“Narc-what?”

“Person choking” is what the dispatcher says. A young person, too.

We skedaddle on over there, to find the nice fire crew already on scene. From what the friend says, the unconscious guy on the floor took a bite of a chicken sandwich then passed out and turned blue.

Somebody is bagging this guy, but “his sat is good with the bag, so I didn’t tube him.”

His vitals are okay, except for the unconscious part. He is breathing on his own, about 10 times a minute. Sugar’s normal. Heart rate is normal. Pressure is better than mine. Something about pinpoint pupils, but whatever. Everything is going smoothly so far.

While I’m thinking of the logistics of how to get this unconscious fellow up two flights of stairs, I hear some wonderkid say “Narcan.”

My ears immediately perk up, and my head turns as I say “dowhatnow?” But they don’t hear me. They are too busy talking amongst themselves.

“Yeah, we might as well.”

“It ain’t gonna hurt nuthin.”

“Yeah, it can’t hurt.”

“How much you want me to give?”*

“Give half of it.”**

“Okay.”

I interject. “Uh, if we’re gonna give naloxone, how about we go with point-four milligrams instead of one?”

“So you want me to give a fourth of the vial?”***

“Uh…”

The other guy speaks up: “Just eyeball half of it, it’ll be alright.”****

Before I can begin to process the shit show of patient care that just occurred right in front of my eyes and ears, someone gives ‘about half the vial’ of naloxone.

You know what happens next, don’t you?

Homey promptly awakens, retches, and coughs up a humongous piece of a chicken sandwich, which was obviously lodged somewhere north of his vocal cords.***** (It was just too big to go past the cords. Imagine you took a huge bite of a sandwich, and decided to inhale it without chewing. Yeah.)

My head is literally about to explode at this point.

 

* Personally, I don’t want you to give any, but the question wasn’t being asked of me.

** ”Half?” Is your partner not intelligent enough to read the numbers on the side of the little cute glass tube?

*** Okay, now we know you can’t read, and you suck at math. For the record, zero-point-four is one-fifth of 2 milligrams. Or twenty percent.

**** Seriously, I heard a paramedic say this. In the company of 4 other paramedics. Have you no shame, mustachioed dude?

***** Seriously, what the hell is going on here? The call was for “choking” and you arrived on scene to find an unconscious guy lying on the floor with a fucking chicken sandwich in his hand missing a bite. Did nobody think to look in his airway? A blade and a set of forceps would have done fixed this problem a long time ago, but now this guy’s going to have to sit in a hospital for a few hours.

 

Newguy and I are left to try to pick up what remains of our jaws from the floors. We literally can’t believe the serious shit-show we just saw happen. And meanwhile, these yahoos are patting themselves on the back.

What the hell is wrong with people?

The New Guy

I haven’t given him a name yet, but I’m working on it.

Sort of.

Newguy seems alright by me. He’s a medic with a few years under his belt. I’m not sure I’m feeling the double-medic thing, mostly because I hate to drive.

He also hates driving.

But we spent 4 hours discussing Russell’s teapot and the barber paradox.

He likes Pink Floyd and found Malcolm Gladwell to be fascinating.

He literally has no idea where he is at any given moment, besides inside an ambulance, house, or hospital.

We’ll figure it out, though.

So long, Slimm

After three years, and thousands of calls, the end of C and Slimm is here.

Management has seen fit to end the best work relationship either one of us has ever had and give us two new partners.

We did the math a few days ago, and figured we have run 3,285 calls together. Give or take a few. That figures 6 calls per day on a 12 hour shift. We’ve run some awesome calls: together we have almost 25 saves (seriously, he is that good), delivered 5 babies, one being a set of twins, and we even made the news a few times. He looks handsome on film. I just look stupid. We’ve run the bad calls too: nasty car wrecks with fatalities, more than a handful of deceased shooting victims, both homicides and suicides, a person hit by a train, and the man who asked us not to let him die. We failed him.

It’s been more good than bad, and even through the bad times we had each other.

We’ve laughed. A lot. We’ve cried. Not really. We’ve spent dozens of hours throwing a football, and even more arguing about what to get for lunch.

We had lengthy conversations during the Presidential election, and I couldn’t win the arguments. Slimm was hung up on the Mormon thing.

So now I get a new guy. He’s from Minnesota or something like that. Some state that isn’t Mississippi, but starts with an ‘M.’ I haven’t given him a nickname yet. I guess he’s going to have to earn it.

I often call Slimm my ‘brother from another mother of a different color,’ and I mean it. Slimm has become a trusted confidante, and an even better friend. I’m sure going to miss working with him.

“Fixed it”

Slimm and I are taking some poor lady to the local rehab hospital. This poor hapless soul made the mistake of slipping on ice, and banging her head on the pavement. Now she has a tracheostomy and needs a ventilator.

Unlucky for her, she is now here.

We make our way to the room after the obligatory signing in of the patient at the front desk. Which makes no sense to me, but I’m just an ambulance driver transporter paramedic, and not a policy maker.

We hear the alarm before we make it to the room.

Slimm makes it to the door first and I can hear his eyes roll from the other end of the cot.

Inside the room is an obviously exasperated respiratory therapist, fumbling with the hospital ventilator. Obviously, something is not like it should be.

“I can’t get it to work! Something is wrong!” she says very excitedly. “I’ve never heard it do this before!”

Slimm catches my eye, and his eyes glance at the wheels of the hospital bed, and back up to mine, and I get it. Three years of silent communication are good for a partnership.

Meanwhile, the RT has reached the end of her wits. She looks like she is about to quit.

She pulls out her phone and punches the numbers violently. “SOMETHING IS WRONG WITH THE VENT IN FOUR EIGHTEEN AND I NEED ANOTHER ONE AND THERE IS A PATIENT HERE ON A VENT WITH AN AMBULANCE AND I DON’T KNOW WHAT IS WRONG WITH THIS VENT AND I KEEP HITTING ‘SILENCE’ BUT IT WON’T GO OFF AND SOMETHING IS WRONG.” she says, to someone who might have more experience in these matters.

She turns to us: “I’m going to have to go get the vent from across the hall” she says as she walks out.

Slimm’s face doesn’t move, and his eyes don’t turn. His right foot makes an almost imperceptible movement to the foot of the bed, and activates the bed’s lock.

The alarm stops. Like we both knew it would.

Our patient continues to be unconscious and unresponsive on our cot.

The respiratory therapist reappears at the door, less exasperated and more perplexed.

“What happened?” she asks.

“I fixed it.” Slimm replies. “It’s cool now.”

 

The Curious Case of the Bumbling Buglers

“Hey man, wake up.” urges our bantam hero from the driver’s seat of the ambulance, “we’ve got a call.”

Arising from his light slumber, our second, slightly more portly hero reads the information on the MDT and presses ‘RESPONDING’ with an undaunted confidence that is rarely seen.

Then mumbles “bullshit.”

Over the radio crackles updates from dispatch: “PD-related call…male says he overdosed on cocaine about an hour ago and feels light-headed…requests EMS and Fire to check him out…PD is also enroute…”

Slimm deftly maneuvers the ambulance through traffic, never making contact, nor spilling his coffee.

The heroes with the big tank of water and fireproof clothing announce their arrival at the home of the cocaine-sniffing dipshit over the radio, making sure to establish command and set up a landing zone. No need to launch the water rescue though, this is on dry land.

Returning to our ambulance, we find the first two heroes moving in the direction of the distressed person with an alacrity only seen in nursing homes. Shortly, they arrive on scene, making sure to check in with the incident commander.

“Med 4 on scene with two personnel.”

As they deftly maneuver across the barren land, interspersed with pine cones and the remnants of a despair-filled, low-class life, they are intercepted by a first responder; Slimm executes a spin move but is still stopped in his tracks, just short of the goal line. Even Slimm can’t get past a man with bugles on his collar.

“This guy in here snorted some cocaine a little over an hour ago and says he feels funny.” he informs our altruistic, polyester-clad heroes. “His vitals are fine. He wants to go get checked out. No LOC, no medical problems, nothing like that.”

Slimm finally speaks since arousing his best friend in the world from his slumber earlier “you mean he don’t want to go to jail” he says, as we are granted access to the rust-streaked home that is easily moved.

The bugle-collared gentleman has associates, two of which are standing around what appears to be a dude afraid of the Iron Bar Motel. Local law enforcement stands back a little bit, contemplating his impending lunch hour, and the laborious task of deciding where to drive his cruiser. The third associate, who looks more like a nefarious cohort, wields a metal clipboard with an expertise rarely seen in the field, his ballpoint pen perfectly poised to write down any information at a moment’s notice.

Slimm notices one of the Bugler’s friends has established access for intermittent needle therapy on the Sniffer. The Bugler’s friend proudly turns and proclaims, loud enough for the neighbors to hear, “I gotchew an ate-teen in his raht arm.”

The Bugler interjects: “we gave him 2 of Narcan right before you pulled up.”

A look of perplexed bewilderment crosses the faces of our heroes. Slimm’s head instinctively cambers a few degrees while his brow furrows “WHY?”

“Well, cause he overdosed on cocaine. DUH.” is the reply from the Bugler.

Slimm turns to C: “I can’t man, I just…I…man, I gotta go…I’ll be in the truck” he stammers, as he turns and walks back to the ambulance with a mixture of incredulousness, disdain, and sadness.

“We got it from here, fellas” our portly hero informs the Bugler and his Nomex-clad cohorts. Turning to the Sniffer, “come on man, we better get out of here before that Narcan wears off.”

 

 

Helpful

I’m running a call with another crew, Chonk and the Yankee. It is pitch black outside, colder than a polar bear’s toenails, and we are standing in a wooded median of an interstate with traffic going by at 80 miles an hour.

It is a pretty delightful scene.

Somehow, the driver of this pickup truck managed to lose control of his vehicle on a dry road, cross 6 lanes of traffic, crash into half a dozen large trees, destroy his truck, but walk away. All without anybody seeing the wreck.

He called for a wrecker, who in turn called for police, who said “oh shit” and called EMS and Fire. PD didn’t want to go down there. PD says they can’t ticket him because his license is valid, and he doesn’t seem drunk.

“Failure to maintain lane,” perhaps? Officer Cutiepie shrugs at the suggestion.

There are Ford parts strewn all about in this median, along with all the other trash you would expect to find in an interstate median.

I think I saw a water heater in the distance, but it was dark.

Chonk and the Yankee have him loaded up, and are about to leave. I’m climbing my way out of the median when I see it, wedged underneath some juniper and loose dirt.

“Found the bumper!”

I drag it out to throw it in the back of the truck. Maybe the body shop can put it back on or something. If they find the rest of the pieces.

“Check it out,” I point to Officer Cutiepie. “His tag is expired.”

“Sweet! I love expired tags!”

 

We do what we can.

Nunnya

Slimm is in a mood. He hasn’t had his coffee or his sausage biscuit, and it is cold outside. Slimm doesn’t do well when cold, hungry, and decaffeinated.

We are running a call for a “sick person” who “doesn’t feel well” at an office building. Your typical Monday morning call. “Please. I don’t want to be at work either” Slimm mutters as we get out of the ambulance.

We make our way to the patient. She wants to go to a hospital 30 miles away, past 5 other hospitals that are perfectly capable of handling her lack of a medical problem. Coincidentally, the hospital of her choice is around the corner from her home. The patient is playing opossum, which is absolutely fine with us.

As we leave, we get accosted. By a security guard.

“What’s going on? What is wrong with her?”

Slimm responds. “Nothing, ma’am.”

“Is she going to the hospital? What hospital are you going to? What’s wrong with her?” She even has a clipboard in her hand, a pen perfectly poised to record the details of her exciting shift.

“We really can’t tell you anything, ma’am.”

“You have to tell me, I need to put it in my report. I’m in charge of security here.”

Slimm stops walking as a fireman and I continue walking with the patient through a lobby. His voice rises, and we are still able to hear him.

“Fine. She has NUNNYAtitis, her condition can be described as NUNNYA, and we are taking her to NUNNYA Medical Center. Put that in your report.”

Cath lab

I’m running a call with Joe again. A little old lady fell down.

Literally.

Fire is on scene. We all mosey into the house.

“Hey, guys. Whatchagot?”

“Hey, this is Maude*. She fell right here walking to the kitchen. She has a complete heart block.”

“Okay. Is she hurting anywhere?” to Maude, “Hi. Are you hurting anywhere-”

“Dude, she has a complete heart block.”

Joe and I both notice the leads are on Maude, but not the combo pads. That, along with the fact that Maude looks like she feels better than 50 percent of us on scene, don’t worry us too much.

“Yeah, I heard you. How about we get her on the stretcher and out to the truck?”

“Man, I don’t think you understand. She has a complete heart block.

“Okay, okay. I get it. Let’s get her on the stretcher and move her to the ambulance.” Joe is good at hiding his annoyance. Very good. But someone has a point to make, apparently.

“Dude! Listen to me! You aren’t hearing me! She has a COMPLETE HEART BLOCK!”

Joe turns to the Captain on the engine, who, up to this point, has been expertly wielding the clipboard.

“Hey, man. Can y’all run out to the truck and grab the cath lab? We forgot to bring it in.”
“Dowhatnow?”

“The cath lab. I left it in the truck. Can someone run out there and get it for us? Oh, that’s right, we don’t have a cath lab in the truck. Maybe we should take her to one?”

 

*obviously I made that name up.

Hearsay

“So-and-so came up to me the other day and said they were talking with you and Whatshername and Whoshisface and you said mean things about me.”

 

I’m too old for this childish shit.

MCI review

When at an MCI, assignments are given to you. For example “take those three patients from that car right there to Local Hospital.” But we all knew that already.

When those instructions are given, it isn’t necessary for you to hang around and give scene reports to the arriving units, directing them to where their patients are.

Incident Command is the one with that responsibility.

When informed that you are to “transport them to Local Hospital,” that doesn’t mean you hang around for another 15 minutes with your thumb up your butt then ask the IC “hey, is it cool if we leave now?”

“Your ambulance should have left 15 minutes ago!”

MCIs work much, much smoother with just a tad bit of cooperation.