Tuesday, June 19, 2012

No real changes, and a trip in the Wayback Machine

Hello again Loyal Readers..

Waiting game continues..had the 38 week OB appointment with SWMBO this morning. She is still only dilated to 2 cm and the baby is still high, although to me at least it looks like she is starting to drop. Heart tones are still good and everything still looks healthy. Plus, the doctor discussed the intricacies of the cervix which was rather interesting. 

Went down and picked up my check from orientation and training at Oompa Loompa EMS. The ALS coordinator tried telling me that he needed some more hours covered by me. I explained to him when I interviewed that I was only looking for extremely part time, and that I was NOT giving up hours at overtime pay at the full time gig to work for peanuts. I think it helps that the pregnant one was there to point at and remind him that I am not picking up any extra hours ANYWHERE till after Little Man is born.  

Work is getting busier at Big City Trauma Center. It is summer, and Darwin is in full effect. I have never understood the why of increased activity by the Knife and Gun club when the temperature rises, but it is definitely true. This weekend was not too bad as far as the Club's activities, although we did have plenty of assaults. Saturday was spent in a wonderful Xray vest and oh so breathable plastic trauma gown for most of the night. The fat man sweats when the temperatures increase much above what most people would consider cool to slightly warm..it is much worse when I am put in a plastic sweat bag with an extra 10 pounds of lead. Sunday got to go in a bit later since I had Little One until 730. Tomorrow I get to go in 2 hours early to make up for it, so hopefully the wonderful citizens of my town stay quiet and give me a bit of a break..we shall see.

Since the stories about what I have done with my time in EMS seem to be rather popular, lets hop into the Wayback Machine and take a trip back to when I was but a newbie in this career field.

As the esteemed Mr. Grayson would agree, there are those calls that will always stick with you. For me, the one that I think I can remember most vividly is the one that hearkened the end of my time as a Probationary Medic. It was a typical warm summer evening and I was working with Corey. Corey had been a medic for years and was stuck with me as his minion. We worked an odd 16 hour shift, from 10am-2am. 3 days a week, made it easy to pick up overtime or have a social life. We were sitting post somewhere, relaxing and talking. "Dispatch to Medic 36." "36, go ahead" we answered. "Priority 1, MVA at not so high speed intersection near campus." "Clear, enroute." Grab the VHF radio, lock in the city's dispatch channel, and call "Life Medic 36 is responding." We go bombing through town, sirens wailing and light's flashing. Move quickly but carefully through the usual traffic near campus, and pull up to the scene. I notice the usual collection of City and Campus Police cruiser's blocking the intersection, along with Engine 6. I see one car parked near the side of the road, not really noting a lot of damage too it, and the other car is nowhere to be seen. While not unheard of, you can usually find either a second vehicle, or an object that the lone car hit. Did not see anything like that here. Jumped on out, like a nice eager lil probie, and noted that Bennie was grabbing a backboard and collar bag from the engine. Odd...the city usually did not take much initiative on their own. Then again, it was Benny. Where Benny was, Larry was usually there also, and they both were EXCELLENT First Responders, the kind who not only did not mind EMS runs but actually enjoyed them and did a good job with them. Glance over, and see Larry kneeling down on the ground in the grass island/median. Started sauntering on over to them, hands empty, while Corey called us on scene with our dispatch and the City. Pulled my gloves on, full of my usual swagger. As I got to within a few feet of Larry, Benny ran past me with the backboard and bag, and Larry looked up with panic on his face. My mask of cool, calm, and collected slipped a bit. Larry shouted to me, "I think she just took her last breath." Tunnel vision broken, I looked down and saw my patient, a young lady with a rather bloody face and chest lying on the ground in front of Larry. I turned, shouted to Corey to get me everything, and rushed the last few feet. Larry gave me a quick run down, 20ish female, hit at moderate speed while crossing the street, unresponsive with agonal breathing until I showed up. I dropped an Oral Pharyngeal Airway in place without any response, and began ventilating with a Bag Valve Mask. Ok, so far so good. Good equal chest rise as best as I could see in the fading twilight, decent compliance. Corey jogged up, stretcher loaded with airway bag, suction, drug bag, and monitor. I could still feel a decent carotid pulse, but still no respiratory effort from my patient. I grabbed the suction unit, and cleared out blood, dirt, and who knows what else out of her mouth and airway. I told Larry to take over bagging while Benny got a c-collar in place. I grabbed the Combitube, pulled it from it's nifty plastic case, and traded places with Larry. Luckily, the Combitube slipped right into place without difficulty, and we very quickly verified lung sounds. Like a well oiled machine we rolled her onto a backboard, secured her, and it was off to the truck. Corey re-verified tube placement while I got a quick set of vitals. Grabbed a firefighter to bag for me while I dropped a 16 into her AC, first shot, no problem. Corey began running us in hot to the closest trauma center. The next 7 or 8 minutes went by as a blur. Quick trauma survey showed several broken ribs, unknown internal injuries, and not much to find externally. A second IV was started while rocking and rolling towards the hospital. Vitals were crappy as to be expected, but she maintained a pulse during transport. I turned her over to the waiting trauma team at Bronson, and wrote my report. The next shift day, found out she died from massive chest trauma. Although the thousands of patients I have treated in my career are mostly a blur, I will never forget Rayma. She was the patient that showed my ability to maintain my calm and treat a critical patient during such chaos. She also was one of those patients that remind us all of our own mortality, since she was close to the same age as me. Always humbles you a bit when you are taking care of someone who could very well have been you had circumstances been a bit different.

Well, enough rambling from me for one day. Time to relax, try not to melt in the 90+ degree heat, and maybe slip on down to the Casino to use my $10 in free slot play...

Till next time.


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