Tuesday, September 28, 2010

Narcan

Day like today are ones where I think I should invest in the company that produces Narcan. I worked 6 calls requiring this drug. The top reason was for perc overdoses! I mean seriously! how many people can require this med in the amounts these Pt's had? Now don't get me wrong I understand pain issues for me I have had my fair share of kidney stones and thus needed pain med but geeze these people have it for some of the stupidest crap or got it from someone else. People if you have pain meds and you live with a junky then lock them up don't leave them in your bathroom!
1. Headache
2. Stomach ache - This guy didn't have a disease he just said he went to the ER for stomach pain and was dx'ed with gastritis and given these pain pills! WHAT!?!
3. wanted to get high - took grandmas pills for her back
4. needed to sleep - had a bottle of 60 filled 2 days ago and only 21 left in bottle when we got there.
5. cancer - I completely understand on this one he was one tiny guy and had perc 10's and took 3 he just could not get the pain to go away and could not get a hold of his doc.
6. attempted suicide - had pills from car accident. Life sucked because he cheated on his wife and was getting a divorce.

Monday, September 27, 2010

Busy

Sorry for putting the blog on the back burner but I have classes starting this week for my grad degree and trying to work those classes with my work schedule is well interesting to say the least! I have some new professors and I am debating on telling them I have type 1 diabetes or not. I would not want them to be scared crapless if I had a low BG or some complication of the D but at the same time what are the chances of that happening? I take that last statement back that was cocky and really asking for future issues. I don't know I will keep thinking about it. what do you all think?

Monday, September 20, 2010

Rookies

We all know rookies in EMS when we see them. Their uniform is all nice and neat and they have every piece of equipment known to ems on their belt and in their pockets. These are the ones that tend to act one of two ways either 1. they are quiet and do not do anything unless they are told otherwise known as scared sh!tless and 2. being the trauma chaser ( these tend to say the words quiet or slow on an other wise good day and then hell brakes lose and a lot of times they get in the way and tend to have to be knocked down to size and put in their place.) either way when you become their FTO a.k.a babysitter you know you are screwed until they learn the ropes. Now let me say this before I get slammed yes I was a rookie at the time and yes it was scary at first till I learned the ropes and yes I am sure I was a pain in the arse to my FTO. Now that being said, I have had a rookie on the truck for the last week and dear lord someone shoot me! I am already A trauma magnet and psych call magnet but the rookie had to go and say "man I wish we would get some action already " on a day where I was doing good as I had only had 2 calls in 6 hrs. So I figured it was time to guilt trip him.

Me: "Seriously? you want people to get hurt or sick so you can get some action?"
Rookie: "What? huh? I mean I just want work I don't want them to get hurt or sick."
Me: "Dude no medic wants to work a call, we actually want it to be quiet because that means people are safe and healthy. We are here when they need us but we hope they don't."
Rookie:" Why did you become a medic?"
Me: To help others in A time of need and the fact that I love emergency medicine. I am apart of a different breed. We tend to take the abuse and not fight back, we help all rather they have insurance or not, and we sure as heck don't get the sleep we need or a warm meal 1/2 the time but we still do it. I am sure for me that I get more out of helping these people they they get from my help. all it takes is one kids smile or a thank you and knowing you saved someone to make it all worth it."
Rookie: "My dad and brothers work as medics so I did the same thing."
Dispatch: "medic 464 please respond to XXX Pace road for a 3 car mva, police and rescue have been notified"
Rookie: "finally"
Me: " Crap!! Dude one day you will see what I mean when you will hope you don't get a call"
Me: "dispatch medic 464 on scene"

The three care wreck was bad one was a older wind star minivan with two young children and the mom driving. She was the reason the wreck happened. She was 29 and the cops at first thought she was DUI but after assessing her we found she was diabetic and was suffering from a hypoglycemia and passed out while driving. The two kids, 6 and 8 yrs old were injured one with a broken arm and cut on his forehead and was screaming at the top of his little lungs which was a relief in a sense that he was doing okay, The other much worse. The child was quiet he didn't respond to any of my questions,His vitals were up sh!t creek and we needed to get him out immed. When he was packed and ready we discovered a seat belt bruise across his chest and abdomen giving us the signal that he was high risk for internal bleeding especially with his vitals.
Mom was treated for the hypo and she received stitches from where the windshield shattered and needed urgent transport as well since her vitals were not as good as I hoped. when we got he BG it was 31 mg/dl When she awoke in the back of my ambulance she of course wanted her children and I informed her of their whereabouts and condition. I had to ask her why she was low and why she didn't stop? she said she tested before she left the house and her bg was 101 mg/dl and she didn't feel the low. I told her I was diabetic type 1 and I do not feel mine drop either so that is why I have a CGM (continuous glucose monitor) to let me know when I am out of range. She thanked my rookie and I for all the help and for taking care of her sons. The boys were life flighted to the children's hospital.  Rookie and I went to check on the boys and they were doing well the younger one was okay minus the broken arm and cut and would be released when his father arrived while the other son was in surgery to repair he fractured pelvis, lacerated kidney and his spleen. He will recover and was doing way better. the boys smiled at us and said thanks for helping my mommy she was low. We thanked him for his help because when we got there he told me his mommy was diabolical and low ( he meant to say she was diabetic and low. Bless his little heart.
Back in the truck my rookie looked at me and said " I understand now " I nodded and we went to get some lunch.

Thursday, September 16, 2010

Changing and learning...

Well as you can tell I have updated the blog to be more festive. You know give it some spunk. I felt it was due for a change. With all that is going on in my life right now like College which is kicking my butt and work that well I love but feel so unappreciated which brings me to a call that changed that feeling today. It was 3am or so and we received a EMS call to a older couples home where we have been many a times. The call came in as Chest pain and SOB so off we go and I see the address and quickly remember the couple. The woman always has a fresh batch of cookies that she always offers us and her EMS calls on her husband are usually not life threatening. a couple of times it is the I can't get him up call in teams that he fell or a diabetes related call, but today was different. She was so scared and crying when we got there as he was talking to her and then became unresponsive. so vitals were going down the drain fast he was a scoop and guy pt. he stopped breathing and went in to cardiac arrest. IV was placed and he was intubated immed. CPR was going life pack on and flat line crap crap crap! so shock and shock we get him back thanks to my cardiac drugs and he got him to the ER and he ended up having an infection in the blood cause him to have these issues. In a normal healthy young adult they would have the immune system to help fight but not Mr. B he Was still on chemo and thus leaving him open to any infection and harder to fight off. I did hear from Mrs B he was doing better and that she was just not ready for him to go. She told me their 50 yr anniversary was next week and he promised to be alive for it. This brought a tear to my eye I mean almost 50 yrs what an accomplishment. I am truly blessed as she brought us dinner at the station with all the fixings including my fave homemade apple pie. It is people like Mr. and Mrs B that remind me the love of why I do it.
As for my diabetes I met with my endo this week and we made some adjustment to my workday basal rates and sensitivity factor to improve my numbers my blood work was great with an A1C of 5.7 Heck yeah was i excited. I am looking at changing my mini med 722 to maybe the ping and then get dexcom for my CGM but not sure yet I am very happy with my current pump but just want to try the ping after hearing all the good press on it in the d.o.c so we will see.

Tuesday, September 14, 2010

The calls I am subjected too.

call # 1 of the day came over the radio for A 24 yr old female complaining of broken foot. okay no problem I am game lets check it out. well we get there and for starters the lady answers the door while walking on both feet might I add no limping involved and  in fact the lady told me that she got a call from her doctor this morning that her Xray came back with a break in the right foot and she was told it needed to have a cast asap and so she called us to take her to the hospital to cast it.Her doctor told her to stay off of it till it is casted. Really?? first you broke it two days ago, second you have been walking on it for those past two days, third the hospital won't cast it they splint it give you a referral to ortho and maybe a script for pain meds if needed ( which she clearly did not ) and fourth this is not an emergency! I of course kept my composure and explained to her that she was not going to get a cast at the ER but instead she needed to call a ortho doctor to have it casted and cared for but she did not budge she wanted to go to the hospital and even insisted we get the stretcher out and take her to the ambulance as she did not want to break it worse. but before she got on the stretcher she decided to walk to her room to get some things like and brush her hair. We took her and I later found out from ER nurse that she had a hairline fracture and was splinted and sent home with the referral and a script for Tramadol (she was not happy about the script since it was not a narcotic. Oh and she wanted a cab voucher as well to get home. imagine that lets see how many resources we can wast in one morning.

Friday, September 10, 2010

How to ruin a emergency officers day

Now if you follow these instructions you will successfully ruin your responding emergency officer day.
1. Drink whatever beer you drink and get drunk oh and don't forget to add in your fav. illegal drug but don't do so much you pass out you want to be awake to follow the instructions.
2. Go to girlfriends/boyfriends house and have your drunken argument and threaten to kill yourself and then leave.
3. Go to so and so bridge and sit on top of bridge with beer in hand and cell phone and call that girl or boyfriend and tell them where you are and that you are going to jump.

~~~ This will result in the girlfriend calling 911 and us getting called to the scene to have a standoff with this guy for 4 hrs why you ask? I have no clue as it is not a busy bridge, it is not a well known area heck I think the whole time we were there the cops had to block maybe 5 cars? needless to say they talked him down and we took him in on a psych hold.~~~

Wednesday, September 8, 2010

Counting my blessings...

I am blessed in this life to have a good job doing what I love and helping others in the process. I have a nice home to go to and a family to share it with but some calls in EMS will remind us that not all are so fortunate. We received a call around lunch time to a apt. in the projects as many of the officers and my fellow co workers call it, to a woman in her 20's unresponsive. Now with this area these unresponsive calls are usually to a drunk or drug overdose but not today. We arrive to a home with three children none over the age of 10 who were in need of a bath and some clean clothes and the oldest who was 10 took us to their mom who was in the bed not responding to any of my calls to her. The child tells me mom is sick and goes to the doctor for medicine and it made her lose her hair so I guessed mom had cancer as the little one did not know the disease but looking at this frail woman with no hair, very skinny, pale and mouth sores just told me the story on it's own. My partner and some of the firemen kept with the children while I helped mom. It seemed by her vitals and presentation that she was dehydrated and sick from more then just the chemo. after many attempts I got an 22g in the inside of her wrist and started fluids. A 22 is not ideal for fluid pushing but it was all I could get so I figured use it till the hospital could do better. The kid comes up to me and asked about her mom she had tears in her eyes, she told me she had been helping with the little ones so mom could feel better but she wanted to know what to make for dinner since mommy could not cook tonight. I wanted to cry I explained we were taking mommy to the hospital to get help and that she needed to get shoes for all the kiddos and pack a bag with some fav. toys. and she did and they all rode to the ER with us. The ER had the social worker waiting when we got there to help with the children and the nurses were great they got all the children cleaned up and in a room where they could watch t.v and play and then one nurse went to mcdonalds and got them all dinner. They were so happy for that. Mom finally came around and I was right about the cancer she had breast cancer and was a single mom with 3 wonderful amazing kids. She had been sick for a week with nausea and vomiting and weakness and other stomach issues. She thanked us for our care for her and her children and the her sister was called to take the kids till mom was released. I didn't have the heart to ask where the dad was but the sis told me he left when she was dx'ed with the cancer and has not been seen yet. How do you leave your wife and children in a place like this when they need you the most? The social worker  was getting her the resources she needed to better care for her and the children.