Some things just hit hard.

It's been a very long time since I've written. A lot has happened. Some good, some bad, most indifferent. Tonight has been an interesting night. I should tell everyone.....or really myself, that I've gone from Bad partner to Great Partner back to New gal, knows everything partner. That won't last long, I'll break her in (like I did with Bad partner) or I'll break her totally.

Tonight we started off the night taking two geriatric jobs. Both are simple and just plain silly. Nothing important in those. Though while clearing the second job with operations I hear a call go out. It's for the fall down stairs and non responsive. The address is what gets me though. I know it all too well. It sounded like my parents house, but it wasn't. It was the same street just not close to their house. I offer up for the call as we are considerably closer then the rig they want to send. I've got to remember not to offer up for any calls any time soon.

I arrive on scene with one of the fire depts were not a big fan of. They tell me it's probably a precautionary and it doesn't look good. Normally we take what they say with a very fine grain of salt, yet something in his voice told me otherwise. I get down the stairs and I see what they mean. This lady is not in good shape at all. 12 steps, about 12 feet, strait down into a hard wall. The friend says she went to use the restroom and just took the wrong door. One fateful step too many. She's barely breathing, and when she is breathing it sounds as if she's in a deep sleep and is snoring though her dreams. One look in her pupils tell me they are probably the last of her dreams, and will be nothing more then nightmares. They are high, all you see is black, and they don't react, neither of them. I quickly ask for RSI as she meet criteria....unfortunately we have none up. We load the patient, I steal a firefighter (the new partner truly has no clue what she is doing, let alone where she was going and got us lost not once but twice) and off we go. i decided that the patient really needs a tube and can't wait for the ER. And so off I go. I look in and see nothing, well nothing good, lots and lots of emesis, no blood though, that's good right? I push forward a little more, and I see what I need, the epiglottis, but no vocal cords....She needs the tube though and if that's the epiglottis, then the cords have got to be there. Lucky for her they were and the tube helped. Though she refused to wake up. No sooner did I pass the tube though, did my RSI (rapid sequence induction, using drugs to stop the lungs and loosen the muscles) Paramedic show up, just a minute too late. Though as my partner pulled over to meet with the RSI medic, she turns the lights off, every light off...Boy was I pissed, glad I didn't lose the tube or she would have lost her head, and me my job. From this point everything else is easy, IO in (damn people for not having any veins) and speed to the nearest trauma center another 10 miles away.

We arrive and we all know it's not good. The pupils are blown, so is her life. Barely 55 and a child left behind, scared. Her brain had no brain, it was all blood. There is no chances of surviving that, well not at least back to normal. The docs have told me she'll be comfort care only. What a shame, maybe the loss of her life can benefit multiple others. In her career she cared about giving to others, maybe she'll continue on with that theory.

I'm not sure why, but this call really hit me hard. I've had multiple cardiac and respiratory arrest. A few (hundred?) shootings and stabbings, and a lot of drunk wrecks, yet not one has effected me this bad. Maybe its time I take a day off and just enjoy myself. I've been fighting with my family and I guess I should apologize and make sure they're alright and tell them I miss them. This is one of those cases that just prove how fragile life truly is.

The little big doll house.

I knew the address, worse, I knew the patient. I heard the call first go out over fire as they were dispatched. "FD for the male passed out in the bathroom, unknown if breathing." Why do they always die in the bathroom or on the toilet? I heard are medic unit called on the radio....where the hell is IP?! I answered the radio, already knowing what loomed ahead of me. I answered the radio, beating dispatch to their own dispatch (they hate when I do that, but I need to find IP!). I turn on all out lights, maybe it'll flush him out. The whole time I'm thinking of what I'll need, what steps I'll take, and what rhythms I'll see. Then it happens; "FD to Dispatch, we have a confirmed arrest." Great, my first cardiac arrest on my own as a cleared medic, oh well might as well happen early on, but why with IP! Finally he arrives, 2 minutes, where was he!

I know when we get there it is definitely the old man. I've taken care of him several time, always for hypoglycemia, he never watches his sugar. We never take him in and he's always so kind. His wife offers us beverages and candy when we show up, and always talks about her doll house. That doll house I will never forget, So elegant and yet so huge. Yet so empty with out any dolls to occupy its walls.

As I walk in the house I notice the wife just sitting in the living room alone, with no worries in the world. And then, outside the bathroom, lies the naked, frail body of the kind old man. FD has already gotten a tube for me (thank god, one less thing to worry about) and is working on a line. How could I be so stupid, I forgot this FD was ILS and able to actually do these things! I attach the patient to my monitor...asystole, continue CPR. It doesn't look good for the poor guy, then it hits me again, he's a diabetic, I bet his sugar dropped too low and he coded! I check his BG...I wait, and wait, and wait until finally..... HI! His sugar is above 550mg/dl! No wonder he coded he's way beyond DKA! (Diabetic Keto acidosis). Call med control, got orders for Bi-carb and push it....get it in and manage to pull my EJ line, thankfully we had two lines. Wait what that! Holy shit batman he's got a rhythm! Does he have a pulse? HE DOES! I have no clue what that rhythm is, but it sure works for me! I couldn't believe that we got him back! Whoops spoke too soon, he's gone into V-Tach, don't touch him IP I'm about to shock him! Good got that funky rhythm back.....nope spoke too soon again, now he's in V-Fib, thank god I'm giving him amiodarone and that didn't last. He might just live after all.

Call the doc back while everyone gets the Pt on a board and loaded into the ambulance. "Hey doc this is Medic13 again, I've got good news and bad news. Bad news is where inbound to your facility with that cardiac arrest and about 5 minutes out. Good news is that he's not in arrest any more and we got pulses and a REALLY good pressure back." I could tell the doc was stunned, but non-the-less happy and even said, "Wow, Good Job! I'll see you soon." Damn IP missed the turn again!

We get the patient to the hospital after nearly getting killed ourselves and give report and transfer care. My OPS officer and myself stay and watch as thing progress, in case they need any more information. Thats when thing began to go downhill. That Patients pressure began to drop, as well as the heart rate. They continued to drop until the patient went back into V-Tach, though with a pulse this time. The doc decided to shock the Patient, not once, not twice, but three time, according to the outdated protocols. I couldn't watch anymore. This poor old man is being taken after being given a second chance. Alas he has passed, nothing they do will work now and they let the family know. I wish my best to the family and to the wife. I truly hope someday I'll get to see that doll house again, under better circumstance of course.

I write this post some time after it actually happened as to allow for HIPPA and some other circumstances to pass.

Time has passed and so have people

It has been several month now since I have cleared. I've been doing a lot of thinking, a lot of reading, and then even more thinking. I've been reading a lot of other medical blogs, some from fellow paramedics, some from doctors, some from nurses, and even a few from pharmacists. Theres one main thing I've noticed between us all (besides that your friendly local pharmacists truly can be cynical) is that we seem to hate certain types of patients. This all has made me think...what type of blog do I want this to be? Well I think the answer is that I'm just gonna have fun, I'll make fun of the idiots that reproduce and populate my fair city in large numbers and then talk about the souls that haunt my dreams. I figure that anything in life that happens is fair game to be shared, especially if you are stupid enough to do it and then have to tell the paramedics about it.

In the past few months I must admit there have been a lot of changes. I've changed shifts and changed partners. If had temporary partners who where great and those that I wonder how they get dressed in the morning let alone got their EMT card. My first partner when I cleared was Great! Always helping out and more then willing to learn, fun to talk to and knew where to actually drive to (let alone how to drive). My new partner is...interesting to say the least. New partner (NP from this point, or maybe IP for idiot partner?) is annoying, always getting lost and not knowing the proper protocols. I know it may not seem right to backboard and collar the little old lady who looks like she has no injuries, but she's got dementia and can't tell you if she actually does! Oh and when I press on her back, and you say it's flank pain, you REALLY need to learn your anatomy. Especially if you want to be a paramedic some day. I understand that maybe not everyone knows how to drive on the road, especially if we're running hot with the lights and sirens going WOOOoooo WOOOoooo, but that person driving like an idiot should not be you IP! I should not be clinging to my seat for dear life! Alas, management is aware and other paramedics have had issues as well, including one big blow up and yet you still manage to hold onto your job. Oh well. Some people just need to be shot or made Infertile and you are one of them IP. Well until next time I'll sign off as well. I think starting next month I'll make this blog a more daily (well daily as in nights I work) occurrence.

Life as a new Paramedic...no not a Paradick

So it's official, I am a fully cleared and certified paramedic. Yet, the question still sits, does 18 months of hell truly make me ready for it? Does the torture and training I have endured for the last 18 months of life truly prepared me to be the best damn paramedic that I can be? Truly I think that I will be alright and shouldn't have to much of an issue. I've had some of the best preceptors, from the zombiemedic to the other Jew, to the cynical knuckle dragging cousin fucker. These people and many more in the field have taught me that it is not just me out there and that I will do the best for my patients.

I understand I am not alone on the ambulance and the partner I get is only as good as I train them to be and allow them to be. We are a team and must act as a team no matter what. I could hate this person from the very bowels of hell and I must still like them and yearn to teach them. I know a good basic will save my ass not once, but every single day! And thus I must also have they're back. this person must also have a fundamental understanding of the basics and more. I know that when I come upon a scene I must be able to deal with every person I come in contact and control them with a air of respect to the patient and the crews. I must be able to command chaotic control. But these things, all must be done without getting the title of Paradick or Paragod, neither of which I hope to be. I really hope that my friends will be able to keep me inline and away from this fault.

So as short as my Paramedic career has been already, I have already had to deal with two double fatal accidents and it's hard on the soul. I am scared of what the future holds for me and my career. I hope and know that I will do the best for my patients and myself. I look forward to seeing everyone read on in the near future.

Till then, Medic13 signing off.