Genius

Some lady attempted suicide.

The MDT notes say she left her car running all night in her garage, and was found on the floor of the garage by a neighbor. It’s 6 o’clock in the morning, and she’s been there all night, and the car was still running when the neighbor found her.

The neighbor only found her because he thought the red light glow coming from her garage was strange. Apparently she left her headlights on. Neighbor broke into her house, opened all the doors and windows, turned the car off, and somehow dragged the lady outside into her driveway before calling us.

Somehow, she’s still breathing.

Brave man. Now he’s over in the bushes throwing up breakfast.

No, it wasn’t an accident. The note she left in her car removes all doubt of that.

Shaq and our supervisor are getting some stuff done while I gather information before we leave.

One of the fireman comes out of the garage and walks over to the ambulance. “Hey, do you know which hospital you’re going to go to?”

“Yeah, we’re gonna go to Saint Catholic’s. They have that hyperbaric chamber there they can put her in.”

“Cool. Good deal. Make sure you tell them the readings we got from our meter is six hunnert and fitty parts per million.”

This guy is speaking some language I don’t understand. But whatever. “Sure thing, dude. Six-fifty parts per million. Got it.”

He looks over my shoulder at my supervisor and nods “How is she doing? She gonna be alright?”

“I don’t know, man. She looks pretty sick. But her O2 sat is at one hundred percent, so at least that’s good.”

Fireman and I make eye contact and neither one of us have anything to say.

And Supervisor McDipshit wasn’t trying to crack a joke, either.

 

I looked it up later. At 400ppm, a normal adult will have headaches within 1-2 hours, and it is life-threatening after 3 hours. 800ppm is nausea, vomiting, and convulsions within 45 minutes, unconscious within 2 hours, then death. And this lady’s garage was over 600ppm, and she spent the better part of 9 hours in there.

Nobody could figure out how she survived. But she did.

The O2 sat of 100% is probably what saved her.

Glad we hurried

We drove almost 15 miles. A little less than 25 minutes. At 5 o’clock in the morning. In a torrential downpour.

For a grown man with abdominal pain for about 8 hours.

Because he’s lactose intolerant.

And ate a Wendy’s Frosty for dessert.

Then we took him to the hospital.

And his wife followed all the way in her car.

With her emergency flashers on.

Sigh.

“You’re gonna be here tomorrow, right?”

That’s become the mantra where I work. It doesn’t matter how bad you screw up, or whether or not you are actually competent at your job. As long as you show up on time, you’ll have a place to work.

They won’t fire you if you give the wrong dose of the right drug to a patient, and cause serious complications. No, they won’t fire you, as long as you can make it to a meeting where we can slap your wrist.

Oh, you gave the wrong drug to the wrong patient at the wrong time and the patient died? Don’t worry, that pink slip isn’t your termination notice, it’s your transfer notice. That’s right, they’ll just ship you to another division.

What? You sexually harass your employees and got arrested for beating your spouse? Geez, now they’re going to have to transfer that harassed employee! Don’t worry, though, they won’t fire you. You’ll get a new job title out of the deal, though.

You did what? You called a STEMI because the monitor doesn’t know how to recognize a right bundle branch block, and you activated the cath lab and cost the hospital thousands of dollars? They won’t fire you. Heck, they won’t even give you any remedial training. They’ll just make you transmit all your EKGs to the hospital.

Oh my goodness, you called a patient deceased in a motor vehicle crash without actually touching the patient? And that patient wasn’t actually dead? And another ambulance had to take that patient to the hospital? And you told the patient’s wife that her husband was dead? Don’t worry, they’ll somehow blame it on the fire department, even though the ambulance service is responsible for all patient care.

Yeah, you’re gonna be here tomorrow, right?

Hold your applause, please

Med four, you’re available at Local Hospital?”

Ten-four. My partner is walking out now, we’re ten-eight.”

Ten-four. Copy a 911 at Local ER. Female patient, white t-shirt, blue jeans, leaving the hospital now, wants to go somewhere else.”

…oh…kay…”

Med four, EMS Captain is clear, switch to talkaround.”

Ten-four…Four on Talkaround.”

Hey, guys. I’m clear on the call, I’ll head up there if you need me.”

Okay then. I’m not sure if we will need you yet. Shaq just got back in the truck.”

I’m clear. Just be advised, we can’t transport any patient from the ER from a 911 call.”
“Come again?”

If a patient calls 911 from the hospital, they have to be evaluated at that hospital, then the hospital has to arrange for a transfer if needed. We can’t take a 911 patient off of their property. The patient will have to leave the property before we can transport”

Okay, we’re clear.”

 

“Hey, buddy. You want some of these Oreos? They had them in the EMS room — what the hell is this on the MDT?”

“We got a call.”

“How did we get a call? We just went in service?”

“The call is here. Some gal is going to be walking out of the hospital. Wants us to take her to another hospital apparently.”

“Oh, so this has BLS written all over it, and you want me to handle it?”

“You’re the professional one, Shaq. Now how about them Oreos? Did you get me any milk?”

“Boy, I swear, I’m about to smack you upside your head. That must be her right there” he says, pointing to a woman meeting the description.

“Yeah, let’s go check it out.”

My mouth is full of the aforementioned Oreos as we watch a young, marginally attractive woman shuffle out of the ER front entrance, and shuffle her way over to a bench. We walk over to meet her.

“Hi, ma’am. I’m Shaq, and this is my partner C. Are we here for you?”

“Yeah. Y’all need to take me out of here to another hospital.”

“Well, what’s going on?”

“They are just rude in there, and they won’t take care of me. Take me somewhere else.”

“What brought you into the hospital this morning?”

“Well, me and my boyfriend was having sex, then after, I started hurting and burning.”

“Okay, What did they tell you inside?”

“I’ve been here for like, four hours and they try to tell me that I have gonorrhea or some shit like that. I ain’t got no gonorrhea. Me and my boyfriend are clean!”

“Well, did they do a pelvic exam and take a swab?”

“Yeah, the doctor did all that, then he tried to give me antibiotics, but I’m telling you, I ain’t got no gonorrhea.”

“Well, they are doctors, and those antibiotics are really important for you and your boyfriend to take.”

I ain’t got no disease. Take me somewhere else!”

“Well, I’m terribly sorry, but we can’t take you anywhere else.”

“You have to! I called 911.”

“I understand, but since you are at the hospital, you have to be evaluated and treated here, then the hospital has to have you transferred to another hospital.”

“That’s bullshit. You aren’t going to take me anywhere else?”

“No, ma’am. We spoke with our supervisor, and he says that we can’t.”

“Well what the hell am I supposed to do?!”

“It seems like you have several options. You can go back inside, and get those prescriptions filled. You can call someone to pick you up and either take you home or take you to another hospital, or you can leave the hospital property and call 911 again.”

“I can’t believe this. Y’all are going to make me leave and won’t take me to a hospital!”

“We are happy to take you to a hospital, but we can’t pick you up from this one. You’ll have to leave the property.”

“Fine then, I’m leaving.” she says, after which she gets up and starts shuffling off, down the sidewalk.

I’m still enjoying my Oreos, when Shaq turns to me.

“Let’s get in the truck. It’s gonna take her at least ten minutes to make it to that Citgo. We can probably be at the next post before she calls back.”

Med four.”

Med four.”

Ten-eight again. She’s gonna call back once she leaves the property.”

Ten-four. I’ll show you guys in the area standing by. I’ll let you know when she calls back.”

Shit.

Lame excuses

My employer runs a paramedic program. When I say that the company runs a paramedic program, what I want you to take away from that is that the company supplies a physical location for a paramedic program, and students to fill the chairs.

But, they attached the words “EMS Academy” to it, so maybe it is sorta-kinda-official.

Whatever. It’s a moot point.

My employer runs a paramedic program.

Being one of the company’s Field Training Officers, I get to see the aftermath of the paramedic program, when the newly graduated paramedics spend several shifts riding with me. Some of them aren’t prepared, but most are.

I was having a talk with another FTO, Tony, while at the hospital a few days ago. This must have been early in a shift, because I actually cared about the topic.

Tony mentioned that he rarely sees the same paramedic student more than twice, and that each student does at least twenty rides at our company. He thought it would be wise for a student in our paramedic program to be ‘assigned’ to an FTO for the duration of their preceptor rides.

While we’re on the subject…our program is putting paramedic students on ambulances for their preceptor rides after three months of school. They don’t know how to read a monitor, and they aren’t allowed to perform any ALS interventions. What the hell is the point of riding for twelve hours on an ambulance if you can’t do anything?

Anyway.

Tony made a good point. After ten rides or so, there should be a pretty good rapport between an FTO and a student. They should be able to communicate openly with each other, so the student can get the most out of their classroom time, and their ambulance time. After twenty rides, any bad habits should be corrected, and the FTO can feel confident in his evaluation of the student. Alongside the FTO’s confidence in his evaluation, the course director can feel confident in the evaluations he gets from the FTO.

But instead, the students just ride whenever, and wherever. Rarely more than once with the same paramedic, or even with an FTO.

So Tony and I brought it up to the director of the program.

“Assign each student to an individual FTO. We have twenty-five students, and eighteen FTOs. Surely we can come up with a list of seven competent medics to fill the roster of needed FTOs. Once a student is assigned to an FTO, that student does all of their rides with that FTO. It only makes sense.”

We got a reply:

“Well, that would just be too hard, and we don’t want to make it any harder on the students.”

This is why I don’t care.

Lame-ass excuses.