A day like any other..

Sad to say, nothing exciting the past few duty days. Stupidity is the norm. We did just go out on a "detail" to pick a poor older lady up off the floor and put her back in a recliner. We get those calls every once and a while, people get down on the floor from a fall, or just slid out of their chair. She wasn't hurt, just couldn't get up. She's a regular, we probably go out to pick her up once a month or so. Odd thing is she's always baby sitting for her grand kids that range in age from 1 year to six. We decided we're not too sure who's baby sitting who. Luckily the older kid knows how to dial 911.

We have several older regulars that either call us when they need help up, or when they're sick, need meds, ect... Some I'm sure are quite capable of living on their own, but some should be in a home if nothing else for their own safety. We just had a guy last day that calls frequently. He's late 60's, weights at least 350, looks like Santa Clause after a 3 week bender. I guess normally he is able to drive, witch is scary on its own. When he calls, it's usually trouble breathing, (COPD), and he's out of his meds. It's always the same story, that his Dr has somehow messed up getting his prescription to the drug store. Anyway, the sad thing about this guy is the way he lives. His house is filthy inside, usually old food containers and leftover food laying all around the kitchen or the chair he sits on in the living room. His clothes look like he's had them on since the last time we were at his house. He has a colostomy bag, that is always leaking. He urinates in his chair/clothes. Without getting too gross, he sits in the same chair all day, and spits. Always the same direction, at the same wall, to the point that the carpet and wall in that one area are covered with phlegm. Every time one of our units goes out to pick him up, they file a Social Services evaluation form on him. The hospital also follows up with a Social Services form. I got a call from the Social Services director from the hospital that we took him to last day, I think because she didn't want us to think they weren't trying. So far, they say he's alert and oriented, he chooses to live the lifestyle that he lives in, doesn't want any type of outside help, and their hands are tied. Just because we feel he's a danger to himself because of the filth he lives in, or that his mental status is questionable because of how he lives, is no reason to intervene . Legally there's nothing they can do. He's not the first guy we've seen where that's the case, nor will he be the last I'm sure. I'm sure that in his mind, if he chose some sort of outside help, it would be the beginning of the end of his independence. So, the cycle goes on... we'll keep picking him up until one day, they'll find him stuck to his chair, dead.

Crazy Never Sleeps

So Mark, my partner, and I are driving back to the station at 2 in the morning. We had just left the hospital after taking in the city's latest shooting victim. We pull up to a stop light and there's a 30's year old guy standing on the corner. He starts waving us through the intersection, telling us to go ahead and drive through, even though the lights red. We tell him we'll go as soon as the light turns green, and he goes into a huge rant about how then it'll be too late because he's waiting on the corner for the "beings" to pick him up and they won't come to get him if we're there.
As we pull away, I look at Mark and say something about how odd it is that someone like that able to be roaming around the streets at 2 in the morning... He looks at me and says "Hey, crazy never sleeps"
When I write my memoirs, that's going to be the title.

So our latest shooting victim was a 19 y/o boy. Shot thru the upper left arm and into his chest, right in the arm pit. Even though there were powder burns around the wound, he says he didn't ever see who shot him.
He's stable, so we get IV's in him and head to the hospital. Once in the trauma room, they do all their x-rays and stuff and find the bullet still lodged in his lung. The area of your chest where your lungs are is surrounded by a "sack" for lack of a better term, and if outside ait is introduced, or your lungs bleed, blood and air build up in this space and can cause the lung to deflate. Since he'd been shot, he had both blood and air built up and the trauma Dr decided to place a chest tube. A chest tube is about as big around as your thumb, goes into your chest about nipple height in your side, and hurts like no other.

I'm back after a few days off...
The day started a little exciting. Our medic was called to stage at @ 6:50 am for a multi-jurisdictional drug task force to serve a warrant on a house that was known to contain drugs, dogs and guns. They also said that there was a 90+ year old grandmother that lived with the guy and they were a little worried about her. Thankfully, nothing happened and we were released soon after they stormed the house.
Then a few minor auto accidents...
A few minor medical runs...
Then a call for an overdose. It said on our computer that a female had taken some pills. We got to the house and walked inside to find our patient laying on the couch, crying softly.
"What did you take?"
"I don't know, stuff in the medicine cabinet"
As we walked in I noticed a cute little girl standing in the doorway leading to another room. She's maybe 2 1/2. As we're talking to our patient I glance around and see a bag with a baby bottle in a pocket on the side. Then it hit me...
"You have a baby in here?"
"Yes"
She also has a 8 month old baby in the next room.
So we find the prescription bottles that she had taken the medicine from, @ 20 pills total she told us. As we stand her up to help her to the medic, she was complaining about her stomach hurting. I glance down to her abdomen and notice that it is unusually distended.
"Are you pregnant?"
"Yes, 6 months"
"How old are you?"
"19"
She said that she was tired of taking care of the kids by herself, so she wanted to kill herself.
If that was the case, why did she call someone after she took the pills?
Drama.....
I hope she gets help. I hope that she didn't hurt the baby she's carrying. I hope she learns what causes pregnancy.

On a lighter note... today, 6/20/07, is my 20th wedding anniversary. My wife doesn't know yet but I sent her 40 roses, 20 red and 20 yellow. The note says "20 yellow roses for 20 years of being my friend, 20 red roses for 20 years of being my wife". She'll get it at work in front of all the girls she works with. The flowers will make it ok that this morning, on my anniversary, I'm playing golf.

It is now officially summer....

My captain says that it's not officially summer until you see the first girl in a tank top, barefoot, drunk, with a baby on her hip on a run... It's now summer.

We were pounded Wednesday. 18 runs in 24 hours. If you figure a minimum of 1 hour per run, that doesn't leave a lot of time. Of those 18 runs, 3 were actual "I need a medic" runs. The other 15 were things that most people would handle different.

Ass whippings were being handed out one after another, and I'd guess at least 6 or 7 of our runs were assaults of some kind. One guys "old lady" stabbed him with a broken beer bottle. He had a few scrapes and a couple punctures but nothing serious. It was hot, he'd been drinking, she'd been drinking and the next thing you know she's chasing him around with a broken beer bottle. I'm sure you've all seen it before in your neighborhoods. Same ole story. The last thing he told me as we were pulling into the hospital parking lot was "But you know, I still love the bitch".
Another guy was in a bar and "for no reason at all", some guy sucker punched him in the mouth. Split his upper lip clean up to his nose. Now this guy easily stood 6', and probably weighed 220. He wanted me to tell the police that he fell off his bike. That way he could go back to the bar and "take care of business". I told him that from the looks of him, he may want to keep away from that other fella cause I didn't want to pick him up for another ride to the hospital again. I wasn't too keen about doing it this time... What ever happened to the day when you took your ass whipping like a man and just went home afterward and put a bag of frozen vegetables on it? All he could say was he didn't have a bag of frozen vegetables.

My first run of the day was an actual 911 run. A poor little old lady was having trouble breathing. You cold hear her gurgling when she'd breathe from the front door. This is usually CHF, (congestive heart failure). Your heart doesn't pump well and fluid begins to back up into the lungs. It's almost like a slow drowning. By the time you can hear audible gurgling, they need to get to the hospital. These poor people are tired from trying so hard to breathe, it puts stress on their heart. I've actually had people ask me to put a tube down their nose to help them breathe. Nasotracheal intubation is not fun for the patient at all. First, if they've had it done to them before, you know that they are prone to needing it again. Second, if they've been through it before, and are asking for it again, you know they're in trouble.
In her case, we gave her some drugs, lots of O2, and got her to the hospital before she needed to be intubated.

My second actual emergency run was on a guy that was at work and co-workers called a medic for him because he was acting lethargic and confused. He had a history of diabetes, and had eaten lunch but not taken his insulin yet for the day. We tested his blood sugar and it was 356 which is high, but not high enough to make someone act strange. (Normal is 80 - 120). He could stand, walk, acted a little dizzy on his feet. He understood questions, but when it came to answering questions he had problems. You could tell that he understood the question, but couldn't form the words to answer. We ran him to the ER, and gave the ER doctor the story. Just as we got him into their bed, he had a huge seizure. For an epileptic, a seizure is like hitting the re-boot button on your computer. Their brain shuts down, then slowly comes back "on line". That's why they're so groggy after. This guy was seizing, but would try to look at you if you talked to him during the seizure. The only thing was that his gaze was up and to the right. He was having a massive bleed in the right side of his brain. I haven't heard yet what his outcome is. That run kind of bothered me because during the whole run, he didn't care about taking anything with him except for a stack of about 30 envelopes. They were invitations for his daughters graduation and he was supposed to mail them out.

My third true emergency of the day was at 1 am. It was a guy that while riding his bicycle was hit from behind by a speeding car. A witness said that the guy and his bike were both knocked thru the air and into the ditch. He estimated the cars speed at about 45. The car never stopped. My patient was pretty lucky. I think that he got off with just a broken collar bone and leg. Lots of gravel rash on his face and body. The biggest obstacle on the run was that my patient was a deaf mute. It's hard to find out what hurts a person when they can't talk. I'll give the guy some credit, if it were me and I'd just been hit by a car and I wasn't able to convey to my caregivers what hurts, I'd probably be a basket case. He was calm, and of course quiet, throughout the whole run.

Beef. It's what's for dinner.

Marinated London Broil
Buttered Corn
Twice Baked Potatoes
Salad
Bread

*Sigh*
We rotate cooking, driving and other assorted duties here at the station monthly. This'll be my month to cook. The one benefit to cooking is you usually fix what you like. The hardest part to cooking for a station full of firefighters is trying to decide what to fix. Sure, everyone has their specialties, but you can only spring those once a rotation or they soon become not-so-special. Our crew has some great cooks on it, and some not so great ones.
Mark is our out of the box guy. "Cook and serve" means easy-to-make for him. One of the funniest meals I ever had at the firehouse was the day he had pork loin slices, white rice and corn. What made it funny was the look on the guys faces when they each took a bite of corn. I knew what it was, so it didn't take me by suprise, but Mark had never heard of hominy. He just looked at the label on the can and figured it was "king size" corn. So he just fixed it like a can of corn...
Sean is a good cook, he likes to put some effort into his meals. He makes an awesome lasagna.
Roscoe likes to try new things, some from recipies, some off the top of his head. He's the type that'll throw chicken breasts, mushrooms, cheese, wine and rice in a skillet and throw it in the oven to cook. Some of his creations are good, some are better.
Rick's menu consists of just a few things. Taco salad, lunch meat, hamburgers and pizza pie. If he gets a wild hair and tries something different, well, lets just say you're really pushing your luck.
I'm the meat-and-potatoes guy. My mom is an excellent cook, we didn't eat fancy things... I guess a kind of southern type cook. I cook like her, (or try to).
So... it's gonna be beef tonight for dinner.
It was simple, easy chicken salad for lunch.

Dont worry, I'm not dissappearing again... Just nothing exciting. I work again Saturday, I'm sure there'll be something noteworthy then.

What? Me bitter?

I've decided that after reading back on some of my posts that I could be misconstrued as a tired, crabby, burnt out medic. I just want to set the record straight. That's not the case at all. I still love my job! Some nights it gets old getting up in the middle of the night for the same old "bull shit" runs, but all in all, I still like it.

I still like mentals, you can mess with them and they don't even know it...

Nothing gets your blood pumping like a good ole trauma run...

And a few runs, where you know you've done something right, and done it well, still make you feel all warm and fuzzy inside. We had a 53 y/o male the other day that called because of chest pain. Now, probably 7 out of 10 chest pain runs we go on turn out to be nothing. A couple of the rest may be cardiac related, but still nothing serious. But then, every once and a while, you get on the scene and take one look at the patient and just know that this one's going down the tubes.
This guy was one of those. Pale, sweaty, clutching his chest.
Where I work, we have a system in place with the local hospitals where a medic can call in and request a "Cardiac Alert". What that does is alert a cardiac team that's on stand-by at the hospital that a patient is coming in that needs to go directly to the cath lab. Now if I call the ER Dr and request a cardiac alert, but don't convince him that either it's needed or that I'm smart enough to know what I'm talking about, he'll just tell me to "come on in and we'll see you when you get here". That means that he isn't convinced that the patient is having an MI, (heart attack), or is a candidate for the cath lab.
This guy was a walking "Cardiac Alert". I called the ER Doc and told him about ST elevation in V1, V2 and V3, with reciprocal changes in Lead II and AVF, narrow QRS waves, blah, blah, blah... All stuff relating to a 12 lead EKG. Anyway, I must have convinced him, because he went ahead and called the alert.
Now what this alert also does is save time in what they call "door to cath" time. On an average, if a person comes into a hospital ER with chest pain, it takes 140 minutes to make it to a cath table. They have to run tests, do an EKG, gather the cardiac team, get a bed, so on and so forth. On average, if a patient comes in via medic with a cardiac alert called, it takes less than 100 minutes. The record in the city I work in is 12 minutes from door to cath.
This guy didn't make it there in 12 minutes, but was there quick. Turns out he had 3 blockages, had 3 stints placed, and now is doing ok. On the way to the hospital, he began saying "I don't want to die, don't let me die". It's a fact that 70% of people having a heart attack that start saying "I'm going to die" die. The ER Dr told us that we made a good call with this guy. Turns out he's the same Dr that taught my last 12 lead EKG class.
So, that was a good run. All warm and fuzzy... Guy was dying, we intervened, and now the guy is alive and well. He can call 911 at 3 am some other night...
"911, what's your emergency?"
"Well, you see... I'm having severe back pain.... It's been going on for the past 6 weeks, but I just can't stand it anymore."
"OK sir, the medics are on their way...."


Back to the reason for this post, I'm not bitter, I still love my job. I just started this blog because people I talked to, such as friends & family, couldn't believe some of the stupid things people called medics for. So, that's the kind of things I try to tell in here. No one wants to hear about the everyday stuff, just the dramatic, bloody, gory and ridiculous.

Today's been slow, which is sometimes a good thing. I'm on the ladder today instead of a medic, so even if we get called out for a medic assist, we don't have to go all the way to the hospital with them. Unless it's an honest to goodness medical emergency... we haven't had one of those today. Our medic has been busy. They've been out on a couple auto accidents, a few sicks. We went with them for a lady with "severe" abdominal pain. We of course go screaming out there in 750 thousand dollars worth of equipment because she called 911, only to learn that she has had this pain for about 6 months and decided that she should probably get it checked out. Our medic has also gone out today for a splinter in a finger. Yep, that's right, a splinter in a finger.
We've had our drill for the day. We've been to the garage to have some work done to the ladder. We've done our house duties... We've even gone out and checked hydrants. It's not like we haven't been busy, just not dealing with sick people.
Tonight we fly helicopters... At least 'till the "big one" comes in.