Sunday, July 29, 2007
Friday, July 27, 2007
I grab the bag and head towards the stairs of a decrepit trailer. Our third rider is way ahead of me, and suddenly learns why "Don't Run" is a rule we take seriously. He trips on the second stair up and goes to his knees, the monitor flung out in front of him, looking all the world like an old lady losing her umbrella in a gust of wind. I step over him and walk through the open door from the porch. A firefighter turns around. "What's all the noise?"
"My rider got tagged by a sniper. What we got?"
"Baby ate a plant or something. He got pretty red and was havinga hare trouble breathing, but we gave him some O2 and he seems OK now."
I walk in the room to see a nice little backwoods family waiting for me in the "living" room - all the rooms in this trailer run together, so It's hard to tell where the kitchen begins. I think it's where stained, ugly carpet meets stained, cracked linoleum.
Maybe they're not hick trailer trash, I wish feverently. They're a hard working family down on their luck, forced to live in this shit hole by an evil...shit, an evil godmother or something, I don't know...it stinks in here.
Wait a minute. I thought a whole backwoods family is in here, but I see it's only HickDad and HickBaby - HickMomma is MIA. This is not the happy family combo plate I expected. I raise an eyebrow to the Cowboy FF.
"Mom's in the cruiser out front with Steve, Mike, and The Taco".
Steve and Mike are the local deputies around here and The Taco is the largest, friendliest, tater tot lovingest German Shepard I've ever met.
That is, until, Mike tells Taco it's work time. The Taco? He becomes....well, a werewolf is too mild. He becomes a werebear - a slobbering, evil monster capable of devouring criminals, boats, and small houses in a single satisfied glomp.
"She thought she would try to flush her meth when she saw us get here. Only, she's kinda high, and was trying to wash it down the kitchen sink. She got about half way done with Mike and The Taco came in through the front." He lowers his voice to a whisper. "Taco was real rowdy when they walked in..she peed a little. Well, a lot. They've got her out in the cruiser. Dad gave this address instead of the one next door, which is where the baby was. They walked out front when the crusiers pulled up and went in next door and watched mom get busted."
"You checked the baby? Is he ok?" Cowboy nods yes.
Hickdad hands the baby to me. The baby has big blue eyes, a big ole smile, and a big diaper, full of smelly, soft, baby shit. The diaper is not containing the poop, I conclude. It's cruising slowly, just everday shit without a care, from my gloved hand down towards the crook of my arm. After a quick assessment, I hand the baby (who is fine) back to dad, who, I realize is sweating profusely. His face is red, and he is scratching his side absently. I tell him we need to take his son to the hospital, JIC. I ask him what happened.
"Well, I's on my way home from work when my mom called me and said he was out on the back patio and he got into one a her plants. He had two handfuls of leaves in his hands and was cryin'. She thought he ate some so she called me. He was fine, there weren't none in his mouth or nuthin'."
HickDad is still sweating and scratching his side. Sweating. Red. Wheezing a little. Something isn't right.
I ask HickDad if the baby has any history or anything, and he tells me No.
I am beginning to form a picture in my head. Dad is real nervous...maybe his wife? No....why is he scratching. Those Wheezes.
No, it can't be.
Things have fallen into place rather quickly.
"Are you ok?" I ask him.
"Well yeah, uh, no, man, I'm having trouble breathing."
I direct Stumbles the Third Rider to get vitals and motion for my partner to grab the stretcher, and I kneel next to Hickdad.
"Well, uh, I wasn't sure if that's what he ate or not, so I, uh, I ate some of the plant. Like, 5 or six leaves. A branch worth. I wanted to make sure that's what he had."
I swear, the stupid hurts so much my ears start to bleed. I sigh as I put my steth to the man's chest.
"Do you have any medical problems?"
Later, we are parked in front of the Sonic. Mike and Taco are next to us, and I sit on the back of my ambulance, the module doors open. We have had two codes out here today, an assault, a breathing problem, another assault, said poisoning, and three transfers. The sun sets over a rice field. Neon light from the sign casts down on me and my powerade slush. Taco is sitting obediently next to the cruiser, watching Mike as he slowly polishes off a hamburger.
Mike then pulls a giant box of tater tots out of his Sonic bag. Taco licks his chops but continues to sit. Taco is the Zen Master of waiting for tots. I have seen Mike put a tator tot on Taco's nose, sit down, and start talking to someone, with Taco waiting patiently. Mike then gives Taco a look and says "Take it!!". Before "It" reverberates to my ears, the tator tot has vanished, Taco has licked his chops, and he is in place for another tot.
Today, Taco has worked hard, and made a lady pee herself in terror, and does not have to perform such indignities. Mike tosses the tots at Taco, rapid fire, as fast as he can, and Taco does not miss a single tot.
"Are you supposed to be doing that?" I ask Mike. "I mean, feeding him that shit?"
"Meh." Mike, 6'4", 280 lbs of muscle, meh's like a 70 year old Yiddish Housewife, shrugging his shoulders pragmatically. "He loves 'em. No one at the department cares. He's a good boy. I'm not supposed to, I know I'm not, but Taco's smart enough to not tell anyone." He winks at Taco conspiratorially.
I look Taco at the eyes. "You're going to get fat. That shit goes directly to your hips, Taco my boy. You're a good pooch, but that shit'll kill ya."
Taco turns his head away from me, dismissively, and licks his chops. He's a happy pooch.
The Sun has set on another day in BackWater Parish. My new turf. My new home.
Tuesday, July 24, 2007
I see this sort of thing routinely, and I've always wondered why people get so panicked when a loved one is injured, when if you just keep a cool head and hold it together you can get things accomplished. It's arrogant of me to say so but I've always prided myself on being the eye of the hurricane in an emergency.
Now I know why people get panicked. Now I know why people fall apart. Now I know why some medics work far away from their area so they don't have to see someone they know. To be honest with you, it scares the shit out of me to think I might have to pick up one of my friends who've been seriously hurt. But I'd rather it be me. I trust myself enough to take care of one of my friends, and not many others.
I'm just hoping he pulls through right now.
Monday, July 23, 2007
Why has ole MedicMarch been so busy these past two weeks?
Because I'm officially cleared as a Paramedic.
On my own.
Updates coming soon! This evening! Swear!
Saturday, July 14, 2007
PS - Some of you make this is gross or unfunny. I don't care. I think it is. If you've been reading here long enough you need to come to the conclusion I may offend your sensibilities every once in a while, but usually I pop right back with something that makes you wet your pants. So if this bothers you, stick around. Or not. It doesn't matter. It's just a blog, guys.
PPS I don't abuse cats, or even dislike them. I just think this is funny.
PPPS - Also please note the new poll - your voting is encouraged.
PPPPS - I suddenly realized that my draft version of this didnt have an "h" after the C in "Cheezeburgers" was the one I sent in to LOLCATS. Oh well, they're not going to post it anyway.
As I look at the paperwork the first thing that jumps out at me was the address of the patient. It's in a local area famed for it's rampant drug use, violence, and abuse of EMS units and personnel. I try to force this from my mind as I fill out our forms and get the nurse to approve everything. Our patient had come into the ER tachycardic and elevated body temperature that resolved after about 15 minutes w/o Tylenol being administered. Did I mention that this guy has a past hx of IV drug abuse? I'm not going to mention what drug it is, but I'll give you a hint - The Bolivians use it to march. This guy is getting off after having surgery not more than two weeks ago. Genius. I guess this is the part where I feel bad for him and rail at the hospital for not getting him proper substance abuse counseling. Wait a minute? He has insurance? Oh. State Insurance. My Money. Jerk.
Look, I've seen people who have state insurance who truly need it - I've transported them in my ambulance - people who without the state insurance would be screwed so hard they'd make a porn film about it. But I've also seen people who have no business having a state card, who abuse the service, and who don't deserve it. Know what some medics call having Medicare and State Insurance? Platinum and Gold Cards.
Yeah, so as you can see I'm going into this with a positive mindset already. Despite my choler (thanks, word-a-day calender!) I professional up and walk into the room, where Spidey is waiting with the stretcher. I introduce myself to the patient, who glares at us with a tough guy face. "I don't like ambulances. They're bumpy." He's restless in the hospital bed, tapping feet, playing with his pulse ox, etc.
The patient's girlfriend is with him - she's not so bad, I suppose, but also seems jittery. "Can we go now?" asks the patient? "We've been here for an hour already, and I need to see MY doctor!"
Oh, fabulous. An entitled jerk drug addict. Ladies, too bad this guy is already off the market.
We load him and his girlfriend up and get underway. "Full speed, 20 knots. Depth, 200 meters. Make it so!" I yell to Spidey through gap. We get on the road.
We are on the road for exactly 5 minutes (I took the guy's pulse and I happened to be looking at my watch again when he pipped up) when the bitching starts. "It's cold in here. Turn off the A/C!"
Silence for another 5 minutes or so. "Damn, it's hot, turn that A/C back on!"
Again I comply. "I'm cold, turn it off!"
I had the patient an extra blanket and tell him, politely, that I'm going to leave it on
"This chair is uncomfortable!" Says his girlfriend, fidgeting on the bench seat.
It slips out before I can stop it. "They're on back order!"
"What's on back order?" she questions, unsure of where this is going.
"The Lay-z-boy bench seats. We should be getting them next month."
The patient on the stretcher BRAYS with laughter, and I'm reminded of Super Troopers, where Farva tells Rabbit "I got you, you fucker!"
After he calms down he asks me for some ice chips. The fridge, I tell him, is with the Lay-z-boy seats.
I go over his medical history with him. He tells me about the surgery and everything, and I'm thinking to myself "Why didn't they sedate him? If he's coked out he's got to have a big chance of aggravating his already unstable cardiac condition!"
"Oh," he remembers. "Also, I got two hernias, one in my belly, and one in my nut-sack, hurrrr."
The next forty five minutes of a whirlwind of excited talk between the two of them regarding her upcoming birthday. If you're unfamiliar with how two coked out individuals discuss something, it's like eight 12 year old girls jabbering at one another in your den - Dennis Leary nails it in his No Cure for Cancer routine. The gaps are filled in with them bitching about the ride and asking for other favors.
I tried to cut my wrists with my ID card and when that didn't work I just stuck it out and took vitals every 15 minutes.
Some battles, I learned that day, are unwinnable.
Please welcome Detail Medic's Life In A Fire House to the link love list! She's pretty funny, and she loves hotdogs!
Also welcome Strings! He's a pirate! With a permission slip! C'mon people, it doesn't get any better then that! A marauder of the high seas who's ALLOWED TO DO IT! Like Sir Francis Drake. Uh-huh. Didn't think I'd go all history book on ya, did ya!
Friday, July 13, 2007
Go check it out. I'll wait.
Waking them up with it is a big no-no, because A) Sudden withdrawal from a narcotic overdose is extremely stressful to the body - increasing the heart rate and blood pressure, possibly causing vomiting, and pain, and just generally upsetting and panicking the patient, and B) Do you really want to wake someone up so abruptly and painfully, then have them realize that it's your fault they're in this condition? Having someone go apeshit on you in the back of a 5x5x8 box is no picnic, cap'n.
These are things I know ("what? did why did you give it?" hold on-I'm getting there). I've only ever been taught to give it for known narcotic overdoses or unresponsives when we have no clue why the patient is down. So this leads us to the burning question voiced by Gary and JB, (and to make it clear, I'm paraphrasing- Good Ole Gar-Bear and Johnny B did not say this explicitly and they certainly were not vulgar) - MedicMarch, you shithead, why are you giving this person Narcan? From what you stated about the patient (hell, the fact you said that they were awake) and from what we've just read, this person had no indication for this medication to be administered to them. The fact that you gave it shows you have a complete misunderstanding of how the drug works and is malpractice. You disgust us, and you need to quit immediately before you hurt someone.
I know how the medication works, OK? It binds to the opiate receptor sites better then the opiate does and blocks their reception of the opiate, causing instant withdrawal...or something like that.
I'm gonna be honest here: I pushed the Narcan at the urging of my preceptor.
???Whiskey Tango Foxtrot???
Hey! Mom-Partner is his Preceptor! What is his preceptor doing telling him to give this patient Narcan? She doesn't need to be precepting if she's giving advice like that!
If I would've been running the call myself, I probably wouldn't have given the Narcan because I had no indication for it. Something I didn't add to the post was the discussion Mom Partner and I had as we were eating lunch, when I asked her: "Hey, why did we push Narcan?" and her answer "Because she was acting so strangely. Thought that might fix it," And then me going back to my cheeseburger. I didn't pursue the questioning any farther. Mom Partner didn't give me good enough reason to repeat the act of giving the Narcan in a similar situation, so I chose not to add that to the big bag of paramedic tricks in my head. I've precepted with three people so far and if I've learned anything it's that each person has their strengths and weakness, and I try to draw from the strengths of each to make myself a stronger medic.
Mom Partner may not have impressed you with her Narcan administration criteria, but let me also say this: The IV hints that Mom Partner gave me were invaluable and every time I stick an IV there's a little of her skill in me. I will agree that the patient, in all honesty, did not need or show the need for that Narcan I pushed, but I did push it, and my preceptor and I will be held responsible for that action should anything have come from it. I think that as both a preceptor and a preceptee you have to pay attention and be smart enough to filter and take out the good and leave the bad.
I posted the call for it's humor value, and I'm going to stand by the post. I think it's hilarious, and if you work in this profession you know that you need laughter to get you through some of the rough spots. I'm open minded enough to realize what makes me spit coffee all over my keyboard just laughing about it may not make you laugh, and make even make you curl your lip in disgust. If you don't find my brand of humor at all amusing, I don't blame you at all and furthermore respect your stance that I am a blubbering jackass.
That is, I will say that if you don't like what you're reading, I understand. My humor tends to be rawer and bawdy, like I am in person. Following the sage advice of someone I've come to respect immensely, I type like I talk. Professional? Not all the time. But this is ME, and this is MY BLOG. I'm not going to force it on you at all, so please change the channel if you're not into it - Ambulance Driver, for example, is HILARIOUS and posts frequently. I'm sure he's been doing this long enough so that you wouldn't find any fault with his humor, such as telling a patient he may've accidentally given them the rectal side of a thermometer orally. As I see from JB's blog page, you thought that was quite humorous, actually. I think it's funny too, but I if I didn't, and started to complain about how it disgusted me and that the possible transmission of Hep A was no laughing matter, and called for him to leave the profession, might you think I was being a bit over the top? This isn't a personal attack....just a little food for thought.
PS - Finding a new career? I'm not going anywhere. I love this job, and respect it, despite what you may have perceived as me not taking it seriously or as a lark. Get to know me before you make an accusation like that - work a shift with me, or hell, talk to me or my patients. I love what I do and I try to get better at it every day, and besides, judging and condemning someone for one post? Kind of lame. You guys have a valid point with Narcan issue, I think, but what I've take as some harmless fun in the comments section you've taken much too seriously. AD tells me you guys have a sense of humor, so hey....try and see it like that. And if you can't, I'm sorry...your loss, I suppose. Just remember, as my O-Line coach used to say, Opinions are like assholes, boys. Everyone's got 'em and they all stink.
Wednesday, July 11, 2007
Oh, happy day.
I stick my head out from the nurse's station at Metropolitan Area Hospital and take a gander. Metropolitan Area EMS is bringing in someone who's flopping around on the stretcher like she's got 50,000 volts running through. It looks funny, and I snort, and shoot a snot rocket down onto my boots, which I had freshly polished. That's what I get for laughing at the infirm.(I'm sure there's a study that could be done somewhere regarding the tendency of my clean polished boots to attract a mess.)
I grab some gloves and give the crew a hand getting the patient over to the bed. The nurse doing her clinical time, I am pleased to see, is freaking the fuck out.
Heh heh. Newbs.
Apparently this lady's been seizing for a while and they've yet to get an IV on her - not at all surprising, considering this Land Whale weighs at least 350 lbs and she doesn't have shit for veins. She's twitching something fierce and although I can see BAPS Nurse fighting with the Pixsys thing, she's at least another 2 minutes from getting ready. Newbie Nurse and the crew members are fighting to keep the lady from jiggling out the bed (like so much jello off of a cliff, I think poetically) when I decide to intervene. We have just gotten the rails up and Spiderman walks in behind me. I jump on top of the lady, placing my shin across her legs and using my body to hold her down - it's like riding big fleshy washing machine. I grab the wrist Newbie nurse is getting ready to try and stick and hold it against the rail. If Newbie Nurse can avoid sticking the needle into herself or me, we should be OK.
Alas, it is not to be. She uncaps the needle and sticks it directly into flesh on the right side of her thumb. The ladies arm had bucked a little, despite my grip on it. He undulations are getting stronger.
I look up at Newbie Nurse, who has her pretty mouth hanging out in an "O" of shock and an IV needle hanging out of her hand.
"You OK?" I ask her.
She looks up at me, still wearing the big, dumb O face. The needle is still embedded in her thumb.
"Pull it out," I say. "You're the first person it touched, and it was sterile. So go get it cleaned up and come back, ok?" She looks back down at the needle and lets go of Land Whale's wrist. I think she makes a little "eek" as she pulls the needle out and drops it in the sharps. It was only a little 22, and it didn't go in very deep. I think this has been a good lesson for newbie nurse. Needles go in other people's bodies, not your own. Unless you're on the junk.
BAPS nurse has finally gotten some seizure juice pulled up in a MAD equipped syringe (I LOVE THOSE THINGS! GET THEM ON YOUR UNITS!) and squirts it into the lady's noggin, which is gently being held by Spiderman. "Take that, bitch!" I hear BAPS nurse whisper under her breath.
I love BAPS nurse.
I ride the trembling Land Whale, and grin. The juice should work in a hot second, and all will be well. I can get out of here and eat my dinner.
Thirty seconds later I am still grinning, but it is starting to fade, because with my razor sharp intellect, I have deduced two things.
1. This lady is still seizing, and how!
2. It appears she has become incontinent while I'm on top of her. WORST RIDE EVER! I want a refund.
So now I'm trying to keep my leg out of the veritable sea of piss on the bed and still maintain my hold on the lady. If I get off, she's going to start flopping around real bad. This is the worst seizure I've ever seen. For some reason, in between the noise, in between the nurses and paramedics clustered around each limb, I suddenly blank out to my happy place, and I start giggling.
For I have come up with a joke!
"Hey, Guys!" I shout. "Guys!"
Eight pairs of eyes look up at this sparky kid, riding a giant land whale lady, and wait in anticipation. Spiderman realizes what is coming and puts his head down.
I let loose.
"If I stay on for eight seconds, I get a belt buckle, right?"
There is silence in the room, except for the land whale lady bouncing in her bed, which if you've never heard it before sounds like you threw a bunch of ham in the dryer with your towels and turned it on high.
I'm beginning to think I've made a horrible mistake when MILF Nurse (yeah I'm a pig, I own up to it, she's got a great personality in addition to a hot body, so get off my nuts) snorts and BLOWS HER OWN SNOT ROCKET! Hahahah! Sweet! This sets off everyone in the ER room, we're cracking up, people are crying, etc.
This is the scene that awaits Dr. Jones - his real name, I might add. I figure there are enough Dr Joneses that I can get away with this once. He has the IO box in his hand, but he looks apprehensive. He asks if we have an IV yet, and we say no. This lady really is a hard stick - these are some of the most talented ER nurses I know, and they CANNOT get a stick, after what we later figured out was 17 attempts, all together. Dr Jones busts the EZIO (another tool we have that I love!) and slips the needle on. He is looking for a site, really taking his time with, when I bust out with my second gem of the night. In my best Short Round voice I shout "NO TIME FOR LOVE, DOCTOR JONES! JUST DRILL HER!"
This sets off everyone again. In addition to riding this jiggly land whale I am riding the crest of popularity, and it warms me up like a few shots of Goldschlager. Whee!
Anyway, Dr Jones does not get the IO. The lady is too fleshy for the needle to penetrate. Later, they get an IV in the lady's foot and get her sedated.
Spiderman high fives me as I come out of the bathroom. "You rode that bitch like she was your prom date."
"Haha!" I say. "By the way, how is your mom, Spidey?"
"Fuck you." He says.
So I found out I've made it through our company's clearance process. They will be cutting me loose any time now.
Uh, no, that pee's not mine. What kind of medic would wet his computer chair in fear at that statement?
Monday, July 2, 2007
Anyway, I'm looking in the mirror a few minutes later holding my brand new neck trimmer in my hand. I'm a little nervous. The plastic guard I've removed from the box the trimmer came in seems flimsy. I dimly remember that hair stylists use a different guard for each size - not a handy-dandy all in one that slides in over the back and of my trimmer here. Brushing the thoughts away and attaching the small, plastic guard to the head of the trimmer, I'm ready to go. How hard can it be? I'm a grown-up now. At 22 I shouldn't be afraid to give myself a trim.
Let me tell you something folks. Something I found out this evening as I tried to cut my own hair.
People go to cosmetology school for a reason.
As I later figured out, I had incorrectly adjusted the guard, and of course, my first cut was right down the center of my head. I got about halfway back when I realized the guard was at a 0. I had a reverse mohawk.
I rubbed the gully on top of my head. It looked like the canyon Mustafa falls into and dies in The Lion King. I thought I saw a wildebeest stampeding down the middle.
But, I'm not one to give into despair, or admit failure. So for 45 grueling minutes I attacked my head with a neck trimmer with a shit-ass guard and determination.
After hopping in the shower and cleaning it up, I'm not impressed. The hair is almost all the way down to the scalp in some places, and in others? Not so much. I don't have any patches, at least, but I'm thinking I may have to get professional help. I look like....well, I don't know what I look like. I'm not sure I've ever seen anything quite so hideous. I could be a monster in a Greek myth.
Look out, Perseus, I'm kick your ass!
For some reason I've been in a melancholy mood this week. It could be that the house is empty - one of my roomies is in London for 3 weeks and the other is in Flordia for 6 days. I'm not sure why, but it seems, to quote a face book group I saw, that all my friends are getting married and I'm just getting drunk. They aren't actually getting married, but out all of a circle of about 30 guys, only myself and two others aren't attached. The last relationship I got out crashed and burned spectacularly, and the next girl I asked out, who I'd liked for about 8 years rejected me almost out of hand. I'd like to think I've gotten it together enough now that I think I can hold down a relationship but I'm not an easy person to get along with - I'm too sarcastic, very hairy, out of shape, needy, and I drink too much. But Hey - I do my own laundry, my closet is sorted by color and clothing item, I have a steady job, and I'm dynamite in the sack.
It's just that I've had a few one night stands and nights of play with some female friends, and I've enjoyed it, but I'm just ready for something beyond mindless sex.
Heh. Never thought I'd say that.
And of course, if I get involved, within 6 months I'll be wishing for mindless sex again.
Just can't win.