It could have been so much worse!

A rush of adrenaline...this doesn't sound good! I listen intently as the tones drop for our neighboring rescue squad. "Aplha Response! Respond for nursing home on fire, approximately 50 residents to be evacuated." Normally when the tones drop for another squad you wait until your squad gets toned out before responding because it is not technically your call. When I heard this dispatch I didn't hesitate in marking our Advanced Life Support crew en route to the scene to help out. I asked for more information from dispatch while I was on the way and was told that there was indeed already smoke in the residence halls and the staff was getting all the people out into the parking lot as quickly as possible. "Great! If the smoke doesn't get them they will freeze to death outside!" I was glad that we had gotten en route so quickly because half way there I heard dispatch begin to tone out for multiple squads all across the county to come out and help. This was a nursing home. It wasn't like we could announce to the residents to please exit the building and wait outside. Most of these people were in wheel chairs and could not be left alone anyway. We arrived on scene to find the small amount of staff that was working at 10:00 at night trying to take care of almost 50 residents that were cold and scarred out in the parking lot. Fire alarms were sounding and people were running everywhere.With the help of multiple different rescue squads we were able to get the people over to another building with minimal problems. Thankfully after the whole escapade we only ended up having three patients one suffering from smoke inhalation, one that had injuries from a fall, and one that was unresponsive from a condition that had nothing to do with the fire. All in all everything turned out very good considering what could have happened and it was great to see the community coming together to help us in our efforts. Some of the neighbors even came out and helped us calm the residents down and help in any ways that they could. After only about an hour and a half we cleared from the scene and were back in service with the residents back in their beds and all the rescue personnel very thankful that everything had turned out so well. It could have been so much worse!

The Small Details Count

My crew and I recently responded to a call for an allergic reaction. We had a small crew that night with only Eric, a student, and me. Eric was driving so it was just me and the student in the back. We arrived on scene to find a female that was basically "out of it". I asked her daughter what had happened and she said that she had taken an antibiotic that had been prescribed to her and she thought that she was having a reaction to it. In the case of an allergic reaction time is very important and getting medication into your patient to combat the reaction as soon as possible is very important because often times the airway is the first thing to be affected. We quickly brought in our equipment and loaded her onto the stretcher. Before leaving I asked the lady's daughter what all of her known allergies were. She replied and I repeated them back to her so as to make certain I had heard right. Asking a patient or close family member about allergies is a very important thing that is done with each and every patient encounter. We loaded our patient into the back of the medic unit and marked en route to the hospital. Once en route I started an IV and administered a medication to combat the allergic reaction. She seemed to be somewhat better by the time we got to the hospital so I was very much relieved. As we were unloading our patient and getting ready to take her inside the hospital her daughter came up to me and asked how she was doing? I told her what I had done and that she was doing a little better. The look of shock on this woman's face told me something was very wrong. She stated that she was very sorry, but she had forgotten to tell me that her mother was severely allergic to the medication that I had given her.I couldn't believe it! Wow how could you forget something like that! Praise God that nothing had happened and the medication had actually helped her like it was supposed to. There was no way I could have known that the lady was allergic to the medication, but I sure was happy that God had been with me in the back of that ambulance and that everything went ok!

Don't cry wolf!

There is a lady in our 1st due response territory that continues to call 911 for help over and over for reasons that do not warrant EMS response. Now, I will say that we get calls from people most everyday that they should have not called 911 for, but this woman gives a new meaning to "crying wolf". We have gotten called to help her down the steps, to help her to the dinner table, to help her to the car, and to help her into bed. One of the last times I actually called dispatch and reported her for abuse of the 911 emergency system. When a person gets reported for abuse of the system the next time a call goes out for that residence instead of dispatching us (rescue) they dispatch the head county Paramedic and he responds. This happened and she was informed that if she continued to call she would not get a response that it was very dangerous to do this because if something was ever really wrong no one would come to her aid. Well last week when my crew and I were on call at the station we heard our tones drop for that residence. Naturally we were not happy about it and some of the crew did not even want to respond because we knew it would just be another wasted trip. We marked en route anyway because even though we are not obligated to respond we knew if something actually was wrong we would feel bad for not going. On our way we asked for patient information and dispatch told us that she had said she was bleeding uncontrollably. Right! She'd tried that one before too! We got on scene and and I walked into the house in no big hurry whatsoever. When I got inside I heard the lady's husband yelling from the back bathroom, "Get in here!" Again, no big deal because they were always demanding and rude so I was used to the urgency in his voice. When I got to the bathroom the lady was sitting in a chair by the sink. The counter was covered in blood! The clamp on her dialysis port had come off and she was bleeding heavily. Both her and her husband were panicking! I was even caught off guard...this was an emergency! We finally got the bleeding controlled and got her to the hospital. Finally, this woman got the point! Real emergencies happen and if you abuse the system and call for help when you really don't need it you can get yourself in real trouble. In other words, "Don't cry wolf!"

Diagnosis: Inexperience

Anytime a crew gets dispatched for a call involving a Pediatric patient I think there is always an element of apprehension. One of the things that you are taught in emergency medicine is that kids are not "little adults". They can not be treated the same way because their body systems are so much different than that of an adult. Children are very resilient, which is a good thing, but they also have a tendency to compensate for a very long time and then crash all at once when you are least expecting it. My crew and I responded to a call for a three month old male that was having a seizure. We arrived to find a young mother standing outside of her residence holding her little baby. Naturally, we were all a bit nervous because we just don't see as many children in the back of the medic unit as we do adults. After we had checked the baby and were on the way to the hospital we came to the assumption that the baby had a seizure only because the fever had gotten so high. An experienced mother would have probably recognized this, but this young mother had no idea. We took the baby to the hospital and on the way I got the opportunity to "educate" this young mother on some things involving medical emergencies in children. Being able to teach and be able to prevent future emergencies is one of my favorite things to do!

Thoughts...

I have been looking into becoming a CPR/First Responder/EMT instructor. Being able to teach others to do what I am so passionate about doing would be amazing! I have helped with multiple classes, but would love to be able to implicate my thoughts and beliefs into the medical teachings. When people start out in emergency medicine they think they are invincible and that they can handle anything. Few instructors will tell you that you are helpless with out God. This fact has become so real to me in my experience in EMS and is a great comfort when despite your best efforts with perfect circumstances your patient dies. Likewise, I have cleared from calls and thought, "How on Earth did that person live?" I try to always remember when I mark en route to a call to pray for my patient and for God to allow me to use my medical skills to help the person I will soon come into contact with. I have personally seen miracles happen in the back of an ambulance! It is such an amazing place to work because truly every second counts!

What were they thinking?

So every once in a while you run one of those calls that just makes you stop and say, "What on earth were they thinking?" The next few calls I depict are true and are not exaggerated.

The latest one was this past week when we got tones out for a 59 year old man that was vomiting and having difficulty breathing. Once on scene we found out that his problems were caused when he went outside in his front yard, saw a mushroom, took it inside, cut it up, and ate it! He had poisoned himself!

A man wanted to cut a large branch off of a tree out in his field. He had to use a long ladder to reach it so he propped the ladder up against the branch that he was cutting off. I won't even go into the details.

A woman needed to reach something on the top shelf and thought that it was a good idea to put a small step stool on top of a rolling office chair. I think everyone gets the picture.

And then there is the people who I say, "What were you thinking?" when they call us. Like the woman who called us when she dropped a can of Lysol on her toe or the lady that called us at 6 in the morning to take her to the hospital because she had an appointment that day and she didn't want to be late!

All this for nothing!

Last night my crew and I got dispatched to a 22 year old female that was having severe abdominal pain. This woman lived in our fourth due response area which means we had an extremely long response time. When we marked en-route we had no idea how far out this call really was. We drove for over 30 minutes on gravel roads, and wound around hairpin curves that were most often times single lane roads. When you are driving around in your personal vehicle on roads like these it is bad enough, but doing so in the back of a bouncy ambulance and not being able to see in front of you is ten times worse!The entire crew (even the ones not normally affected by motion sickness) began getting really sick. By the time we got to the woman's house all of us were sick! It was a terrible feeling knowing that you had to suck it up and go out there and take care of your patient when you felt sick yourself. So after getting her inside we began the horrible ride back out of the "woods" and to the hospital. I almost passed out on the way there and both of the guys in the back with me were sick as well. It was a miserable ride. Finally, we got to the hospital and got the patient transferred to the nurse. I was feeling terrible, but knew the woman was in a lot of pain so I was glad we took the call and was able to help her. As I was walking back to the EMS room to begin the paperwork the nurse asked me for the woman's last name. When I told her she just looked at me, smiled, and said..."Oh, her again. Yeah she was in here two days ago for the same thing. Frequent flyer." With disgust I walked back to the EMS room to inform the rest of my crew that we were missing sleep and were all feeling sick for someone who was just faking it!