floor in the new building. The Second floor in the old building is now the first floor in the new building. The funny thing is that they are both in use and connected. Currently they are tearing down and rebuilding the East tower. The West tower is now open and the center section (or Pavilion) is still in use and will be the last section to be replaced. So now it is possible for you to take the elevator up to the third floor (in the Pavilion), turn left, walk ten feet and you are now magically on the second floor (of the West tower)! Trying to find a specific room is difficult to say the least. To try and lessen the confusion they put up posters in the elevators to let you know what floor you should be on. When you don't know that the have messed up the numbering system of the floors these posters are just confusing.

LHP 2.1

We got the call to respond as a second unit in for a traffic collision. When we got there we found a man, 23, a woman, 19, and their 3 month old boy standing on the side of the road. The woman was complaining of left wrist pain. The man was complaining of neck pain and the baby was just fine. We gave her an ice pack and placed him in a cervical collar and onto a backboard. We then transported all three to the hospital. It's a challenge to get all the paperwork done for three people in the time that you normally get for one.

Bonus points go to the person that figures out the meaning behind the title of this post.

A boring week

2 jobs. 6 Days. 9 1/4 hours commuting. 72 hours worked. and only 2 boring transfers. What a slow week.

Fire in apartment 114

We were sitting at our station eating lunch when the call went out for a fire alarm in an apartment building. Usually we would not listen to the tactical channel but this time I thought there might be something interesting. The first engine on scene made entry (broke in the door) and found food burning on the stove. Just after that they found a woman unconscious in the next room. We immediately were dispatched to the call. By the time we arrived TFD had the patient outside on the grass. It turns out that she had just been drinking a lot and decided to cook at the same time. The patient passed out and left the food on the stove. She was very lucky to have working smoke detector. morale of the story is if you are going to drink yourself into a stupor don't put something on the stove!

6th grade all over again

The other day my partner and I were dropping off a patient at the hospital when a nurse approached my partner and asked him if he were single. She told us that she was asking for another RN that was too shy to ask herself. Throughout the day he was bewildered that someone wanted his number and didn't know what to do. Our last call of the shift I worked it out with the RN that initially approached us that if I could provide my partners email address she would get the nurse to email him. My partner was a little embarrassed so he made me wait to give his email address out until he had left the ER. I guess this qualifies as above and beyond the call of duty.

Ambulance driver becomes patient

Right after one of our EMT ambulances was canceled by TFD on a 911 call the driver called the station. I happened to take the cal. He stated that he was going to come in to the station because he wasn't feeling well and his blood pressure was high. At this moment TFD called for his unit again. Our dispatcher asked the driver if he felt up to doing the call. When he said no we told him told pull over and let his attendant drive him back to the station (we also dispatched another unit to the 911 call which later got canceled).

Once the ambulance got back to the station my partner and I jumped in the back to check out the EMT. One of the best ways to tell how a patient is really doing is their "skins". He was very pale, cool to the touch and sweaty. My partner and I were instantly concerned. Here was a middle aged male with a history of heart problems looking not so hot! He said that he was very weak and dizzy and later told me that he had a feeling of impending doom. His BP was high (180/120), pulse was between 46 and 54 (about half what he says is normal), he's a sinus bradycardia on the monitor, his oxygen saturation is at 98%, and his sugar was a little low at 65. We put him on O2, gave him some Aspirin, did a quick 12 lead ECG, stuck him with an IV, and transported.

It's amazing how quick you get attention in an ER when the staff knows your bringing in one of your own. By the time that we got him to the hospital his "skins" were much improved. His heart was still beating slow but his blood pressure was down a little. I guess I'll find out later what the official diagnosis was.

I hate vomit

We got the call to go to one of the city's many convalescent homes for a visitor that fell. When we got there she had sat in a chair but she had a good size bump on the back of her head and she was nauseous (which can be a sign of bleeding in the brain). I hate vomit. Since we couldn't rule out head or neck damage we place her in a neck collar and strapped her to a backboard. Once we had her loaded onto the gurney she started to throw up. When your head is stuck facing straight up throwing up has to be one of the worst things that can happen. I hate vomit. We quickly grabbed the backboard and rolled her onto her left side so she could toss her lunch. In the back of the ambulance she only threw up twice more and got half of the vomit in the bag. The other half landed on the floor of our rig. I hate vomit.

Show and tell

This last week my partner and I were selected to go to a kindergarten class for show and tell. They were having an emergency services week and were having a cop and some firefighters there on other days. It's a lot fun letting the kids play around in the rig and answering all of their questions.
During the question and answer part one of the boys raised his hand. When called upon he informed us that one of the Transformers was an ambulance (named Ratchet) and that it was his favorite one. He was disappointed to find out that our ambulance did not transform into a robot.

CVA at the doctors office

We got the call for a 78 year old patient at a doctors office having a CVA (cerebral vascular accident aka stroke) as I was about to eat the ice cream that I had just purchased. We arrived at the office to find our patient sitting in a chair trying hard to breathe. The Nurse Practitioner told us that our patient had had some difficulty speaking for the last two days and it felt to her the same as when she last had a stroke. The reason she came in today to the doctors office was her shortness of breathe. We did a quick neuro check to try and rule out a CVA and everything came back as it should. We also listened to her lungs. She was wheezing pretty heavily. We patched her on the monitor and got a breathing treatment ready. On her ECG she was having VERY frequent PVCs (premature ventricular contraction, which are early beats of the heart). This can, in severe cases, lead to V-Tach (ventricular tachycardia) and death. We gave her the breathing treatment and kept an eye on her heart rhythm. Once she started breathing easier the PVCs were a little less frequent. We called the hospital and let them know what we had and that we were only a couple of minutes away. Once we dropped off our patient and finished all the paper work I returned my sights to my ice cream. Unfortunately it was now mush. Oh well.

Day 1 call 2

LASD (Los Angeles Sheriffs Department) called and asked if we would come out and check on their prisoner. When we got there we found a 14 year old girl in handcuffs, face down in the grass, with a female officer sitting on top of her. It turns out that she had assaulted the manager of the half way house she was staying at who then called the cops. Once in custody in the back of the patrol car my patient told deputies that she was going t kill herself and then kicked out the window of the car. The officers then decided that she should not be in the car any further and started to take her out. The girl soon realized that she liked the back of the cop car. In the ensuing struggle she grabbed onto the gate and received a coupe of minor cuts on her fingers. We were really called out there because the officers did not want to go to the hospital but I informed them that they had to go. Our patient was kicking out windows you know!

Day 1 call 1

I met my partner, Michelle, at 6:30 and she showed me the morning routine. I went to paramedic school with her. While we were checking out our squad we caught up on what we have done since paramedic school. She told me that she had been working in a hospital since getting her paramedic license and had just recently decided that she wanted to be in the field. She quit the hospital and got hired onto LHHFD and AMR in Riverside. She also told me that she had only 3 patient contacts since her internship. That made me the experienced paramedic on duty.

At about 9:20 in the morning we got a call for a motorcycle down. When we got there we found the rider moving around. He was complaining of head pain and left rib pain but that was it. All his vitals were stable and there were no other injuries. He stated that he was coming around a blind curve when he came up on a stopped truck. He tried to stop but couldn't. He ditched the bike and smacked into the rear of the truck which then fled the scene. He was a very lucky motorcyclist.

LHHFD

If you can't tell I'm just a little excited to be working for a fire department. Now all I have to do is make it full time.

I think that you put the wrong emphasis on the wrong syllable.

Sometimes the paramedics at Gerber will help out answering phones. There are people in this world that speak English with a very heavy accent. This combination leads to some funny stories.

We had a lady call in a while back and she was a little excited. She said (or so we thought),"Chickenbreath! You take to are. You come NOW!" When told that we couldn't understand her she would just repeat the phrase. After a while, and a couple of different people on the phone with this lady, we finally figured out what she was really saying: She can't breathe. You take her to ER. You come now! At least the last part was clear.

As it turned out the patient was just sick and had a nasty cough. It could have been bad if chickenbreath.

"Skilled" Nursing Facilities

Skilled Nursing Facilities (SNF pronounced sniff) are long term care facilities like live in rehab centers, convalescent homes and acute care centers. They are by reputation staffed with less than the most competent of RN's. I can understand this because if I were a competent nurse I would choose to work in a hospital instead. Now this is in no way a dig on those few nurses that are great and work for SNF's.

Yesterday we got a call to go to the local acute care center for a patient that was unconscious. As my partner and I were doing our assessment we were both asking questions of the nurse (lest this seem confusing I was asking questions about the patients past medical history, allergies and medications and my partner was asking about her current condition compared to what she is normally like). This is common since the paramedics that respond to these facilities do not know the patient and the nurses do. We can get a great deal of information from nurses that know their stuff. This RN, in the middle of our assessment of her patient, said that we ask too many questions and walked away. At that point we had to go off the information that an unconscious patient could give us and go. When we told one RN at the ER about our experience she said that she would've smacked the nurse up side the head. Laughing makes it all better.

LHHFD

Here is a link to the La Habra Heights Fire Department web page. http://www.la-habra-heights.org/index.php?option=com_content&task=view&id=38&Itemid=78

Put on clean underwear

I don't know how many of you have ever been told by your mother to put on clean underwear before going out just in case you have to go the the hospital but I have some advice that pertains to staying at home. Don't sleep in the nude. That way when you wake up having a major asthma attack (or some other emergency)you are not found naked on the floor by 8 firefighters and paramedics. That can be rather embarrassing as a woman in her 40's found out today. We ended up covering her up with a couple of our sheets and transporting to the ER while giving her a breathing treatment. I guess that her mother didn't quite prepare her for everything.

Choices

Today my partner and I had to transport a patient from a acute care facility to the county hospital for a check up. The patient was non-verbal and had a tracheotomy (a surgical opening in the neck allowing the patient to breath with a ventilator). Unfortunately he was a little sick and was coughing up large amounts of thick, discolored mucous (graphic description for Tom). We had to suction out his airway every 3 to 5 minutes the entire time he was under our care. While suctioning the patient my partner half said to himself, "why'd I go to medic school?" That question alone sums up how we felt about this call.

Tachycardic EMT

A couple of days ago my partner and I had a brand new EMT ride along with us. When this happens, during our down time we teach them how to help out with some of the paramedic skills like putting a patient on the ECG monitor. I happened to walk by the ambulance as my partner was hooking up the EMT to the 12 lead (this is where we take a look at your heart from 12 different location and we can see if you are having a heart attack and where it is located). As my partner prints the 12 lead he mentions to me in a concerned way that there is ST elevation. This can indicate a heart attack. My partner hands me the rhythm strip and asks the EMT if he has any chest pain. At this point I realize what my partner is doing (since the EMTs ECG was fine) and I asked the EMT if he was having any trouble breathing. Still assuming that we are joking he says no. At this point I ask if he has been more tired than normal lately. His eyes went a little wide and he went pale. He had been more tired than normal this week (which was due to starting a new job that was 12 hours a day...he never thought of this). I told the EMT that I was going to call the hospital and see what they thought that we should do. At this point my partner told him it was a joke. When we looked at the monitor again we realized that he had gone from a normal sinus rythm in the low 60's to sinus tachycardia at 130. I guess that we scared him a bit.

Choking

A call went out this morning for a patient choking. As we were responding to the call I was talking to a relatively new EMT about choking calls. I told her that very few "choking" calls actually end up with a choking patient. . By the time that we get there the patient has either coughed up what was choking them or has fallen unconscious and then we have an unresponsive person with an airway obstruction. No sooner had I said this when the Torrance Fire dispatcher said over the radio that the patient was now unconscious.

The mentally handicapped patient was choking on a piece of bread which was removed with ease and the patient came back around. I wish all patients were this easy to treat.

Smoke in a Bank

The other day a call went out for the Torrance Fire Department for smoke inside a bank. The smoke was reported by employees when they arrived to work. TFD had to stage outside the bank and wait for the Torrance police to show up in case it was a robbery. After the building was cleared of potential suspects TFD entered the to find that the smoke was caused by a botched robbery. The assailants had tried to blowtorch their way into the vault and the ATM machines but were unsuccessful at both. I don't know if anyone has been caught for the attempted robbery.

La Habra Heights Fire Department

I just had my chiefs interview with La Habra Heights Fire Department and I was offered the part time firefighter/paramedic position. I still have to go get a medical done and figure out what my schedule will be but soon my stories will include tales from the city of La Habra Heights.

Come check this out!

In certain professions there are things that should not be said such as "oops" at a dentist. As paramedics, when we find something out of the ordinary we want others to see it as well. Today our patient had some chest pain and in the process of checking him out it was discovered that he had very interesting lung sounds in the base of his left lung. Immediately the paramedic that discovered this said to my partner and me, "Hey, come check this out." I realize looking back that that is probably not what a patient would like to hear from their paramedic.

Closest Receiving Facility

In LA County EMS the closest receiving facility is the hospital that is closest to you (in time not distance) that can take care of your patients problem. We generally like to take our patients to the MAR since it means that they will get seen by a doctor sooner. Paramedics can take you to another facility for a couple of reasons, most often because the MAR is closed to paramedics (possible reasons to close include saturation of the ER and internal disaster such as a hazardous material leak or a power outage). The other major reason we do not take a to the MAR is they request to go somewhere else. This may be due to insurance or just because they like a certain hospital.

The call goes out for an altered patient right outside Little Company of Mary Hospital's ER lobby doors. My first thought is why isn't the ER staff walking the 15 feet through their lobby and treating the patient?!! Evidently our patient just found out that her dad has cancer. After she got the news she went outside that lobby of the ER to try and stave off a panic attack. In her agitated state of mind she thought that it would be a good idea to up the dosage on her Xanax. She was now not acting normal (for her) and her family was getting worried. Then, a helpful hospital volunteer happened to walk by and called 911 (instead of getting a wheel chair and walking to the ER). When we got there we found a woman in her 40's that was unable to tell us her name. She could answer everything else just fine. When asked which hospital she would like to be taken to she decided that it would be better to drive across the city to another area hospital than to be seen by the doctor that had just "given" her father cancer. All we could do was check to see if the hospital she wanted to go to was closed. We crossed our fingers but no luck. We had to drive away from the ER to go to the ER.

Photo!

This a shot of our new medic unit sitting in the bay of the fire station Hermosa Beach. We covered their city for a couple of hours while they fought a large structure fire.

Chest Pain at Gerber

My partner and I decided to go get something to drink. While we were out on the air our dispatcher came on the radio and said "MEDICS! Return to station for chest pain." Here a bit of back story is needed. Our dispatcher (that day) has heart issues. When we hook him up to the ECG monitor while he drinks a Monster energy drink it shows him having an MI (heart attack). Sometimes when he wants a Monster he tells us he needs his heart medication so when we got this call for chest pain we thought that he might just be thirsty. When he didn't ask us to phone in we realized was probably serious.

When we got to the station we were told that it was one of the billing ladies (we are a compartmentalized company can you tell?) and that she was upstairs in the conference room. We grab our stuff (drug box, ECG monitor...) and went up. Turns out she had had a chest cold with a non-productive cough for 7-10 days and is a smoker. The chest pain, which she described as a pressure, had been going on for a week and she was told to have us check her out by our office manager. Everything checked out normal and she did not want to go to the hospital so we made base contact (we are required to contact the hospital for patients with possible serious medical complaints to cover our butts) and signed her out AMA (against medical advice).

Job Security

While I was in our dispatch center this last week we had a person call us to find out how to get a hold of 411 to look up someones address. I'm willing to bet that this person drives and votes. Scary thought huh?

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.

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.

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.

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.

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.

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.

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.

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.

Heart Attack

Today we got a call from San Pedro Peninsula Hospital (SPPH) asking us to transport a patient from their ER to Torrance Memorial Medical Center (TMH) for an angiogram. Since the patient was on a nitroglycerin drip a nurse had to take the call. We get calls similar to this all the time, no big deal. This call was different because the staff at SPPH told us that the patient was about to arrest and that we needed to hurry. Because of the serious condition of the patient we decided that the paramedics would take the RN instead of the EMTs. This is done on critical patients because we can do things for a dying patient that the RN is not allowed to do (such as intubate). Once we got the the ER at SPPH it was apparent that our patient was in no such distress. As it turns out the cardiologist at TMH is more than a little panicky. I talked the nurses in the ER at TMH and they confirmed that the cardiologist on duty that day needs to mellow out just a bit. He wouldn't make a good ER doctor.

Firefighter 1 License

Today I found out that the city of La Habra Heights is hiring paramedics. They don't pay very much at all and I would only be able to work there a couple times a month but they are willing to train me as a firefighter and get me my firefighter 1 license. If I had that I would be able to apply to just about any fire department in California. As luck would have it, my partner at Gerber knows the guy that is in charge of hiring at La Habra Heights Fire. I am going to apply on Monday and see where it leads.

http://www.la-habra-heights.org/2006_NewSite/city-dept/fire-ems/fire_paramedic.html

You think you had a bad day?

One of my patients today was recently caught by ICE (Immigration and Customs Enforcement). While under their care he developed chest pain. Last night they took him to the ER where they checked his troponin levels and sure enough, he was having a heart attack. After going to the cathlab we transferred him to another hospital where he could be stabilized just to be sent back to....Syria (I know that all of you thought Mexico).

Los Angeles County = Frustration

Today we had a patient at a dialysis clinic that had her heart rate shoot up pretty high. It was ranging between 148 and 162. Even though our patient had no real complaints at the time (and her vitals were all stable except her heart rate) we wanted to get her heart rate lowered. We got her on some oxygen and started an IV. We then had her try a vagal maneuver without success. I then made base contact and tried to get an order for Adenosine (a drug that can sort of reset the heart but it doesn't feel too good so I'm told) just in case the patient started to deteriorate during transport. They decided that if the patient starts to deteriorate during transport that we would have to recontact them for the order of Adenosine. I'm sure that is just what my partner would love to be doing right when the patient is talking a nose dive....call the hospital instead of treating the patient. In other counties (where they trust the paramedics) we would have gotten the order.

The best part is what the MD did as soon as we arrived at the ER. He gave her Adenosine! How frustrating.

A Great Shift

A great shift is when you can go into work, check everything out then get 4 1/2 hours of much needed sleep. The afternoon was much rougher...we actually watched a couple episodes of Band of Brothers. I love being paramedic.

Spare Uniforms

I always try to have a spare uniform at work just in case I get some undesirable stuff (blood, vomit, etc.) on the one I'm wearing. Today I was waxing my rig and as I squeezed the bottle of wax it exploded. I had wax all over my uniform from neck to boot. I never thought that I would have to change my uniform due to a wax explosion. The wax didn't even work out well for polishing my boots. How frustrating.

Ghosts?

Today we transported a patient from San Pedro Hospital (SPPH) to little company of Mary's Hospital (LCM). We do this quite frequently because SPPH does not have a cathlab for cardiac patients. The only thing that made this call blog worthy was the "visitor" that my patient had last night. Evidently a security guard was walking by my patients room at about 11 at night and happened to see someone standing behind the bed. Since it was well after visiting hours the guard went to the nurses station to tell the nurse. When the nurse entered the room and asked the patient who was in there with him he thought that she was a little nuts. The RN checked the room and found no one. She then tried to check the bathroom but it was locked (interesting since there are no locks on the door). The RN did not believe the patient and had other people ranging from nurses to doctors to priests check out his room. After about 30 minutes the bathroom opened up and no one was ever found. My patient never saw anyone or any thing. The only person to see a "ghost" was the security guard. I heard that he incident even made it into the priests afternoon sermon. I'm sorry I missed that one.

Medicinal Use?

A few days ago my partner and I got to work a standby (that's where we sit around a location for a movie shoot, stunt or other such nonsense) at an r&b concert. It was put on by Microsoft, which was promoting the new Zune, and the State Parks and Recreations department. It was at an park just outside of Chinatown near downtown LA. I don't know what they were expecting but the promoters went a little overboard on the EMS. We had two different BLS providers there plus a private paramedic unit and LAFD showed up with an ALS engine, a Rescue, two bicycle paramedics, and their tactical command post. Of course with all those resources, nothing happened.

Half way through the concert my partner and I were approached by to girls that looked about 18. They asked us if we were firemen. We said no, we were paramedics to which they replied that will work. They then asked us for alcohol. When they found out we had none they asked for a bowl to smoke. As they walked away disappointed I couldn't help but wonder if they wanted the marijuana for medicinal purposes.

Ice Skating Rink

The call came out as a leg injury at the public ice skating rink. When we get there we find an 8 year old boy that was crushed beneath a 300 pound section of rod iron fence that was leaning up against the wall. Bystanders had already pull the section of fence off the kid. The boys upper leg was bent at a point where there are no joints. We place the screaming kid on a back board and then apply the traction splint to the broken femur. We get him into a position that he says is OK and transport. While on our was to the hospital my partner tries to get an IV. The kid screamed more about the needle than he did about his leg. My partner ended up not getting it and decided not to try again. As we wheeled him into the pediatric ER at Harbor UCLA a swarm of MD's come rushing in to see him. One of them told me it had been a slow day so everyone wanted to be in on the femur fracture case. I guess doctors need their excitement too.

Technical Rescue

The call comes out, "station 1, station 3, station 5, station 6, rescue. Battalion 91, truck 91, engine 93, rescue 93, air and lighting, USAR, respond to a man trapped beneath a load of cement."

That's one way to get a paramedic excited. A minute or two later we all learned that the man was not actually trapped. When we got there we found that the man had a several hundred pound slab of concrete that had fallen on his legs. Afraid that more might be coming down on him he crawled under his delivery truck. That is right where we found him. We had to climb under the truck in order to splint his leg and place him in c-spine precautions. I started a line on him and we gave him some morphine. He still complained that it hurt but what can you expect. I love trauma calls.

Elk Grove Community Service District (CSD) Fire Department

I'm spending a lot of time and money recently applying to the Elk Grove Community Service District Fire Department (EGCSDFD? That's a little long to put on a hat!). Today I had my Captains oral review. There was a panel of 3 captains and 2 civilians. The interview lasted about 35 minutes. Theey asked questions ranging from "tell us about yourself" to "tell us of a difficult situation where you handled it poorly."Overall I think that the interview went well. I was the first of all the candidates to be interviewwd. I don't know if that has anything to do with my ranking but I would like to think so. I'll find out in about 10 days if I passed. The next step is the chief's oral review. I think that it's the same thing but with higher ranking officers.

Letting your license lapse.

One of the paramedics I worked with let his paramedic license lapse. He couldn't work for almost two weeks until the state came through with his license (sounds familiar). Since I am always concerned with the well being of my fellow medics I decided to start collecting applications to jobs that did not require a paramedic license. He ended up getting several fast food and delivery driver applications. He did get a kick out of it when he got them all.

Never bring a paramedic your woes!

At least not while he is at work. Today, the operation manager at my company, had his fairly new Ford F-350 4x4 pick up stolen from the driveway of his house.To make matters worse there was thousands of dollars worth of equipment (new radios, tools, brush jackets, etc.) in the truck at the time. So as consolation, my partner and I bought our manager a copy of Truck Trader (for those who don't know it's a magazine that has local trucks for sale). We of course thought that this was hilarious but it only got us a dirty look.

Oh well. I think that our manager will someday be able to look back on this and laugh. Someday.