Firefighter-EMT-Medic Student

Happy it's over

2005-04-24T13:54:00.000-07:00

After a week like last week I'm so happy for the weekend. So far I've slept, set up a big screen TV and surround sound system at the firehouse, slept more, watched a movie, slept more, etc. etc. It's been great!!

I've been spending a lot of time at the firehouse lately. I enrolled in a Pump Operator class on Monday and Wednesday nights and coupled with wanting to be away from school and my apartment means I've been spending about 2 nights a week in my own bed. I haven't run many good calls, some interesting ones, but none that truely require much thought. On friday evening we were dispatched to the part of the county that borders the city, for an accident involving a trash truck and a car. I didn't hear the initial dispatch, but I think it had something to do with the trash truck being on top of the car. We arrived to find that the truck had moved into the car's lane, almost running it over. The driver and child were out of the car, the passenger was still in it, but was not trapped. It was a pretty good tease, it looked like we'd have to do some serious cutting, but instead we put the guy's seat back and pulled him out the driver's side rear door. Later on that day on the ambulance we were dispatched to an accident involving an ambulance in an area that my company's not due to, even on the third alarm for a fire. We easily drove for about 20 mins to get there. We were the 4th ambulance on the call and transported the ambulance crew to the hospital for check ups. Both had back pain, but both signed refusals for the board and collar.

I'm home from the firehouse now, I have a clinical at the ER in about an hour. Wish me luck!

Music for now: "Boulevard of Broken Dreams" - Greenday

If I were a zebra my stripes would fall off...

2005-04-20T04:25:00.000-07:00

...From all the stress associated with this Paramedic program.

So it's 0425 and I'm up studying for an exam later this morning, and it's frustrating me to death. The exam's in my medical emergencies class, which had been excellent because MD's are doing all the lecturing on all the topics. Sounds great right? It would be, except for the fact that the guy who writes the exams FALLS ASLEEP IN THE BACK OF THE CLASS ROOM!!!. Therefore he doesn't know what's taught in their lectures, and gives us the old professor's exams, which frequently don't match the material we've learned in class. He does the same thing with quizzes. There was a question on the last quiz about giving pain medications to people with severe abdominal pain. The classic answer would be not to do it, but according to one of the MD's there's new research supporting it, stating that it doesn't truely interfere with the surgeon's abdominal exam. It's been like this the entire semester, we (my class) just didn't realize that this was why we're all doing so poorly until now, and therefore greatly contributes to our extremely high stress level.

Hey look, I posted!!!

2005-04-12T12:02:00.000-07:00

So I'm still here, not dead (yet). I've just been really really busy, classes are a bit crazy now, and we're coming into a big week with exams and such. The firehouse has been good for a relief, except we haven't been running much. National Registry EMT-I exam is in one month one week and two days and I don't feel ready AT ALL, so I've also been trying to get ready for that. Clinicals are also still in full swing. I'm almost done with my time on the city medic units, and just getting into my ER rotations. On top of it all I enrolled in a pump operator class for the firehouse. All this business is getting to be very overwealming. I was hoping to have a little sanity left over for this summer, but that's not looking like it's going to happen.

Best call lately was on the major highway that our rescue squad is due to. We were called out just after the ambulance went out the door at 0530 for a MVC. On the way Communications advised units responding that they had reports of 9 cars involved with multiple trapped. Command arrived on scene and asked for an extra squad (for reasons unknown to me we ended up with three squads on scene). We were first arriving squad and found that only one was trapped in an overturned GMC Envoy. We went to work stabilizing the car and began extricating the patient. I had the O-cutters and my friend had the spreaders. For some reason the combo tool wasn't hooked up like usual, but that didn't really matter much, the big spreaders were a good thing here. My friend started spreading the door, when the ambulance arrived on scene (their call was canceled). This is were things got STOOPID. The driver from the ambulance turned off the pressure to the spreaders, unhooked them, and hooked up the combo tool. WHAT A DUMBASS!!!!! He left my friend wondering why the spreaders weren't working while he went to work trying to spread the doors off. It wasn't working well at all. Finally I kinda pushed him asside at the direction of my Lt. and cut the Nader pin and cut the hinges, the B post, and the Nader pin of the rear door, which was enough to get the patient free. I don't understand why the ambo driver did what he did, and I was kinda mad too, it made us look pretty goofy on scene, which really irritates me. The patient was pretty well messed up. He had been wearing a seat belt, but it hadn't done much for him due to the roof of the truck being pretty well crushed on top of him. He was lying on his back on the roof with an obvious leg and head injury. He was conscious, but I didn't get the impression that that would last very long. Either he'd lose it pretty fast or the flight medic would RSI him. Aside from the stupidness, it was a pretty good call, and I got some good experience tearing the truck apart to get him out.

Trauma again

2005-03-30T22:11:00.000-08:00

Went to the firehouse Monday night, only ran two calls. The only one of note was for a man who was stopped at a red light and was rear ended buy someone going way too fast. The call came out for an accident with one not breathing, but that wasn't the case. I found him laying beside the car on his side vomiting. At his head was a guy in a suit, he claimed to be a nurse. I'm hesitant to believe him, he didn't know anything about the patient that I couldn't figure out by looking at/asking the patient, yet he claimed he saw the whole thing. He wasn't sure if he ever stopped breathing. The patient's abdomen was pretty hard for a guy with his gut and very tender. The medics arrived and transported him to the trauma center. It was a decent call, pretty straight forward except for the incompetant engine crew. When we got there both cars were still running and in gear and leaking all kinds of fluids.

No music tonight, watching Law and Order.

Good to be back

2005-03-28T13:34:00.000-08:00

It was actually nice to be back in class today. I gave a presentation in Medical Emergencies on gastroenteritis. I'm not so sure it went that well, we'll see. I also handed in the paper on the same topic. I'm glad that's done with. Very glad actually. I hated that project with a passion, not so sure why, but it probably had something to do with the fact that it was just a little BORING!!! (Only a little...) I learned a lot in trauma emergencies. I now better understand what happens with crush injuries and the associated syndromes.

I have lab in 20 mins, then off to the firehouse for a meeting and to run some calls. Hopefully I'll have an interesting story or two afterwards. I looked at the website today, looks as though I missed all kinds of good fires. Oh well, that seems to be what happens every time I go home for a little while.

Music for now: Southside Double-Wide Acoustic Live, the AWESOME live album by Sevendust!!

Sweet spring break

2005-03-26T21:13:00.000-08:00

Had an awesome time!! Saw Meet the Fokkers, it was absolutely hilarious! Also saw Robots, it was great too. Went to Boston for dinner, and caught up with some old and very good friends, and got a nice break from reality for a while. Damn did I need that!

Heard a sad story today from a friend of mine. Just last night he was sittin' around his firehouse and they got a call for a vehicle rescue. His department has a lot of people who respond from home. Their rescue got out staffed, and they pulled the engine as well with the people who came from home. Just as the engine was clearing the rescue call (the rescue engine was held on scene) the call was put out in their first due area for a house on fire. My friend jumped on the engine as it was pulling away from the scene of the crash. On the way they saw a black column rising in the distance. One of the guys on the engine was getting all nervous. The call was in the area where he lived, and when he left his house for the rescue call he left a pot of food on the stove. They arrived on scene to find a house fully involved, with the owner to the house on the engine... My friend said on arrival they had flames 30 feet above the roof of the house, but they went in and put the fire out in an attempt to save what little they could. Ended up that the poor guy lost almost everything. After the call when they were wracking up the president of the company had a meeting with the board of directors. When the engine pulled back into the station they handed the guy a check for $10,000 from the fire company. He's still not out of the woods by any means, but it's an awesome display of brotherhood. I hope nothing like that ever happens to me, I wish the guy all the best.

How's this for messed up...

2005-03-24T12:29:00.000-08:00

So I'm reading over an online source for this paper I'm writing, and I accidently quit my browser. I go to open the browser and look at this page again......and I get the message stating that the server could not be found. WHAT THE ****?!?!?! That's only about the most significant source I've found so far, and I only have half this paper written so far.

Just lovely.

HOME!!!

2005-03-23T21:59:00.000-08:00

It's SOOO nice to be home for a week!!!! Wasn't so sure I'd say that at first, but it's awesome. Even though I have a paper and a presentation due Monday this is turning into a nice break. Already I've seen a bunch of people I needed to catch up with, and I GOT OUT ON THE MOTORCYCLE(!!!!!!) for the first time since Thanksgiving. So happy! Motorcycling is the greatest release of pent up energy in the world. I took the bike up to my grandfather's house to bring a battery tender over to plug in the other bike so it'll start when my dad takes it out of storage.

As happy as I am to be home I still miss the firehouse. I won't be back there until at least a week from now because of crazy school projects like this paper and presentation that I can't seem to get motivated for....

Music for now: "Cumbersome" by Seven Mary Three

First ER shift!

2005-03-19T15:11:00.000-08:00

Wednesday I had my first shift in the ER. It was fun, I started a bunch of IV's, only missed a few, did quite a few 12-leads, and lots of blood draws. Most of the IV's were easy sticks. We're supposed to be assigned to a nurse, but I found it easier and more enjoyable if we just roam and do whatever needs to be done in the way of IV's and EKG's and draws. A few cool patients came in, one lady who's core temperature was 80.1, and a pretty good CHF'er. I was pretty well wiped by the time I got back to my apartment.

I stayed at the firehouse last night, had one decent call. A lady from a pretty upscale neighborhood in our area (upscale is used loosely...) called for chest pain. She reported feeling pressure in her chest radiating to the left side of her jaw, 5 on a scale of 1 to 10. When asked to point to her pain she pressed a fist against her chest. She was pale and a little sweaty. We had to work hard to convince her to go to the hospital. I spoke with the medic from the call later, he said she was suffering from a posterior MI.

I'm a little frustrated, I expected to be home by now, but I'm not because I ran into a few problems so I'm at my aunt's house until early tomorrow, when I make the long drive north. Can't wait for the break-that-won't-be-a-break-because-of-a-project... Argh. I need the summer...

Almost a fight (Big City BS)

2005-03-17T16:01:00.000-08:00

We were standing around the medic unit at one of our main receiving hospitals shootin' the breeze with another crew when a guy in his Ford Taurus station wagon drove up to the ambulance entrance for the trauma center side of the hospital. I didn't think much of it, even though it's an ambulance only area. After all, it's the big city, people do stupid crap all the time. I wasn't paying any attention to the car. I heard a horn beep, but again, it's the city, people honk horns all the time. I turned around slowly to see the taurus' rear bumper about a foot from me, with the driver honking the horn at ME. I figured I was in the way, so I moved. He backed up some more, 'till the passenger side window was next to me and started yelling at me.

"I DON'T APPRECIATE YOUR FUN AND GAMES, MY WIFE IS VERY SICK!"

"I'm sorry sir, I didn't see you."

"BULLSH*T!! EVERYONE ELSE MOVED!"

Everyone just looked around, my preceptor told me he didn't see him either. The guy gunned the engine (still in reverse) and parked in front of the public entrance to the ER. He came running up to me, and began screaming: "I WANT YOUR NAME AND YOUR BADGE NUMBER YOU'RE BEING DISRESPECTFUL........." All the while he was forcefully stabbing me in the chest with his finger. I tried to mention the fact that I was just a student and don't have a badge number, but he just yelled on some more over me, so I told him not to touch me again and that he should be helping his wife out of the car if she was really that sick. He just stormed off in the direction of his car and we didn't hear from him again. It was good for him that nobody else could see that he was actually touching me with his finger, I was told it would have ended badly for him... I suppose he's lucky I keep my cool so well.

Gotta love the idiots in this town!!

Calls

2005-03-13T17:08:00.000-08:00

I had another clinical shift with the big city fire department on Friday night. We were busy, but none of the calls required ALS care, so no skills. Actually, the firehouse was better for calls than the medic unit. Saturday morning started off with a pretty substantial trauma at about 1000. A gentleman was driving on one of the major highways in the area and lost control of his car and put it sideways into a tree. Beer bottles and half empty liquor bottles were strewn about the inside of the car and the scene. The car was almost in an "L" shape from hitting the tree so hard. The squad arrived just before us and began extricating while I began patient care. My partner was useless, he ran to the squad and began trying to take tools off and extricate. I was FURIOUS with him, I could have used his help, aside from the fact that extrication was not his job, because he was on the ambulance. Someone needs to teach that idiot the difference between an ambulance and a rescue squad. One other minor detail that puzzled/angered me but was not my responsibility was that the carreer lieutenant from the squad had obviously never used Hurst tools before, because he was BEATING the roof of the car with the O cutters. I'm not sure what he was trying to accomplish with that extrication technique.... Anyhow, when we arrived the patient was unconscious but breathing with a decent carotid pulse. There were a few abrasions to his face, and LOTS of blood coming from his left ear. Extrication took about 10 minutes, and we boarded and collared him and brought him to the medic unit to wait for the helicopter. A better physical exam done in the unit revealed unequal pupils that weren't reactive, i.e. this guys in crappy shape. The rest of the call was uneventful, the helicopter transported to a local trauma center.

The other call worthy of note was in our first due area for a child having seizures, with no prior history of a seizure disorder. We arrived to find a postictal 7 year old female, afebrile, who promptly began seizing for us. We brought her out to the ambulance just as the paramedics were arriving. They ditched their unit and we transported to to the children's hospital in the area. Turns out what we thought had been a postictal state was in fact just a continuation of the seizure activity. Her jaw never relaxed and she actually began to breathe better after the diazepam administered by the medics. They said (and it makes sense to me) that they were expecting to have to bag her after the med administration.

That was about all the excitement for the weekend. I'm chillin' at my aunt's house tonight with hopes of getting some reading done before class tomorrow.

Skills: 0
Music for now, none, my music is in my apartment and I'm not.

Just stuff I guess

2005-03-10T13:32:00.000-08:00

I rode the officer's seat on the engine some more yesterday. I have the propper training (maybe required would be better than propper?) but it still makes me a little nervous. The carreer staff took the rescue squad and the ambulance to the training academy for an agility test. The chief, another firefighter, and I covered the first due with the engine. I was surprised when he told me I'd be riding up front. We didn't run much, a few medicals and a fire alarm, but it still had my nerves going, even though I liked it. He didn't really give me any prompting either, on the fire alarm he just sat there in the driver's seat and told me to go to it. All this makes me wonder if farther down the line he wants me to be the next Lieutenant. That's an interesting thought, I've always said I never want a white helmet, but it's looking more and more attractive...after I learn A LOT more.

I ran one ambulance call over night, for a lady complaining of "excrutiating pain" from a disc injury in her lower back. Sounds pretty straight forward, but it wasn't. She had a history of hypertension, and her BP was 246/120. She wasn't experiencing any effects of the HTN, but I still wanted the medic unit to transport. Instead they tried for a refusal. We politely convinced the patient that she should go to the hospital. Needless to say, the medics went out and got our stretcher. I was not pleased, but instead of making a scene (the patient's family was doing a great job of that) I just documented the crap out of the call and took her to the hospital. I even called them on the med radio, something that is pretty unheard of for a BLS provider in that particular county. I think the hospital was pretty impressed. The transport was uneventful, luckily.

The weekend should be good. I have a clinical coming up in the city and more time at the firehouse, then I'm visiting family that lives near by.

Music for today: Collective Soul

Projectile vomiting in the nick of time!! (And a poll)

2005-03-07T10:07:00.000-08:00

Wow, It's hard to believe that I would forget to post this call, then again the way things are going lately maybe not...

We got called to one of the many municipal parking garages in the city for one unconscious after the assault. After much searching we found nothing and were put on another call all the way across the city, only to be diverted back to the call after the truck company on scene found the patient on the 3rd floor of the garage. We went up and found a 22 year old male who'd been beaten. He was very much conscious and yelling and screaming in drunken babble about coming back to get the people who'd beaten him. Apparently the victim had been trying to start fights with everyone in the club, and picked the wrong group. He had a few cuts on his head, and an egg on the side of his head from being hit and a foot print from a tennis shoe across his nose, which was obviously broken. His cheif complaint was somthing similar to "Those Chinese guys pulled that Woo Tang s**t on me!" My preceptor promptly sat him up and proceded to clear his C-spine (I'm not so sure we're supposed to do that in the field...). We put him on the stretcher, brought him down to the unit and left for the hospital. When we got there we put him in the room, finished the paperwork and left, just in time for him to projectile vomit all over the hospital room. (Can't imagine how crappy that would have been for him to do that in the back of the unit... Vomiting happens to gross me out more than anything else.) When we were back in the ER later I asked one of the nurses how he was doing. They suspect a small bleed, but thought the vomiting was due to the rather heavy consumption of alcohol.

So, how many readers agree with me and the driver that he should have been boarded??? Leave comments! (Please)

Broken

2005-03-06T12:17:00.000-08:00

I've been all out of sorts lately. School's been more demanding than ever lately, but it seems that I've never been so unable to concentrate in my entire life. I suppose it might have something to do with not liking my professor much. It seems that the only fun I have any more are my clinicals and the firehouse. I don't think I've ever felt more like a fish out of water.

I finally had another clinical on the city medic unit on Friday night. I've never been busier in my entire life!! We ran 16 calls in 13 hours before I left, and just as I was leaving they were hit for another run. We have an evaluation sheet that gets filled out by the preceptor at the end of each shift and one of the questions on it asks about the appropriate use of downtime. I find that amusing because there is no downtime for me. Most of the calls were for drunks, but a few were interesting, like the lady who tried to commit suicide by overdosing on heroin. When we got there she was not alert with snoring respirations. I got to give her 1.2 mg naloxone, and then she was wide awake (that's putting it gently...)!! Admitedly we gave her more than we probably should have, but there was no way we'd have been able to carry her down her tiny, steep, winding stairs. The other interesting call reinforces my belief that nursing homes/specialty care centers aren't worth their weight in crap. We were called to a well known rehab center that's (surprisingly and ironically) associated with one of the best hospitals in the area for a cardiac arrest, CPR in progress. I was all excited thinking I'd get an intubation, but that was not the case because the patient had a trach. Apparently she was a chronic vent patient who had gone into cardiac arrest, so stated the staff. They told us that when they got there the hose from the vent was off her trach and she was in agonal respirations without a pulse. Correct me if I'm wrong, but If you have any respirations you must have some kind of a pulse. They said she didn't, so they started compressions. When we got there she had normal sinus rhythm on the monitor, and she was starting to wake up a little. The whole story seemed fishy to all of us there (the engine company, the EMS supervisor, and us). We loaded her up and took her to the hospital that the crap hole is associated with and they put her on a vent.

The rest of the calls seem to run into one. We were so busy that I didn't get back to the station once between 1630 and 0430. I was supposed to leave at midnight.

Skills:
IV attempts: 2
IV successes: 1 (FINALLY!!!)
Drugs:
Albuterol/Atrovent: 1
Naloxone: 2

Music for today: whatever goes with my crappy mood

Excitment Wanted...

2005-02-28T12:55:00.000-08:00

You need not apply unless your house is on fire or you're seriously sick or injured!

My last clinical was pretty crappy. I didn't have my phone so my preceptor in the city couldn't call me to tell me that he was taken off duty for the rest of the 4 days because he came down with a case of food poisoning, so I didn't know that I would be riding with Psycho Blond Lady. Because Psycho Blond Lady isn't my preceptor, I don't think the shift counts toward my clinical hours, so I figured I'd just ride and do skills, but that didn't happen. All we had were drunks and one kid with the flu. Seeing how PBL treated the drunks didn't exactly make me want to work there like I had in the past... We did end up going to my preceptor's house for dinner tho, that was good food!! (Good food always makes me happy)

We had a bit of a long weekend due to snow. That was the first time in a long time that I can remember being happy to seen snow. We had our morning class, but school closed early in the afternoon so I didn't have to go to math. That made my day. My clinical got canceled for the following day too, so I went to the friehouse with the feeling that I'd be going to a fire (love that feelin') We did get a fire, but the house was so fully involved that the first due engine company set up for exterior operations from the get go. That just made it a pain in the ass, but it was pretty to look at. My company was positioned in the back of the house, which was pretty crappy, because the company on the front of the house kept shooting their hose line straight through the house, out the back windows, and into my face. 200 gallons of water per minute from a 2" in diameter hose line doesn't feel good... Especially not in the face. Needless to say i was happy it wasn't a 2 1/2" line. The rest of the weekend we had nothing until about 2000 hours on Sunday, but I was on the ambulance so I missed the rippin' apartment fire. I was a little pissed, but it won't be the last rippin' fire we run. Needless to say I can't wait for my next clinical so I can actually do something exciting.

Welcome!!!

2005-02-22T19:50:00.000-08:00

Here's a new addition to the emergency medical blog community! A Work In Progress shall be a fun read, she's a 21 year old medic student who will undoubtedly keep us all entertained with her craziness!!

Fun with dead people.....(is that wrong...or just wierd?)

2005-02-22T19:43:00.000-08:00

Yesterday was our cadaver lab. We had two cadavers in the basement of this old building that I believe is the state anatomy board. It was loads of fun! We practiced some of the more fun skills in our arsenal as paramedics such as needle cricothyrotomy, needle decompression, and intubation, and we got to watch the doc perform an open cricothyrotomy (that was by far the coolest!!). Excellent stuff!!

I didn't make it to class yesterday. Instead I elected to sleep in and attempt to not spread my flu to the rest of the class. It didn't do much good, as I'm sicker today than I was yesterday. Early to bed it will be for me tonight, I have a loaded day tomorrow including classes from 0800-1245 (with a quiz in one of them), teach basic cardiology to a human anatomy lab from 1400 'till i'm done, and then a clinical with the city medic unit from 1730 - 0130. I intend to rely on heavy use of NyQuill and DayQuill to make it through the day.

No music so far tonight.

Made off like a bandit!

2005-02-20T19:51:00.000-08:00

After about a month, the dry spell at the firehouse finally ended in fine style, with four working fires this past week. The fun started on monday night with the electrical fire from this post. Next came the first due townhouse fire at about 0400 Friday morning. We arrived with smoke showing, and found fire in the walls in the bathroom on the second floor. The fire started at an electrical outlet in the bathroom and moved up the wall into the attic. 8 hours earlier the call would have been for investigation of a wall outlet. The family sleeping in the house owes their lives to the mother, she heard the fire crackling and woke everyone up and got them out of the house. The most serious of all the fires came about 5 minutes after I walked in the door on Saturday afternoon. We were alerted to respond as the fourth due engine for the house on fire with reported children and adults trapped on the second floor. The first due engine was onscene for a while by themselves as the house was right around the corner from their firehouse. They did a very good job, they arrived, rescued a large blind man, and put the fire out. We arrived second, and with reports of a woman still on the second floor I went up a ground ladder and through a window to start a search of the second floor and meet up with my engine crew who was bringing a line up the stairs. The search was negative, so we vented the second floor and packed up and left. The last fire came at 0130 this morning and was the most fun for me. We had three crews last night, one for the ambulance and one for each engine (the squad is OOS). There was a small fire a few areas away from us, and the first engine transferred to cover a station. While transferred, the ambulance was dispatched for a crash. That left the second engine, with me, my lieutenant, and the driver. Not 5 minutes after the ambulance left on the crash communications rang the direct line asking us if we had an engine crew. Lt. told them that we did, and they said "Get on the engine and go to ......... in your first due for the building fire." We rolled out and were about half way there before they put the call out. We turned the corner to the street and smoke was banked down to street level. We Layed out from the hydrant and nosed up to the townhouse with heavy smoke showing from the third floor. I ran a line upstairs to find black smoke down to the floor and an orange glow coming from the front bedroom that was the mattress and part of the wall burning, mostly held in check by the sprinklers. I finished off the fire and we cleared an hour and a half later after the investigators finished their work. The fire was started by a kid smoking. His father knocked on the door and the kid threw the cigarette under the bed, before it was out. The family was lucky, without the sprinklers the whole third floor would have been blowin'.

That's about all the excitement, for the week. I'm off to bed early so hopefully I won't have to miss class 'cause of this damn flu...

Music: "Fire" by Ohio Player

Meds!!

2005-02-18T09:06:00.000-08:00

The clinical went well, no more IV sticks, but I did get to push drugs and see something cool (well, not cool for the patient...) on the monitor. Most of the calls were respiratory in nature or resulted in respiratory symptoms. The notable ones were asthma, emphasema, a-fib with RVR and bad trouble breathing, CHF, and a working code. The guy with a-fib came from a nursing home, his pulse ranged from 130 - 150. The nursing home staff listed it as 84 on the transfer paper... Just reinforced my belief that nursing homes are never to be trusted, with a few exceptions. My preceptor didn't want to treat the a-fib because his rate wasn't significantly above 150, so we just transported with high flow oxygen to the hospital directly across the street. The working code was a loss, but it was still fun for me. I didn't get to intubate like I'd hoped because my preceptor was going to let me but the guy who went to get the suction was too slow so he did it himself without it. She was asystolic, so I got to give 3 rounds of epi and 3 rounds of atropine though, so it was decent. The call for the code came in at about 2355, and i was supposed to leave at midnight, so I didn't get home until about 145, and was up again at 530 for a conference put on my the ICISF. Rough night for sleep, but still good.

Day off!!! (Well, only half a day off, but still...)

2005-02-16T12:15:00.000-08:00

Went to the firehouse last night because we have the day off from classes today. There's a conference in the city for the ICISF that we're doing community service at, and my day to go is tomorrow, but the canceled class after yesterday. Had one interesting call last night. While returning to quarters after a box alarm in a neighboring area we were added to the assignment for a shooting with a gas leak. Apparently there was a shootout in a townhouse neighborhood and a stray bullet hit the gas meter on the side of the house. There was one priority 1 patient and one priority 2, but I didn't see either of them. We just checked a few of the townhomes for residual gas and cleared. That was it, after that we didn't turn a wheel for the rest of the night.

It's been good to have some time to relax today. I go to the city for another clinical shift at 1530. Maybe it will be a better shift for calls than the last one.

Music: Ladder 49 Soundtrack

Ramblings

2005-02-15T07:41:00.000-08:00

Every now and then I'm reminded of why I love this so much.

Layin' on the couch relaxing and watching standup comedy on HBO, I hear the printer start. I walk briskly into the watch office, the bells ring and I pick up the print-out. The words that catch my eye are "HOUSEF - HOUSE FIRE" At about the same time communications puts out the call on channel 1:

"BEEEEP BEEEEEEP BEEEEEEEEEP 2900 Block of ------ Rd, to the rear of the location, for the house on fire....Engine --- Engine -- Engine --- Engine ---, Truck - Truck -- Rescue Squad -- respond, box ---, 2230 hours"

The ambulance is out of the station meaning only one thing.....I have the line on the second due engine!! I don't get the line very often, and if I do get it it's because I stole it from someone else. We go tearin' down the road and pass the first due engine checking out an apartment complex. They tell us they found nothing, to go check a house behind the strip mall. We turn into the strip mall parking lot and can see smoke coming from behind the mall. Lt. knocks on the window dividing the bucket from the front of the firetruck and I get out and lay a line from the hydrant. The truck pulls away as I jump on the back step. The technician stops at the gate, he doesn't think he can fit through. I get off and pull the 200' crosslay to the front door. As soon as I get in front of the truck I see the orange glow and smoke coming from the back of the house. The feeling at this point is indescribable unless you've been there before. I can hear the rest of the box assignment approaching and the electrical box arcing and sparking on the side of the house. I take the line in the front door, head towards the glow in the bedroom, finding only smoke. Turns out the fire was in the walls. After the line burned itself off the box and stopped arcing we pulled the ceiling and the wall and i hit the fire.

Overall not much of a fire considering the light show coming from side C, I didn't even mask up, but it still reminds me that while EMS is the love of my life, fire is the alluring mistress!

FUMING!!!!!

2005-02-14T16:25:00.000-08:00

It's been a long time since I've been this angry! My phone was stolen from the firehouse. My phone is (was?) my line to my family and friends still up north, and what's even more frustrating is that I can't call my mom and sister on Valentine's Day. I'm pretty sure it was the kid (or hoodrat....) who was in the station doing community service. I had my phone, and then took it off to run a box alarm, and came back and it was gone, and that kid was the only one left in the station. SO ANGRY!!!!!!

Had so many calls this weekend that they all run together, not many good ones, not even the shooting. The guy was shot in the arm, so there were concerns about his brachial artery, but he maintained stable vitals through out the transport to the trauma center. We may even have been safe not calling him a trauma, because the wound was confined to his extremity, but I didn't want to do that. Bleeding was pretty much controlled PTA, so all i really did was help the medic with a few things like spiking the IV bag and attaching the monitor.

Had another clinical in the city, much slower than last time. I missed an IV, then was asked to consult with poison control and the receiving hospital. I got very nervous and asked my preceptor to do that one because I wasn't comfortable with it. He agreed, but was very clear that I'll be doing the next one....except that shift there weren't any more.

Had a quiz in class today, did pretty poorly. I'm used to the last instructor asking questions that were pertinent to what we would be doing in the field. This guy asked the most obscure questions, most of which I had barely a clue about. Overall not a good day (nothing like being single on Valentine's Day, but that's another story...)

Skills:
IV attempts: 1
IV successes: Goose egg!!! (0)

Music: Paul Oakenfold

Riding the Seat, and other things

2005-02-09T13:39:00.000-08:00

While at the firehouse on Saturday evening one of the older members came by with some guys from his other fire station. He (M) has been a member longer than I've been alive and left the station a few years back and has decided to start coming around again. It should be a big help for us, cause he's a qualified driver on all apparatus in the station. When M came by with his guys I was the only volunteer in the station. J, the deputy cheif had been there earlier with the intention of staying the night, but he got sick and left. So that left me, M, his two guys, and the carreer staff, enough to run two crews. It didn't occur to me that among all of us, only one of us was an officer (the carreer captain). I took M's guys over the engines and the squad, and called in the second crew to communications. We were discussing who would be riding where on the volunteer piece when it was brought to my attention that, because I knew more about the area than anyone else on the piece, I would be riding the seat as the officer. I pretty much dismissed it because every time we have two suppression crews we don't run crap. A few ambulance calls came out and the carreer guys took 'em. Right after they got back they put a box alarm out for an apartment building in the neighboring area (for the uninitiated ones reading this a box alarm consists of four engines, two ladder trucks, and a rescue squad and is dispatched for anything involving fire in a building).

"Communications to engine ***, copy: BEEEEEEP BEEEEEEEP BEEEEEEEEEEEEEP 1971 -------- Ave, 1971 -------- Ave, fire reported in the laundry room, engine *** engine ** engine ** engine ***, truck * truck ** rescue squad ** respond at 2000 hours" (*'s are used in place of actual unit designations)

I hardly expected THAT! Let me tell you, that was not the first time I'd ridden the seat before, but it was the first box alarm. I've never been more nervous in my life. All at once I was trying to look up the address in the map book, reviewing what the 3rd due engine is supposed to do on the fire ground, and OH MY GOD THIS MIGHT ACTUALLY BE A FIRE!!!! Lucky for me it wasn't. I'd much rather be in the bucket running forcible entry or the line than in the seat.

On another note, we got a fourth carreer person assigned to our station around the clock last Sunday. That means we volunteers don't have to ride the ambulance anymore. Why am I excited about that you ask? Because I like the ambulance but occasionally it becomes down right oppressive with over 3000 calls a year for the ambulance alone. Now I might actually be able to get some rest every now and then when I'm there.

That's all for now.

Music for the day: B.B. King

Firehouse, clinicals, etc.

2005-02-08T14:27:00.000-08:00

This weekend was a good weekend for trauma at the firehouse! We ran three working vehicle extrications in 24 hours, two of those not more than 2 hours apart. The most challenging and most serious came at about 0400 Sunday morning. A (presumably stolen) car was traveling at a high rate of speed on a very low speed road when it struck an older smaller car on the driver's side front corner. The stolen car then caught fire after the perps bailed. All doors in the smaller car were stuck shut, and the driver was severely pinned. The pedals were almost under the driver's seat and the base of the windshield was at his chest. I arrived first on the ambulance and called for an engine for one on fire and a medic unit, and advised the squad that two were trapped. Because the squad was understaffed my partner and I worked to free the people and then treated them once we had them out. I know it's not supposed to be that way, but that's how it had to happen. The driver suffered from a fractured right humerus, bilateral femur fractures (his feet were not facing forward, in fact one was facing backwards) and a fractured left ankle. The passenger was not injured, only trapped by the doors.

Last night was my first clinical on the city medic unit. It was a great time, and we were pretty busy. The most notable call of the night came at about 2300 at a well known nursing home in the city for one with seizures. We arrived to find a male on the floor actively seizing. His nurse said she'd been in the room for 11 minutes, and in that time he had nine seizures. We were unable to get a line in him, but we consulted with the receiving hospital and accessed the Pt's PICC to give him Valium. I was kind of hoping to get a tube out of it, but he was holding his own airway quite well. Overall it was a very good night. I felt I got along well with my preceptor and I'll be very happy to go back this coming Sunday.

Skills:
IV Attempts: 3
IV Successes: 2
EKG interpretations: 2

First day of spring semester....

2005-01-31T21:00:00.000-08:00

Today was the first day of spring semester, and what a day it was. We found out in an 8AM meeting that our cheif instructor won't be coming back until the fall, for reasons not explained to us. That was quite a shock, to say the least.

Classes weren't to bad, had lots of reading to do to start the semester off, as in 110 pages or so, that theoretically was supposed to be done before class today, but we didn't have the assignment sheet.

Off to bed early, still tired from being at the firehouse for a few weeks straight.

Music: Collective Soul

Every good call comes with a bad one...

2005-01-29T14:30:00.000-08:00

Drugs seem to have been the theme for the past few days. It started off with an attempted-suidice-turned-working-code that appeared to be an overdose, but I'm still not sure. The Pt. was on methadone, but he didn't have it in his house, he had to go to a clinic to get it. There was a half empty bottle of ibuprophen and another half empty bottle of some black pill. Police were on scene trying to talk to him when they noticed he wasn't breathing. He was a full cardiac arrest by the time we arrived. We left the scene to meet up with the medics (a whole fiasco in itself...) and before we met them we shocked twice with the AED. Shortly after our arrival at the hospital a pulse returned, with a BP of 98/46. I was left wondering if it would be a true save, or if he would code again later and die.

The next day we got a call for the squad (ambulance was out on another run) to check on the wellfare with the county police. The text of the call stated that two males were trying to break into a car with a white female inside who appeared unconscious. We arrived to find what we expected to be a working code, but after we broke into the car (through the driver's window) we found the Pt. to be in respiratory arrest, but with a strong carotid pulse. I began bagging her while the rest of the crew collected information from the two males who had been trying to break into the car. They eventually copped to the fact that she had indeed been doing IV drugs (which I already knew by the fresh needle mark in her left AC). The medic unit arrived, we packaged her and they left for the closest hospital. Turns out she woke up in the back of the medic unit when they tried to intubate before they'd given her anything (like Narcan). I was happy to hear that the call had a positive outcome.

The last call worth reading about came after we cleared the hospital from bringing in a Pt. in heroin withdrawal (more drugs...). We were sent from the hospital to a strip mall across the street from another firehouse for a pedestrian struck by a trash truck. We arrived shortly after the crews from the other station to find a homeless man who'd been sleeping in the alley behind a strip mall when the trash truck had come through to empty the dumpster. The driver never saw the man sleeping and ran him over. When we arrived CPR was in progress. We boarded him and loaded him into the unit. When I started compressions it just felt like jelly, and he had contusions that looked erily similar to tire tread across his left shoulder. The medics arrived just as we were ready to pull out. He was pronounced less than tem minutes after we arrived at the trauma center. We returned to service 2 hours later after decontaminating the back of the unit.

I've long since lost track of how many calls I've run, and it's time to sleep.

Crap

2005-01-25T21:00:00.000-08:00

I saw one of the medics with whom I worked on the shooting victim Thursday night. He confirmed my suspicions that the patient had died, and told me that during a CT scan they found a bullet in his brain. The small wound that we found at the base of his head/top of the back of his neck was a penetrating GSW, not the graze that it looked like. I wish we didn't miss it.

Again, I'm the only volunteer at the firehouse tonight, so that means I get to run every ambulance call tonight. Sometimes thats a good thing and sometimes it's a bad thing. So far it's not bad, but we'll see how many calls come in after midnight

Enough trauma to go around

2005-01-21T10:32:00.000-08:00

Last night was the first real eventful night at the firehouse since I've been back. We were running an engine crew, a squad crew, and a dedicated ambulance crew 'till 0630 this morning. The excitement for the night came at 0100. The ambulance was alerted to respond down the street from the station for an injured police officer. Before the ambulance had time to get out communications added a supplement to the call stating that there was an accident at that location with a police officer injured. A further supplement was added stating that there was a car accident with possibly people shot. The engine (with me on it) arrived first to find a million and one police cars around the one car involved in the accident. There were three patients; one police officer and two from the car. The police officer had tried to stop the car and pull the driver out when the passenger shifted into reverse and the driver stepped on the gas, dragging the officer about 40 feet. Another police officer fired into the car, hitting the driver in the chest and the arm and hitting the passenger in the abdomen.

My patient the driver. He was an 18 year old male with one GSW to the upper left chest and another to the left elbow. He was in obvious pain and having substantial respiratory distress. We (a medic and I) controlled bleeding and boarded and collared the patient and moved him to the ambulance, where we transported him to the local trauma center by ground. Enroute breath sounds revealed rales and decreased sounds left and clear right, SaO2 65%. Only treatment enroute was two IV's (each AC) and O2. At the hospital they took a CXR which revealed a hemothorax and the bullet lodged about an inch to the left of his heart. The ER doc inserted a chest tube and drained LOTS of blood. I'd never seen a chest tube done before so I was pretty excited. At that point I left to clean as much blood as possible from my running pants, as I kneeled in a puddle of it on scene. Overall a good trauma, and I met a medic who graduated from the same degree program I'm in.

The officer ended up with only bumps and bruises, lucky guy, the driver died.

I'm BAAAAAA-AAAAAACK!!!!

2005-01-16T21:09:00.000-08:00

I suppose it wouldn't surprise anyone who reads this to know that not counting the grocery store, the first place I went after picking up my car was the firehouse. I couldn't resist, even though I had to be at work the next morning at 0700. No special calls that night.

So far the weekend (at the firehouse...) has been pretty good. The deputy chief was here friday night, it was good to catch up with him. He showed me how to enter the MAIS (Maryland Ambulance Information System) reports into the computer, that kept me busy. I also brought a bunch of movies, which was good because after midnight on Friday the station didn't turn a wheel. Saturday was much different. The day was steady, and then I never got to bed until 0530. While out on an ambulance taxi ride the rescue squad was dispatched to a car into a house. The squad cleared, we cleared our call, and made it into the station just in time to be sent non=emergency back to the scene of the crash to stand by while the tow company removed the car fromt he front porch. We were there 'till 0500. What a pain in the ass, we never figured out why they needed us there, the house was still stable and deemed safe by the building inspector.

I slept all day today, until this afternoon when we were sent out to a not-so-nice part of our first due for a shooting. The address was bad and no patient was found. Just after returning to quarters (not even enough time to finish the report) the squad was dispatched to the far end of a neighboring company's area for the accident with one into the trees. Enroute we could hear the chief on scene asking for our location a few times, and then requesting a helicopter for a priority one trauma. We arrived to find a car that was demolished, with the patient laying across both of the seats unconscious with very shallow breathing. I proceded to stabilize the car until we realized that we didn't need to cut to remove the patient. He was removed on a back board and loaded into the medic unit where he stopped breathing. CPR was started and he was transported by ground (the helicopters won't transport with CPR in progress) to the local trauma center. The point of the story is that I've never seen a car so demolished. It looked like the driver lost control and spun and then struck the trees while on its side. I've never seen so much passenger compartment impingement. The only other car I've seen that even comes close was completely torn in half. I'll post pictures if I can get them and figure out how to make it work. The patient was 20, his birthday in October. That's younger than me. And he wasn't wearing a seat belt.

The good medical for the day was an ambulance call to one of the nicer housing areas in our first due for chest pain. We arrived to find a 63 year old female patient sitting in a chair obviously very nervous. I think if I had made an initial impression based only on what I saw the instant I walked through the door I would have said she was having "the big one." My interview (I was the driver, but I ran the call because I don't trust my partner tonight) revealed that she didn't have any chest pain, only a little discomfort, onset almost immediately after taking her Digoxin. With a pulse initially of 64 and later only 50 I think she was experiencing digitalis toxicity, but I'm not sure. I don't know much about dig tox, so I need to look it up, but I suspected it due to the low pulse and a comment made to me a few months ago by one of the more respectable medics in the county. The paramedic unit transported to the local hospital.

The rest of the day was uneventful, except for a crappy phone message.

Be safe everyone, and WEAR YOUR SEATBELTS!!

No music today, watching The Shawshank Redemption and waitin for more calls.

Getting my car back today!!

2005-01-13T13:08:00.000-08:00

I'll be going to pick it up today after R. gets out of work and can give me a ride to the place. It took suprisingly little time to fix, as all it was was the clutch master cylinder. The mechanic says it drives quite nicely now. I'll be happy to get in it and boot to the station, and therefore have the potential to run some calls that actually make me think. Probably not the smartest idea with work tomorrow at 0700, but I'll deal with that.

The night shift last night was ok. Not too many calls cause a few of 'em took a long time, and I even got to sleep a little. The fog last night was crazy, on the way into baltimore you couldn't see much past the sides of the road, and you couldn't see the tops of most of the buildings from the road. It was crazy, and it lasted all night.

Music: Starless by Crossfade

Fire station

2005-01-12T16:32:00.000-08:00

Oh how I miss it! I miss the bells, the ambulance, the engine, the squad, the working codes, the shootings, the fires, the extrications, the basement, the cold bunkroom, being up all night and sleeping all day and not giving a damn about anything else. They'd better fix my car quickly, I want to get back!!!! I may be moving in there when my car's fixed, I don't feel like being cooped up in my apartment all the time.

Got called to work 1700 - 0500 tonight. I hate that shift, but they said they'd pick me up because i have no car, and I have nothing better to do and need money sorely. It's BLS, so it'll be all taxi rides. What fun.

No music so far today.

Decent

2005-01-11T22:32:00.000-08:00

It was a decent shift, actually got one emergency taxi ride, took the PICU team from Sinai Hosp. to GBMC to pick up a young girl having an allergic reaction to a medication, with a BP of 60 (still low for someone her age). Then we took the PICU team and the patient back to Sinai. The other six calls were taxi rides. Got held over for an hour, then had to wait another hour for my ride cause my car's still not fixed. It's going in tomorrow via AAA.

Good night all, time for an early night.

Free hit counter stopped?!?!

2005-01-11T07:28:00.000-08:00

Did anyone else's?

Work

2005-01-11T07:25:00.000-08:00

Workin' the day shift today at the "taxi service" (a.k.a. private ambulance) driving a medic around 'till 8. We'll see how it goes. I want a new job but the people at the new place won't return my phone calls asking if they got my application. Idiots.

Feelin' pretty crappy about recent events, actually really crappy. Maybe work will be a nice diversion, make me not think about it for a while.

Night shift...

2005-01-09T16:37:00.000-08:00

Was completely uneventful. Did two taxi rides, on hospital transfer and one ER return. Niether was worth writing home to Mom about.

The flight back here went well, but I came back to some pretty substantial unplesantness. BUT I have my movies to keep me company tonight so I'll be ok. Next order of business is to get my car fixed so I can get to the station on my own time, and to work, cause money is good and I'm a college student who doesn't have a lot of it.

Anyway, have fun everyone, and be safe!

No music tonight
Movie: Man on Fire or something

Night shift tonight....

2005-01-08T19:13:00.000-08:00

Has potential to get intersting if it doesn't stop snowing. I hope I'm not held over, cause I have to be at the airport by 10 for my flight at 11 to BWI (CAN'T WAIT TO GET BACK!!!!)

Gotta keep packing, have to get it done before my sister's birthday dinner, and hopefully I'll talk to R. before the shift.

Fire house drama

2005-01-07T21:50:00.000-08:00

Any kind of drama is (IMHO) a pain in the ass. Fire house drama is the worst kind. I'm surprised we get anything done in this profession. First off my friend told me tonight that he's resigning from the fire house. It's the right decision, but he'll still be missed there. Second, WHY CAN'T WE ALL JUST GET ALONG?!?!?! A volunteer member of my station has been in the hospital since before Christmas from injuries sustained in a house fire. I'm not sure this really happened or not, but if it did it's terrible and if it didn't happen it still reminds me of the stupid issues in this fire department. Supposedly the VP of the union was asked by a nurse at the burn unit how the firefighter was doing. His response was something to the effect of "Who cares, he's just a volunteer." Does this strike anyone else as terrible?!?! I get frustrated at these career/volunteer issues. We are all providing the same service, only difference is that some of us get paid for it and some don't. Some of the county firefighters think that each volunteer represents a missed opportunity to hire a paid firefighter, and that the volunteers will put the carreer department out of business. Maybe that's true in some places, but in this county it couldn't be farther from the truth. It's pretty obvious that the department couldn't function without the volunteers OR the carreer people. On the station level, again we all do the same job, so why can't we get along? So many times I get to hear the career firefighters' beef with one volunteer member or another. First of all, I'm a volunteer, so why are they telling me?? It makes me feel like they just want to start dissention in the ranks. I know some of them would like nothing better than to see all of us leave. THAT'S not going to happen any time soon. I dunno, it's all stupid BS.

On a different note, I took a shift at my part time job here in MA, midnight to 8 on Sunday morning. Hopefully I'll actually get to do something, but it isn't likely, kind of a slow service.

Current music: December, by Collective Soul

This makes me mad....

2005-01-06T20:44:00.000-08:00

Tsunami Scam

I love helping people. So much so that I get angry sometimes at others' blatant disregard for human life and suffering. I think that says enough. If I can think of anything more I'll edit the post or post again. >:-o

Grades and other things...

2005-01-06T18:55:00.000-08:00

My grades for the semester are finally posted!!
Cardiology: A
Pharmacology: A
Respiratory and Critically Ill Pt's: B
Assessment: B

Those are the ones I care most about, there's another B and a C. Next semester will be challenging, with medical emergencies, trauma emergencies, special populations, and field operations, and math (cause I failled it the first time...). All that on top of clinical hours with the city and a job.

Other things.....I hurt myself running last night twice in the same run. :-\ I rolled my ankle first trying to dodge a car that didn't notice the big orange vest with reflective yellow stripes, and then a muscle in my back began to hurt quite badly, apparently for no reason, although I'm sure something caused it.

Got a new phone today, I finally have one that rings!!! AND it takes pictures!!! This will keep me occupied/distracted for weeks!!! (What can I say....simple toys for simple minds??)

Music for the time being: Crossfade

Back

2005-01-05T17:40:00.000-08:00

Just got back from a 2 night 2 day trip to Montreal with some friends from high school. Was an awesome trip, coulda been a little better if the twins would stop arguing.... That made the trip back miserable and next to unbearable. Not to mention, the Wendy's for lunch is making my stomach turn.

I ran on Sunday and Monday, felt crappy on Sun. and awesome on Mon. I finally made 4.5 miles at the pace I need to run to qualify for the 2006 Boston Marathon. It felt good to be fast, but it is humbling knowing that I had to work pretty hard to do 4.5 miles at that pace, when I'm going to have to do 26.2 at the same pace, which when you think about it isn't that fast as far as a mile goes. I'm hoping to run tonight, but it won't happen if my stomach doesn't calm itself.

Can't wait to get back to MD, I miss just about everything there, especially R. and my apartment and the fire station, and I'm getting sick of just about everything here.

Hello

2005-01-02T21:05:00.000-08:00

I started this blog because in this business there's lots of things that need to be talked about, for a number of reasons. I suppose I'll get started by telling about myself and how I got started.

I'm 20 years old and I've been in EMS almost 4 years now, but only been able to use my training for 3 of them, so we'll call it 3 years. My interest started when my mother was trying to decide if she could take care of two kids (my younger sister and I) and go to night school to get a nursing degree. She decided to try it out by taking an EMT course at a local community college. She used to get mad at me because as soon as she came home from class I'd run off to my room with her book and have my nose in it for hours looking at all the pictures. Mom got her MA state certification and has since never done anything with it. I still have the book. My high school offered a first responder course, so I took it to see if I'd really be interested. I loved it, and next year enrolled in their EMT class. Soon as I turned 18 I took the MA state exam, passing with an 85. At about the same time I enrolled at a college with a 4-year degree program in Emergency Health Services. I will get a bachelor of science degree and graduate with my NREMT-P. I've since found a fire station to volunteer at in MD (where I'm living for the time being) where I run a lot of calls (almost always busy) on the ambulance and became interested in firefighting. Through them I recieved the proper training and have been a firefighter for about a year.

I want to be a paramedic mostly because I enjoy helping people and I would die of boredom at a 9-5 desk job.

I intend to use this blog to talk about experiences with medic school and the fire station, and maybe life in general too, if I decide it's worth talking about I'll put it in here somewhere.

It might be a little while before I'm back in an ambulance. I'm going to Montreal tomorrow :-D for a trip with some of my old friends from high school, and then have to get my car fixed. For now it's sleep, gotta be up early tomorrow!!