Just got home from a really good clinical. I went to the same station that I wrote about in my previous post since I had such a good experience the first time. I had amazing medics that were funny, had excellent patient care, and made a point to include me.
We started out the day with a call for a 90 year old man experiencing stroke symptoms outside of a restaurant. We arrived to find him feeling some generalized weakness, although he showed no facial droop and his speech was fine. We did a load and go, pretty routine transport. On our way back, we were driving along, and all of a sudden the medic noticed the car in front of us swerving in and out of the road, barely missing a telephone pole. Something wasn't right. He pulled over and flagged us down. I was in the back so I had no idea what we were doing parked on the side of the road until I hopped out. I put on my ugly neon orange safety vest that was about 5 sizes too big, and grabbed the equipment. The man was clammy, had a decreased level of consciousness, said he felt weird, and that we was also a diabetic. Ah ha! His sugar was probably too low, so I hurried to get a blood sugar reading and it was in the 40's. Way too low. The medic started an IV, and pumped some dextrose. Within seconds the man was alert and oriented, and his sugar shot up to 120. I was amazed at how instantly the dextrose worked. A neighbor came to drive the guy home since he refused transport and we were on our way! I thought it was cool, what are the odds that we were right behind him when he started getting hypoglycemic?
The afternoon at the station was slow, we got called out a few times but they resulted in cancellations. I mostly read my book, studied, and we watched a movie. For some reason, despite waking up at 5 in the morning, I just wasn't tired. Finally around 11:30, I crawled in bed, and had just started drifting to sleep when the tones rang out. On our way to the call, I learned it was for an 82 year old woman with abdominal pain. We arrived and walked up two flights of stairs, I was just hoping we wouldn't have to carry the lady down. She was super nice and wasn't in any pain at all when we got there. She had experienced sharp pain in her left rib that woke her up but then it went away. She didn't want to be transported but we talked her into going. It was a routine transport, she was very nice and willing to answer all of our questions. By the time we got back and finished paperwork, it was 1:30. I crawled into bed and starting dreaming when...
I somehow slept though the ridiculously loud tones but woke up to the shuffle of people around me. I was so confused since I didn't know if I was suppose to be up but i grabbed my shoes and blindly found my way to the hallway. One of the medics took one look at me with my hair looking crazy, one shoe on, and what must have been a very disoriented look and started cracking up. I tucked my shirt in and attempted to look presentable on our way to what was labeled as a "right knee injury". Whatta injury it was! We pulled up to a bar, where two drunk guys were sitting on the curb talking to the police, one was holding his leg in agony and freaked when anyone tried to look at it. When I finally did see it, I saw the strangest deformity and what I think was the bottom corner of his femur poking out. Ouch. Not that I was expecting anything different, but the guy was a total jerk. First he didn't want to be transported, saying his drunk friend was going to take him. The police shut that down real quick. So he still didn't want to be transported because he was fine and it "wasn't that bad." We couldn't leave the guy there with a bone poking out like that. The next 15 minutes were spent talking him into going with us. When he finally agreed, and he was loaded in the ambulance, he made us wait until his buddy could find his phone and keys. Well that took forever, and then FINALLY we were ready to go. I tried taking his blood pressure but he ripped it off as soon as I put the cuff on. The medic started asking for his information and the guy refused to talk. Wouldn't give us a name or anything, yelled when I fixed him up with an ice pack, and was just an all around unpleasant person. I was getting frustrated that he was wasting my precious sleeping time. When we got back to the station and finished paperwork it was 3:30 in the morning. I was so tired and fell asleep before I hit the pillow.
5:30 am. The tones rang out and I dragged my butt to the ambulance, riding in silence. I was so exhausted. We were called to a 64 year old woman that had fallen in her bathroom. We walked in to her apartment and the most disgusting smell hit me in the face. Well that woke me up. The medic smiled at me and told me this patient was all me. She was about 250 lbs, had a shirt on but was naked from the waist down. It was a lovely view. She had fallen on her knee so we got her into the stretcher, it took 5 of us. I should mention that she was hard of hearing and so it sounded like a screaming match between me and her in order to get any information across. In the back of the ambulance, she proceeded to yell that she had nerve damage, high blood pressure, diabetes, gas in the back of her head (?), acid reflux, she was going to throw up, blah blah. She had every problem in the book. All of her vitals checked out and she seemed fine other than the pain in her knee. The rest of the way she yakked/yelled about her cousin, her problems, her address, her neighbors, everything she could think of. I was happy to smile and wave goodbye as we were leaving the hospital. When we got back to the staion, I was free to leave and go home. I took a much needed shower and crashed for about 7 hours.
Overall, the clinical was great. I loved my preceptors, they taught me how to radio a report to the hospital, and let me pretty much run the calls. I really felt like I was part of the team, and will be returning on the 19th to finish up my last clinical!
Saturday, March 5, 2011
Monday, February 21, 2011
Sittin' on puke duty.
I experienced my first "real" call as an EMT student last weekend when I was on my second 24-hour clinical. I tried out a different station for this clinical, one a little further from home, and had an awesome experience with the staff. They were welcoming and professional. They seemed to take pride in their jobs, and had a real interest in teaching me. I felt more like I was apart of the team, compared to someone they had to drag along for the day. A much better group than I had gotten stuck with the previous weekend.
I arrived, claimed my bunk, met the staff, and made myself familiar with the location of everything in the ambulance. They went over some of the basics with me to make sure I knew how to do everything that would be expected of me. I took everyone's blood pressure for practice, took a blood glucose, spiked a bag, etc. Then we waited for a call. And waited. And waited. Then finally, at about 2 in the afternoon, we had our first call of the day! We arrived to a laundry mat for a 35 year old woman who had suffered from a seizure while doing laundry and fell while seizing. We pulled up to find that the volunteer fire department had already started an assessment of the woman, and was doing an absolutely terrible job of it. The oxygen tank was open but somehow unattached to anything, just leaking air. I quickly hooked her up to a nasal cannula, and tried to make my way through the eight inexperienced fire fighters. I stood there and came to the conclusion that there were enough people trying to "help", and I was more in the way than anything else. So I stood next to my preceptor and waited while they back boarded the patient and loaded her onto the stretcher. It took them a few attempts, but eventually the patient was in the back of the truck and ready to go. I hopped in behind the medic and when it was just me and him, he rolled his eyes, and told me that if I learned anything, I should have learned to do everything opposite of what just happened. I laughed, began hooking our patient up to the monitor and obtained some vitals. I guess I should mention that during this entire time, our patient was completely out of it. She was in what they call a "postictal state", which is what people experience after a seizure. She was in and out of consciousness, and wasn't talking to us at all. Well, sometime during our ride to the hospital she began snapping out of it, and decided to be violent. She began ripping out the Styrofoam blocks that were supporting her head, and in her confused state, didn't understand that the sticky side was getting caught in hair. The paramedic asked me to hold her hands while he removed the blocks without chunks of hair coming with it. I'm about 110 lbs and not exactly going to be winning any strength contests anytime soon. Or any mean contests for that matter (I'm the kind of person that feels sad for a squirrel's family if I accidentally hit one with my car). So you can imagine how uncomfortable it was for me to wrestle this crazy stranger's hands away from her head. The medic finally, very sternly, ordered me to "sit on her hands" if I had to. I held them so tight, I thought I would break her wrists. After what seemed like an hour of crushing this poor lady's hands, the blocks were off, and we were nearing the hospital. We hoisted her from the stretcher to the bed, and that was that.
We had another call that afternoon for an older woman suffering from shortness of breath. She had been having anxiety and difficulty breathing. I guess after dealing with it for the last few weeks, she decided that today was the day to call 911. Her perfectly able husband could have driven her to the hospital that was no more than 5 miles away, but I guess she preferred an $800 ambulance ride instead... I will never understand some people. She was super sweet and told us about her cute grand kids on the ride over. There's nothing much else to say about that call except that no matter how much your EMT instructors assure you that oxygen is the easiest thing to hook up, and there's no way to really screw it up, there IS a wrong way to do it. I guess they just didn't think someone would be dumb enough to hook the mask up to the handle instead of the air valve. I was sitting there like an idiot wondering why I could hear air but the bag wasn't filling up. Duh.
We had a quiet night and I fell asleep around 9:30. It's really hard to fall asleep at a fire station, because I'm always expecting the alarms to go off. I never want to fall into a deep sleep and be out of it if we get a call. But, somehow, I was dead asleep around 4:30 when the tones rang out and jolted me out of bed. I heard a groan from the other side of the room, and scrambled around to find my glasses and my belt. Of course, I put my shoes on the wrong feet, and had to correct them on the way. Half way there, dispatch told us that it was a class red call, which means that it was serious. An actual life or death call. I was wide awake now. We met an officer at the door, he had gotten to the house first and told us that there was an unconscious 74 year old man lying on the couch, he was completely unresponsive. His family surrounded him, and they spoke very limited English. I am embarrassingly bad at understanding anyone with an accent. I feel terrible about having to ask people to repeat themselves a million times, so I went right to assessing airway, breathing, and circulation, letting the medic ask the questions. We packaged him up quickly and high-tailed it to the hospital. The officer rode with us for some extra help, and I quickly started hooking the guy up to the monitor and the AED pads, in case it was a cardiac situation. Then he started vomiting. There was so much of it all of a sudden, it kind of startled me. Guess whose job it was to suction? I was the lucky winner! I grabbed the suction machine and had the suction part down his throat, when surprise, no suction. The paramedics response was something like "oh crap, the battery must have not been charged, just stick your fingers down there and shovel it out". Afterwards I was so grossed out by what had just happened. But at the time everything was happening so fast, I just did it without thinking about how nasty it was. Weird how adrenaline can give you those kinds of powers. I spent the rest of the ride on puke duty. As soon as we got him to the hospital, the nurses and doctors took over. He stopped breathing and they incubated him. I got to watch. It was so cool! We got back to the station and the medic asked me if I was bored on the call. I was confused so I asked him what he was talking about. He said while I was cleaning the man's throat out, I looked super bored. I told him I was going crazy inside, and he complimented me on my ability to keep a calm face in the midst of chaos. I gave myself a mental pat on the back. I was so hyped up, there was no way I could go back to sleep, so I stayed up until it was time to leave and paid for it later when I couldn't keep myself awake during chemistry class.
Overall, it was a great clinical, and I think I'll return to the same station for my other ones. I have one more 24 and then one 12 hour station clinical, and an 8 hour hospital clinical to complete before I'm finished with my emt class. Wish me luck and lots of trauma! :)
I arrived, claimed my bunk, met the staff, and made myself familiar with the location of everything in the ambulance. They went over some of the basics with me to make sure I knew how to do everything that would be expected of me. I took everyone's blood pressure for practice, took a blood glucose, spiked a bag, etc. Then we waited for a call. And waited. And waited. Then finally, at about 2 in the afternoon, we had our first call of the day! We arrived to a laundry mat for a 35 year old woman who had suffered from a seizure while doing laundry and fell while seizing. We pulled up to find that the volunteer fire department had already started an assessment of the woman, and was doing an absolutely terrible job of it. The oxygen tank was open but somehow unattached to anything, just leaking air. I quickly hooked her up to a nasal cannula, and tried to make my way through the eight inexperienced fire fighters. I stood there and came to the conclusion that there were enough people trying to "help", and I was more in the way than anything else. So I stood next to my preceptor and waited while they back boarded the patient and loaded her onto the stretcher. It took them a few attempts, but eventually the patient was in the back of the truck and ready to go. I hopped in behind the medic and when it was just me and him, he rolled his eyes, and told me that if I learned anything, I should have learned to do everything opposite of what just happened. I laughed, began hooking our patient up to the monitor and obtained some vitals. I guess I should mention that during this entire time, our patient was completely out of it. She was in what they call a "postictal state", which is what people experience after a seizure. She was in and out of consciousness, and wasn't talking to us at all. Well, sometime during our ride to the hospital she began snapping out of it, and decided to be violent. She began ripping out the Styrofoam blocks that were supporting her head, and in her confused state, didn't understand that the sticky side was getting caught in hair. The paramedic asked me to hold her hands while he removed the blocks without chunks of hair coming with it. I'm about 110 lbs and not exactly going to be winning any strength contests anytime soon. Or any mean contests for that matter (I'm the kind of person that feels sad for a squirrel's family if I accidentally hit one with my car). So you can imagine how uncomfortable it was for me to wrestle this crazy stranger's hands away from her head. The medic finally, very sternly, ordered me to "sit on her hands" if I had to. I held them so tight, I thought I would break her wrists. After what seemed like an hour of crushing this poor lady's hands, the blocks were off, and we were nearing the hospital. We hoisted her from the stretcher to the bed, and that was that.
We had another call that afternoon for an older woman suffering from shortness of breath. She had been having anxiety and difficulty breathing. I guess after dealing with it for the last few weeks, she decided that today was the day to call 911. Her perfectly able husband could have driven her to the hospital that was no more than 5 miles away, but I guess she preferred an $800 ambulance ride instead... I will never understand some people. She was super sweet and told us about her cute grand kids on the ride over. There's nothing much else to say about that call except that no matter how much your EMT instructors assure you that oxygen is the easiest thing to hook up, and there's no way to really screw it up, there IS a wrong way to do it. I guess they just didn't think someone would be dumb enough to hook the mask up to the handle instead of the air valve. I was sitting there like an idiot wondering why I could hear air but the bag wasn't filling up. Duh.
We had a quiet night and I fell asleep around 9:30. It's really hard to fall asleep at a fire station, because I'm always expecting the alarms to go off. I never want to fall into a deep sleep and be out of it if we get a call. But, somehow, I was dead asleep around 4:30 when the tones rang out and jolted me out of bed. I heard a groan from the other side of the room, and scrambled around to find my glasses and my belt. Of course, I put my shoes on the wrong feet, and had to correct them on the way. Half way there, dispatch told us that it was a class red call, which means that it was serious. An actual life or death call. I was wide awake now. We met an officer at the door, he had gotten to the house first and told us that there was an unconscious 74 year old man lying on the couch, he was completely unresponsive. His family surrounded him, and they spoke very limited English. I am embarrassingly bad at understanding anyone with an accent. I feel terrible about having to ask people to repeat themselves a million times, so I went right to assessing airway, breathing, and circulation, letting the medic ask the questions. We packaged him up quickly and high-tailed it to the hospital. The officer rode with us for some extra help, and I quickly started hooking the guy up to the monitor and the AED pads, in case it was a cardiac situation. Then he started vomiting. There was so much of it all of a sudden, it kind of startled me. Guess whose job it was to suction? I was the lucky winner! I grabbed the suction machine and had the suction part down his throat, when surprise, no suction. The paramedics response was something like "oh crap, the battery must have not been charged, just stick your fingers down there and shovel it out". Afterwards I was so grossed out by what had just happened. But at the time everything was happening so fast, I just did it without thinking about how nasty it was. Weird how adrenaline can give you those kinds of powers. I spent the rest of the ride on puke duty. As soon as we got him to the hospital, the nurses and doctors took over. He stopped breathing and they incubated him. I got to watch. It was so cool! We got back to the station and the medic asked me if I was bored on the call. I was confused so I asked him what he was talking about. He said while I was cleaning the man's throat out, I looked super bored. I told him I was going crazy inside, and he complimented me on my ability to keep a calm face in the midst of chaos. I gave myself a mental pat on the back. I was so hyped up, there was no way I could go back to sleep, so I stayed up until it was time to leave and paid for it later when I couldn't keep myself awake during chemistry class.
Overall, it was a great clinical, and I think I'll return to the same station for my other ones. I have one more 24 and then one 12 hour station clinical, and an 8 hour hospital clinical to complete before I'm finished with my emt class. Wish me luck and lots of trauma! :)
Monday, February 7, 2011
Weeeoooo Weeooo! My first clinical on an ambulance.
It has been so long since I've updated! Between the holidays and school, I just haven't had time to hit up the ER much for volunteering. I'm afraid I may have lost some of my readers with my long absence, but for those who keep up dutifully, here's what I've been up to lately:
I haven't had anytime to volunteer because I have started my EMT-B program! It has been very exciting and stressful. The class is only 3 months long, and so I am already studying for my midterm. The first half has flown by. So far we have learned about medical emergencies: allergic reactions, heart attacks, diabetes, childbirth, etc. I have learned so much, but the material has been a little dry. Next week we start the trauma emergencies, should be exciting. I have that class three days a week, and I am also taking 17 credits at the college. All that paired with the 24 hour clinicals I have to complete each week has made for a crazy schedule.
This morning I finished up my first EMT clinical shift at a fire station. I went in from 7:00 AM on Sunday morning to 7:00 AM on Monday. I woke up at 5:30 to get ready, I was so nervous I had hardly slept a wink. I got into my uniform, grabbed my little notepad, pen, watch, stethoscope, sleeping bag, and all my other gear. I arrived at the station ten minutes early and met the entire crew, only to find out I wasn't actually working with that crew, as they were all leaving and MY crew was walking in. Great. So I reintroduced myself to everyone else, and asked for a tour of the ambulance. After making my self comfortable with where everything was located, I helped wash the trucks, and sanitized the stretcher and other surfaces with clorox wipes. Then we played the waiting game. At about 10:00, the alarms went off and I just about jumped out of my skin. Dispatch announced a location and said the patient was a 30 y/o female with chest pain. I hopped in my little jump seat in the back and rode in silence as my heart was pounding and my heart was racing. Holy crap, this is it, my very first call! We arrived to a little house where a fire engine was sitting outside. We walked in to find another crew completing an assessment on a woman lying on the couch. I took a glucose test and started her up on oxygen, while the medics prepared her for transport. In route, I took a BP (blood pressure) reading, an O2sat (the little finger thing that measures the oxygen in your blood), and applied a 4 lead (measures cardiac activity). I also was told to give her a squirt of Nitro for the chest pain. Then as soon as we had finished all of that, we were at the hospital and taking her though the double doors. The nurses got her situated, and the medics were answering questions. I wiped down the stretcher and put fresh sheets on.
The rest of my shift, we got paged for three other calls, but they ended up in refusals before we even got there. One was for a young woman who was attempting suicide by laying in the road of a cul-de-sac in a small, residential neighborhood. A major highway was less than 200 feet away, so we concluded that she was only wanting a little attention. She ended up getting a little embarrassed that 911 was called by a neighbor, and refused treatment. We had another call that lead us to a church. It was one of those churches where the gospel choir sways, and the members dance in the aisles with their hands raised high. I guess the power of the lawdy lawd almighty overcame one young woman, as she had felt a little weak and passed out. She refused treatment to a crew who had arrived before us. The last call of the night that I was hoping wouldn't get canceled was for a bar fight right after the super bowl ended, but we turned around before we even got there. There were no calls after that.
Even though I had woken up much earlier than normal that morning, I was wide awake most of the night. It didn't help that the radio was in my room, pretty much right next to the bed. And so, although the station I was at wasn't receiving any calls, I got to hear every call for the entire county that night. It was fun, at first, then it got really old at about 3 in the morning. Overall, it was a quiet night, but I got some homework done and got to watch the entire super bowl. I even won the bet on what color the Gatorade would be when they threw it on the coach.
I haven't had anytime to volunteer because I have started my EMT-B program! It has been very exciting and stressful. The class is only 3 months long, and so I am already studying for my midterm. The first half has flown by. So far we have learned about medical emergencies: allergic reactions, heart attacks, diabetes, childbirth, etc. I have learned so much, but the material has been a little dry. Next week we start the trauma emergencies, should be exciting. I have that class three days a week, and I am also taking 17 credits at the college. All that paired with the 24 hour clinicals I have to complete each week has made for a crazy schedule.
This morning I finished up my first EMT clinical shift at a fire station. I went in from 7:00 AM on Sunday morning to 7:00 AM on Monday. I woke up at 5:30 to get ready, I was so nervous I had hardly slept a wink. I got into my uniform, grabbed my little notepad, pen, watch, stethoscope, sleeping bag, and all my other gear. I arrived at the station ten minutes early and met the entire crew, only to find out I wasn't actually working with that crew, as they were all leaving and MY crew was walking in. Great. So I reintroduced myself to everyone else, and asked for a tour of the ambulance. After making my self comfortable with where everything was located, I helped wash the trucks, and sanitized the stretcher and other surfaces with clorox wipes. Then we played the waiting game. At about 10:00, the alarms went off and I just about jumped out of my skin. Dispatch announced a location and said the patient was a 30 y/o female with chest pain. I hopped in my little jump seat in the back and rode in silence as my heart was pounding and my heart was racing. Holy crap, this is it, my very first call! We arrived to a little house where a fire engine was sitting outside. We walked in to find another crew completing an assessment on a woman lying on the couch. I took a glucose test and started her up on oxygen, while the medics prepared her for transport. In route, I took a BP (blood pressure) reading, an O2sat (the little finger thing that measures the oxygen in your blood), and applied a 4 lead (measures cardiac activity). I also was told to give her a squirt of Nitro for the chest pain. Then as soon as we had finished all of that, we were at the hospital and taking her though the double doors. The nurses got her situated, and the medics were answering questions. I wiped down the stretcher and put fresh sheets on.
The rest of my shift, we got paged for three other calls, but they ended up in refusals before we even got there. One was for a young woman who was attempting suicide by laying in the road of a cul-de-sac in a small, residential neighborhood. A major highway was less than 200 feet away, so we concluded that she was only wanting a little attention. She ended up getting a little embarrassed that 911 was called by a neighbor, and refused treatment. We had another call that lead us to a church. It was one of those churches where the gospel choir sways, and the members dance in the aisles with their hands raised high. I guess the power of the lawdy lawd almighty overcame one young woman, as she had felt a little weak and passed out. She refused treatment to a crew who had arrived before us. The last call of the night that I was hoping wouldn't get canceled was for a bar fight right after the super bowl ended, but we turned around before we even got there. There were no calls after that.
Even though I had woken up much earlier than normal that morning, I was wide awake most of the night. It didn't help that the radio was in my room, pretty much right next to the bed. And so, although the station I was at wasn't receiving any calls, I got to hear every call for the entire county that night. It was fun, at first, then it got really old at about 3 in the morning. Overall, it was a quiet night, but I got some homework done and got to watch the entire super bowl. I even won the bet on what color the Gatorade would be when they threw it on the coach.
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