Another week done.

Ah yes, the second week of classes is out of the way. It’s been an interesting week, both at school and work. I’ve forgotten how much I love being in class, but I’ve always been weird like that.

Class Monday we started in the first volume of the 5 book Brady/Bledsoe set. A lot of it was review, but hearing it put a new way is always good. We also started going over IV therapy. As the only EMT-I in the class, I was asked to help show a couple of the students the basics and setup of the equipment used for cannulating a vein. Surprisingly I actually enjoyed the little bit of teaching I did.

Downside was apparently my fear and hatred of needles (I know, weird thing to be afraid of being that I have 4 tattoos) is at an all time high. I let a student stick me to get a feel for it. I pretty much pointed to him exactly where and how to stick, and from what I’m told he would have gotten the line successfully too… Except I managed to pass out when I was watching him stick me. Let me tell ya, it’s not a good thing to wake up to a circle of faces that look concerned. Although considering where I passed out at, I’m lucky I didn’t wind up with 2 lines in my and on my way to the ED. Not fun. But hey, I asked for it.

Tuesday was another day at work for me. I have to say I’m getting pretty damned tired of bad calls. With my service only having one truck on duty and 1 on-call, if anything bad goes down then you’re pretty much guaranteed to be running on it. And if you’re the on-call crew you usually head out to the bad call as soon as both crew members are at the station.

I got so frustrated with a bad call involving a child that I posted a status on my facebook that was a combination PSA and venting. Well, someone decided to let my boss know about the post and I was written up for it. Since I’m already the FNG, finding myself on the boss’ shit list didn’t help my mood either. With the trouble I’m already having fitting in at this service once about half the other EMTs and Medics found out I wanted at least my AAS and to get my LP… Well, suffice to say I’m looking at maybe talking to a contact of mine from Williamson County EMS. I also will be very careful, even more so since I got written up and there was no violation of anything as the reason, not protocols, SOPs, or HIPAA, of what I put up on Twitter or facebook (for those of you on my friends list there).

My original plan was to stay here for up to 3 years to get my EMT-P, then my AAS and LP, then move to a larger service somewhere. Well, ATcEMS and Williamson County EMS are both on my short list of places I’d consider moving to as a medic. WCEMS is an all medic service that I’ve heard nothing but good things about. And the Austin area has several places I can finish an AAS and go for a higher level degree as well. Or ENMU-R has an online EMT-P to AAS program which I am also considering. I don’t know what to do now, I just know though that this service and myself are not getting along as well as I was assuming that we would.

So anyways, after a long shift on Tuesday, I had class again on Wednesday. Again I helped the students practice sticking, although we had a new proctor that showed up that made me test out. Since I didn’t come to class in uniform this time he had no idea I was an EMT-I. It was funny to see the look on his face as I finished in less than half the time of anyone else. He asked me if I’d ever done that before, and when was the last time I started a line on someone. I just smiled and told him that I started 2 less than twelve hours ago at work. After I told him I worked on a box as an EMT-I he kinda realized that was why I managed to get it done fast. Besides, it was the mannequin arm, so it’s not like it was hard to stick. Just aim for the collection of the little holes.

After I got back from class, I was tempted to go to NM for a day to visit a friend who was with her little family in the hospital. I have been wanting to see her and the new addition for months but they wound up going home while I was in the City, so I just came back to BFE. Good thing I did too, sicne I am now sitting at work. I’ve been on since 1800 on Wednesday and I get off tomorrow at 1800. It’s been a long shift. And I’m sick to death of pedi calls. We worked yet another pedi code due to MVC along with another adult code earlier in the shift. I’m getting experience, but I know I’m getting burnt too. I am lucky I have Sunday off this week, so I can do homework that I haven’t finished yet and take a break before Monday’s class. After all, I think I’m running out of clean uniforms.

Well, all ya’ll stay safe out there, and for those of you who are also on the #questforthediscopatch study hard and good luck on exams and testing you have coming up.

And so it begins… Again.

So now that the tough post is out of the way, let’s move on to something happier shall we?

Today was the first day of medic school, mk 2 :) As with any other first day it was interesting, to say the least. One of the most telling things about the program is that there were four of us out of 20 that were not members of the City FireDept, and one of the 4 has been trying to get on with them for years. It does sound like CFD tends to use them as a medic mill, but it is an 11 month program, so it’s better than most mills.

This first semester will be Intro to Advance Practice for the first 8 weeks and Airway/Patient Assessment for the second eight weeks. And for about 14 of the 16 weeks we will be doing clinicals both in the hospital and on the bus. And I was told that I can do up to 50% of my 80 hours down here in BFE. Which is nice considering that just driving to class twice a week will rack up 300 miles at least on my car per week.

We also will do 2 4-hour OR rotations for ETI. I like this a lot, since my program in NM couldn’t secure any OR time for medic students due to the increasing popularity of LMAs and the asses some of the medic students made of themselves in the OR. I’ve got an advantage in that since moving out here I’ve gotten several field tubes, so I know I know how to do it.

And on the subject of skills, I’m apparently the only EMT-I in the entire program. All other 19 students are EMT-Bs. So I was told I’ll be held to a higher standard for skills that I have more practice with than the other students. Not that I mind that. It also means I don’t have to check out in class on IVs I get to go to clinicals a little earlier than the other students in the program.

So far the staff seems good to us. The only thing that struck me that I hate is… well, it’s something I’m not getting away from since the college is an accredited school now. And that’s FISDAP. FISDAP is something I used a little bit in NM and I swear it is just like dispatchers, minions of satan. But win some lose some I guess.

And one of the better parts of medic class is I might have someone that I can car pool with and study with here in BFE. A Vollie for Tiny Town Vollies is in my medic class. And she’s very very cute. It’ll be nice to have someone to drive with, if she agrees to it (we’ve already brought it up once) anyways. The only downside to her incredible cuteness though… her father is a TX DPS Sgt… I rather like my body parts intact and she’s just barely 21 so I’m a little scared off.

Anyways, that’s just first impressions of this medic program. Next class day is monday and I’ve got a ton of extra paperwork to fill out for them, not to mention finish reading the first 5 chapters of volume 1 of our Paramedic text. Not to mention get on Blackboard and register for Med Terminology and A&P (which I’m not dreading at all since they’re both online courses). Ya’ll have a good night, I need to try to get some rest. I go in for a thirty-six in 6 hours.

It’s like a roller coaster.

The last two and a half weeks have been both the best weeks and the worst weeks of my life professionally and personally.

It all started on what was supposed to be a 36 hour shift over New Years Eve and New Years day. Great time to work EMS right? Good calls, fun times.

Well it didn’t quite work like that. First few calls of the shift were all routine. A drunk or two, a minor MVC or two, a drunk doing CPR on a fully alive drunk person (“Sir, if the patient is saying ‘OW!’ every time you compress his chest, he DOESNT need CPR!”), and then it started to get interesting.

We worked a nasty tractor trailer rollover about 15 miles from town. We get on scene and see a pretty much demolished tanker truck laying on it’s side. The roof of the cab had been peeled back by the wreck and the patient was laying about 10 yards from the truck. He was laying on the ground moaning but not really responsive to us at all.

We quickly get him collared, boarded, stipped, and strapped and then haul into the bus. Just a quick look at him showed what looked like a grossly deformed femur, shattered left arm, distended neck veins, and no breath sounds on the right. Left pupil was sitting pretty at about 4mm and slow to respond while the right was about 2mm and non-responsive.

Our second bus pulled up on scene as me and my medic were getting him situated in the back. We pull the medic from the second truck to come with us while her basic drove. A PD officer drove our second truck back into town. It was decided by my medic that we would call the local fixed wing transfer service to get them ready and just meet them at the airport to get the guy to the Lvl 1 200 miles away from us, since the rotor would take at least a half hour to get to us, and the airport was in town.

We took off towards town and started our thing. Pads and electrodes on, 1 14g in the good AC, an EZ IO in the good leg. Started giving him a fluid bolus cause his pressure was in the dumps. My medic darted his chest and got a little air out, but not much, which led us to believe maybe a hemo. I cleared his airway with suction and tossed in an NPA, then tried positioning and tossed in an OPA.

I noticed his breathing was getting more and more ragged and irregular, so I double checked with the medics and grabbed a scope and ET tubes. Snap on a Mac 3 and grab a 7.5 w/ stylet. Go in and take a look and I can’t see crap. I suction him out some more and still can’t see anything. Ask for cricoid pressure and finally see that white winking of the cords. I sink the tube, pull the stylet.

Grab the slipstream, hook it up and start bagging. Listen to lung sounds? Yep they’re there. ETCo2 looks good too. I look over the patient, who is looking more like a train wreck every minute. His femur that’s deformed looks like it’s quickly collecting tons of fluid, which between that and the chest would very easily explain his low BP. We get about to the airport when I notice that I can’t feel a pulse in his neck anymore. I look quickly to the monitor and notice flatline (like the monitor making all sorts of noise doesn’t clue us in). My medic starts CPR just as the back doors to our bus open up and the flight team hops in.

Since we’re not sending him by flight we beat feat to the ED and get him in there as soon as we can. They work him for another twenty minutes but never get any organized rhythym, let alone pulses, back.

We take our time cleaning up from that call and get paged out to an 911 hangup call that PD went to and then called us out on. The PD officer sounded frantic which made us wonder what was really going on. We get on scene and find something that goes down as the worst call in my career so far.

“PD, Medic 4, we’re pulling up now, does the officer have an update for us?” I casually ask into the mic, wanting to make sure the scene is still safe for us to enter and see what we might need.

“Medic 4, PD 214, get in here quick, young child unresponsive, trauma related!” This PD officer used to be one of our EMTs back when we were a volunteer agency, or so I’m told, so we know we can usually trust his judgement. Hearing him that upset rattles us a little bit though.

We bail from the unit, grabbing our pedi-board, collar, first in bag and toss it all on the cot. As we get inside we get the story from the officer.

“The husband and wife were apparently having an argument, and the kiddo dropped and broke something. So because the father was upset and the kid broke something he beat the kid until the kid was quiet. Wife called 911 then hung up after she thought better of it,” The officer tells us. We take a look at the kid and my vision goes red.

He is completely unresponsive to us as we get in there. He has bruises already forming on his face and neck, along with old bruises that we reveal when we start cutting into his clothes. He has several lacerations to his face, along with several to his forearms that look like they are defensive injuries. His face appears to have several fractures, but we can’t tell just how bad.

My medic and I work quickly and silently as we get the little boy packaged up onto our board and call our local fixed-wing service to get the boy transferred up to the childrens Lvl 1 250 miles+ away from us. I drive the bus so the medic can be in the back with the kiddo but we wind up staying in the ED to help prep the kid for the flight out. During transport my medic had intubated the kiddo because he had stopped spontaneous respirations, and reported that the kids’ pupil was blown.

The kid was transferred to the flight crew without any more problems and flown to Big City Hospital Lvl 1. I’m still waiting to hear more, I would love to hear that the kiddo would be ok, but I don’t know if he is. He is still on my mind and I can’t get him out of there. It’s just… I don’t know…

Seeing that just shook me to the core. I don’t like kids, but I want them eventually. My ex-fiance and me were supposed to have one, but working in the field made her miscarry, at least that’s what the docs said. There’s another little girl that I would help take care of in a heartbeat if the mother decided she wants to come out here with me. I love them both more than anything and I haven’t even met the little one yet.

What makes this even more like a roller coaster is the fact that the call that I term as the best call of my career. I had my first delivery in the field as a lead EMS provider. It was the most amazing experience I’ve ever had. I helped deliver a healthy little girl into this world without any problems for her or mom. I.. I can’t even begin to put into words how this felt. It felt like it made up for all the bad calls I’ve had since I moved here, all the bad stuff I’ve seen since I became an EMT 3 years ago (BTW, I realized that earlier this month marked my third year anniversary as a certified EMT). It has given me the energy and drive I need to push me forward, to continue on and keep going. To keep on riding hte bus day after day.

Then again, life is like a roller coaster to begin with, and EMS just exemplifies this.

Who are we?

I was watching the movie Across the Universe a week or so ago. And one of the quotes from the movie struck my interest when it comes to EMS.

Uncle Teddy: Because, Maxwell, what you do defines who you are.

Max: No, Uncle Teddy, who you are defines what you do, right Jude?
Jude: Surely it’s not what you do, but it’s the…the way that you do it.”
That symbol up there should be familiar to almost everyone who reads this blog. It’s the Star of Life. The symbol most used to represent the prehospital medical profession. We most likely see it daily. On our uniforms, our ambulances, our equipment, and even sometimes on ourselves.
So I’m going to turn that quote around a little bit. What do you think? Does that symbol define who we are, since so many of us are so passionate about what we do? Or do we help define what that symbol means to the public at large? I know if you show some member of the general public the ‘Maltese Cross’ (which really isn’t a maltese cross, but that’s a whole nother topic) the first image that strikes them is big fire trucks or firefighters with air packs running into a burning building.
Personally, for the past 3 years, that blue star has helped me define who I am. I’ve had some rough points since basically flunking out of college in my first year, and since then I’ve been able to dive into EMS to forget about bad things that happen. From day one in EMT class I knew I’d found something I loved, even to the point of getting a blue star of life tattooed on the back of my shoulder the week after I got my state card in the mail.
So, yes I am a little bit defined by what I do. I love helping people, I love working with people and getting to know them so well they are just like family, I love the feeling of actually belonging somewhere. And I also love the feeling of brotherhood that does tend to crop up from time to time. Due to the splintered and fragmented way EMS is provided in this country it’s not a thing like fire departments or police departments have, but it’s there in it’s own way. EMTs come together when one of our own is in need, and that’s good enough for me. I’m proud to be part of such a family.
But at the same time, also feel that one of our duties is to be the ones to define our jobs. A lot of our newer EMTs (which I’m not so far removed from. I still feel like a baby EMT at times) come into this job expecting lights, sirens, explosions, blood, and guts every shift. Those of us who have been around a little longer know better. Those calls are fun, but they can also be the cause of a lot of our nightmares.
The truth of our services is that the majority of our calls are ‘sick’ calls. That can range anywhere from a 21 year old with a low blood sugar to a 91 year old woman having an acute cardiac event. None of these calls are as glamorous as I’m sure the newbies have been lead to believe, but they are essential in shaping EMS into what we want it to be seen as.
Those younger EMS providers like me, @EMTGoose, @MsParamedic, among lots of others out there, are the ones who are going to be responsible for shaping EMS into what it hopefully will mature into. Our profession is still a young one, and we are having our share of growing pains. But when you’re out on a call, think. “How do we define what we do, because of what we’re making it?” and try to act like you want to make this a respected career in the medical field.
So, for now yes. I am defined by what I do, and I’m proud of that fact. I’ll continue to get called an EMS Nerd and try my best to soak up every bit of knowledge I can for the good of my patients. But on the other hand, I AM EMS. Every single one of us out there riding the trucks and walking into the scenes are EMS. Maybe Jude had the right of it. It’s really not what you do, it’s how you do it that’s the most important.
And lastly, just like each and every one of you out there reading this (I hope), I am EMS 2.0 just like each and every one of you.

Yay… new year… new challenges

Well, another year is over. I’ve noticed a lot of bloggers looking back on the last year, and figured I might join in. But, take note, that I hated 2010 for hte most part, so there will be very few good things I can say about it.

Last year:

My ex-fiance got married to my ex-partner,

I quit my job and moved to CO on the promise of a job (which never materialized),

found a job at a private IFT ambulance, then promptly got fired for doing something stupid.

Fell BACK in love with a girl who had been out of my life for years, had my heart stomped on in front of me, set on fire, and then the ashes scattered by said girl.

Moved back in with my parents,

Spent a lot of the rest of my money that I had saved applying for state certs in bordering states and going to places for interviews.

Got a job in BFE TX on a 911 truck (probably the highlight of my year)

Applied for, and get accepted to, paramedic school in the City.

Strengthened a lot of ties with #CoEMS friends and other great friends I’ve made on Twitter. I’ve found out who really will be around when I need a friendly avatar to talk to.

———————————–

Yea, that’s my list of 2010. This next year will hopefully be easier to make better. I’ll have new challenges. Like working FT, PRN, and being a full-time paramedic student. But I know I can make it through everything that gets thrown at me. I’m used to being on my own, and I’ll prove that I can make it all on my own.

Although the year is off to a rough start with us here in BFE. I pulled what was supposed to be a 36 hour shift over NYE and NYD. It wound up being a 24 since we had a busy day and 1 really bad call. We worked 3 major MVCs and one of those turned into a trauma arrest while we were transporting to the airport to meet a fixed wing to get him to a Lvl1 Trauma in Big City 250 miles up the road.

Curiously I didn’t really feel anything with any of those patients. Sure it was sad they got into accidents over a holiday weekend, but I just did my job and walked away with no questions in my mind or doubts about why stuff like that happened.

For the most part, calls that day had been routine calls. Headache, dizziness, drunk, the usual for a holiday weekend. No suicide attempts or people doing grossly stupid things… Until we got the call that got me sent home early.

We got dispatched out secondary to PD for a 911 hangup call. They got on scene and sounded pretty damned flustered when they were calling us, so we got there relatively quickly.

Now, keep in mind, I hate kids. With one very large exception I don’t want them. And the person that I would have helped them raise their daughter… well, long story. Longer than I wanna go into. That and kids on calls scare me, since I don’t deal with them well.

Anyways, we get on scene and find a kiddo that has been beat to within an inch of her life. Why? Because her low life dad was a fuckign drunk and apparently she had dropped something that broke. His solution? To wail on the kid until she was quiet. The mom called, then apparently ‘thought better’ about it and hung up.

I don’t wanna talk too much abotu that call, since I know it’s already going to give me nightmares. But yea, this year is not off to a good start.

So anyways… new year, new challenges. Let’s hope things go well. School, work, work, school. That will be my life this next year, and I can’t say I mind. Keeping busy is good. Keeps me from thinking too much. As I’ve found out this past year, thinking hurts in more ways than one.

Oh and I decided to not give up caffeine like I was planning this year. That would be suicidal I think. So I decided to just give up carbonated beverages (like my Monster  O_O), with maybe the exception of a beer a week if I ever am off duty long enough to have one. So, the drinks and losing weight are my only new years resolutions other than rocking the paramedic course and earning my disco patch by the end of the year.

It’s the Handover!

Happy new years everyone! It’s time for the first edition of The Handover Blog Carnival for 2011. Thanks to Rescue Monkey for letting my little niche of the interwebs host this edition.

Following in the same type of pattern of Just My Blog, for this edition I have chosen a seasonal topic. It’s the new year now, so I’m curious. What are your plans for this new year? What do you hope to accomplish? Plan on not doing anything this year you’ve done in the past? Share it with us.

Last month we got 22 entries, which is good, but let’s see if we can beat it! Email me your entries transportjockey (at) gmail (dot) com . I can’t wait to start seeing what ya’ll send me! Try to have all entries to me by the 29th so I can post the January edition on the 31st!