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.


TS&T

Friday, June 15, 2012

The Waiting Game Begins...

Hello again loyal readers!

As promised, I have not waited nearly as long to update as my last little hiatus. Not a ton new has happened, but figured I should write ya something new to read anyways.

I worked Monday and Tuesday, had Wednesday off, then went to go pick up Little One on Thursday. Today was spent being pretty boring, hanging out inside due to her still recovering from sunburn from last weekend. Tomorrow, if she continues to improve, I think we will have to test out the new Amazing Kiddy Pool of Wonderment. The one from last year sprung numerous leaks in the inflatable ring, as well as several in the sidewalls. I am quite certain that a number of those resulted from my unceremoniously dragging it down the concrete steps to the basement due to the snow that was falling. I put the old pool up 2 weeks ago, and then spent a fair amount of my time chasing down and attempting to patch all the leaks I could find. Despite my best efforts, there were still a number of leaks in the ring around the top that I could not find. Wednesday I busted out the new 12 foot pool that actually has a metal frame to it that the Father In Law bought. He originally purchased it to put up at his house, but due to his fear of ever marring his lawn and it being 2 feet larger than the identical pool that we had it would not fit on his deck he never put it up. I should have known as soon as I saw the "Simple 1-2-3 setup" written on the side that it was gonna be a bit of a pain to put up. I was right...My back was not so thrilled with me by the time I finished installing the frame. SWMBO came out and helped me to install the legs, and then I grabbed a Frosty Cold Adult Beverage and waited for it to fill..and waited..and waited. Apparently it takes quite a while to fill a 1550 gallon pool with a garden hose that leaks and pipes that are cobbled together and are 100 years old.

Yesterday, SWMBO pointed out that the water coming from beneath 2 or 4 points of the pool was likely a bit more than just old water left from the last pool. Of course, as usual, she was right. Found 4 small tears in the floor of the pool already. Today, a trip to that god awful Wally World produced the new chlorine tabs that I needed, a bag of shock that should last most of the summer, and a neat little $10 patch kit that claims to work underwater. Added a handful of new chlorine tabs, rinsed the filter element, and discovered that for once the advertising did not lie. That stuff not only sticks underwater, but the cool little fiber swab for slathering on the adhesive somehow did not stick to it or hold the glue at all!! Now, no more leaks, and I was quite pleasantly surprised to find that the solar cover had warmed the pool to a comfortable temperature already. An hour of water from the super-fantastic hose and the pool was filled again.

I have to work tomorrow and Sunday night..I will get up with the Kiddo's in the morning, hang out with them until mid-afternoon, and then catch a bit of a nap before going off to Save Lives and man triage. Sunday will be coming home and crashing for a few hours in the morning, then get up and hang out with the lil ones for a bit before saving even more lives.

Yesterday morning was spent with a trip to go see the O.B. SWMBO is now dilated to 2 cm, but Little One is still sitting up high. She is ready for him to come out, but I already asked her to wait till after the weekend so I can have a bit more time off to help out...lol.  I have 2 weeks worth of time off and holiday pay banked up to help out, get them settled and bond with Little One before I go back to the grind.

Speaking of the grind. About a month or so ago had a really nasty case there in the ER. Got a tiny lil infant brought in by the Big Blue Whirlybird from an outlying facility. Apparently a family member's dog decided to take a lil taste of the baby to see what the new squirmy thing was that was squeaking and it did not end well. The little one was small enough that I spent the entire time holding the head in position to maintain an airway, including through several episodes of arrest. Continued holding the head while family came in to see the little one and make the final call. I managed to hold myself together, professional detachment and all, throughout most of it. I will admit that the tears started flowing as some of the family came in to say their goodbye's and talk to the infant before the call was made. I was quite appreciative of the fact that those of us directly involved with the several hours of care were allowed to stand back as the parents held the baby when life support was terminated..brought a bit of the closure to that experience that is sometimes lacking in EMS. I stepped outside once it was all done, said a prayer for the family, and had my little bit of a breakdown. Got to call and talk to SWMBO for a few, which made me truly thankful that I have a partner in crime who is in the same business as me and can understand. Went back in, and helped to make the impression of the hand for the family to keep, and to finish up the few things that needed to be done before the baby could be released to the coroner. Then, cleaned up the room, and went on caring for the other patients in the department.  I must say, it is times like that where the fact of how amazing my ER is comes out to shine. EVERYONE worked together perfectly even with the stress of the situation. Our Charge Nurse (coordinator, sorry..lol) that night handled the family with dignity and poise, more than I think I could say if the situations had been reversed. He was a fantastic leader and guiding spirit throughout it all. Definitely blessed to have such great co-workers.

The other night at work we had another nasty peds patient come in, and one of the other medics was sent in on it..Good for him..I have had my fill of nasty pediatric cases for the moment. Not that I would not jump in and do what I do best if I needed to, but he could have that one..

Well, since despite my best hopes and dreams, the dishes do not appear to be cleaning themselves. I suppose I should go take care of that and a few other things before I try to get some sleep.

Hope you all have a great and safe weekend..

Until next time...

TS&T

Monday, June 11, 2012

June, heat, and rain.

Good morning friends..Yes, I know for many of you odd daytime folk's it is far from morning, but not for me and my nocturnal brethren..

Life continues marching steadily on, although at times it seems to be it is charging headlong with no apparent brakes.  Had another great weekend with the Kiddo's, and even had my brother and my dad come to visit. Was definitely nice spending time with them. Mom couldn't make it as she already had other plans.  Little One and the Gman spent pretty much all day Saturday and Sunday in the pool, splashing, fighting, and generally being kids. Sunday SWMBO's sister and boyfriend also came over, bringing the grand total to 6 children acting like hyperactive chipmunks on cocaine to the pool.

Friday, SWMBO lost her mucous plug..combined with the pre-term labor she has been having, I think I am going to have my very own Little Man quite soon.  She has been on Terbutaline for the labor, but is scheduled to stop taking it on Wednesday. Last week she missed 1 dose and ended up at the hospital, having contractions nice and regular and strong at a 6 minute cycle..somehow I am thinking I may very well be having my own Father's Day Party up in L and D..lol.

The weekend was also spent doing the assembly on the stroller/infant carrier combo that my grandparents very generously purchased for us, figuring out how the heck the baby carrier pack thing that CompuSciBro bought for us, and getting the diaper bag assembled. Today was spent putting together the swing that he also bought, and unpacking the Baby Bath.

Last weekend, we took Little One with us, hit a few garage sales, and also a really cool new resale shop that opened down the road from us to buy some baby clothes, since SWMBO apparently gave away ALL of the newborn and 0-3 month clothes that she had from Gman. If you are in the Toledo area, I would recommend checking them out for ANY kids stuff you might need!

SWMBO's Gramma is supposed to be taking her out shopping soon to get some more clothes and some diapers, which are always needed. We bought a pack of the newborn size the other day, but have not even come close to stockpiling what we need.  We are thinking that we will have a post-birth Diaper Party in a few weeks..just have to figure out where we are having it and such, since parking is such a beast here.

Has been amazing to have the last 2 weekends off with my daughter. This weekend I am scheduled to work Saturday and Sunday (booooooooo) but I suppose 3 perfect weekends in a row is too much to ask!  I am back to work tonight and tomorrow, then off until the weekend.

I have been asked to help co-write a blog post with EpiJunky so that should be coming out soon as well. Should be interesting, and looking forward to the experience.

Alrighty..I have dishes to do so that we can eat dinner, and other assorted minutia to do before work. I apologize that this post is rather incohesive and lacking in major substance..

Until next time...

TS&T

Thursday, May 31, 2012

wow..apparently it has been a while..

Hello Loyal Readers!

I have neglected you, left you in the corner to starve like small pitiful creatures, and I apologize for that.

I have been incredibly busy for the last few weeks. Between working my full time Big City Trauma Center job on nights, picking up a few shifts at my contingent squad gig, working Big Rock Concert, and getting rolling with the Oompa Loompa EMS Co, I have had very little free time.

At the Big City job, the warm weather event type patients have been coming in with more regularity. More patients are coming in with extra perforations that they were not born with, whether formed by sharp pointy objects, really fast and small lead ones, or using their own motor vehicles to unleash Mayhem on themselves, people have been leaking out more fluids than they intended when they left their humble abodes. Granted, true Summer has not arrived yet, so there is MUCH more to come. Since I have such fantastic staff that I work with, I look forward to the challenge. Between the nurses, respiratory therapists, residents, attending doc's, and my fellow medics, I think we got this.

Big Rock Concert was a blast as always. One of the best things about working in EMS are those rare occasions we get paid to do something fun. Big Rock Concert is definitely one of those things. Saturday kinda sucked, as I was stuck on a transporting unit, in a city that I was not familiar with, with a partner (ambulance driver) who also was NOT from the area. Granted, we pulled through and rocked the job, but definitely not as much fun as getting paid to watch the shows and the crowd. Had several critical patients we took in, including a nasty trauma-alert head injury that was not discovered until well into the transport. Was pleased to receive several compliments on my assessment and field treatment, which I chalk up to my new experience from Big City Trauma. Sunday was amazing, as I was up at the main stage almost all day. In short, for being some people who are getting to be some Old Farts, Marilyn Manson and Rob Zombie F#$%ING rocked! They put on such impressive shows that we had many less injuries than during headliner shows in the last few years...I attribute this entirely to people too busy actually enjoying the show than thrashing and dropping each other.

Picked up a rare shift on the road for what I guess is now Big Aquamarine EMS..worked with someone I truly enjoy spending time with, and had a blast. Got to pick up one of our regular dialysis patients that I had not seen in almost a year, and happily attended. Got to drive out to BFE and do a ridiculously short tote to a doctor's appointment and back...approx 1/40th of the mileage for that trip consisted of the transport....

Got hired on with the Oompa Loompa EMS Squad, which consisted mostly of "You are a paramedic? *insert drooling and fawning here*." Gotta say, the only reason I went over to this agency was at the request of Epijunky..apparently she would like to work a shift or two with me. Orientation was a disorganized mess, at least to someone who has worked at several different agencies over the last 10 years. Had my "training" shift today, which consisted of getting quizzed over drug dosages (have I mentioned I have not seen the protocol book yet??) and writing all the reports. Oh, and I drove back to the station to prove I won't recklessly play bumper cars while being supervised...yeah. All of my patients today were neck bubblers. For those of you who have not had the joyous experience of deep tracheal suctioning, I think there is no way to put across in words what a nausea inducing experience it is..Between the sounds of the thick mucus and sputum, to the vibrations of the suction tubing..UGH..grooooosssss. Yes, I understand it is part of the job. Yes, I understand it is NOT the patient's fault that they have a trach. No, it does not make it any less hideous and disgusting to me.

On a separate note, Oompa Loompa EMS is not as bad as I thought it was going to be, based off of what I was told by many people. They are a small start up company in the already flooded EMS market here in Big City. They have issues as does any EMS agency, be it private, fire dept, or some other system. However, they are trying, and by all accounts things are improving. Plus, they have several contracts for special events in the area, AND they pay an extra $1/hr for working them. I like the sounds of that.

For now though, it is time for this Nocturnal Medic to head to bed. I have my princess this weekend, and have to drive to pick her up tomorrow, and then work tomorrow night.  Sleep well, be safe, and as always, until next time!

TS&T

Thursday, May 10, 2012

Overdue Update

Welcome back Loyal Readers!

I know, I know, it has been a while, and you were actually beginning to forget I ever existed!!! I have had a busy start to the week already, after another fantastic weekend with Little One.  At the request/urging/begging of a friend, I applied for a 2nd part time job, bringing me up to 3 total.  Interview was cake/a joke, and I have my orientation next Monday.  I work full time in a big city Trauma Center on nights as a medic, I am extremely contingent at my former employer still as a road medic, and I am now a proud member of the Oompa Loompa EMS squad. If you had ever seen the uniforms, you would understand...

At my full time job, we use a 2 step triage system. The first step just covers vitals, a very brief narrative, and is designed to get the patient into the computer system and able to be placed in a room. The second step is much more thorough, covering full medical, surgical, psychiatric, and social history, along with review of meds, allergies, and "What does very good care mean to you." I worked a short lil 8 hour shift today, and spent the first half of it, dodging from room to room doing the second step triage. Needless to say, I got more practice at it than I would have preferred. On the other hand, I learned how to do full visual acuity checks, found out how fast a pregnancy test can come up positive (about 10 seconds!) and figured out how to put in orders for the radiology department.

The second half of my shift was spent out in the Land of Unicorns and Rainbows, or as more commonly known, Triage.  As usual, I worked my non-sunny magic on the waiting room, and turned it from a steady but consistent flow of patients into a morass of huge numbers registering, and then waiting for a room. Of course, that is not nearly enough fun, I had to throw my usual Winged Simian Minion into the mix, and come up with several rather acute patients for the nursing staff in the back to untangle. Among those, just hitting the highlights of course, was a wee one with some impressive respiratory distress, and a younger lady with a history of cerebral aneurysm who felt like she was having another one. Always a good time when you deliver a patient from triage and head directly to the Attending physician to make sure they are aware of the happy happy good times you have just blessed them with.

Now, it is home, and time to curl up with SWMBO, who has long since headed to the land of Nod.  Tomorrow brings a regular 12 hour shift of fun and excitement, plus trying to make sure I am conscious in time to see The Family before I go to work.

On a better note, next weekend will be spent with 50,000 of my closest friends working EMS for that there Former Employer, working Rock On The Range..to those who are at least somewhat familiar with modern Rock Music, take a gander at this and I am sure you can see exactly how I will earn money doing nothing but listening to great music (*insert eye roll here*). Just looking at the headliners for both Saturday and Sunday night, we gone be biiiiiizzzzy.

Till next time kids!

TS&T

Sunday, May 6, 2012

Weekend with the Kiddo

Well, I have been enjoying a fantastic weekend, both because I am off work on the combination Cinco De Mayo, College graduation, prom, and Full Moon weekend, and because it is my weekend with my daughter.

Since it was rainy and nasty out yesterday there was not much that we did other than hang out inside and play, although it did get nicer enough in the evening that Little One got to go outside and play while I grilled some steaks up. Today has been a nice lazy day..Went grocery shopping and restocked the rather bare shelves in the fridge and the shelves, then just hung out for the afternoon. This evening SWMBO and I took Little One to one of SWMBO's friends weddings. Nice ceremony, not too churchy. Outdoors at a nice park with an attached reception hall.

Both Little One and I enjoyed the reception, and "danced" several dances together. I say "danced" because there is not much in the way of coordination and cooperation from a 3 year old lol. SWMBO even took LO out and danced the Cupid Shuffle. LO caught on pretty quickly, and it was quite entertaining watching the two of them out there having a blast. SWMBO sat out for most of the dancing, as apparently being 31 weeks preggo takes a bit out of ya.

Tomorrow is the last day for LO being here until she returns to purgatory for 2 more weeks. SWMBO's sister is coming over with her two kiddo's to hang out and play with LO. Should be lots of loud, raucous fun for all!

The only thing that has really brought the weekend down was a letter I received in the mail today from the lawyer..Apparently The Ex called MY lawyer, complaining that I was actually exercising my rights to vacation time this summer. Since she infuriated her own lawyer to the point of dropping her as a client, she has made the oh so logical choice to complain to the lawyer who was working against her..yeah, that's the kind of logic I am forced to deal with when it comes to LO. She apparently made the brilliant move of threatening my lawyer and me on voicemail to him that if I continued to pursue my court appointed (and agreed upon by HER as well) vacation time this summer that she would stop allowing me to see LO, claiming that I am "disregarding the court order." Understandably, I must be, since I am following the exact language of it (roll of the old eyes here...).

She then goes on to claim that I am nothing but "basically a part time father". Umm yeah, that is the unfortunate truth, since I am limited to 3 phone calls per 2 week period, and seeing her every other weekend, by her refusal to allow me to play a more significant part of her life..

Sorry to vent to all y'all...just gets a bit frustrating at times. Wish the court system around here was not such a "mother rule" system and would allow a father who does EVERYTHING in his power to be there for his daughter a little bit more leniency when the mother is being unreasonable.

Hope everyone has a safe and happy weekend..it's back to the grind again next week...which is probably better for the paycheck anyways!

TS&T

Wednesday, May 2, 2012

Back after a few day's off...

Well, since there seems to be a small but steady following here, it appears that I am overdue for a new post!

Tonight is day 4 in a row of working, hence the lack of updates. Before you get too sympathetic, tonight and Monday were my only full 12 hour shifts. The other two were shortened due to shift trades!

For lack of a better topic at the moment, I guess this will be another about me post.  As I mentioned before, I work full time as a paramedic in a busy Trauma Center. I have only been here for a little over 6 months, but I love it! One of the common questions I get from both patients and other EMS providers who aren't familiar with us, is what exactly does a medic do in the ER? Well, here we go!

Triage, lots and lots of triage..Pretty much at any point, you will find at least one of us out front, manning the triage desk. After registration enters the patient into the computer, they either come straight to the triage area, or go to the waiting room, depending on how busy we are. From there, we snag patients, check vitals, obtain a quick history of current complaint and related medical history, meds, and allergies. We determine (if we are busy) the severity of their complaint and whether they need a room immediately or if they can wait a bit. If we are not swamped, they go straight back to a bed regardless.  Busy nights it is a very stressful place to be, with people coming up every few minutes demanding to know when they will be getting a room.

In the ER itself, we assist with getting patients into gowns, getting them hooked up to the monitors, and obtaining full medical history, confirming medications and allergies, surgical history, social indicators, etc.

IV's and 12 lead EKG's are a big part of what we do, bouncing from room to room helping the nurses out.

"Bedside Testing" such as glucometers, urinalysis, and blood chemistry's using the I-Stat machines.

Since drawing Blood Culture's takes a bit of time, on night's that we don't have a phlebotomist in the department we are usually responsible for these. On nights that we do have a Phleb, we still usually end up helping out.

When we have a trauma come in, we are responsible for establishing the IV's and/or IO lines, getting the patient on the monitor, and any other assistance as required.

In general, we function as nurse extender's, functioning fully to the scope of our practice, with the exception of medications. We also place foley catheters, as well as Orogastric and Nasogastric tubes. We also do a whole lot of patient transpots, be they taking someone in a wheelchair up to the observation units, or taking a cardiac patient on a monitor and med drips over to the Cardiac unit.

Being in the ER has a ton of new learning opportunities and a nice variety of patients that I get to encounter. We are a training hospital as well, so new changes to healthcare as they come out are regularly being brought up and utilized. All in all, I really enjoy my job.

When I feel the need, I can still go get my "squad fix" as I still work (very)contingent at one of the private EMS companies in town. Later on this month in fact, I am working back to back days at one of the premier Rock Concert/festivals around for said company..should be a blast!

Till next time, be safe, and have fun!

TS&T