Nothing going on lately, no good calls, nothing too interesting to report about. I was sent to one of the slowest stations in my department last shift. Big suprise, nothing happened- at least not until I got sent back to my home station that night. We got a call 10 minutes before shift change. We finally made it back from the hospital around 0845. I was so happy to get out of there!
take care
Accidents and Arrests just seemed a fitting title after my shift last week. The first 3 calls were for chest pain, some worse than others.
07:07....respond to ____ for a 28YOF chest pain.
Dull call, ECG was unremarkable. She got her sister to drive her so she wouldn't have to worry about her children.
We ran a few errands and made it back to the station around 09:30 or so (I think).
(A couple minutes later...) Respond to_____ for a 42YOF chest pain. Will be in green SUV in locations parking lot.
Mom and daughter are in the car, mom's chest was hurting for almost a week and she was waiting until the weekend to get checked out (This all happened Friday) . We move her to the back of the rescue and do another 12-lead ECG. The strip says "biatrial enlargement", but nothing can be confirmed or ruled out without going to the hospital or seeing a specialist. She also was having the pain when she would move a certain way or touch the spot...A sign that the pain could simply be a pulled muscle. She allowed us to call for a BLS or basic transport, ETA about 20 minutes.
We come to find out she has another daughter at the high school a mile away and wants to go pick her up before going in the ambulance. After doing most of our paperwork while waiting on the BLS unit, mom decides she'll go on her own.
"Radio, cancel the basic transport coming to this location."
As my partner is getting the refusals and witness info signed, she wanted to move the car. I'm walking around the unit to see if I can help her get out of the parking space without having to move the ambulance. I don't know if she slipped, but she sped up and hit the corner of the ambulance. She also managed to hit my elbow and knee, it would've been worse if I hadn't jumped backwards when I did. I was lucky I wasn't really hurt, no bruises, but I was riding high on adrenalin for a few hours.
We went out of service and called for PD and for a Battalion Chief to make reports and take pictures. No damage to the rescue other than a little paint. We had to go back to the station to write letters and do more paperwork, then to the body shop for an estimate. It was after 1330 before we went back in service.
Right as we pull into the station... respond to ___ for a 57YOM chest pain, difficulty breathing. Will be at ___(Insurance provider's office)
Onscene, Dr. gives the guy's complaints...He had a syncopal episode (passed out) at the barber shop, and drove here. He's been diaphoretic (sweaty) and keeps saying his chest hurts. Given 1 nitro spray, 1 81mg asprin, and his last set of vitals were 125/85. They also had a small IV started in one hand and were giving him half saline (.45%).
My partner goes to the guys head and asks the favorite question "How you doing today?"
Meanwhile, we've hooked him up to our monitor and find that he's in second-degree heart block. Very bad sign so we go ahead and put the shock pads on him just in case.
The guy responds "Not so good, my chest feels funny."
Looking away to get his penlight and saying "Let me check your pupils," by the time he turned back-BOOM!! The guy's pupils are dialating, I'm starting to move because I saw him stop breathing...Our guy is now in full cardiac arrest. We started scrambling to get the BVM out and the Dr. was told to start compressions. He does 1, looks around a moment, does 2 more, looks around again, 1 more compression and our patient gasps for air.
We immediatly noticed that he was now in third-degree block and kept trying to brady out (his heart kept slowing down). Switching to pacer mode, we cranked it up to 30mA at 70 bpm (beats per minute) to keep him from arresting again. We got a large-bore IV started and got him loaded, one of the guys from the engine was in back also. I volunteered to drive and was met with a very serious direct order "Don't touch the brakes."
Who knew a reserve truck with 144,000 miles could still do 90mph?!
At the hospital, his underlying pulse was 46 with the pacer making his heartbeat 70. He had been given Morphine enroute to ease the pain from the pacer. Even the hospital had a rough time getting a good capture with their pacer, the timing has to be good and his timing was horrible.
I don't know how he's doing now but he was alive and talking when we left the hospital. They were talking about transferring him to a more specialized hospital, he desperately needed an internal pacemaker.
I've read that cardiac arrests only make up 2% of EMS calls. Most of those patients are in full arrest when we get there and have a poor outlook. This guy was one of the few lucky ones, he not only arrested at his Doctor's office, but the Paramedics, EMT's, and Firefighters were watching and ready.
Take care
Not too much has been going on lately. A couple interesting calls but mostly dumb stuff.
I DO have some very good news. The next class of rookies came out of training, and we got one of them. This may seem asanine or irrevellant to you, but it's not. In fact, it's huge! I am still a rookie, but no longer "the" rookie. I got to pass off some of my chores to him last shift. He took it all in stride, it'll all be easier with both of us working.
Since I haven't had any good calls lately, or posted recently, here's one from a while back.
Every now and then, we get a call where dispatch won't tell us anything other than person down. We can usually get a little more information from the KDT in our trucks. Scrolling down the call info my partner read it aloud "possible 22." (demented person) OK, so this guy could be nuts. We beat the engine crew out of the station and got to the street quickly. Turning onto it and coming down the hill, I saw it.
"Uh, this is gonna be fun..."
"Why?"
"2 PD cars onscene."
OK, nobody said anything about PD even being enroute. Stepping out of the truck we can hear someone screaming. Not an occasional yell, but using every breath to yell. We walk inside to find 3 officers sitting on the patient, his dad holding one of his arms, and his big brother trying to help. We later learned that big bro works for our county PD and was just off-duty.
We learned he started screaming about 15 minutes before PD arrived, it was another 15 minutes until we got there. We tried talking to him but nothing worked. There was no chance he'd taken any drugs, legal or otherwise, he didn't have or do anything that would explain his behavior. So we did the only thing we could- restrained him to a backboard. We tied the soft medical restraints to him, strapped him to the board, and buckled him down for the ride. Dad rode in to the hospital with us.
Once inside the back of the rescue, he quieted down a lot. I don't know if it was getting away from his family that helped or not. He tried to work himself back up enroute, but my partner warned him if he didn't slow his breathing and calm down his head would keep hurting and he'd eventually pass out. Dad thought maybe his girlfriend had broken up with him or something like that. I hate to think all of that happened over a girl, but you never know.
We got him to the ER and unloaded him under the watchful eye of security. They were called to the ER in case we needed help, certainly nice to have another pair of hands. (Security is called down for different types of problems- psych, obese, respiratory diseases, and whenever PD brings one in...to name a few reasons)
We never did find out why he got so upset. We've been on many calls on his street since then, it's tempting to knock on his door to see how he's doing. Sometimes I wish we had a way to follow-up on certain patients, see how they're doing.
Take care
