I went to my new job today for some ride-along time.
First I went to a prospective client’s place; a seafood distributor twenty miles away. They want me to set up their system so that when they get an order, the shipping label immediately prints in the warehouse. A simple enough thing; maybe ten hours, but it means my foot in the door at a different place and a possible reference.
I got to the warehouse and the person I was supposed to talk to wasn’t there. Big drag. I wasn’t too upset, though; I didn’t sleep well last night and really didn’t feel my best. I got the impression that they were embarrassed and sorry, so we’ll give it another go. The first consultation is free for my clients; I guess I’ll spot them a second visit, too.
So then I went to the municipal fire/ambulance place. It turned out to be fairly exciting in several different ways.
About ten minutes after we got there, we went out to the local hospital for a helicopter landing drill. The li’l hospital has to shut down a parking lot to land the chopper so the fire department has to go out to set up and secure the landing zone. I didn’t do much; rode to the hospital in the back of the ambulance, stood around, watched the chopper land, stood around, watched it take off. I did talk to two EMTs that I will be working with. One of them I had worked a scene with last winter, the ‘ex-member’. She reminded me of the scene and asked if the compliments from the patient’s family had been relayed. Cool. I had worked another scene with the other EMT; she also knows someone from my EMT-I class and is related to a distant consulting business associate. Small pond, I guess.
Riding in the back of the ambulance, I noticed a fire extinguisher pin on the floor. I didn’t think much of it.
After we got back, I started working through my ‘3rd-rider sheet’. This form guides my learning the location of items on the ambulance and procedures of the department. I watched a ten-minute video on how to use the ambulance stretchers. I learned how to use the nifty stair chair (a stair chair is a chair used to take people down stairs. This one has rubber tracks and the thing runs itself down the stairs. The harder the EMT in back pushes *down* on the thing, the slower it goes).
I started going through one of the ambulances (A-1) with the ‘ex-member’ EMT. We looked at a bunch of stuff; I figured out where things were and how they worked. At one point, though, sitting in the back of the rig, I turned to get something out of a compartment and hit the fire extinguisher handle with my leg. The pin on the floor, it turns out, was from this unit; it discharged, spraying yellow dry-chem agent all over the back of the ambulance.
I grabbed the extinguisher and jumped out. The other EMT jumped out as well. Yellow dry-chem dust hung in the air, drifting out of the ambulance.
I was mortified. The other EMT laughed and laughed.
We discussed how to clean the rig. We finally decided to ask the EMT captain, the person in charge of the EMTs, his opinion. Luckily, the department chief had already left for the day.
We went into the office. The EMT captain was in the office, entering run sheet information into a computer.
The EMT who had been helping me asked the captain how he would clean fire extinguisher agent out of the back of the ambulance.
The captain stopped typing and sat motionless for a few seconds. Then he turned to the EMT and fixed her with a baleful stare.
“You set off an extinguisher in the back of A-1?”
“Yes,” she said.
It was nice of her to take the heat, but I couldn’t let her do that.
“Actually,” I said, “It was me.” I didn’t bother to point out that someone else had knocked the pin out.
He looked at me as though I were something distasteful. The FNG. The FNG just loaded loose dry chem into the back of the primary ambulance.
“Try to sweep it up.”
I suggested maybe we should wet it down first so that it wouldn’t become airborne again and spread further.
The captain looked at me as though I were a talking moose; amazingly able to speak but still not welcome in the fire station.
“Yes, maybe that would help.”
As the other EMT and I left the office, I said something humorous to the captain about him being sorry he’d hired me. He agreed without mirth.
The other EMT and I cleaned up the mess in about twenty minutes. We went back to going through gear.
After a while, we went back into the office and started looking at paperwork. By this time, only the captain and the other EMT were left; the last two day staff waiting for the night staff to arrive. Ten minutes before quitting time, the tones went off.
Both the captain and the other EMT swore in unison. Tones ten minutes before quitting time means working at least a half hour late. Probably more.
Dispatch informed us that an 89-year-old male had fallen and hit his head at a hospice where he lived.
I ran out to the ambulance and ran around the outside, closing the open compartments and pulling out the ‘shore power’ plug. I jumped into the back.
The captain (an EMT-I) and the other EMT (a Basic) got in front. The captain drove.
It was only a few blocks to the hospice. When we got there, I got out and grabbed the jump kit. I went into the building, expecting the other EMTs to be right behind me.
All of the other ambulance services I work with leave the stretcher in the rig and go in with just the jump bag. I guess this one is different; I got inside and the primary EMTs were still at the back of the ambulance. I knew what to do, though, so I went in and found the patient.
The man had fallen out of bed, gashing his head and ripping open the back of his hand. The side of his head had a 1 ½ inch laceration and significant bruising; there was blood on his neck, his shirt, the sheets. He had a larger laceration on the back of his hand, although the hospice staff had already patched it with tegaderm; a clear film.
I introduced myself.
“Hello, I’m , an EMT with the fire department.”
Convenient that I can use the same salutation as I use in my own town.
The hospice nurse filled me in on the details. I palpated the patient’s skull for softness or crepitus. There was none. I unzipped the jump bag looking for gauze to patch the patient’s head laceration.
About this time, the other EMTs came in with the stretcher. I deferred to them.
After some time, we decided not to collar and board the patient. We helped him onto the stretcher and took him outside, then put him into the ambulance.
The other EMT-B asked me if I wanted to ride in back with the I-tech; the captain. Sure, I said. I hopped in; the other EMT-B got in front to drive.
The captain hopped in and rattled off a list of things we needed to do; take a set of vitals, start oxygen, put on a cold pack. I took a pulse while the captain got out the cardiac monitor; the monitor would take a blood pressure and measure SPO2 as well as confirm my pulse reading.
I gave the captain my measured pulse rate, 64, and got to work on the cold pack. I went for a wash cloth to wrap the cold pack in; the captain suggested a pillow case. I grabbed the pillow case, wrapped up the cold pack, and put it on the patient while the captain started oxygen. The monitor started to report readings; my pulse was spot on.
I talked to the patient. I asked the captain if the spine had been palpated; it had not. He had checked the patient’s circulation, sensation, and motion in extremities on scene, but no spinal. I ran my fingers up and down the patient’s spine feeling for deformity while asking the patient if he had any pain. He did not; his spine seemed clear.
I held the patient’s head and the ice pack until we arrived at the hospital. A few minutes before arrival, the captain called the hospital on the radio and delivered ‘the patch’; the description of the arriving patient and the care provided so far. I provided a correction and a clarification to the Intermediate captain while he was on the radio that he relayed to the hospital.
We got to the hospital, took the patient inside, and turned over care to the emergency room staff. I changed the stretcher linens with the help of the other Basic then took the stretcher outside to the ambulance. I put the back of the ambulance back in order, then got out. The captain was standing near the rig, completing the patient care report, writing on top of a trash can.
He looked up and spoke to me.
“You’re an Intermediate, aren’t you?”
“I just passed the National Registry. I still need to get state certification.”
“Good. We need more people who can work in back.”
He went back to his paperwork.
I know I’m going to take a lot of grief over the fire extinguisher for months to come… I think I acquitted myself well on my first call, though.