It’s Bxiie Q. with the 411

I had a few interesting calls this weekend.

We got toned out for “difficulty breathing on home oxygen.” The call was way out in the sticks; not right to the edge of our rural call area, but far enough out that the nearest hospital is twenty minutes away. Our response time was about twenty minutes and there was a first responder on scene before we got there. We arrived at the same time as two additional first responders.

We were met at the door by an elderly female. “Sorry you had to come all this way,” she said. “He was having one of his episodes and I couldn’t remember how to turn on the oxygen tank. He’s much better now.”

No problem, we said. We explained that our protocols dictate that we have to take a set of vitals and fill out some paperwork when we are called out but do not transport a patient. The woman agreed that we could take a set of vitals. We went downstairs where the patient sat slumped on a sofa with the first responder kneeling beside him. The patient didn’t look so good; pale, not moving. His eyes were open and he was following motion around the room, though. The patient was wearing a pediatric oxygen mask which covered his nose and not much else.

As the first responders started to collect the vitals, we got a little more history from the wife. The patient had congestive heart failure and had infrequent ‘episodes’.

Given the patient’s presentation and the CHF history, I decided that the sign-off process should include an EKG. I went out to the bus and grabbed the monitor, brought it in and hooked up the patient.

I wasn’t very happy with the strip. It was immediately clear that this wasn’t a sign-off.

I said that the man needed to go to the hospital. The wife disagreed.

We discussed for about ten minutes. She had called her son in Boston; he was driving up and she wanted to wait ’til he arrived before she made a decision. We finally convinced her that her husband needed to go; she then wanted to drive him herself. We took another few minutes to make her understand that he really needed to go by ambulance. Then she wanted to go to a hospital about forty minutes away.

Meanwhile, the monitor showed the husband’s heart rhythms changing every few seconds. None of it looked good.

At one point, the wife asked which one of us was the doctor. There were a few seconds of silence. I was in charge of the scene as the highest-certificated EMT, but I didn’t really want to say so. My partner admitted that none of us were doctors but that we were highly trained.

After a while, the insistent alarms of the monitor every few seconds and my partner pointedly stating that she was putting her husband’s life at risk with the delay got through to her. She went to change clothes.

We quickly put the patient on the stretcher and got under way. On the way out the door, the patient went into ventricular tachycardia. I was not at all happy; I thought the patient was going to code in the back of the ambulance.

The ride to the hospital was tense but uneventful. The patient’s rhythms continued to be unstable but his ticker continued ticking. We got him to the hospital and thankfully turned over care to the emergency department staff.

The wife arrived and seemed to have had a change of attitude. She warmly thanked us for our help. We could tell that she had been in complete denial about her husband’s condition.

As we cleaned out the back of the bus, my partner brought up the exchange regarding the doctor question.

“I hope I didn’t step on your [toes] when I answered her question, princess.”

“That was great. I wasn’t going to admit that I was in charge.”

He called me an unprintable name.

The following day, Mrs. Turquoise and I transferred the patient from the local hospital ICU to the regional big hospital’s ICU. We saw the wife on both sides of the transfer; she was very nice. When we dropped the patient off at the big hospital, she gave me a hug and a kiss and thanked me warmly. The patient himself was more lively and thanked me for the trips.

I was pretty happy with that set of calls. I think that my deciding to run an EKG strip before allowing the patient to sign off had a huge impact on the outcome.

In other news, someone played a prank at the department.

This is a lieutenant’s locker filled with leaves.

Circumstantially, it looks like another particular lieutenant was behind this. That lieutenant came in yesterday and knows that he will be blamed. He’s very defensive. He claims that he has an alibi for the six-hour period where it appears that this could have been done.

Do I know anything? Was I somehow involved?

I’m just disappointed that I won’t be there to see the fireworks.

I’m sliding into biotech. I’ve brought my resume up-to-date except leaving out the Divergent stuff.

http://www.divergenttechnology.com/jpayne/resume.html

Hey, have fun at the ‘Thon. I’ll miss you all.

I worked a 48 over the weekend. It wasn’t as busy as the last one but I was still tired when I got home on Sunday.

Here I am on the way back from Dartmouth Hitchcock. It seems that everyone who works at DHMC has self-esteem in spades but they almost make up for it by regularly stocking the EMS alcove, the place we go to complete the paperwork, with candy. I’m enjoying a blow pop in the back of the bus; we took a nurse on the transfer to DHMC and I gave her the front seat on the ride back. You can also see that I’ve borrowed the pillow off the stretcher so as to increase my comfort that little extra bit.

When I got back home on Sunday, we received six phone calls in about fifteen minutes from my SAR team. It seems that there was a search going on since Friday up near Burlington and they were looking for help on Monday. Yesterday I dragged myself out of bed and got up there by nine.

Here is the track from my GPS; over the course of the day, I walked nine and a half miles through cow pasture, swamp, and dense forest while we did critical separation searches of three search areas. Critical separation is where you walk in a line separated far enough from the next searcher so that you can each see an object midway between the two searchers. Critical separation, then, varies with the terrain and ground cover. Whille it looks from the tracks above that the ground was not well covered by searchers, imagine the map covered with the tracks from my team’s five searchers’ GPS units rather than just my one, plus the myriad tracks from all of the other search teams. When we get back to the command post, we all hand in our GPS units and the incident command staff downloads the tracks onto one map, showing very clearly what has been covered and what has yet to be searched or researched.

The interruptions in my tracks are where the woods are so dense that the GPS satellite signals can’t penetrate to the device. You know that’s fun to tromp through.

It’s deer season so we all had to wear orange. Somewhat amusingly, one of the dairy farms had fitted all of their cows with orange vests. Sad to think that some morons would mistake a cow for a deer and shoot at it.

Anyway, I’m exhausted now.

Silver lining department:

‘Anti-marriage amendments were on the ballot in eight state referendums and were approved in seven of the eight, but by significantly lower margins than in past years. In 2004, there were 11 anti-marriage amendments on the November ballot, and in only two of them did opposition top 40 percent: Oregon (43 percent) and Michigan (41 percent.)“It’s clear that fear-mongering around same-sex marriage by the GOP and the extreme Christian right is fizzling out,” said Matt Foreman, executive director of the National Gay and Lesbian Task Force. “It doesn’t have the juice it had just two years ago — people are getting sick of it.” ‘

http://www.247gay.com/article.cfm?section=66&id=11463