November 2003


Two calls on ridealong tonight, both from a local ‘urgent care’ facility to the regional hospital. The first was a transport of a post-ictal patient. Poor patient was pretty freaked out and very twitchy. The second one was for transport of a patient complaining of ‘chest tightness’. The urgent care facility stated that no paramedic was needed, so the crew I was riding with (we had just picked up dinner) consisted of three EMT-Basics (if you count myself). We got to the facility and found that the physician’s assistant who had made the call wanted us to run cardiac monitoring but did not realize that monitoring was advanced life support, requiring a paramedic. We picked up the patient (who was a little grey and not too happy) and drove back to to the depot (which happened to be on the way, so no paramedic intercept, per se, was required). We took some vitals and started oxygen on the way back. The EMT-B doing patient care got out and the medic got in. The patient transport was uneventful in that the patient did not get worse and in fact got a little better with the paramedic’s interventions. The medic hooked up the monitor (the urgent care facility had conveniently left the sticky lead patches on, so the medic simply plugged the patient into his monitor) and took some vitals, then administered nitroglycerine and two baby aspirin. While the nitro was taking effect, the medic started an IV. I was quite amazed to see the medic brace himself against the motion of the ambulance on the floor between the cot and the bench seat and put the needle in the vein on the first attempt (I’m proud to say I was able to watch the entire procedure). After the medic got the line in he took four tubes of blood so that they could be sent to the lab immediately on arrival at the emergency department and started a drip feed of some solution. Two more doses of sublingual nitro and an application of transdermal nitro and we were there. We got a call from the squad dispatch while we were at the ED about a motor vehicle accident on the highway that the other unit was enroute to so we rushed back down in case the medic was needed. By the time we got there the patients had been assesed as minor injuries so we headed back to the depot.

Let’s see.

First, there’s this.

http://www.theaustralian.news.com.au/common/story_page/0,5744,7784387%255E1702,00.html

Next, speaking of Guy Fawkes day, I saw ‘Braveheart’ last night. It’s a fun movie, but claims to be ‘based on the life of William Wallace’. Unfortunately, not really. I googled a bit to clarify some details and found that the movie has some character names in common with the life of William Wallace, but that’s about it. That really burns me up. Good costumes, nice period tactics, completely made up situations.

Mel Gibson hates the brits, that’s for sure. Comparing ‘Braveheart’ with ‘The Patriot’ shows a pretty clear formula. Mel apparently thinks it’s not okay to stand up for your rights until the baddies off your loved ones. And that’s okay, I guess. Did I mention he hates the brits? I liked ‘The Patriot’ up to the point the brits locked the colonists in the church and burned it down. Call me particular, but if you are going to base your film on history, honor history.

Yep, I’ll probably see Gibson’s Passions, but I’ll bet Christ remains a carpenter until the romans off his puppy.

Harrumpf, harrumpf, harrumpf.

I’ve now spent almost fifteen hours at the stupid ambulance place waiting for ‘good’ calls. Three nights sitting around the depot with only one minor call each.

I figured for sure someone would get hurt on a Halloween that falls on a Friday, so I elected to go ride-along after we got back from trick or treating. Trick or treating was fun; I went with a ghost, a puppy, and a witch. I carried newspaper and a trowel for the puppy. We went to the shopping mall up yonder where we’ve gone for the last two years, this being the third. Hey, it’s a rural area. If you were doing houses rather than shopping centers, you could walk all night and end up with three pieces of candy.

The only action this evening at the ambulance squad was a quick jaunt to look at a girl that got punched out at a party. She was fine, fine, fine, but her mom had taken her to the police station and they called us. According to the scanner, the state police were having a busy night (including a 100 mph hot pursuit right past our house), but no trauma in our call area.

It’s not that I’m a complete sicko, but I don’t want the first stressful scene I’m on to be one that I’m running. My own squad has set me up with a radio, 911 maps, and half an ambulance full of supplies (oxygen, anyone?) and they expect me to go on calls now as a first responder. Thankfully the town only has about 2500 people in it, so how many can get sick or hurt, right? It’s scary to think that I’m the third most experienced EMT on the squad (there are only three, including me) and the vast majority of my experience to date has been putting bandaids on people at marathons and fairs.

I’m really sort of terrified at being on the pointy end of prehospital care on some messy trauma incident, especially by myself. Critical medical emergencies I think I can deal with, even now, but the thought of having to provide care to people with rips and smashed parts is weird. You have to look at that stuff to assess it, right?

Kind of the nice thing about street medicine (as opposed to wilderness medicine) is that you package the parts where you find them. In the backcountry, you have to ‘reduce’ fractures and dislocations in order to restore circulation. In the street, they expect that you will get the patient to the hospital quickly enough that the patient won’t lose those parts if you don’t reduce injuries immediately; they don’t have you do that sort of thing, which is just fine with me.

I have gotten to see a lot of TV. Tonight alone, I saw an episode of Seinfeld, one of Friends, ‘Small Soldiers’, and part of ‘Pulp Fiction’. More passive entertainment than I’ve had in months, all at one go.

Driving home, I noticed that every mailbox on the right hand side of our road had been destroyed. For some reason, though, they didn’t do ours, although they are on the right (if you are coming from that direction). That’s good news, unless the cops decide that our unharmed mailboxes mean that we had something to do with the broken ones.

The guy that owns the ambulance squad (it’s a private enterprise) was a state trooper for many years. He really made my day this evening (?) when he referred to the state to the south of us, the land of bad drivers and idiot tourists, as ‘My-ass-achussetts’. Consider my vocabulary changed.