When I receive a message on my phone/ email or Blackberry like device, I started feeling more and more obligated to respond. Even worse, I feel obligated to respond within a respectful time line.
But now for Christmas, I gave myself a few things from the pets and invented friends, but what has gone the furthest is that I use my "communicator" (Blackberry) at my discretion. I am reducing my commitment to replying to this machine, which has enslaved me for near a year.
. It is meant for my convenience, not the convenience of others. .
If I want to talk to a friend, or they want to talk to me, we drive to the other's yard. No texting. And I would like to embrace the benefits of that, more than I have been. My phone is shut off right now.
I love being a medic and that's all there is to it. The union keeps getting in the way of that love. This means that the union must be tamed, or the union must go. But it can not lead anymore. It is hurting too many people.
We may have found Hoffa. This post was in 2009 in Neha and yes, a person who is now Cupe was very bad for members. The person that I referred to as Hoffa. I then was part of MAHCP, Then back to MGEU which was by then cleaned up due to the new President getting rid of the evil doers. Ask where they now work. The anonymous keyboard warriors are very brave when they don't have to debate but just take things and present them out of context
Apologies readers. I have used a lot of excuses not to Blog. My work won't give me permission = now tired of waiting and don't know what they are scared of And its just my take on it anyway. Never have time near a computer anymore = now I'll use my phone (pardon the auto sig at the bottom of each post). And at one point I was going through a stage of not wanting to write. Now I want to write and the stories are back logging. So with that said, let's see.
There was this. ...........
Was on my way home a few days ago and feeling a bit poorly. There was a bug going around with sudden onset diarrhea and nausea. Actually, both were projectile from what I was told. I only ever did get the vomiting.
A few of my coworkers were already out of commission with it and I was trying to get home before it struck. About forty minutes into my drive I figure that I might as well deal with it, so pulled to the side of the road. It was a barren stretch of road, cold and blowing snow. At first, my symptoms abated with the fresh air but soon the rumblings started. I was in full uniform, with a huge EMS symbol on my parka.
Just as I start to vomit, a car pulls to a stop.
"are you OK?"
"I'm fine" Whhaaaaaaa! "I'm OK" Whhaaaaaaaa!
They said something comforting and went on their way.
I just get over the worst of it and was dealing with the dry heaves when another truck pulls up.
I start my "I'm OK" routine and then some lost, forgotten meal came flying out.
I see the fellow with my peripheral vision, bending over as though trying to see me better, but then realize that he is vomiting himself.
"I don't do very well with this he says" Whaaaaaaa " but my wife is just up the road, I could send her back."
"No thank you, I'm OK, I'll be back on the road soon"
So to those kind folks that stopped to help out a Paramedic on the side of the road,I would like to say "Thank you"
We received a call for a 65 year old male having chest pain. The call itself went well, except that the patient's wife busted him for "sneaking a nip" of vodka once in a while. "He hides it in the basement." Nitro seemed to relieve the pain and we transported without incident. We got him to the emerg and transferred him to their EKG machine. We then waited for the Doctor to arrive. One of the things to ask a patient before administering Nitro is if they have taken any Viagra recently. This affects their blood pressure. My patient had replied no, not Viagra, "I took Cialis, it's a weekender" The Doc had come in and done a brief exam and was now a few feet away talking with a nurse. I moved closer to the patient just to say that I had to get going and would see him later. I then remembered a Cialis story that a GP had told me. He had a patient come back for a visit after taking Cialis. It seems the patient had trouble sleeping on Cialis. The Doc ask if it was insomnia (a possible side effect) but the patient said that it was because of his new sleeping position. It seems that he prefers to sleep facing down but was repeatedly interrupted and forced to roll onto his back. This also made for a drafty sleep. Not thinking it through, I shared this with my patient who was having a mild heart attack. When I finished he just was smiling, but as I turned to leave, his laughter got louder and louder. The Doc heard the commotion and was looking back and forth between the EKG and the patient. He then realized that I must be the cause of this sudden outbreak, so he shot me a stern look. The patient by this time was in fits of laughter and holding his belly. One of the electrical leads had come off so the EKG machine was in alarm. In short, the room was not in the tranquil state that is best for a cardiac patient. I meekly started to slink out the door. What a boner!
I am writing this on my birthday. My present to myself is to start writing again. I enjoyed the feedback from the blog, and really just had fun sharing the stories that rattle around in my brain.
I started working for a new service but still have two years worth of material to get down on 'paper' before I get to this job. Maybe I'll just intertwine the two, this will help protect the privacy of patients and coworkers even more.
A couple of weeks ago, we had brought a patient in to the hospital. We cleaned the ambulance and finished up the paper work and just as I was leaving, a family member of the patient mouthed thank you to me. Caught off guard, I said something like, "anytime....." Dumbbell!
Then yesterday, a little white haired elder drove up to the curb, rolled down her window and said "we really appreciate you guys". This time I was ready and said "thank you" No other words came to mind.
Thank you's are few and far between in this job, so if you thank a paramedic and they say something stupid, like I did, please know that we really appreciate it, and that it means the world to us.
I made sure that I passed on the comments to all my coworkers, I just left out my replies.
Called for a 40 year old having a seizure. Arrive to find a party going on in full swing, the middle of the afternoon. Of course, everyone is very helpful. We manage to clear some room around the patient and begin to access him. He is known to EMS as one who is very combative when he starts to come around. We put in a call to the Band Constables but they won't come. He is laying in a chair with a glazed look in his eyes. Now is the time to grab a quick set of vitals. Too late, he all of a sudden gets a horrified look in his eyes and starts swinging. He has a forearm cast which makes quite a formidable weapon. We start dancing around the living room and he then decides that we are going outside. He is about my size but still too intoxicated to really take me on. We go out to the porch and he decides that he is going to escape the evil that has befallen him. So off we go across the yard. As he reaches the boundary, I grab him and steer him back across the yard. My goal was to play him out until I could gain his trust. There is a heavily trafficked road near by and I am worried that he will run out to it to get away. After a few laps, he has had enough of my interference so decides to stand and fight. I end up sitting on him, out in the yard, him swinging his one good arm and the cast at me. I look up just in time to see a RCMP truck going by. The officers just wave at me and keep going. Like this happens every day. Its normal for a Paramedic to be sitting on a patient out in the yard. My partner had placed a call into the RCMP for help about ten minutes prior so they do finally get the call and respond. By this time the patient is sitting calmly in the back of the ambulance letting us do a full assessment. The officers are very cordial and tell us to call them anytime that we may need them, no problem. OK, thanks guys, we're under control, but thanks for coming.
Caller "she doesn't feel well, you better come" click Are you in pain? No What is wrong? I don't feel right, my head is going to explode. Do you have a headache? No Is there pressure in your head? No Tell me how you feel. I feel funny all over. I went to the clinic after school but didn't feel well enough to wait to be seen. Would you like us to take you in now? No, the ambulance is too showy, my sister will drive me. OK, give this list of your vitals to the nurse, we'll call ahead and talk to them.
Needless to say, we told the clinic exactly what we heard, saw and found. I wonder if she'll feel well enough to wait and be seen tonight?
A teacher should know better than to waste the government's money.
Green is stable, Orange not so stable, Red unresponsive.
Charlie is conscious, Uniform is unconscious.
Three is trauma, Five is medical
So Really, Really, Stable ,conscious, trauma
Call received from the nursing station to go to the school.
12 year old girl went to open the door with her foot and her nail bent back.
When we get there, she is totally embarrassed by all the attention and really shy.
Someone had already put a band aid on the injury, so what to do?
I know, throw her on the stretcher, hang a 1 litre bag of saline, run the drip set under the blanket, bandage her head in gauze, put the O2 sensor, bp cuff, accutest.... in plain sight, blanket her so that only her eyes are showing and leave lights a flashing.
Once we were under way I peeled back the blanket and was met by a huge grin.
Ok, stage two, to pay back nurse that called us, we fly into the emerg parking lot but are met by a new nurse and nearly gave her a cardiac. OOps! Just kidding, where is so and so?
Ok, stage three, lets scare the folks. (patient's idea not mine) Problem was, grandma knew me from a past prank and busted us. She tried not to but was grinning so wide that I thought her head would hinge back and fall off.
So, seven calls since 0830hrs, now for some food and maybe even a nap.
Called to a three year old that was found at the kitchen table that was covered in 100+ pills. The pills were in an acetaminophen bottle but were an antispasmodic med prescription. What is the name of your pills? I don't remember exactly. Where did you get the prescription? Winnipeg. How many did she take? I don't know. How many were in the bottle? I don't know
The total bill for us, the clinic and the medivac plane must have exceeded $5000. Billed to the government. All for what was explained to me as a more convenient container. "The bottle that my pills came in was too hard to open"
You know your a Nurse If....... 1) the front of your scrubs reads "Nurses... here to save your ass, not kiss it!" 2) you occasionally park in the space with the"physicians only" sign... and knock it over. 3) you believe some patients are alive only because it's illegal to kill them. 4) you recognize that you can't cure stupid. 5) you own at least three pens with the names of prescription medications on them. 6) you believe there's a special place for theinventor of the call light. 7) you believe that saying "it can't get any worse" causes it to get worse just to show you it can. 8) you wash your hands BEFORE you go to the bathroom. 9) you believe that any job where you can drive to workin your pajamas is a cool one. 10) you consider a tongue depressor an eating utensil. 11) eating microwave popcorn out of a clean bedpan is perfectly natural.
Male caller, cut arm. Arrive on scene at a wooden shack, a party shack , with its namesake going strong. Older male sitting at a table with a blood soaked towel wrapped around his elbow. "Hey Doc, wanna look?" OK, just a minute and let me get some dressings ready. He removes the towel and shows me a three inch gash near his elbow. How did you do this? My brother and I were arguing and he threw a bottle of whiskey at me. I could picture the Hollywood version, as the two square off, one grabs the bottle by the neck and smashes the bottom off of it to produce a jagged weapon. As I'm cleaning up the wound, I notice only beer bottles around. I am supposed to be thinking of scene safety and should be getting control over the weapon. Where is the bottle? I asked this more as a reflex and a bit out of curiosity to confirm my vision of the fight. He's got it he says pointing to a fellow laying on the floor with no obvious signs of life. Is he OK? Oh yeah, just can't handle the drink you know. I'm not sure why but something made me ask if the bottle was broken. No he says, it hit me on the arm and fell on the table. Good thing too, there was still some left. I exam the wound further, and with a little movement, a jagged piece of bone comes out. I had just broken rule number one for a broken limb. Stabilize and splint in position found. But in my defense, I didn't suspect a break from the MOI (mechanism of injury). The bone had broken at a 30 degree angle on impact and then, or sometime later, had cut through the skin. I dress and splint the wound. I then go and check on the brother, who, although smells quite dead, is in fact just in a restful slumber. OK, rookie, never assume that you know what the injury is until you do your exam and ask all of the questions that you can think of.
We get a call to a shortness of breath, possible cardiac. I recognize the description and begin to fill in the PCR. Birth date 01/01/01 We arrive on scene to find our known patient, sitting in a rocking chair by the window. She has obviously been waiting for our arrival. With out wasting any time, I begin on vitals. My patient seems more animated than usual, and a little more active trying to resist me than I normally find in a call of this description. She points to her home care worker who is sitting, smiling on the couch. I continue to try and do her vitals. She picks up a stick that she uses to open and close the curtains and gains my full attention. With her Babe Ruth stance, I start to clue in that help was not summoned for her but for her home care worker. We check out the home care worker and advise that she come with us. The home care worker will not leave her station until her relief arrives. While we are waiting, my original patient, through a translator, gives me a list of the care that her health care worker should receive. Including a Doctor's note describing that a paid time of leave should be granted for a period of rest. Dumb white guy.
We arrive on scene to find an elderly lady all dressed and ready to go. Her house is sparse but immaculate. She is dressed very stylish. She is old enough that her scribblers in school could have been granite tablets. I think that Moses mentioned her in his will. I try to help her up from a sitting position but she slaps my hands away. She eventually gets upright and with the grace only found in the elderly, makes her way to the porch.
Her front steps are best left to a seasoned mountain climber, as she starts to descend I foolishly try to offer assistance and she swats my hands away.
Again, no help in or out of the ambulance, no matter how gentlemanly my offer.
The ladder to the plane is quite steep, and forgetting my previous instructions, I attempt to boost her up the steps. Again I am met with a well aimed swat.
The flight paramedic grins, signs my PCR and follows her into the plane.
Seizure call, unspecified. Enter house to find three adults, one female standing in the kitchen holding an infant, one male sitting at the table whose eyes are wandering independently of each other and another male sitting comatose on the couch. My astute powers of medical observation lead me to the altered LOC (level of consciousness) possibly postictal male on the couch. As I walked pass the female, something causes me to focus on her and I am just in time to grab the infant by the jumpsuit and slowly settle the adult female to the ground who is now vibrating like a bad break dancer. I pass the baby to my partner and have him call for backup to take the baby. I place the seizing female in recovery and try to get some information from the disco eyeballer. The only information that he is currently willing to pass on is something about a birthday (birfday) but whose or when I can't make out. The female comes out of the seizure and is dazed and quiet for a moment. Then with the agility of a gymnast, she is on her feet and swinging like Cassius Clay. She lands one or two punches before I am able to redirect the blows. I feel like I'm in a bad Jackie Chan movie. Baby appears to be OK so we turn her over to Family Services who have finally arrived, and have them take baby to the Clinic. Meanwhile the seizures return and the outcome keeps repeating itself. She is far too combative to try and start any medical attention, so new plan. I get a blanket and lay it on the floor. The next seizure we grab her, plunk her on the blanket and carry her down the stairs and strap her into the stretcher outside. She starts to come around in the ambulance and recognizes where she is. She is now transformed into a very pleasant lady who entertains me with Hank William's tunes, sung in a mixture of English and Cree. Angelic voice, I'm very impressed. The inside of the ambulance has a Kryptonic effect. This scene repeats itself over and over during the following months. The trick is to get her into the ambulance to re-awake the lovely lady and not the combative pugilist. She gets wise to the blanket trick so we keep it out of sight until she drops and then bring it out. I never see an infant there again.
Mid thirties male, feeling faint, known ETOH abuser (booze). Have you ever felt like this before? No Have you been eating? No When's the last time that you had something to eat? I can't remember. How long have you been drinking? About a month. Do you have any idea what could have caused this? No. OK come with us.
I left the speech making up to the receiving nurse. With only one call interrupting a six hour sleep, I was in way too good of a mood to give a speech. Plus he was a good candidate for a 16 gauge IV (large bore), and practice is always good.
Well, yesterday was a pretty normal day, Got called to the clinic for a medivac, not for us (could have been sleeping) called to medivac, plane late 45mins (could have been sleeping) Called to a scene, no patient (could have been sleeping) Another dropped baby, from three feet. Baby's OK. But when you think of it, baby wasn't even one and a half feet tall. That's the same ratio as me falling at least 12ft on my head and side. Now, I understand the acceleration due to gravity, but still, pretty amazing that these babies crawl away unharmed. Day before 19 calls in 24hrs, wasn't a record, but yeesh! Today, spent the mid day laying George to rest. While we were waiting a puppy came to me so I fed him and cleaned him up. Help to focus on something else. We carried George to the truck and rode with him in the back to the Church. Then had to go back on duty and the first two calls were right back to the Church. Then had a seizing patient who chooses not to take her meds because they make her sleepy. Still not quite rested up. That was a 40hr run with only a nap here and there. Hoping for a quiet night.
"She's pregnant and something came out" Enter the home to find three crying adult females, not a good sign. "something came out in the toilet, its still there." I go and look in the toilet but really can't see anything except a little tail in the bottom. I reach in and pull it back and to my surprise it is connected to a large oblong mass, bigger than my fist, with the consistency of liver/balogna. At the clinic, the Doctor cuts into it and determines that its a blood clot and all is fine. A blood clot.....................I had no idea. Mom carried to term and all is well
If you have called EMS.... Get the vehicles and all the yard booby traps out of the way. Lawn furniture, garden hoses, bicycles, foot wear at the door, at least clear a path. Get control over the children! Don't expect EMS to wait for you to get ready if you are coming along as an escort. Make sure that there is lighting near the patient. Telling a paramedic that there is no light bulb in the room is not acceptable, Get one. Get control over the children! Turn off the TV and the loud music, No we won't wait five minutes until the movie is over. No you don't have time to pee. And yes your hair is fine, but those pants, well, you know. Get control over the children! If EMS asks the patient a question, and you are not the patient....Don't answer the question! Let me rephrase that If EMS asks the patient a question, and you are not the patient....Don't answer the question! No you can't smoke in the ambulance, and no we won't wait while you finish your smoke. No we don't want a shot or just a little sip I'll have more suggestions later, but am going to nap now
Lost count at a dozen calls. Then, one of the last ones was a roll over, six patients, 2 minor, 3 being medivac'd, 1 staying for observation. The other service and the fire department were also on scene.
The police were trying to question the patients as we were working on them.
I think that we have used every tool in the bus today.
A young caller, "they are fighting outside, hurry" click. We wonder why we are called for a fight that isn't over yet. We have dispatch call the Band Constables because they have a quicker response time than the RCMP. We arrive on site before the Constables to find some children outside crying. One of the little girls comes to us and says that we are not needed. The adults are in the house but all is OK. Ah! A domestic call. I go to the house, poke my head in and confirm its a domestic dispute while my partner rounds up the kids. The inside of the house shows signs of a pretty good fight, I step on some porcelain and kick a piece of tea pot.The adults say that all is OK and that we are not needed. Still no cops. The little girl is afraid because she was warned by her mother not to call the cops. Was this her then that called the ambulance? We load the children in the ambulance, all minors, each a separate offence in itself and leave the scene. Still no cops. We head straight to family services and drop the kids off. We are horrified to find that we have left some children behind in the house. Paramedic rule number one. Scene safety first, wait for police. We struggle with this all the time. The next similar call will I enter the house to check for more kids? If you are a licensing body reading this, my answer is of course no, I will park a block down the road and wait for police. Final outcome, all children are safe.
One of these x-rays was from a snowmobile accident last winter.
The male patient was reluctant to drop his drawers to let me check him over thoroughly.
I thought that his shyness was a bit odd until he confessed.
It seems that when he got home from work, he had no clean long underwear.
So he grabbed a pair of his wife's flowered ones. They were in fact, quite pretty.
But the story doesn't end there. His wife meets us at the clinic emerg and hears of his current underwear issue. Then she proceeds to share with us (in a very loud voice) the time he had to borrow her silk panties because of a midline rash. I don't think that there was a dry eye in emerg due to the laughter. Including the patient, he was a very good sport. A really wonderful family.
No dogs came for breakfast this morning. None, not even Chico, the husky in the picture. Every morning there is usually at least six for breakfast. Not sure what to think. I was gone a long time through the night, about 12+ hours. Where Oh Where.......
One of our own passed away yesterday, losing the battle with cancer. He was only 38.
I first met George when I was precepting up here last year, I have a love of cooking and love to make way to much so I was feeding everyone. On the day I was leaving, George tried to quietly slip me some money for the food that he ate. I was blown away. George was optimistic to the end and believed that he would win the fight. He was always optimistic and did his best to cheer everyone up around him.
George will be truly missed, he was a one of a kind.
Call for a broken leg Patient sitting on bed, crutches on the floor. When did you get the crutches? In June I tore a ligament in my knee When did this new injury happen? Last night, I fell down some stairs. How many stairs? 2 steps So about two feet? No, about six feet, four of the steps are missing. Oh.
We arrive on scene to find our patient sitting at the table surrounded by evidence of quite the party. Patient is alone and showing signs of obvious ETOH (booze). Not another soul is there with any noticeable signs of life. I am tempted to go around the house and check vitals.
Did anyone witness the seizure?
How long did it last?
About 5 minutes.
Can you describe it?
Yeah, it was real bad this time. I was shaking like this and my eyes rolled back and my lips turned blue.
Was it petite or a grand mal?
Did you extend your arms or draw them in to your body.
I little while ago, I bought a slash vest for doing some of the more violent calls.
I was in the back with a girl just coming out of a seizure. She had decided that she needed to pee and that we had the facilities to accommodate her in the front of the ambulance. I am struggling to keep her in the back when she becomes combative and starts delivering body blows. Fortunately, I am wearing my vest so I can just barely feel the punches. I am very proud of my new purchase and make a mental note to also always wear it for seizure calls. Just as I am praising myself for my new body armour, BOOF!, she clocks me in the left temple and rings my bell. Thus having a good reality check, I go back into my pre-vest guarded position and eventually play her out. She was a handful even though I out weighed her by at least 70lbs.
Lesson learned. Less body armour or more good sense.
We get a call while we are just off loading a patient. The call is for a female that is too sick with too much pain to get up. We explain that we are on a call and for them to call the other service. As we are putting the stretcher back in the bus, the "emergency caller" drives up, parks, gets out and lights a smoke before walking over to the emergency entrance.
Phew, close call, good thing that she could drive herself!
We were called to bring a patient to the airport to be medivac'd out for a psych evaluation. The patient and the escort were brought to the clinic by the RCMP. Trouble was, my partner and I couldn't tell who the patient was. As we were driving to the airport, I decided to focus on the oddly dressed one listening to music through headphones that weren't plugged into anything. I started asking the normal questions to get a base line for the flight nurse when I was politely interrupted by the 'normal' looking escort to tell me that she was in fact the patient. Don't judge a CD by its straight jacket.
Call received........female 40ish, abdominal pain, so bad that she can't get up.
We arrive on scene to find her moaning on the living room couch. It seems that she has some leg pain and has been taking Tylenol 3. This then lead to severe constipation, or as she put it " my poop is stuck, here look!"
We loaded her in the ambulance and she ask for diaper pads. Not a good sign. She apparently felt that I wasn't understanding her plight because in one swift motion, she repeated " my poop is stuck, here look!", dropped her drawers, spun around on the stretcher so that I could get a clear view of her situation.
Now, I really didn't need to see the plug, and wasn't really comfortable being in the direct line of fire. But she insisted that I confirm her medical opinion of the situation.
For those of you that read this, if you ever need a paramedic for a similar situation, keep in mind that the medic will take your diagnosis as gospel, and there is no need to show them the exact point of exit that you are waiting on. To make matters worse, she was giving in to her need to push and straining as though giving birth. I was trying to get her to breath and not push but to no avail.
My pleas to my partner to hurry but to try to avoid the bumps fell on deaf ears, maybe because he was laughing too hard.
We were able to make it to clinic without incident. I gave report to the RN and explained that the patient would show her exactly where to expect the awaited result.
This is an account of my life as a paramedic. Please feel free to add comments. I work as a medic for different services in Manitoba Canada. If I use a patient's name, then I made it up. I will also change the dates on some stories just to protect the privacy of patients and partners. I have spent most of my time so far on Native Reserves but am now also working in the rural south. See my rescue Blog at http://mcneill-rescue.blogspot.com/ or my website at http://www.mcneill.ca/