OK, all AMI's aside Tuesday's lecture was enlightening. Really starting to understand all these ALS dispatches that come out, know what CHF is now, what AMI stands for CVA, TIA, REALLY know what an anurism is vs. a cranial bleed. The real meat of medical stuff is just starting.
Start with strokes and stuff tonight. Boring stuff that any of you medical people/EMS people already know about, but its new to me so its NEW boring stuff. We'll never get to treat any of these injuries or respond to calls WITH those injuries in our jurisdiction, that is unless we take advantage of being able to ride ALS units as a 3rd. Then we stand a chance but we're not really allowed to do anything outside of our basic medical assessment, i could tell the Medic, he i THINK they had a stroke etc.
Enough with the boring class stuff. I rode our BLS ambulance yesterday for the first time in more than 2 weeks. A decently busy day, good calls, great use of our system, good lessons all around on allocation of resources and working with career guys for efficient patient care.
Day started off a little later than our usual shifts, we like to get there at 0700 when the career shifts switch just so we're on an even playing ground, i know the guys at our station appreciate when we put the unit in service, but i like to at least keep ourselves on even footing so there is no "Well we've been here since 0700 you slobs rolled in at 0830 and bitched about how it was early." in any case, we're there a smidge late, luckily its one of the more forgiving shifts AND they are out on OARS (training drills) so we were still a benefit filling the house while they were out.
We're signed on and ready to go about 0840 and my black could kicks into effect. BOOM, 0853 the tones drop for a BLS emergency, little kid, injuries from a fall, undetermined height, supposedly unconscious at the scene. The hitch is we listen to the address and not ONE person on the shift knows where the hell it is. Its WAY outside our first due. Mind you this is a heavy traffic volume time in our 1st, 2nd, and 3rd due, headed in the direction of the call. A little confused we take off WAY up the road. Airhorns got a workout yesterday! 9 miles in 11 minutes during rushhour, not bad, marked onscene at 0904 only 3 minutes after the first due engine. NOT TOO SHABBY, great driving BOB!!! Little Mr. Bumponhead was in his kidneygarden class and just DFO'd, teacher said he tensed up and fell over and "curled into a fetal position", by the time we got there the engine crew had him isolated, the rest of the kids were out of the room and mom was there (holy fast acting phone tree, batman!!). I grab everything we could possibly need, airsplints, pediatric board splints, the pediatric backboard, restraint bag, the aide bag, the cot, ... I look like a vagrant, i have literally 6 bags and they're dragging the cot in front of me. Sir Bumpsonhead seems to be ok, Initial and rapid assessments don't reveal anything, at all really. Just because we're not taking any chances on this we package up Bumpsonhead with the ped board (completely alien technology, they should really teach us this stuff in class, not that OJT is bad.)
C-collar, spineboard, straps, this kid is a trooper, calm as a cucumber with the whole process as long as mom is holding his hand and explaining things to him. All in all a good patient. No clue why he DFO'd, our OIC thinks it may have been a reaction to a possible choking incident, or an isolated focal seizure. The medic checks him out and encodes the hospital for us since technically it was an ALS transport due to reported Loss of Consciousness, but without altered LOC or identifyable serious MOI they gave us the BLS transport with a courtesy call to the ER. No issues on the other end, we re-encode the hospital about 2 minutes out and drop Bumpsonhead off in the Ped unit. The docs check him out and take his collar off and take him off the backboard, soon enough he's running around like a madman.
The only real downside to this call is mom and lil' brother (his indian name would be Little Big Poops) came along with us, somewhere along the line lil' bro drops a big stinky mess in his pants and it gets sucked into our vent system so we're all sniffin' poop for the rest of the way to the hospital. I don't know what Lil' Big Poops was eating but DAAAAAAAAAAAAAAAMN. HOOFAH for sure! But, if thats the worst thing that happens i'll consider myself fortunate.
Get back to the station about 1000 and are just getting settled in when our company president shows up and pulls me off the unit to drive out chief's buggy over to the county apparatus shop while he drops off our reserve engine. OK, ALRIGHT, this can't be that bad, but i get this ooky feeling in my gut that we're going to get a call while i'm OOS. Get out to the apparatus shop about 15 minutes away from the station and i hear my OIC get on our response channel asking dispatch to start him a Medic unit to our front pad for a walkup diabetic emergency. CRAP! I knew i'd missone. So i round up our president and haul butt back to our station. We get there just as the medic unit from a neighboring area is loading up the patient. ALMOST MADE THAT ONE !!!! Eh, nothign we could have done anyways guy was hyperglycemic, and we're not allowed to do much other than give him water and recheck his dexy in a few minutes. The REALLY positive side to this whole call is that when the guy walked up and our OIC realized what was going on he called our EMS Supervisor to get direction on how to handle the call. We could transport and monitor patient stability, or roll a medic and let them give fluids and transport. EMS Supervior tells us the safest thing to do is roll a medic. Silly part is they really arent going to do anything that we wouldnt other then fluids, only they'll give them IV and we'd give them orally. In the time it took to get the medic unit to our station we could have been to the hospital. But, in retrospect it was handled well, the medic unit trasporting limited our liability as a BLS only unit. The OIC on the medic compelmented our OIC for an excellent transfer of care, a GREAT report, and a generally well handled call. I think the biggest benefit from that whole experience is that one more career paramedic crew realized we're competant pre-hospital caregivers not just volunteer scabs.
Not much else for the rest of the day until about 1545, the tones drop and waaaaiiiiit waiiiiiiiit engine, medic, ambulance, rescue, police, another engine, a truck BAM huge dispatch for a car into a wall with a truck involved. OOOOH NICE CALL! We mount up and tear ass down the street tailing our academy's medic unit that was filling our house. BAM we hit the interstate, horns blaring, middle of rushour sirens wailing people scattering another great display of driving from our crew driver. Weave and dodge just the right way. Usually we never make it to the scene of accidents on this particular interstate before being put back in service. We're monitoring our interstate incident channel and we're getting excited. No service call yet, WE CAN SEE THE ACCIDENT, 1000 yards, 750 yards, CLOSER .... CLOSER 100 YARDS, BAM ... ambulance blahdittyblah you can go back in service, no need for EMS on this call. CRAP!!!!!!!!! Oh well, so close yet so far. No where near as dramatic as the dispatch had made it seem, looked like a pickup truck rear ended a van and the van swerved into and sideswiped a wall lowspeed. Oh well, such is life. It was a wild ride for a minute there.
That was about it for the rest of the day.
Got in a great workout later that night and i think i'm almost to the point where i'm comfortable going back to CPAT practice, gotta try putting a LITTLE more stress on the leg tonight and see how it responds.
Class tonight is on Altered Mental Status, Diabetes, Strokes, and using the glucometer. All stuff that should be marginally interesting.
I'll write more later i'm sure, just to keep everyone updated.
I'm contemplating riding our medic unit this coming sunday after class so we'll see how that goes.
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