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.
Chico, This sweetheart is looking for a permanent home. He is now living under our deck up here at the station. He greets me after each call and is very smart and obedient. He was just skin and bones at first, and of course a little shy. I will bring him south as soon as I find a home for him.
Very calm caller "can you come to #####, John has a bleeding nose" It has been our experience that the calm ones are the hard calls. We get to site to find a mid 30ish male, unconscious, unresponsive, seizing, semi fowlers, blood gurgling from his mouth and yes, a bit of blood trickling from his nose. I couldn't get in an OPA because he was clenching his teeth, and didn't want to use an NPA because I wasn't sure of the injury behind the trickle of blood from his nose. So we suctioned and bagged him to the clinic. There we intubated and had to bag him for about 6 hours waiting for a plane. The rolling fog was keeping them from landing. It turns out that his "fall" had driven his nose bone into his frontal lobe! He is south in a major Hospital and will be there for a while. It turned out to be quite the bleeding nose call.
Last night, with my evening partner, we got a call (we dispatch ourselves) "come to ########........Hurry!" Click No other info. We get there and there is a room full of panic stricken adults and a 7 year old boy with a broken and dislocated elbow. His first words to me were " I don't want to be carried and I don't want it cut off!" Great, now we have to totally change our plans! I used a wooden spoon to splint him and we transported him to the clinic with no problem. Then shift change and a new partner and a new call " Hurry, my baby, Hurry" Click, No other info. A good shot of adrenaline and lights and sirens. I ran into the house and again a group of bewildered adults standing around a baby with a cut on his forehead. He had fallen out of bed and knocked himself out. He was discharged from clinic before I even finished the PCR, Patient Care Report. We really have to try to get the callers to stay on the line and give us more info!
I am a Primary Care Paramedic, working 24hrs/day for 15 days of the month.Then I work casual for the last half of the month. Any names of patients or coworkers will be made up. Some of the calls will be out of sync just so that there is no way to track who I am talking about. I love working up here.
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/