My adventures as a pre-med college student volunteering in the ER and trying to hold my own as an EMT student.

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! :)

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