I am excited to go to work tomorrow on the ambulance. No, there is nothing special going on tomorrow that isn’t going on any other day. I am just looking forward to going to work. The last three days I have been at work on my clinic coordinator job reading other responders’s run forms, reading research papers, and putting together CMEs (which included getting to hear an awesome lecture by one our cardiologists about ECG interpretation). Tomorrow is my turn to play paramedic again, and I love being a paramedic.
My last “tour” or week of work was last Friday, Saturday and Monday. This week I am working Friday, Sunday and Monday. My last two days at work I did three transfers each day in addition to about the same number of 911s. Three is a high number of transfers for a medic to do in a shift. I usually do at least one, sometimes none. I don’t know what it was those two days. I weigh the reasons. The dispatchers didn’t know we were a medic car (which sometimes happens if we get entered in the system wrong), we were heavy medic cars (the most likely possibility), the dispatchers were boning either me or my partner or both of us, or we just happened to be in the wrong place at the wrong time. In other words when the transfers came in, we were the closest cars to the transfer’s location. As I have written before, I don’t mind doing transfers, I only mind when I am doing a transfer and a basic car is sent on a 911 and calls for a medic and there are none available because the medics are doing transfers. Sometimes, it can’t be helped, other times it can. At its worst, I feel demeaned like what is the worth to being a paramedic if it doesn’t matter if a medic does a wait and return while a BLS car stays online and does the cardiac arrest or bad CHF. I guess the way I feel about it now is: it is what it is. I don’t want get too aggravated complaining about it. If it is a wait and return, I get to pull my Kindle out and read. If it is pouring rain, I don’t have to be out there getting drenched doing a minor motor vehicle. If the Red Sox game is on, I get to listen to it while I drive.
But enough about transfers, I did get to one awesome call last week. 25 year-old female ate a cookie that had a peanut in it. Two minutes later she felt her throat closing up, was wheezing and then was unresponsive. By the time we got there, she had no palpable pulse and was so out of it the first responder was getting out an oral airway to drop. She was cold, diaphoretic, responded only to deep pain, and while her torso was red, when I touched her with my hand and then moved my hand, her skin was white where I had touched her, a perfect hand print.
I wrote a while back about the various drugs we carry and I rated epinephrine 1:1000 as my number one essential drug. This call only confirmed it. I cracked open a vial, drew up 0.3 mg and injected it deep IM in her deltoid. Another medic had arrived by then and we lifted her up onto the stretcher (she had collapsed on the sidewalk in front of her house) and got her in the back of the ambulance, where we still at first couldn’t get a blood pressure, but we did get two large bore IVs (a 14 and a 16). I did the 16, the other medic who I had once precepted and who to this day remains one of my favorite preceptees, grabbed a 14, smiled at me and sunk it cleanly in the patient’s opposite AC. The patient got 50 mg of Benadryl IV, 500 cc of saline, an albuterol treatment via mask and 125 mg of Solumedrol. By the time we hit the hospital she had a decent blood pressure, her skin was dry, and while she still had considerable redness and some distal mottling, she was alert and talking and breathing without wheezes.
“Would I have died if you hadn’t gotten there?” she asked. “Ah, yes,” we both said. And that was the truth. There aren’t many calls where you can say that, but anaphylaxis is one of them.
I am not expecting to save a life this week, although I would love to do some interesting calls. I just think of all the possibilities the roulette wheel of EMS can spin our way. I know somewhere in the week, I will get some chances to be test my medic abilities, get some good stories to tell, have some good laughs, and in general, get to hang out and shoot the breeze with my co-workers who I consider my friends, many who I have known for almost twenty years.
I also hope to have some down time to type away on my netbook, some time to take my Kindle out and read – I am reading a great book now – Just Kids—a memoir by poet and early punker Patti Smith. I have also discovered a new restaurant – a Brazilian Buffet– where I hope to grab some quick and delicious food when posted in area 9, and possibly write a review. I am considering doing A Paramedic’s Guide to Good, Fast Eats in the Hartford Area.
Life as a medic is good.