Early in the AM on Friday I was called in for backup, the primary crew had taken the patient out of the local area and to a hospital with a specialty. This is all good and well but I was tired and was sleeping good. Ah well I went in and clocked in for a few hours then went home. That night I went in thinking well I was tired but I wasn't really without sleep. We are called for a 911 call for a male with back pain in a rural area maybe 4-5 miles from our base. Requesting no lights or sirens. It is raining and the roads are crappy in that area. We hit one puddle I swore we had fell into HELL! Then I realized it was still raining, which isn't possible there. We arrive and take in the bag to examine the patient.
We find a 40ish male lying in bed complaining of lower back pain due to something stupid. He states he was doing some work outside and went to roll a log end over end instead of pulling it with the tractor and had pulled something in his back. He was in too much pain to do anything but lay. I knew it meant he was getting the backboard. My partner and I go to the truck obtain the backboard and cot and squeeze it into the small house with small rooms and narrow doors. The suggestion from the wife is that we might go out the door on the front of the house. I look at it and it appears a straight out shot.... but it is dark and steeper but at least we don't have to go through the back porch door and the back door. We board the guy rolling him. My partner says you can just feel the muscles in his back tensing. We boards him and load him to the cot. He is yelling in pain. We take him and load him into the truck and my partner gives him the pain medications he needs to make the trip to the hospital. .
Next call is a non emergency call on our regular business line, an elderly woman diagnosed with cancer recently who used to have really bad shortness of breath and anxiety. She was awakened by some chest pain. She has been on a CPAP for about a week and she has removed it. She wants us to check her out. We roll to the scene arrive and enter the home. We find her in bed calling for us. She knows us by name. She really doesn't want to go we can tell already, she knows it is cold and is curled up in a blanket. She said her pain was about a 6 when she called. She took off the CPAP and now it is down to a 3. The cancer is in her lungs and she is taking Chemotherapy. We do a pulse ox giving a good reading in the high 90's and my partner listens to lung sounds expecting to hear the normal wheezes she used to have due to her smoking which by the way she has stopped! Negative clear movement, better then you used to have. Pulse was fine, blood pressure was fine, and chest pain was subsiding. My partner did the speech, just because your vitals are fine doesn't mean you don't have a heart condition, if you have had a heart attack only lab tests and EKG's will show that. We don't have those. We explain the need to go to the doctor for her pain. She says well, and looks at me. "what do you think?" Well I am not paid to think, I am not a psychic and I am not good at guessing. I told the truth. I told her it was up to her. She asked me to get her a popsickle from the freezer, cause her mouth was dry. I went and walked to the freezer and found one and pulled it out and returned to give it to her where she thanked me and told me she didn't think she would go. I got the paperwork and my partner filled it out and let her sign a refusal, and told her to call if the pain continued.
I believe this woman's pain was anxiety. She is scared of death, she is scared of cancer. She is afarid of being alone, she used to call alot asking for us to call her and check on her every few hours. She needs someone to talk to, someone to cater to her wishes. We go back in service and leave the residence.
Next shift several hours later..................................
Call on non-emergency line requesting to speak to one of the paramedics. I took it although I am not a medic. The woman said she had us come out before to help her with her mom. Her mom had been in a deep sleep and she was trying to transfer her to a chair and she was unable to lift her and left her slide into the floor. She wanted us to come out and help. This is kind of a community service we do for this lady occassionally. We arrive on scene, we find the woman awake, and alert, she has dementia but the daughter says this is her norm. She is lying on her side with the gait belt around her, the daughter says she had just layed her down and hadn't dropped her. We use the gait belt to pull her up and put her into the wheel chair, the woman is alert, and ready to eat. The daughter thanks us and says she doesn't want her taken to the ER. Refusal signed and no transport.
Hours later........
Altercation: We hear the local police department dispatched to a possible fight. It seems that from the dispatcher a child of the woman had ran in and said someone was fighting. She called the police, not to let anyone know where it actually was like a couple blocks away. Police roll to the scene and find a guy intoxicated and beaten. He has a laceration to the scalp and needs looked at. They call for EMS. We arrive to find a combative, upset, drunk. He wants revenge he states they tripped him up while he was walking across the railroad track and slammed his head on the tracks and then kicked him in the side, we transport him to the hospital not very much cooperation, and with lots of aggrevation he finally agrees, we are unable to board and c-collar him due to his combativeness, we are able to talk him to going with us though. We get him on some oxygen and he asks for a mask, stating he has a cold. He is calming down. We roll him into the ER, and he just wants sewed up and something to calm him down so he can go home. Does manage to get calmed down as he is ready to leave after refusing some X-rays and such and they said once his Girlfriend was there she talked him into x-rays. They found nothing from my understanding.
Next
I catch some traffic from dispatch, "I WILL BE DISPATCHING AN AMBULANCE AND RESCUE!" Ah crap, tones drop, I always wanted to run, I come running down the hall, "Advise when ready to copy!" Go ahead, "1 vehicle rollover, car on its side, pt is conscious and breathing, unknown if trapped dispatching rescue.." We arrive on scene, and find a car its passenger side about 20 feet of the road and down in a wooded area, it appears the car has went off the road, and struck one tree and struck a second, and then ran up it and came to rest on its side. The driver is in the car alert, to long term thoughts, but short term he cannot remember, we are waiting on rescue and notice some smoke from the hood, we request the fire department. The Sheriff's department has arrived on location shortly after and has requested information, I give them what I can from my point which is out of the way allowing my partner to tell me what he needs or who he wants. As rescue rolls up they setup lights, and get the vehicle stabalized so we can extricate my partner and this patient. We hand off the C-collar, I have the backboard, Kendrick's Extrication Device and towel rolls ready. My partner yells to me, to call for a chopper. Everyone looks at me, "WHAT DID HE SAY?" What do I tell them? "Tell them 20's male rollover mvc, unknown time in cold, extended extrication time and tell them to get the chopper in the air." I walk up to the rig, I place the call, luckily I remember their phone number by the letters. I get dispatch give them my information and all. They will call me back, I wasn't sure of the phone number in the rig, I give them my personal number and wait for them to call., and wait, and wait!
The patient is coming from the car as I wait, a deputy and police officer ask me, Is the patient that bad? I explain my partner's thoughts. The MVC alone is probably good enough to get the pt. to a trauma center in most books.
They load the patient just as I am turning up the heat in the back, my partner jumps in as the firefighters pack the patient up the grade, I tell him still haven't heard from the chopper, but I had managed to get generic cooridinates from the GPS the helicopter service had given us a while ago. I remembered that while I waited for them to call back. I gave them a set and told them it would be west of that. The dispatch calls back and tells me 20 minutes. We put the patient on a Non-rebreather, get him on the monitor and run pulse ox, blood pressures and try to warm him up. We are roasting in the truck. My partner attempts iv access several times, the patient is just too cold, he finally establishes an IV and we run some Normal Saline, aka 0.9% Sodium Chloride. The pt has good grips no cuts, lacerations, no deformities, crepitus, no tenderness in the abdomen , nothing major anyplace! Good lung sounds, pupils are pearl, there is a question about ETOH (Alcohol), I can't smell my partner can't either. The others on scene are sure they smell it. We move to the location of our LZ (Landing Zone) EMS talk. We cover the patient in blankets, and warm him up. My partner looks up and says, I think maybe I screwed this one up. I am saying mode of injury. Well the helicopter crew radios us for a report, we give them a report they are 5 min out.
The crew boards the rig, at the Landing Zone they assess the patient and give us "Great Job" guys. We ask where they will be taking the patient so we can inform the state police as they had asked. They do their assessment and find the abdomen seems swollen and guarded more then what we had assessed. We then released care and helped them with the cot to their chopper. We wished them well and then they took off. We removed our gloves, took a deep breath, looked around to find out where we were and to see who all had came out to help us, then we got into the truck, put ourselves en route back to the base, to restock. We did make a pitstop for food, and caffeine on the way back because it was a long drawn out ordeal. We make it the rest of the shift without a call.
Next evening. .....
Not to awfully bad, right at around 6:45 a woman calls for shortness of breath on the non-emergency line, the day crew should be there any minute and take the call, also then the emergency phone rings for a local nursing facility having a woman who has fallen and has a laceration on her head. We looked around for the day crew unable to find them, we decide to roll on the shortness of breath. It is out in the far North Eastern part of the county. IT will take about 15 -20 minutes to get there running hot. We are running hot, I never realized how much traffic their is on a highway in the early morning, we pass lots of cars who won't stop they just pull to the shoulder, and others that will match or exceed the speed you are running so they don't have to stop. We arrive on location later with our first responders on scene assessing the patient, we load the patient, place her on some oxygen, my partner starts and IV and pushes some Lasix. The patient hasn't had her morning lasix. We roll back. I notice the narrow roads, as we make our way back towards a main road, I see cows in a field, I am amazed that I run EMS in "the STICKS" and still work mainly in the city. It amazes me that we have more runs in town then out in the middle of nowhere, where you think people would be sicker. We make it back to the hospital, unload, fill out paperwork and end our shift a few hours late!
We find a 40ish male lying in bed complaining of lower back pain due to something stupid. He states he was doing some work outside and went to roll a log end over end instead of pulling it with the tractor and had pulled something in his back. He was in too much pain to do anything but lay. I knew it meant he was getting the backboard. My partner and I go to the truck obtain the backboard and cot and squeeze it into the small house with small rooms and narrow doors. The suggestion from the wife is that we might go out the door on the front of the house. I look at it and it appears a straight out shot.... but it is dark and steeper but at least we don't have to go through the back porch door and the back door. We board the guy rolling him. My partner says you can just feel the muscles in his back tensing. We boards him and load him to the cot. He is yelling in pain. We take him and load him into the truck and my partner gives him the pain medications he needs to make the trip to the hospital. .
Next call is a non emergency call on our regular business line, an elderly woman diagnosed with cancer recently who used to have really bad shortness of breath and anxiety. She was awakened by some chest pain. She has been on a CPAP for about a week and she has removed it. She wants us to check her out. We roll to the scene arrive and enter the home. We find her in bed calling for us. She knows us by name. She really doesn't want to go we can tell already, she knows it is cold and is curled up in a blanket. She said her pain was about a 6 when she called. She took off the CPAP and now it is down to a 3. The cancer is in her lungs and she is taking Chemotherapy. We do a pulse ox giving a good reading in the high 90's and my partner listens to lung sounds expecting to hear the normal wheezes she used to have due to her smoking which by the way she has stopped! Negative clear movement, better then you used to have. Pulse was fine, blood pressure was fine, and chest pain was subsiding. My partner did the speech, just because your vitals are fine doesn't mean you don't have a heart condition, if you have had a heart attack only lab tests and EKG's will show that. We don't have those. We explain the need to go to the doctor for her pain. She says well, and looks at me. "what do you think?" Well I am not paid to think, I am not a psychic and I am not good at guessing. I told the truth. I told her it was up to her. She asked me to get her a popsickle from the freezer, cause her mouth was dry. I went and walked to the freezer and found one and pulled it out and returned to give it to her where she thanked me and told me she didn't think she would go. I got the paperwork and my partner filled it out and let her sign a refusal, and told her to call if the pain continued.
I believe this woman's pain was anxiety. She is scared of death, she is scared of cancer. She is afarid of being alone, she used to call alot asking for us to call her and check on her every few hours. She needs someone to talk to, someone to cater to her wishes. We go back in service and leave the residence.
Next shift several hours later..................................
Call on non-emergency line requesting to speak to one of the paramedics. I took it although I am not a medic. The woman said she had us come out before to help her with her mom. Her mom had been in a deep sleep and she was trying to transfer her to a chair and she was unable to lift her and left her slide into the floor. She wanted us to come out and help. This is kind of a community service we do for this lady occassionally. We arrive on scene, we find the woman awake, and alert, she has dementia but the daughter says this is her norm. She is lying on her side with the gait belt around her, the daughter says she had just layed her down and hadn't dropped her. We use the gait belt to pull her up and put her into the wheel chair, the woman is alert, and ready to eat. The daughter thanks us and says she doesn't want her taken to the ER. Refusal signed and no transport.
Hours later........
Altercation: We hear the local police department dispatched to a possible fight. It seems that from the dispatcher a child of the woman had ran in and said someone was fighting. She called the police, not to let anyone know where it actually was like a couple blocks away. Police roll to the scene and find a guy intoxicated and beaten. He has a laceration to the scalp and needs looked at. They call for EMS. We arrive to find a combative, upset, drunk. He wants revenge he states they tripped him up while he was walking across the railroad track and slammed his head on the tracks and then kicked him in the side, we transport him to the hospital not very much cooperation, and with lots of aggrevation he finally agrees, we are unable to board and c-collar him due to his combativeness, we are able to talk him to going with us though. We get him on some oxygen and he asks for a mask, stating he has a cold. He is calming down. We roll him into the ER, and he just wants sewed up and something to calm him down so he can go home. Does manage to get calmed down as he is ready to leave after refusing some X-rays and such and they said once his Girlfriend was there she talked him into x-rays. They found nothing from my understanding.
Next
I catch some traffic from dispatch, "I WILL BE DISPATCHING AN AMBULANCE AND RESCUE!" Ah crap, tones drop, I always wanted to run, I come running down the hall, "Advise when ready to copy!" Go ahead, "1 vehicle rollover, car on its side, pt is conscious and breathing, unknown if trapped dispatching rescue.." We arrive on scene, and find a car its passenger side about 20 feet of the road and down in a wooded area, it appears the car has went off the road, and struck one tree and struck a second, and then ran up it and came to rest on its side. The driver is in the car alert, to long term thoughts, but short term he cannot remember, we are waiting on rescue and notice some smoke from the hood, we request the fire department. The Sheriff's department has arrived on location shortly after and has requested information, I give them what I can from my point which is out of the way allowing my partner to tell me what he needs or who he wants. As rescue rolls up they setup lights, and get the vehicle stabalized so we can extricate my partner and this patient. We hand off the C-collar, I have the backboard, Kendrick's Extrication Device and towel rolls ready. My partner yells to me, to call for a chopper. Everyone looks at me, "WHAT DID HE SAY?" What do I tell them? "Tell them 20's male rollover mvc, unknown time in cold, extended extrication time and tell them to get the chopper in the air." I walk up to the rig, I place the call, luckily I remember their phone number by the letters. I get dispatch give them my information and all. They will call me back, I wasn't sure of the phone number in the rig, I give them my personal number and wait for them to call., and wait, and wait!
The patient is coming from the car as I wait, a deputy and police officer ask me, Is the patient that bad? I explain my partner's thoughts. The MVC alone is probably good enough to get the pt. to a trauma center in most books.
They load the patient just as I am turning up the heat in the back, my partner jumps in as the firefighters pack the patient up the grade, I tell him still haven't heard from the chopper, but I had managed to get generic cooridinates from the GPS the helicopter service had given us a while ago. I remembered that while I waited for them to call back. I gave them a set and told them it would be west of that. The dispatch calls back and tells me 20 minutes. We put the patient on a Non-rebreather, get him on the monitor and run pulse ox, blood pressures and try to warm him up. We are roasting in the truck. My partner attempts iv access several times, the patient is just too cold, he finally establishes an IV and we run some Normal Saline, aka 0.9% Sodium Chloride. The pt has good grips no cuts, lacerations, no deformities, crepitus, no tenderness in the abdomen , nothing major anyplace! Good lung sounds, pupils are pearl, there is a question about ETOH (Alcohol), I can't smell my partner can't either. The others on scene are sure they smell it. We move to the location of our LZ (Landing Zone) EMS talk. We cover the patient in blankets, and warm him up. My partner looks up and says, I think maybe I screwed this one up. I am saying mode of injury. Well the helicopter crew radios us for a report, we give them a report they are 5 min out.
The crew boards the rig, at the Landing Zone they assess the patient and give us "Great Job" guys. We ask where they will be taking the patient so we can inform the state police as they had asked. They do their assessment and find the abdomen seems swollen and guarded more then what we had assessed. We then released care and helped them with the cot to their chopper. We wished them well and then they took off. We removed our gloves, took a deep breath, looked around to find out where we were and to see who all had came out to help us, then we got into the truck, put ourselves en route back to the base, to restock. We did make a pitstop for food, and caffeine on the way back because it was a long drawn out ordeal. We make it the rest of the shift without a call.
Next evening. .....
Not to awfully bad, right at around 6:45 a woman calls for shortness of breath on the non-emergency line, the day crew should be there any minute and take the call, also then the emergency phone rings for a local nursing facility having a woman who has fallen and has a laceration on her head. We looked around for the day crew unable to find them, we decide to roll on the shortness of breath. It is out in the far North Eastern part of the county. IT will take about 15 -20 minutes to get there running hot. We are running hot, I never realized how much traffic their is on a highway in the early morning, we pass lots of cars who won't stop they just pull to the shoulder, and others that will match or exceed the speed you are running so they don't have to stop. We arrive on location later with our first responders on scene assessing the patient, we load the patient, place her on some oxygen, my partner starts and IV and pushes some Lasix. The patient hasn't had her morning lasix. We roll back. I notice the narrow roads, as we make our way back towards a main road, I see cows in a field, I am amazed that I run EMS in "the STICKS" and still work mainly in the city. It amazes me that we have more runs in town then out in the middle of nowhere, where you think people would be sicker. We make it back to the hospital, unload, fill out paperwork and end our shift a few hours late!