A Knife called Envy

As we turned the corner the cop cruiser whipped around in front of us and flashed his directional bar light as if to say follow me. We knew it was going to be a legitimate trauma, as the cruiser turned the corner and pulled up on scene we were fifty yards behind rolling up to the cruiser when he jet further down as if to say there he is boys do your thing. My door opened as I called out on scene fighting through radio traffic, throwing my glasses on the dash I approach the screams and agony through a driving rain. In front of me stands a burdened woman in complete suffering. Drenched either from rain or her sorrowful tears the young woman weeps in misery. This early twenty's white female stands unable to control her frantic shaking. At my feet lays her man, my patient, with his legs over a guard rail and a bystander holding a towel on his shirtless torso. He's Limp and becoming ashen in front of my eyes, he's my age and laying in a puddle. Turning his head ever so slightly with his last gasp for air. Its as though I feel every drop of rain falling as time slows down. I remove the towel and see a non sucking chest wound just left of the sternum and one just under his left arm pit. The on lookers circling like vultures with their beady eyes gazing on my crew. A Sergeant from the Police approaches me and asks what I need, I gaze up through the driving rain and yell over the approaching sirens that I need these scavengers roosting on the railings and side walks gone. I stand to see my medic rounding the corner of the rig with his monitor in hand and the newbie in tow with the drug bag. I jump back to the rig and inform my medic in passing the locations of wounds. Grabbing the radio with my wet gloved hands I call out in an apathetic tone, "County and Control from Medic Two; Advise Trauma Two we have a traumatic arrest with two to three stab wounds to the chest; will advise once in route." I walk to the rear compartment of the rig to grab out the back board and collar bag, throwing them closer to the patient. Its no lie to say I felt no sorrow for this gang banger, though I still had a job to do. I grab the intabation kit from the inside cabinet and proceed back towards my medic. Opening the intabation kit and drug bag I prepare for a quick and systematic approach to the call.

Various other units have been arriving on scene from the Fire medics to the detectives. The street looking like a block party with rave lights bouncing off the buildings. The officers stringing the DO NOT ENTER yellow tape around the scene and various people receiving shiny linked bracelets There is no blood exiting the wounds, even if there were the driving rain would have washed it off his cold limp body. We are joined by two of the Fire Medics I would trust with my child's life, One an RN and the other an EMS instructor. The two of them and my medic use a tag team approach. My Medic Intabating, squatting in the puddle as to not get his pants soaked. The Nurse Medic throwing a large bore IV in the left AC, and the instructor Medic preparing the IO gun in the rig. I toss the prefilled Epi and Atropine to the RN medic and take the drug bag to the rig where I hang another thousand bag. I know only first round med's will be given before they move out of this rain, its cold dark and damp on the street. They secure to the body to the back board and throw it on the stretcher, wheeling it to the rig. Inside five providers pile and I close them in. Jumping in the drivers seat I put the rig in drive, kick the emergency lights on and head to Trauma Two. Just twelve minutes have elapsed since the initial dispatch.

I realize five additional occupants may seem like a little much but I wasn't wasting time to weed any out. We were only a few blocks from the highway on ramp which we jump on to head a village over. Slow and steady I proceed only topping out at 60mph. I have precious cargo, a back full of standing providers working there ass's off to save this man. Regardless of his social or economic background he is our patient and he will have every chance to survive we can give him. Slowing for the exit I hear the boys in the back quickly consult each other over the diminishing lung sounds. A Chest decompression is in order, preformed and quickly realize a shock is to follow. Pulling the rig over to a shoulder, I hear "3,2,1, Clear" and accelerate the rig back up to speed we are minutes away from Trauma two.

Arriving we hand off to the ER. having gotten him back momentarily we were hopeful. Only for all that hard work to come up short. Later we find out this was all over a girl...Not a good reason to loose a young life.

Be Safe
Ambulance Junkie

A Mid Fall's Night

The sun has set some time ago,

The night before last,
And all through county not a call was being placed, not even an "I've fallen" 

Ambulance plugged in, wheels ready to roll, hopes of a stroke emergency will soon be here.
EMS providers comfy are all snug in their seats.

Thoughts of diabetics and traumas of past were dancing through medics heads. 

Suddenly with out much warning, came a tap tap tap at the window. 

Waking the snoring dispatcher in such a startle. 

Getting up from my desk, eyes filled with joy, I head to dispatch to see what was the matter.

The glow from the neon light shows us what the noise had been.
Could it be, A patient in need?

A call for help? maybe it is an assault? 

Or maybe a chest pain

But no, it is none of these
Twas a drunk cold urban nomad slurring as he speech.
"Its Nisss un.....warmth and conthy."
Looking for a warm place to stay no doubt on this chilly fall night.
The aroma of booze lingered off his breath
Before we had a moment to think the door opened again
In came the officer to escort our late night visitor away to his sleigh
"I'll take him" he said with a jolly chuckle
With a spring in his step, and away with his catch
"Sorry to disturb you and have a good night"

Be Safe
Ambulance Junkie

Vegas Series: Meet Mr. Hero

Hanging out in the Centrifuge Bar at MGM in Las Vegas we are enjoying a night out. A bar filled to the brim with people enjoying them selves. Drinks in hand, Fly boy, Nerf Herder, and myself are comfortably set up against the wall people watching, life is good. Our other two former comrades, use to the crowded bar scene, work their way to the bar strategically near an unsuspecting group of ladies. M.S and Fidney anti up to the bar and buy two shots, enjoying them selves Fidney sets his eyes on his target.

Now maybe as outside observers, we could see the pack mentality, the configuration of these woman and the devotion to one in particular. A Petite blonde, the center of attention and the inevitable item of affection to Fidney. Making eye contact he strikes up a conversation, and buys the young lass a drink, on account of celebrating. Though he never really knows what the celebration is all about, and doesn't bother asking.

The rounds of drinks pass and we take notice of M.S with a shit eating grin on his face. We see the ladies look on in disbelief which quickly turns to horror. Fidney continues to ramble on in an animated fashion, arms flailing, head weaving side to side. Quickly M.S leaves his post as wing man and heads to us as to disassociate him self with Fidney. M.S weaves a tale of Fidney's feeble attempt to impress the ladies he was surrounded by. Mr. Hero's, as M.S renamed him, exploits of life as a medic in the big apple, include tales of dying baby's, being shot at, and saving those sworn to protect the people of NY. These are all in a days work for this man. By the looks of the ladies, what went from a casual interest, irrefutably changes to disbelief. With the bar tenders jumping on the bar to do a dance grabbing Fidney's attention in mid sentence these opportunistic ladies simultaneously finish their Cosmo's and beat feet.

Slightly dismayed Fidney heads to the rest of us and talks a big game. We let him chat on and on ever knowing the glorious ball of fire he was shot down in. We continue our adventures of the night and to this day we know Fidney as the man to drive an entire Bachelorette party from a bar, in Sin City.

Moral of this story guys: Never over play the hero card.

Be Safe

Ambulance Junkie

A chance encounter

He sits waiting but for who he doesn't know.

I sit finishing up my chart from the last run.

He looks at the passing faces with confusion and concern.

I look at my fellow workers and strike up a conversation.

He wants to call out for help but is afraid.

I get the call for help and head for the scene.

He meets an officer and he answers "I cant move along" wiith an embarassed feeling.

I meet the officer who admits he thought he was just another vagrant.

He tries to stand but he can not.

I tell him not to stand, though he still attempts.

He doesn't know what to make of me

I don't know what to make of him.

He says he can do it on his own.

I say let us help.

He feels young at heart, he looks old and aged. The sun has blemished his skin, the wind has hardened his face. His wrinkles chissled in his face's granite fasade, His eyes blueish grey screaming out in pain and anguish. Time has washed all the color from his hair and beard leaving it white. His hands, rough as sand paper and cold as ice, his fingers jaggedly contorting inwards with lose of dexterity. This urban nomads right foot externally rotated from years of abuse to his body, his left leg bent.

He wears layers of clothes because he has no place to keep them, his boots tied up with rope. He has spent years on the street. Made it through heat waves and blizzards, droughts and floods, and has received hand outs and has been made a fool of. He is an old weathered man to stubborn to know when to give in to the help that surrounds him. Or maybe He feels to much pride to accept from those who offer assistance.

Not knowing what its like to be him, He knows not what it is to be me. There is something that connects us on this day, we are both fighting to keep him safe.

Be Safe

Ambulance Junkie

What Would I teach Lizzie?

-The Handover-EMS Blog Carnival Aug. Submission-

So your proficient in your skills, able to back board with the best of them. Fully capable of putting on a traction splint, vacuum splint and can sling and swath a shoulder. You've studied all the acronyms needed, DCAP-BTLS, PERRL, SAMPLE, and have a solid understanding of their use as it pertains to the patient.

You have a sound understanding that majority of calls will fall in the "grey realm". You'll have some black & white calls laid before you, but over all you'll have an unproportional amount of grey calls. Understanding that once on the streets the clinical decision making is in your hands. You do not solely rely on your initial education, rather the trends in EMS you have been continually researching and the Con Ed classes participated in.

When all else fails Lizzie, you know when to call for help. People become afraid to show weakness in this line of work, but don't be. The simple fact is the nature of the beast that is medicine is ever changing and progressing. It is impossible to be on the cutting edge of every single change in EMS, but hopefully some one else may have the knowledge where you haven't gotten to yet. We must never forget that we are serving for one single reason, and that is to do whats best by the patient. Sometimes that means to ask for help, but you know that already.

Solid fundamentals, capable clinical decision making skills, and the ability to admit to one's self that you need help. That pretty much covers the whole lot of attributes a newly carded EMT will need for the field, and you have them.

So what do I hope I've taught Lizzie? Keep your sense of humor girl! This Career/Stepping stone/Hobby/Calling surrounds us with people having the worst day of their life potentially. We are always in the thick of their crisis, and are the ones they have summoned to help. That is a lot of pressure on an individual, to be the sole saver of life, the Grand Puba of help. the Sultan of Assistance. In order to maintain our sanity we have to be able to keep our sense of humor. Humor is really just a matter of perspective after all. When in the appropriate times it lightens our moods and gives us that little extra to make it another call.

But I'm sure you already knew that Lizzie, you were always a great student.

Be Safe
Ambulance Junkie

The story of a Druggie

She enters the room seeing the site before her. The curtains pulled shut with only the slightest streak of sun light comeing through. A man lays before her in his own filth, no doubt over dosed on today's black bag special. Shes not afraid, she just goes to work. On the table bag sits emptied and the spoon covered in the residue of the druggies fix. The smoldering wick of a tea lite candle sits ideally by. She prepares the site, cleaning it in a circular motion working out from the center. She has her supplies laid out in front of her, at an easy reachable distance. She wraps the rubber tournique around the arm, ties off the tourniquet in the middle of the bicep and quickly slaps the AC vein a few times in hopes it pops up. Its tiny and tattered, but it'll have to do even though its been used several times before. She picks up her needle and syringe her partner had already prepared. Flicking the syringe to make sure the air is out, she places the setup in her teeth and caressed the vein with her index finger. She hopes that it wont roll or vanish when she sticks it, for she needs this site to be usable. Placing the needle up against the skin, she is ready for it all to come together. Steady and with slight pressure the needle advances tearing a hole in the skin, piercing through with a familiar pain. In the vein unnaturally sits a cold and lifeless piece of manufactured metal, its as though she can taste her sucess. A thumb overs the end of the syringe she begins to push slowly, forcing the fix through the body, a mental escape from the hell in which she lives. Trying to kill the pain she slips away, to a place she feels free. The drug rushes through her veins, coursing through her body leaving her numb. The needle drops to the floor, the tourniquet still attached, she feels nothing. She stumbles from the table completely strung out, she experiences the world in her to familar way. She crashes to the floor just like the one before. Her future is unknown.

Be Safe

Ambulance Junkie

Chuck & Ralph

"County to Medic Four recieving reports of multiple patients reporting Vomiting and other general illness symptoms we are starting additional units and the Fire Department for a possible CO2 condition in the residence" "Medic Four copies, we are two blocks away we'll advise additional upon arrival" my partner chatters.

We see patients from 200 yards away, arriving on scene Patient One & Two are at curb side puking their metaphorical brains out. We call out "Medic Four on scene, will advise the situation" over the radio as I step out and avoid pools of stomach content all over the side walk. The first two patients in agony but breathing we quickly survey for additional bodies. My eyes sweeping the area I catch movement inside the front door, I advance as the faint sounds in the distance of help can be heard. I bend down unsure of the nature of the environment and upon arrival to the door way I am presented with patients three, four, five, and six. They are all inside the front door in what appears to be a common living quarters. All of them also spewing out every last bit of stomach contents they had, though these chaps were all civilized and using various forms of buckets. "If your able to exit this building and come outside" I yell over the sound of the arriving cavalry. All four stand and walk towards the door. "Are there any others in the house other than the four?" I over hear my partner asking patient one and two. They point to the fenced in side yard where I now turn and head, getting to the gate I go to unlatch hearing:

"I think the Clams were bad Charles!" 

"Oh my! Don't even say that word, it'll make me sick again Raphael"

"Why did you have to cheap out on the seafood of all things Charles"

"County from Medic Four, Be advise we have eight patients all out of the residence this appears it could be food related. You can down grade all remaining medic's response to non" I chatter as I direct the two remaining patients out front. The Fire department pack's up as I tell the lieutenant of the possible food illness of all the patients. My partner has all but the last two triage'd and handing them off to various rigs. I direct Charles and Raphael to our rig and sit them down. Assessing them and listenting to the story I hear of a fun get together amoungst friends and them sharing steamed clams and telling of days past. All only to be strickened by food poisoning a few hours later.

Only as I return to service do I realize that This would be a humorous story realizing my Patients names were Chuck and Ralph!

Be Safe

Ambulance Junkie

"The Kings of EMS"

A list I found posted at the station house that pays tribute to a piece of history.

Top Ten reasons Johhny and Roy are "The Kings of EMS"

10) All of their patients lived happily ever after.

9) No One ever puked three 40's of malt liquor all over their shoes.

8) They Never went anywhere, even into the hospital, without their goofy fire helmets.

7) Only Johnny and Roy could get a call for a naked babe in the bathtub (with her toe caught in the spout) and not get aroused.

6) They always got all of their IV's on the first shot, even on a 104 year-old blue hair with no veins.

5) BICARB! BICARB! BICARB!

4) Who else could say "Hey Doc, he needs a shot" and actually get an order for 10mg of MS?

3) They survived all of Chett's fire house cooking.

2) They never had to do a fourth floor carry-down.

...and the number one reason why Johnny and Roy are "The Kings of EMS":

1) The way they could always cath the light just right and make a little rainbow when they were flushing a syringe for a medication administration.

The Yoda kid

"Medic Nine respond with the police to the school with out walls for a child having behavioral out burst" The radio squawks "Medic Nine copy's en route" I chatter back. Pulling up on scene we exit the rig and pull our stretcher out. Wheel it up the ramp and through the main doors, we follow the staff down a hallway past heavy thick steel doors slammed shut. The children glaring through the glass encrusted wire windows with a teacher valiantly trying to educate them. The echo of our foot steps trailing down the hall we are presented with a wall of staff members standing awaiting our arrival along with an officer. "he's not violent but somethings definitely going on that I think your better off handling" the officer says. As the staff parts allowing me to pass, the last of which opens a large door as if for royalty. My eyes adjust to the dimly lit room, the walls with white padding from top to bottom all inked up with sketches from inhabitants pass. The single browned out light bulb in the room is surrounded with a cage lined with dried snot and spit. In the shadows in the far corner my eyes lay sight to a young dark skinned male huddled down. I approach cautiously.
This young man looking at me begins to speak "What looking at are you" "Excuse me? Whats going on today man?" I ask in wonder. "Do you understand the language of the Jedi not?" the boy asks. I turn to the officer in confusion and disbelief. "yeah I don't really have authority to transport here, so that's where you come into play" Says the officer.

Lucky me I think as my partner and I take this non violent young student on our stretcher and secured him with leg lap and chest straps. As we roll the patient out of the building I ask the typical questions like his name, if he is having any complaints, and SAMPLE history. The patient looking at me states "Yoda ki-adi-mundi, my name is. Yes, hmmm. No concern of yours, the rest is." At this point we have loaded our young Jedi Master into the rig, his sudden psychosis or his possession by a fictional character I test his devotion to this act ir the seriousness of the situation. "So you said your name is Yoda Ki-Adi-Mundi right? Like Yoda from star wars huh? than explain to me why are you taking a Jedi Master of an unknown species and combining it with a complete seperate Jedi Master?" The Patient looking at me begins to have the slight enjoyment wash off his face, "well...well....Your Mom!" the patient shouts. "So that easily you've given up your little game huh?" I ask, "I was expecting more, I mean as elaborate as your escapade was to get out of school you could at least sell it to me" "PING" my cell chirps as a text from my partner comes in. I glance quickly reading: you just Jedi Mind tricked his ass! 

The rest of the trip in was rather uneventful. Taking vitals and grabbing what little history the kid felt like sharing. I understood this kids desire to get attention, his outward cry of desperation. It wasn't a long ride into the Hospital, I don't think a two hour trip would have allowed this kid to receive enough time away from his inner demons. Pulling the stretcher out of the rig with our young Padawon in tow we enter the ER. "Afternoon folks, Let me introduce to you my young patient....Yoda Kid, He's been acting out today and is in need of a Psych eval." Glancing out of the corner of my eye I wink at my young troubled person. He smiled back and continued on his way, "Yoda the great Jedi master I am." The staff none the wiser.

Be safe
Ambulance Junkie

The ugly truth

"I don't know how long she's been down" says the bystander. We enter through the doorway into the room. We behold our patient, a Lincoln Continental sized woman. The lifeless body buck ass naked on a mattress that was dwarfed by her size. The inner concern arises as we conceptualize a way to extricate this patient. Is this even possible? There is no way the two of us can move her. I couldn't even believe she would fit through the door way.

"She wont even fit on the elevator" my partner whispers. "Not laying down" I whisper back. "so we put her on the elevator car 1 and hit the lobby button, than jump in car 2 and race to the lobby?" my partner suggests. "are you kidding my? I'm not taking the stairs!" My partner looks at me holding back the laughter "how does you taking the stairs come into the equation?" he mutters, "I don't know, I was feeling confusion, We have a job to do" I say as I enter the room leaving my partner in utter confusion.
We approach, placing the monitor on the floor, and begin our assessment. A truly mute thing at this point. Neither of us are truly thinking this is a viable option for resuscitation, but relying on training we proceed with the steps to confirm. I chirp out a quick radio transmission of an additional truck and the police to the scene. My partner places the four lead on and glances at the monitor, while I throw a set of defibrillator pads on our patient. The Monitor reads Asystole yet her body is still slightly room temperature. We debate our options in the room more for show. We point out the lavidity in the legs and arms setting in, the staff unable to understand the words coming out of our mouths. We pack up and await for the police officer to take over the scene. The instant sign of relief washes across my partners face.
We as EMS providers are imagined as super humans. We arrive on scene and are expected to save a life. We are supposed to operate with no emotion but show compassion. We are supposed to be confident in our ability to over come the largest of obstacles, some times though our human nature and concerns get in the way. We are only human after all, we have our own ways to cope with the dismal and dark side of the world. We often dont deal with people when they are having a good day. EMS typically wont be called until a persons day turns to crap, and we must remain light hearted in order to continue in this job.

Be Safe

Ambulance Junkie

Stop and Listen

The first call of the night went smoothly, and I find myself in the Emergency Room cleaning my stretcher. I begin to listen to the sounds around me and become very enthralled by them. Listening to my personal orchestra I take a moment to enjoy the smallest of pleasures.

Swoosh swoosh of my hand wiping down my stretcher, I listen as a doctors introduction gets drowned out as a passer by talking on her cell with an angelic southern draw "Hello, I'm Doctor..." "Ya, so I ain't to shur but I reckon he'll be admitted" Trailing off as she walks down the hall. "This is the stethoscope and it goes here on your chest to listen to your lungs" the doctor tells his young patient. Click Clack, Click Clack, Click Clack, As Miss registration walks down the hall giving me a sweet hello smile. Beeeep, Beeeep, Beeeep, Beeeep of a patients monitor alarm telling the staff of problematic vital signs. Squeak-squeak-Squeeeak, swoosh woosh woosh woosh woosh the trailing off of the passing environmental services cart wheeling by and the sound of sticking shoes from the cleaner walking behind.

"Hey Boy" says one of my favorite nurses, "How are you stranger" "Hey girl, I'm good, what are you doing on still?" I ask "I'm here till 1900" She says in passing. Click-Clack Click-Clack, as Miss Registration passes by while returning to her station. Ping as my phone receives a text, "Hi, I'm from radiology. I'll be taking you for an X-ray" Says a tech "Excuse me, Nurse" a patient yells out, "OK, so the CT scan came back negative..." states doctor to a nurse. "Room 12 Fire" says a Nurse to the Fire Ambulance Medics.

The singularity of the voices begin to muffle together and build on top of each other. One drowning out the next, becoming an indistinguishable chatter perpetually becoming louder and louder. Then a sudden silence as I slip into my thoughts and think of the perfect blog post for the day. Realizing the the irony of this moment I smirk and just like that the silence is broken. Ring Ring Ring of the nurses station phone, "Med control from Medic 13" the radio chirps "Doctor Strong to Level two North, Doctor strong to Level two north" the over head speaker alerts. The hustle returns to life in the E.R. and I go about dressing my stretcher having enjoyed my little moment of observation.