Well I am several days post needing to post another blog. I don't think many are visiting if at all repeating to come back..... I am a bit dry I guess. Or maybe still to new in the EMS game to understand what people read and or like.
Last week ran a few calls one of them was a female who woke up and was having trouble swallowing. I wasn't sure what it was all about. We got on location a few minutes later to find a middle aged woman sitting then standing in the kitchen. She appeared to be in no distress, color was good, she was kinda doing a hop around type of thing, she was trying to cough and holding her throat kinda like she wanted the heimlich maneuver but she was talking just fine. She has had a history of some sort of growth in the throat which was removed along with part of the thyroid, in that case she said it felt the same way as now, the mass was pushing her trachea from midline and it still has deviation. We quickly load her onto the cot where she is strapped and proceeds to try to do hops and be jittery on the cot. The patient asks for oxygen cause she can't breath. We put her on a few liters by nasal cannula. I look at my partner and we both know this has got to be stupidity, the woman says she just woke up with drainage this morning and can't seem to breathe well and it feels like her throat is closing. I know this does happen. I have allergies and sinus problems I have had it happen to me. I never called an ambulance, maybe because it seems as though I live in one! Once we put the oxygen on she instantly starts taking deep breaths from the cannula. Like that stuff was costing her every breath she inhaled like she was preparing for a relaxation part of yoga, in with the deep breaths and out quickly. I am thinking we are dealing with someone who has some anxiety. We explained to her that we couldn't make it through the doors with her hands out and I began to think maybe she had an issue with nerves. I thought to myself. This woman could have came to the cot. The snow had dusted the ground the night before. Not measureable just a sprinkle here and there. That tell you how cold it was. We load her up and quickly gain IV access and put her on the cardiac monitor. Everything checks out just fine. My partner lets me know we are ready to go. I jump up front and we attempt to back out of this drive which is uphill and on a narrow road. I have some help behind me and they help me down the hill and out onto the road, after some pulling forward and backwards we are on our way. Due to the road being broken up in places and me not familiar with it, I take my time getting back on the main road. My partner leans up front and lets me know I can take my time now but move it when we make it to the hard road! I had no problem I do worry about traffic, and all along with animals. So I just layed into it once we hit the road. We arrive at the hospital and unload. Reports given and such........ come to find out the woman has had a goiter removed in the past. Doctor believes it is a sinus infection, does run tests for other things, and x-rays she is likely released a few hours later.
Not to mention the patient who we took to another facility for a kidney stone. This patient is resting and snoring on the ER cot when we arrive. We wake her to move her over. She is secured for transport she has an order for 2 MG of Morphine every 15 or something like that. I wasn't in charge of that lol. We are nearly half way there and my partner is concerned about her pain even though she is sleeping he wakes her up to see her pain on the 0-10 scale. She responds it is a 7. And falls back asleep, and since Pain is not the 5TH vital sign, he pushes the morphine. We arrive at the hospital, report given she is transferred and moaning the whole way. She may have had a kidney stone but most people I would think wouldn't sleep with pain at a 7.
I read one of those calendars with funny medical stuff on it the other day. A man comes in that has had a head or hand injury and he is calm and the doctor asks him on a scale of 0-10 what his pain is, 0 being none and 10 being the most pain he has ever had. The patient thinks and says 10! The doctor says "NO I don't think you understand the scale. If I took two concrete blocks and put you balls in the middle and smashed them with the blocks that would be a 10!" The patient reconsiders and decides his pain is less!!!!!!!! Enjoy!!!!!!
A couple days later.... after some days off. They day shift had ran like 4-5 calls nearly back to back, including a code and some bull crap! I have lost track of all time and dates, and appear back at work. It appears that we are not going to have a bad night. A call comes in for an MVC. We roll up on it and find a minor who is intoxicated and beginning to think to himself AH CRAP.
1. He knows he has messed up.
2. He knows his parents are going to be upset
3. He knows he is losing his license
4. He worries about all sorts of things.
We transport the patient. He is released we find out later. No major injuries!
I have to go back and think, that could have been one of my friends back in high school, or even in the past, my gf, my sister, my brother in law in the past! I don't know what is so good about driving around and drinking? Maybe I am missing something but Alcohol never appeals to me. I never drank before I was of age and still abstain from drinking. I will occassionally drink socially, but only 1-2. I never hit anything really hard. I would never drink near time for me to be on call for obvious reasons. I have saw co-workers come in to replace me smelling of liquor and I have thought to myself. Should I say something? I know the job is tough but you should at least stop drinking and start drinking something else earlier. I wonder to myself what is my liability for not saying something and knowing someone has had enough liquor to seep it out the next day? What could I say or do for this kid to make him realize he is wrong. I so badly want to say something but I hold my breathe and don't. I figure his parents will give it to him enough. I feel sorry for the guy who by losing his license, risks losing his job, education chances and other things unless someone drives him around for the next year or so. Did I mention it is cold?
Another day begins........ we head off to sleep land. We are still on call. We have been off shift a few hours. The phone rings. I am so totally tired because the day before I hadn't slept well since I had slept during the night before and then couldn't sleep during the day. We are expected to not sleep on our shift although when we get called in during the day they do allow us to sleep during the night. In shifts, of 2 hours after 10pm or so. Rules, we never follow sometimes we sleep at the same time. Who cares? EMS burns so many out. They can replace me, because they think I am a dime a dozen. Well maybe not but I am exchangeable! My personality has greatly changed in my years of service. I started out the nice shy guy, now I am the big mouthed idiot who does things and takes risks and then who also does what my partner tells because I am actually out ranked and under educated to debate most things.
The voice on the other end of the line tells us we are needed in for a couple local calls, the primary crew is out on a call out of town and they are unsure when they will be back. Had the primary crew known the complaints they would have told them to hold off on calling us in. But they didn't know.
My partner and I arrive about the same time to the time clock. We clock in, we receive information. We start the truck and run over to THE NURSING HOME! The report is that a patient had a run of tachycardia around 0200 this morning and now at 1000AM it became an emergency needing him to visit the hospital. Interesting. Gotta love it. We arrive and they tell us he will be the first one to go, they direct us to his room. We wheel the stretcher into the room, sounds of christmas songs sung by kids echo through the halls along with the jingle of bells and the piano. We get the report. "He had a run of tachycardia earlier this morning and he has some edema, his elbows have been seeping the last few days, he is retaining fluid, we called the doctor and he okayed the transport to the hospital." We asked if the patient does get up and move around, the nurse says yes when they get him up for a few hours at a time, the patient is on oxygen and says, what are you doing here? We explained to him that he was being taken to the hospital. He said he wasn't sick. Well we loaded the patient obtained the paperwork, we know him pretty well we as a service transport him several times a month. My partner said the lung sounds were fine, and the seeping sores appear to be actually skin tears on the elbows. What idiots. The nurse sending him is an LPN I remember from seeing around the hospital doing clinical time for RN in the Emergency Department. I don't trust her as an LPN let alone an RN. I swear this one has it out to clear her halls when she works, some reason you get that idea from some nurses. Some nurses in these homes try to send the guy who is alert, and more oriented then I am and has no complaint! The staff state he is combative.... I would be do if you came in and woke me up for stupid crap! Back to the story, the doctor sees the patient has a chest x-ray shot and looks at the patient listens to the lungs and such. The doc says this is the best he has seen the patient. He decides to run more tests, but we learn later the guy was taken back no diagnosis, except being healthier then normal. PARANOID LATELY?
We clock out and go home.
Clock in for our shift, about 30-40 minutes later we are on our first call; a COPD'er who wants to use the Tripod position on the cot because he is short of breath. Not to mention the Emphezema. We finally load him and transport him. He has been diagnosed with some pneumonia, and had been on some antibiotics and said he had some reaction and the doc told him to stop, guess they called him back and told him to start it again but he hadn't yet. We are a few minutes from the hospital and dispatch advises us of a chest pain. We quickly put him in a bed at the hospital, and make the cot. We roll hot to the chest pain. We find an elderly woman, in a chair looks normal just having right sided chest pain and she appears to be one of those women who can't take pain at all. We put her onto the cot and into the truck. We run a strip off the monitor looks normal, she has a history of heart problems, stick her with an IV while she screams in pain from the IV. I know she is a little soft. We administer the aspirin and 2 nitro's sublingual (under the tongue) She has used 3 sublingual sprays prior to EMS arrival and no relief. We arrive at the hospital. She is taken to a room. We get out of there. It looks crazy with patients in nearly every room and by the looks of their triage board they had a long while to go to get that place cleared out!
Shift ends without further, we hand off the report to the next crew.........
Me and my co-workers have sit around talking in the past about how we are going to be to the EMT's when they come to pick us up if we end up in the nursing home. We are going to be pains in the butt. It is funny but it will be likely since we will be so burned out we will maybe help the leave early lol...... Helping the future by telling them not to go into EMS.
Last week ran a few calls one of them was a female who woke up and was having trouble swallowing. I wasn't sure what it was all about. We got on location a few minutes later to find a middle aged woman sitting then standing in the kitchen. She appeared to be in no distress, color was good, she was kinda doing a hop around type of thing, she was trying to cough and holding her throat kinda like she wanted the heimlich maneuver but she was talking just fine. She has had a history of some sort of growth in the throat which was removed along with part of the thyroid, in that case she said it felt the same way as now, the mass was pushing her trachea from midline and it still has deviation. We quickly load her onto the cot where she is strapped and proceeds to try to do hops and be jittery on the cot. The patient asks for oxygen cause she can't breath. We put her on a few liters by nasal cannula. I look at my partner and we both know this has got to be stupidity, the woman says she just woke up with drainage this morning and can't seem to breathe well and it feels like her throat is closing. I know this does happen. I have allergies and sinus problems I have had it happen to me. I never called an ambulance, maybe because it seems as though I live in one! Once we put the oxygen on she instantly starts taking deep breaths from the cannula. Like that stuff was costing her every breath she inhaled like she was preparing for a relaxation part of yoga, in with the deep breaths and out quickly. I am thinking we are dealing with someone who has some anxiety. We explained to her that we couldn't make it through the doors with her hands out and I began to think maybe she had an issue with nerves. I thought to myself. This woman could have came to the cot. The snow had dusted the ground the night before. Not measureable just a sprinkle here and there. That tell you how cold it was. We load her up and quickly gain IV access and put her on the cardiac monitor. Everything checks out just fine. My partner lets me know we are ready to go. I jump up front and we attempt to back out of this drive which is uphill and on a narrow road. I have some help behind me and they help me down the hill and out onto the road, after some pulling forward and backwards we are on our way. Due to the road being broken up in places and me not familiar with it, I take my time getting back on the main road. My partner leans up front and lets me know I can take my time now but move it when we make it to the hard road! I had no problem I do worry about traffic, and all along with animals. So I just layed into it once we hit the road. We arrive at the hospital and unload. Reports given and such........ come to find out the woman has had a goiter removed in the past. Doctor believes it is a sinus infection, does run tests for other things, and x-rays she is likely released a few hours later.
Not to mention the patient who we took to another facility for a kidney stone. This patient is resting and snoring on the ER cot when we arrive. We wake her to move her over. She is secured for transport she has an order for 2 MG of Morphine every 15 or something like that. I wasn't in charge of that lol. We are nearly half way there and my partner is concerned about her pain even though she is sleeping he wakes her up to see her pain on the 0-10 scale. She responds it is a 7. And falls back asleep, and since Pain is not the 5TH vital sign, he pushes the morphine. We arrive at the hospital, report given she is transferred and moaning the whole way. She may have had a kidney stone but most people I would think wouldn't sleep with pain at a 7.
I read one of those calendars with funny medical stuff on it the other day. A man comes in that has had a head or hand injury and he is calm and the doctor asks him on a scale of 0-10 what his pain is, 0 being none and 10 being the most pain he has ever had. The patient thinks and says 10! The doctor says "NO I don't think you understand the scale. If I took two concrete blocks and put you balls in the middle and smashed them with the blocks that would be a 10!" The patient reconsiders and decides his pain is less!!!!!!!! Enjoy!!!!!!
A couple days later.... after some days off. They day shift had ran like 4-5 calls nearly back to back, including a code and some bull crap! I have lost track of all time and dates, and appear back at work. It appears that we are not going to have a bad night. A call comes in for an MVC. We roll up on it and find a minor who is intoxicated and beginning to think to himself AH CRAP.
1. He knows he has messed up.
2. He knows his parents are going to be upset
3. He knows he is losing his license
4. He worries about all sorts of things.
We transport the patient. He is released we find out later. No major injuries!
I have to go back and think, that could have been one of my friends back in high school, or even in the past, my gf, my sister, my brother in law in the past! I don't know what is so good about driving around and drinking? Maybe I am missing something but Alcohol never appeals to me. I never drank before I was of age and still abstain from drinking. I will occassionally drink socially, but only 1-2. I never hit anything really hard. I would never drink near time for me to be on call for obvious reasons. I have saw co-workers come in to replace me smelling of liquor and I have thought to myself. Should I say something? I know the job is tough but you should at least stop drinking and start drinking something else earlier. I wonder to myself what is my liability for not saying something and knowing someone has had enough liquor to seep it out the next day? What could I say or do for this kid to make him realize he is wrong. I so badly want to say something but I hold my breathe and don't. I figure his parents will give it to him enough. I feel sorry for the guy who by losing his license, risks losing his job, education chances and other things unless someone drives him around for the next year or so. Did I mention it is cold?
Another day begins........ we head off to sleep land. We are still on call. We have been off shift a few hours. The phone rings. I am so totally tired because the day before I hadn't slept well since I had slept during the night before and then couldn't sleep during the day. We are expected to not sleep on our shift although when we get called in during the day they do allow us to sleep during the night. In shifts, of 2 hours after 10pm or so. Rules, we never follow sometimes we sleep at the same time. Who cares? EMS burns so many out. They can replace me, because they think I am a dime a dozen. Well maybe not but I am exchangeable! My personality has greatly changed in my years of service. I started out the nice shy guy, now I am the big mouthed idiot who does things and takes risks and then who also does what my partner tells because I am actually out ranked and under educated to debate most things.
The voice on the other end of the line tells us we are needed in for a couple local calls, the primary crew is out on a call out of town and they are unsure when they will be back. Had the primary crew known the complaints they would have told them to hold off on calling us in. But they didn't know.
My partner and I arrive about the same time to the time clock. We clock in, we receive information. We start the truck and run over to THE NURSING HOME! The report is that a patient had a run of tachycardia around 0200 this morning and now at 1000AM it became an emergency needing him to visit the hospital. Interesting. Gotta love it. We arrive and they tell us he will be the first one to go, they direct us to his room. We wheel the stretcher into the room, sounds of christmas songs sung by kids echo through the halls along with the jingle of bells and the piano. We get the report. "He had a run of tachycardia earlier this morning and he has some edema, his elbows have been seeping the last few days, he is retaining fluid, we called the doctor and he okayed the transport to the hospital." We asked if the patient does get up and move around, the nurse says yes when they get him up for a few hours at a time, the patient is on oxygen and says, what are you doing here? We explained to him that he was being taken to the hospital. He said he wasn't sick. Well we loaded the patient obtained the paperwork, we know him pretty well we as a service transport him several times a month. My partner said the lung sounds were fine, and the seeping sores appear to be actually skin tears on the elbows. What idiots. The nurse sending him is an LPN I remember from seeing around the hospital doing clinical time for RN in the Emergency Department. I don't trust her as an LPN let alone an RN. I swear this one has it out to clear her halls when she works, some reason you get that idea from some nurses. Some nurses in these homes try to send the guy who is alert, and more oriented then I am and has no complaint! The staff state he is combative.... I would be do if you came in and woke me up for stupid crap! Back to the story, the doctor sees the patient has a chest x-ray shot and looks at the patient listens to the lungs and such. The doc says this is the best he has seen the patient. He decides to run more tests, but we learn later the guy was taken back no diagnosis, except being healthier then normal. PARANOID LATELY?
We clock out and go home.
Clock in for our shift, about 30-40 minutes later we are on our first call; a COPD'er who wants to use the Tripod position on the cot because he is short of breath. Not to mention the Emphezema. We finally load him and transport him. He has been diagnosed with some pneumonia, and had been on some antibiotics and said he had some reaction and the doc told him to stop, guess they called him back and told him to start it again but he hadn't yet. We are a few minutes from the hospital and dispatch advises us of a chest pain. We quickly put him in a bed at the hospital, and make the cot. We roll hot to the chest pain. We find an elderly woman, in a chair looks normal just having right sided chest pain and she appears to be one of those women who can't take pain at all. We put her onto the cot and into the truck. We run a strip off the monitor looks normal, she has a history of heart problems, stick her with an IV while she screams in pain from the IV. I know she is a little soft. We administer the aspirin and 2 nitro's sublingual (under the tongue) She has used 3 sublingual sprays prior to EMS arrival and no relief. We arrive at the hospital. She is taken to a room. We get out of there. It looks crazy with patients in nearly every room and by the looks of their triage board they had a long while to go to get that place cleared out!
Shift ends without further, we hand off the report to the next crew.........
Me and my co-workers have sit around talking in the past about how we are going to be to the EMT's when they come to pick us up if we end up in the nursing home. We are going to be pains in the butt. It is funny but it will be likely since we will be so burned out we will maybe help the leave early lol...... Helping the future by telling them not to go into EMS.