Staying Snow

Jack B Nimble

Ems Sleep study

http://exclusive.multibriefs.com/content/new-ems-sleep-study-to-examine-the-effect-of-shift-work/medical-allied-healthcare

A porridge kind of day

-39 °C or °F. Is cold either way.

Black Friday

It's cold outside. The store was hot. So I removed up to 70% off. Now I'm being detained by security in my underware. What?

http://www.thepetitionsite.com/289/886/031/tell-the-manitoba-government-to-reinstate-the-licensing-requirement-for-dog-breeding/

Winter is here

OK, let me see if I have this right. No longjohns, and you freeze to death on scene at a collision, put them on and you die of heat with a 3 hour offload time at Emerg. Sound about right Medics?

IMG00376.jpg

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Good Advice

The very second that you hear"Good Idea !"
Stop talking.

My Blueberry

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.
Merry Christmas.

Have you been Naughty?

Definitions

The Edge of Reality should be more clearly defined.
An electric fence would do.

Stress Relief

"Woke up this morning and my liver was laying beside me in the fetal position"

Smoking

Seven or so months in now and I would kill for a smoke. 10, 9, 8,7,6,5,4,3,2,1. there that's better. Now its just a craving and I wouldn't actually break a commandment for one. Man, what a day.

The Wrong Valentine's gift

Gentlemen, post this on your fridge.

OK, so you have probably figured out by now that this is Valentine's Day.

If not, well.....at least you did nothing.

This fellow picked the wrong surprise.

 

 

It seems that he borrowed his girlfriend's van without telling her.

Then went and had a "few" drinks without telling her.

(we almost had to detox after his breath)

He then decides to drive home and rolls the van into the ditch.

Total write off.

He had no real injuries, but was so drunk that he couldn't stay awake on the ride to the hospital.

He was very concerned about the van because his girlfriend needed it for work.

And what does she do for a living you may ask?

Flower Deliveries!

Busiest day of the year, she woke up to find, no boyfriend and no van.

I wonder what his favorite flower is?

 

Priority One

Priority One, Cardiac Arrest.

Copy that dispatch, mark us rolling. Has CPR been started?

Negative, caller says that rigor has set in and patient is cold in a warm environment.

Have RCMP been dispatched?

Affirmative, downgrade to priority 4, scene is safe, RCMP are 10 minutes out.

Copy, we're clear.

Good Ol' Country Folk

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"

Whaaaaaaaa!

Heart Attacks and Boners

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!

A Perfect Day

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.

 

Thank youse

    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.

Churchill, Manitoba

These are a couple of pics that I took while I was working in Churchill.

Wildlife

Call comes in for a roll over 3 patients, local ambulance responding.

This meant that we were responding just to back them up and help transport.

They were an hour away, This is in the middle of the night.

I am still running on the effect of the deliver on the side of the highway earlier in the morning.

We blast north up the gravel road, lights and siren watching for the eyes of wildlife in the ditches.

We arrive on scene and do another triage and load up the most seriously hurt patient in our truck.

And away we go, now south bound, lights and sirens for the hour drive to the closest hospital.

Our patient was a young fellow who had had a few beer so thought it best not to drive home.

The driver that he picked to drive his truck home, lost control, rolled and landed upright in five feet of water.

One passenger was ejected.

This was the second time this year that someone else had written off his vehicle.

I was in the back with him for the trip, keeping him awake and watching vitals.

About 15 minutes north of the hospital, I hear the driver scream " AAAAAAAAAAAAhhhhhhhh" so I braced myself and the patient.

BANG!

 We came to a quick stop from 100kmh (60mph), contact was at 90 kmh (50)

"A moose" the driver calls out.

I check on the patient and he is fine, although now a little sensitive to other people's driving.

My partner is white, I mean that pale sweaty white of a cardiac patient.

The ambulance is in bad shape and not going anywhere by itself.

We call our second truck to come and get us.

Another medic has jumped in the back with the patient and I am out stretching my legs before we transfer.

One of the medics has a tag (license for a moose) so is determined to come and track down the moose.

We are standing out near the ditch, the hunter has his back to where the moose was, I am facing him.

I scream out "Moose" drop my flashlight for added effect and pretend to run.

Big bad hunter, spins and runs right into the side if the ambulance, clawing at it looking for the door.

I thought that I was going to pee myself I was laughing so hard.

Big bad hunter knows allot of curse words.

We get back to town, drop off the patient and fill out the paper work. Lots of paper work.

Now it is about five or six in the morning and pitch black.

I am walking behind the hospital, not paying particular attention to anything.

I look up and there is a bear about twenty feet from me.

I gently reach into my cargo pockets, pull out some dog treats, and toss them off the path.

I am too tired to walk all the way around the hospital so I just quietly walk by the bear, who is now busy searching for his treats.

Time for bed.

There Was A Pregnant Lady

    The patient had been discharged from a Hospital 1.5 hours south of us the day before, 4 cm dilated.

The patient lives 1 hour north of us.

That puts her 2.5 hours drive from the specialty hospital that she was to go to once labour had returned, not including the hour wait for the ambulance to come and get her.

The night shift truck was called out at around 0500hrs to go get her, labour had started again.

They brought her to our hospital and we were called out to relay her  back to the big city hospital from where she had just come the previous day.

She was considered a high risk pregnancy so the next closest hospital wouldn't take her.

About 20 minutes down the road, we had to pull over.

The waters had released and there was meconium staining (the baby was under stress and had defecated in the womb).

They were right, she was high risk.

The little girl just popped out, not breathing, it was a very long hour before the baby cried.

 In reality it was probably more like 3-5 seconds.

I would love to describe the whole delivery but adrenaline and shock make it seem as though it was just a dream.

At some points I was outside of my body watching. Totally intense.

Mom and baby were stable and when we radioed in we were redirected to the closer hospital since she was now not a high risk delivery.

Some how, I feel that we were used.

But Now I get my stork pin.

Am I pregnant?

 

Called for a 17yr old, 37 week gestation

Patient will be walking outside waiting for EMS

 

Expectant mothers waiting outside are never a good sign.

We arrive on site, and as advertised, is the expectant mom pacing back and forth.

Do you feel the need to push?

I don't know

Has your water broke?

I don't know

Are you pregnant? (I couldn't help it)

Then she looks at me like I'm the stupidest person on earth.

Do you know why we were called here?

No answer.

Finally, the mom's mom answers some of the questions.

Will I get a stork pin?......I don't know

 

Kids shouldn't be having kids.

Hunting Tally

 

3 windows

1 door

1 Ford truck

1 hydro pole

Various road signs

Too many trees to count

0 people

0 Moose

0 Ducks

Situation Normal

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.

Northern Triage

Hypothetically of course.

 

On a call with a male after a two week drinking binge.

He's not feeling very good.

Call comes in, Adult bit by a dog, bleeding badly.

Stabilize the boozer and respond to dog bite.

Yep, in fact it is bleeding quite badly, many wounds.

Call comes in, female screaming and crying on phone, can only make out the name.

Stop bleeding of dog bite, have bystander apply pressure and respond to new screaming caller.

Get there, domestic battle in progress, stop the fight, load victim,

pick up dog bite on the way to the clinic 

and then phone the boozer.

Boozer has passed out in his usual chair, family just wants to go to bed but will keep an eye on him.

Radio rings, seizure, come quick.

And so it goes.

 

Hypothetically of course.

I have a headache, I think

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.

It always happens when.....

Call to 40+ year old writhing with upper abdo pain.

Have you fallen?

No

Did you get hit?

No

When did the pain start?

After supper.

What did you eat?

Duck soup, it always hurts after duck soup.

 

Ok everybody, say it with me,

"Stop eating Duck Soup!"

Really, Really, Green Charlie Three

The Basics:

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.

 

No Dogs Allowed

I got it in writing.

No more encouraging dogs around the base.

Apparently, one of the pack growled at the big boss.

What was he doing that would cause them to growl you ask?

Anyway, as soon as I got here I addressed the situation.

This time, I growled " I'm to let the dogs starve while showing compassion for my patients?"

 

Anyway, Chico came to say Hi last night just hours after my arrival.

I made him a bed in the ambulance bay because its so cold and rainy. The main door is stuck open.

And I asked for a raise.

 

Back to work

Well, holidays are over, just got back up here yesterday afternoon.

One day late. I broke down half way, the alternator quit.

A good Samaritan stopped and helped charge my battery so that I could limp into the next town.

Thanks Evan

Luckily, could still get the parts shipped up by bus overnight.

The first motel that I went to was closed for the holiday weekend, go figure.

The next, after some cajoling had a room ($125/night) but no water.

The restaurant was also closed for the holiday weekend.

There was a restaurant run by a Korean family that was open.

They had Chinese Specials, 1,2,5,6.

An American customer came in and was about to order.

Where is three and four? (Southern accent)

No three and four. (Asian accent)

Why don't you name five and six, three and four? (Southern accent)

No three and four.(Asian accent)

I understand, but you could just change the numbers.(Southern accent)

No numba three and four.(Asian accent)

He just wasn't getting it.

Being a frugal business woman, it was more practical to just use the numbers that she had.

 

Its cold and rainy, a really beautiful fall day.

 

New Plan

I am pulling out about mid morning and off to the bush.

May not be posting for a bit.

No cell phones, no internet, no dispatch, no patients.

I should be back posting in a week or so.

 

Too hard to open

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"

Just in case

We are having internet problems so I am having a difficult time posting.

Tomorrow I leave for a camping trip in Northern Ontario so won't be posting for a bit.

Should be back by late August.

You know you're a nurse if

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.

Canine operation

 

On a kitchen table.

There is no vet up here.

Home Sweet Home

 

Our EMS Headquarters.

Need a hand?

 

Our clinic

 

Just kidding!

Our clinic doesn't have chairs

Dog bite

This young girl claimed that a dog sprang at her and bite her with no provocation. She was very evasive and her story kept changing.

My mom said to just shake it off

The centre finger is broken in the mid palm area. The baby finger is an old injury where mom told the young man to just shake it off.

Mom is with EMS.

Summer Sunsets

In the summer, the sun barely dips below the horizon. You can follow it from the Northwest to the Northeast, to where it pops back up, just hours later.

Adoration

Everyone wants to be a paramedic when they grow up!

A bottle of whiskey

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.

Not me you dummy

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.

I don't need help.

We get a scheduled medivac for 0630hrs.

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.

Who's the patient

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.

What not to ask a crowd

Call to a house party, unspecified problem.

I walk in the door to a house full of very happy (read drunk) people, maybe twenty or so.

I scan the crowd, looking for a hint of distress.

Then in my most professional voice I say "who needs medical attention?"

Every hand in the place goes up, illnesses ranging from rashes, dry mouth, itchy groin, numbness, syncope et al come to light. A triage nightmare.

Let me rephrase, who called the ambulance?

Johnny did, he wasn't breathing.

How did he place the call?

He's feeling better.

Were is Johnny?

He went to go get beer, he should be right back. Wanna drink?

No thankyou. Clinic is open in the morning for the rest of you. Have a good night.

 

 

No idea

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.

Still a little tired

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.

Punchy

Well, it was one of those nights,

as soon as you hit the pillow a call would come in.

Hopefully it will be a quiet morning, getting a little punchy.

This last call was an ETOH domestic assault.

Very messy, lots of blood. Head wound, they always bled lots.

Patient wouldn't put her smoke out.

But when police arrived at the clinic, she decided to press charges...this time.

The call before that was man down, trouble breathing.

We arrive on scene and potential patient gets up and books it into the bush.

In my professional opinion, he seem to have made a full recovery.

 He could have just walked away, because I was not about to pursue any business after the last 24hrs.

What is that?

"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 know we're coming

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

Going for the record

Well, two more calls down.

3 month old, mom dropped, landed on his face, he was more mad than anything else, mom was feeling pretty bad,

then a 12 year old that lives on bacon and french fries, URQ pain, hhhmmmmm gallbladder. maybe cut down on the grease.

Speaking of which, we went through goose soup season about a month or so ago, and it seemed like every second call was a gallbladder attack,

"this happens every time I eat goose soup"

OK, say it with me,

Stop eating goose soup!

Crazy day

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.

Even the ambulance looks tired.

Hoping for a quiet night.

 

 

Scene safety

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.

Busy day

The other EMS service is off line.

We have just completed 6 calls in one and a half hours.

Now to catch up on the paperwork.

And dry off, its really hot and humid today.

 

Another call came in before I could post this.

Where oh Where

Well, Chico showed up and got a stern talking to (kisses) but no one else.

There was a dog killed just down the road a bit that fits the description of one of them.

So sad.

 

That's gotta hurt

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.

A very sharing family.

Where did they go?

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.......

Shortness of breath

Run ragged through the night.

Then a call comes in around 4 am. female early twenties, shortness of breath.

Arrive on scene to find patient sitting up in bed with no obvious signs of distress.

When did this start?

2 days ago.

Grrrrrrrr. Just as I am preparing a lecture, I can see my partner with a pillow in hand.

I know exactly what she is thinking, "I'll give you shortness of breath!"

Ended up not giving speech nor smothering patient. Transport was unremarkable.

Sad news

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.

I'll never forget him.

 

Assumptions

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.

Umm, I don't believe you

Call is for a mid 30s male, seizure.

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?

Yeah, me.

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?

Huh?

Did you extend your arms or draw them in to your body.

Oh, for sure, yeah, both.

How long ago did it end?

Oh, about 15 minutes ago.

Are you sure?

Yeah, for sure, about two smokes.

Are you postictal?

No, I had a poo last night.

Do you know where you are?

Yeah, at a dead party.

Can you walk?

For sure, look.

OK, lets go.

I need an IV.

OK, lets go.

Is Sherrie working ? She's nice.

No I think she's off shift.

I feel better now.

OK, lets go.

No, I'm OK.

Do you know what day today is.

Hhhmmm, let's see, yesterday was pay day.......

It's OK, we can manage.

 

Bystanders come in all shapes and sizes, some I'm more delicate with than others.

What's your sign ?

This is one of the signs that I pass on the way to work up here in the winter

Safety First

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.

Its a miracle!

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!

Yeesh!

 

Northern Lights

The northern lights have been strong for a couple of nights but just a few minutes ago there were two bands stretching all the way west to east.

Magical