View Full Version : Any one else having good calls?
Hi all, I have been having some pretty good ALS calls this past week.
I am at our busiest station right now, but most of the calls we have on this truck are the "system abuser with hemorrhoids, toe pain, you get the drift.
This past 3-4 shifts we have had 4 shootings with 2 being critical and one of the patients dying about an hour after getting to hospital. Last night had a good one, A guy shot in the back with an exit on the right rib cage about the 3rd to 4th rib and entered his arm in the biceps and went through and through.
Had a guy who had fell and smacked head on concrete at like 18:00 and then lay in bed vomiting till 03:00 till family decided he needed some help. Yep, subdural.
Had a dude with spinal meningitis that was seizing on us.
Had a few other seizures with actual seizure activity
Had 3-4 actual MI's Plus a rash of regular chest pains
Have had a tremendous amount of Psyche's that have slit wrists, stabbed self etc.
The only thing I haven't had is a big bad MVA. We had one last night but thank god, I was on my shooting call, they had 7 critical ejections from one scene. So I guess my turn probably tonight for the MVA And I feel my weekly code coming tonight LOL.
The sad thing is I have no student with me right now and 3 other trucks do and We have been getting all the good ALS calls and the bad MVA last night, no truck with a student on it went to that one LOL.
Oh well, Just wanted to share. I get plenty of good calls here, but I have been having a higher percentage of real call as opposed to BS calls.
Anyone else?
Smurfe :D
emmit233
09-28-2003, 00:03
Well my last good call was a 70 year old female in a N.H. with severe resp. distress. U/A find that pt. is severely retarded and does not verbalize. Per N.H. staff they understand pt. pretty well and so does her family... so here is the Hx i get...
"well last night she was C/O of left jaw pain so we gave her tylenol. Tonight she C/O's of left arm pain back pain and vomited X2. We gave her Phenegran and about 20 minutes ago she started gasping for air...so we put 2+2 together and I bet she is having an MI" :shock:
The pt. SPO2 on room air was 78% got better to 94% on NRB skin was cool and clammy and the pt. had that "impending doom" look in her eyes... On the monitor there was so much artifact that it was hard to see anything. At times she appeard to be flipping in and out of A-Fib but I could not truly say that because of the artifact. We gave 4 baby ASA and she still had them in her mouth when we got to the e.r. :roll:
The 12 lead at the e.r. showed AMI... and they started their whole AMI protocols.
After we got back on station we found out that she had died... She just had too much damage.
That was my most recent challenge.... Hard as heck to make an assessment.
2 more good respiratory calls tonight, a COPD with BP of 78, Sat's of 41 resps of 50 and a temp of 104, can we say sepsis! Got that ones pressure up to 100 and Sat's up to 91. And a CHF with Sat's of 51, resps of 60. she ended up smoking a tube. Had a heck of a time getting a lock in her.
Also had a decent stabbing to the chest but it didn't hit anything vital.
WHen we ran the CHF call, 4 of the 7 trucks were on CHF calls and we all got to the same hospital within 10 minutes of each other, the ER was stressed, 3 of the patients were tubed. Well, time to crash and see what tonight brings me
Smurfe :D
emmit233
09-28-2003, 10:51
OOooohh forgot about the teenager brought in by another ambulance service that had an arrow to the left chest.
teenager at party... mouths off...imagine that... bigger badder dude shoots him in the chest with a compound bow (80 # pull) at about 3-5 yards (per pt.) target tip.. Lucky for the pt. :roll: The arrow just barely missed everything vital in the left chest...except for the minor hemo-pneumo he was ok. Oh yes he played macho after being shot.. left with his buddy and his new body piercer and drove about 10 miles... while enroute to who knows where he yanked the arrow out... I think he saw 1 too many westerns. :lol: Anywhooo now the dude is hurtin' and calls for the ambulance. :P Bright guy huh?
Long story short we had to transport him by ground to our nearest level 1 trauma center (over an hour away by ground) because all the choppers were grounded due to fog. The kid is ok now... That was one lucky twerp!
Hey smurfe tell me you don't miss the good 'ol midwest! LMAO! :twisted:
Stay safe out there!
Trish
Firefly1361
09-28-2003, 15:22
Ran a few calls at my other volley station last night and for some reason it seemed to be seizure night. Two out of the three pts were post ictal. On top of everything else the other crew at the station ran a few seizure calls too. They werent even good calls. One we transported for check up and the other one was a refusal.
Hey smurfe tell me you don't miss the good 'ol midwest! LMAO!Yeah, I sure do. I had my weirdest stuff up there. I just have a lot more of critical stuff here, but yeah, I miss the snow :shock: I can't begin to imagine a 1-hr transport time. Geez, in our system we could do 2 critical ALS calls given an hourWait till you have to work a cardiac arrest by your self for 40 minutes and empty your drug box, I mean literally, and all you monitor batteries are dead and for some ungodly reason, you keep the patient salvageable for the hospital to revive and patient leaves the hospital. :shock:
Smurfe :D
emmit233
09-28-2003, 19:35
Min,
My shortest transport time has been less than a minute. (lots of apartments all around the hospital) and my longest transport time to my primary facility has been 26 minutes. Any of our hospitals that are a Level 1 trauma center are at least an hour and 15 minutes away. (that's why we try to fly)
I too have had the multiple critical care runs in an hour. Motorcyle MVA resulting in a fatality, Chest pain caused by too much meth :shock: and the to top off the hour a self inflicted GSW to the mouth and yes he lived. Plus we are e.r. based so we get to take care of em at the hospital. I think that helps build a relationship that can be inportant on those ohhhh so long transfers. (sometimes we transport 3 hours to Indianapolis too) :roll:
Hey has anyone noticed a lot of famous people passing away? 2 more today.
Haven't had anything exciting. Same ole run of the mill calls. Everyone around us is having some decent calls. A town 30 miles from us had a 45 minute extrication last night.
Firefly1361
09-29-2003, 11:26
Just got off of my 24 hr shift and had to run a 911 call. My partner and I had just gotten donuts and coffee when he wanted to stop at a 7-Eleven for milk. Well when we pulled up there was a hoard of ppl standing around this guy who was slumped next to a trash can. The guy was deeply unconscious did not even respond to painful stimulus. No mind you we are a hospital based CCT team and usually dont do 911 calls. We wasted no time in calling for the Baltimore City FD. It was a load and go call. Once in the back the my partner hit the pt up with half a mg of narcan. He started to come around a bit. We got him to the hospital and he was coming around even more. I know it wasnt the proverbial "good call" but it was a change to the cct and als calls we run. Take care and stay safe everyone.
emmit233
09-30-2003, 06:22
Had a 17 year old lifting weights alone. Bench pressing 165 pounds...Did I mention ALONE? He dropped the bar on his throat. Upon arrival pt. was having periods of apnea and upon inspiration stridor is heard. Pt got a N.P. and assisted with his ventilations. Upon arrival to the ED pt. bought a tube, CT of the throat and neck and a chopper ride to another facility. ]
CT showed some soft tissue swelling but nothing that looks to be long term problems. The one thing that is puzzleing the docs are the periods of apnea that he is still having. I just wonder how long the bar was across this throat before he was able to get it off... or until he was found. I am still unclear as to how the bar came off of his throat..My guess is it fell.. :roll:
Trish
hageremtp
10-01-2003, 17:01
Ran a good AMI the other night. Started a Nirto Drip to keep the chest pain away. Transport time for that one was 45 minutes from house to ER door, and that was code 3!
I "gave up" some good calls the other night to a truck that had a student on it that was at the hospital when we were. Gave up a shooting to the neck with an exit in the occipital area, they had a hanging that was PEA and worked and another bad bad CHF. See, I can be a nice guy :lol:
Smurfe :D
bigj164019
10-01-2003, 23:23
Ran a good AMI the other night. Started a Nirto Drip to keep the chest pain away. Transport time for that one was 45 minutes from house to ER door, and that was code 3!
Damn, that pretty long transport for AMI.
Do you guys have Thrombolitics?
emmit233
10-02-2003, 13:46
:( kinda bummed... we hit a small cute night critter (raccoon) on the way to pick up a NH pt. for stitches... because he had "care" and "caid" and family did not want to take him to e.r. "well the 'insurance' will pay for an ambulance ride" :twisted: Not to mention that we were the last truck left in the county.
Is it just me or do these kind of runs bother other people here? Don't get me wrong yes he needed sutures yes he needed some kind of care... just not EMS...Oooooh ok I am done venting! :roll:
Thanks for putting up with me LOL
hageremtp
10-02-2003, 19:20
Damn, that pretty long transport for AMI.
Do you guys have Thrombolitics?
Yes we do carry them, however age and a recent surgery was a fact in my decision not to give it prehospitally. They did TNK here at the ER and we transfered her to the next largest hospital in the area, 65 miles West of us.
OARMedic
10-02-2003, 22:17
45 yo female C/A pt. C/C of altered LOC. On arrival pt was arousable to painful stimuli. Deprassed resp. When we removed her shirt to hook her up to the ECG, we found eight Fentanyl patches on her arms and shoulders. It seem they told her when to put on a new patch, but not to take the old one off. Ripped them off, a little narcan, and she perked right up!
because he had "care" and "caid" and family did not want to take him to e.r. "well the 'insurance' will pay for an ambulance ride"
Welcome to my world . I transported one last night that I actually didn't even need to load the stetcher in the truck. Was across the street from the hospital. Had his "caid" card in his had yelling " you got's to take me, I got my rights and I got Medicaid, so yous gots to take me where ever I wanna go!" BTW, he had an abcess on his a$$
Smurfe :D
emmit233
10-03-2003, 04:01
Welcome to my world
Smurfe :D
LOL Welcome to the World of EMS eh Smurfe? :lol: Ya just gotta love those runs that take less than a minute to transport and the pt. is gone back home before you are done with your paper work. :roll:
Well, go to our "retirement" station tonight so my call volume will go WAY down. I am so depressed :cry: I do have to say that when we do get one in this area though, it is usually a really good one. Our worst accidents are in this trucks area. Seen on the news today that there was a head-on with a school bus this morning killing the driver of the car, critically injuring her child and injuring 11 kids on the bus as well as the driver. So I guess the potential is still there
Smurfe :D
SteelMaiden
10-08-2003, 20:07
because he had "care" and "caid" and family did not want to take him to e.r. "well the 'insurance' will pay for an ambulance ride"
Welcome to my world . I transported one last night that I actually didn't even need to load the stetcher in the truck. Was across the street from the hospital. Had his "caid" card in his had yelling " you got's to take me, I got my rights and I got Medicaid, so yous gots to take me where ever I wanna go!" BTW, he had an abcess on his a$$
Smurfe :D
I had one of those calls not too long ago, the guy was trying to outrun the cops and they broke the abcess open when they tackled him. I just love working with guys in handcuffs - NOT! We get a lot of bs calls, where we just walk 'em to the bus, and tell them to be careful while climbing in. Also more that our share of 13 or 14 year old preggers. Maybe they should stop teaching sex-ed and start teaching no sex-ed?
My favorite one was the shotgun wound to the upper chest, supposedly self-inflicted. I was doing clinicals when this one came in. The guy was complaining that he needed to get his arm raised a little, his wife grabbed it, yanked it up and shoved a pillow under it. The guy came up off the bed about 10 inches! LOL, I think she was trying to finish what she started!
msharpe1047
10-09-2003, 13:11
Any body else have the 01:00 am accident w/injuries 2 vehicles involved and only 1 person standing on scene? He was running around tryining to find his keys. The other driver took off and his friends even came and took the plates off the vehicle before anybody got there. This is happening more and more around here. To top it off the pt was out of the hospital before we finished up our paperwork. :evil: :x
SteelMaiden
10-09-2003, 13:56
Any body else have the 01:00 am accident w/injuries 2 vehicles involved and only 1 person standing on scene? He was running around tryining to find his keys. The other driver took off and his friends even came and took the plates off the vehicle before anybody got there. This is happening more and more around here. To top it off the pt was out of the hospital before we finished up our paperwork. :evil: :x
Single car MVA, car went into the ditch, no sign of damage to the vehicle, 4 pts, everybody up running around until they see the bus, then they all lay down in the middle of the road and start moaning???
Medic162
10-09-2003, 15:14
Smurfe - are you the magnet right now or what??? Man, I can't even get a GI bleed call these days. I've had the slowest start in October I've had in ages. Everything is hitting on the other shift. This past Tuesday, my BLS crew at the AFB had an arrest and by the time Chas Co. got there to transport, the guy had a strong pulse and was breathing on his own. These guys did a fantastic job and what a morale booster. Oh well, I'm always careful what I'm wishing for :?
emtp2031
10-09-2003, 21:57
We run plenty of BS calls here.I remember last summer when a crew brought in a 19yo F....we were on yellow alert in the ER(Full dont bring us anymore or you'll wait for 4-5 hrs to be seen status)This girl had called 911 at around 6pm...her emergency......"she had a hard day at work"well I proceeded to tell the crew to wheel her out to the waiting room and let her get off there....4 hrs later she was seen in ER and d/c'd 30 mins later..Talk about totally abusing 911..... :roll:
But I did have a good trauma last week..
300+ 37yoM pedestrian struck trying to cross a 4 lane road at night of course...hit and run..tossed about 75ft...compound tib/fib w/arterial bleed,skull Fx ..I could tell cause there was a hole in his forehead about the size of ahalf dollar and I was looking at his brain...of course ETOH was involved...increasing combativeness thruout call..called medivac for transport to level 1 trauma...rookie flight medic balks at RSI and comes up with an excuse as to why we need to take him to local (No trauma docs) level 3 center.. can we say case review..they freak BP plummets to 60/P...I did keep it at 105/81....and then to top it all off...the pt is possibly HIV/hep C....this guy was soooo combative towards the end we all got his blood on us.....thank god none of us had an exposure......and prior to that lovely call I had gotten 3 refusals from the local drunks beating each other up!God I love being a vollie!!!! :shock:
Smurfe - are you the magnet right now or what???
I guess I am. I, like a Moron, was begged and convinced to work an OT shift last night, had my station of choice so I picked the one closest to home which is usually slow at nights. Well, last night I get another shooting. A 30 Y/O female Vietnamese convenience store owner who took one in the right upper quad with no exit wound. BP in the lower 80's. My wife tells me that the store this gal was shot at, her Aunt was shot and killed at years ago when her family owned it. :cry:
After that call, we get a call for a fall at a bar, so you all no what goes through your mind. We get on scene at this Yuppie bar and the dude is lying on the floor A&Ox3 with a decent gash on his head. He is adamantly refusing treatment. History of hypoglycemia. He finally agrees to let us check him out and bandage his wound. Check his CBG it is 91, have a hard time getting a BP. As firefighter is bandaging the patients head, the patient is rocking forward and backward. I thought he was just moving as the dude was wrapping the kling around his head. I look up at the guy and he is snow white and drenched in sweat, Partner slapped the monitor on real quick and he had a heart rate in the 20's. Stick a line in and give him 1mg of Atropine and his heart rate comes back up and once again, he don't want to go to hospital, but was easy to convince him when we showed him the EKG strip.
Next call is a dude that holed up in a motel room and ate 2 whole bottles of tricyclite anti depressants. He was all altered. He bought the bi-carb drip.
Other than that, had 3 MVA's that were uneventful, and a couple basic medicals.
So, so much for an easy OT shift LOL
Smurfe :D
Medic162
10-10-2003, 12:53
Alright my "break" is over. Last evening had a SUV vs pickup. SUV lost in a BIG way. 3 criticals, all from SUV. Told you I was being careful what I wished for.
hageremtp
10-11-2003, 00:18
Took the week off but still managed to get in on an MCI drill on Wednesday night.
msharpe1047
10-11-2003, 11:18
Just once it would be nice to run a code with more than just 2 people. Last night we were dispatched to an unresponsive 89 yo m pt. The problem is living in a rural area and having calls that run 1.5 hours each can be taxing. The other problem is that I am an EMT-I and every time I call for paramedic assistance I can never get it, So we get the pt and go. It is hard for me when we are working a code and it is just me and 1 other person. This is of course why I am currently in the paramedic program. I know what some of these pts need but at my level I can not do the skills or push the meds that they need.
About a month ago, I had a seizure pt that was in status for 20 minutes before we got on scene. We were on scene less than 2 minutes and I called for a Paramedic to give valium or versed for over the 35 minutes it took to get to the hospital. The only thing we were allowed to do was start an IV and maintain an airway w/high flow O2. The pt was in status the entire trip to the hospital W/grand mal seizures. I felt bad for the pt but I couldn't do anything else for them. These are the reasons for going on to the paramedic class. sorry for venting just frustrating at times.
Medic162
10-11-2003, 14:23
[quote="msharpe1047"] The other problem is that I am an EMT-I and every time I call for paramedic assistance I can never get it, So we get the pt and go.
I feel your pain. I was an EMT-I for a number of years prior to attending paramedic school. At the time I was working for a rural service in Kansas so I'm quite familiar with long ALS intercept times. We just do the best we can with what we're allowed to do.
emmit233
10-25-2003, 13:35
Well back on the first page of this topic I had posted about the young fellow that dropped the 160 or so pound barbell on his throat.... Well after he was released from the hopital he returned to a normal life for a couple days.
One evening we get paged to a 17 y.o. male not breathing CPR in progress. As I walked into the room it is "barbell boy" and one of his girlfriends is rescue breathing for him. As I went to assess him he had a pulse and his breathing was shallow. (I watched the G/F give him a rescue breath and there was def. chest rise and fall from her ventilations) The pt skin was pink cool and dry, pulse of around 90's and regular, SPO2 of 85% that came up nicely with 15 lpm per NRB. pt was responsive to painful stimuli and woke up right away when I assumed care. (maybe he remembered the NP he bought the last time LOL) Long story short we took him to the ER and they could find nothing. He bought a bed in ICU again. He was released next day.
About 2 days after that I heard that our local PD took him to the psych unit....Hmmm I just wonder if he tried to drop that barbell on himself on purpose and the second time was for attention... I just am bewildered...I do not by any means trust my monitors over what I see with the pt. but I do not feel that the SPO2 was wrong. So if he is a faker then he gets the award of the year! LOL
Had a good call this morning, not a spectacular "save", but I felt like we did the patient some good.
Dispatched for an "ill person." Text on MDT said: "F/C states husband fell but seems OK now...He does not want treatment...respond Code 2" It was just down the street from the firehouse so we arrived quickly.
Pt. was a 75 yo male. He was pleasant and cooperative but insisted nothing was wrong, he just fell down. Wife insisted that he had "passed out" and was unconscious for a short time.
Vitals were ok but he was cool and a little diaphoretic. Blood sugar was good, he denied any chest pain or breathing trouble, his only history was hypertension.
Something didn't seem right so I called for an ALS unit. Pt. finally admitted to the Medics that he had felt weak & dizzy before falling down and his 12 lead showed 1st degree block.
Glad we didn't let him sign AMA like he wanted to :shock:
Like I said, nothing spectacular but it felt good to know we helped him and he may avoid further problems down the road because we insisted that he get checked out further.
msharpe1047
10-29-2003, 13:01
Had a rather interesting call Monday night. We had just gotten home from a fire and I had gone in the house to kiss my wife good night when we hear another company requesting ALS from our station or another one on the way to the hospital. So I called in and answered up. Met the ambulance at a convenience store just down from the hose.
When I stepped on the ambulance there was a 60 yo M prisoner holding a trauma dressing that was soaked with blood on his groin. So as I am setting up the IV, I asked him what had happened. He very casually said that he had taken a razorblade and cut his testicles out and flushed them down the toilet. :o :o He stated he was fine till what ever he was using for a tourniquet fell off and he started bleeding. He said that he had lost approximately 2 liters of blood before he was found so started an 18 gauge IV in the left AC on a blood set and tried to start a second line but was unable to as we were pulling into the hospital.
Took him in the ER and was giving my report when the Dr on call came over and went to look at the cut. When he pulled the trauma dressing back got to see that it was an arterial bleed and had to take over applying direct pressure while the OR team was called in. I could not believe that some one could do that and be so calm about it.
Needless to say that this will be a call I don't forget. I wonder how he was able to 1) get a razor blade to begin with and 2) do that without screaming. He told me that it was not a spur of the moment thing and that he had thought about doing it for a while.
While I was down at the hospital the nurses were talking about another prisoner that got his thing caught in the steel beed frame and had to extricated from that. The worst thing was that the prisoner said that it was not the first time something like that happened. It just goes to show that you can't cure stupidity. Take care and god bless.
emmit233
11-05-2003, 03:51
Got paged to a MVC this AM for 1 female pt. U/A I find my pt. sitting in her vehicle that has minor damage to the front bumper. First Resp. is holding C-spine. I asked what happened and she didn't want to tell me. While I am doing my assessment my partner is getting an SOR signed on the boyfriend. Turns out she got mad at him and wrecked into the guardrail To get back at him. No wonder she did not want to tell me what happened. :oops: She refused treatment and we were on our way back to station for doughnuts :D :P :D
Had a Pedi code last Thursday a 3 month old. Looks like probably SIDS, but they found the baby right after it had died, no rigor and still warm to an extent.
We had 3 medics on the truck with one being a new guy in training so I didn't do much on the call, I got to stick the I/O in, hadn't done that in like a year, pushed a round of EPI and Atropine while they were getting the airway secured, then I drove like hell to the hospital while my partner and the new guy worked it up. They didn't work it long after we got to the hospital. Was a real bummer of a call.
Smurfe :D
We had a 77yo male on Sunday. His wife called in for "diabetic non responsive". When we arrived he had a good heart rhythm. While we were en route to the er, we went into cardiac arrest. The medic hit him 6 times with epi after we kept getting a few beats from him. In the er, they hit him another 5 times with epi. After about 10 minutes of doing compressions, the doc called the code.
This was my first cardiac arrest. Usually all the calls are TLC. But all in all it was an exciting call (as weird as that sounds).
E74_medic
11-05-2003, 14:07
Last shift I had a buch of routine taxi rides, two GI bleeds and a diaper change on an older citizen. I haven't had anything good since I moved to "B-shift" last year. :cry:
I haven't had anything good since I moved to "B-shift" last year.
LOL, I work on "B" shift. All the "dramatic" calls around here seem to happen on B shift LOL
Smurfe :D
mcaldwell
11-14-2003, 02:21
We had a strange night on Monday.
It started at midnight with a FD page to an alarm at a local condo hotel, which turned out to be a drunk kid pulling a break-glass station. As we were packing up to head home, one of the kids from the party comes running out to tell us his friend has fallen. We follow him back to a large retaining wall that divides a raised roadway from the condos below.
We find an 18 yr old male lying at the bottom of the 9 meter wall. He is three sheets to the wind, and feeling very little pain. Primary survey finds neck, back, and hip pain and a clearly fractured humerus. We give him the whole package and ship him off to the hospital.
Turns out he and his friends went for pizza, and as they were walking back down to the condo, they decided to hop the concrete highway barricade and walk along the 1 foot wide ledge that overlooks the wall. Needless to say, his beach sandals weren't up to the task in the fresh snow, and he took a header 9.7m down to the bottom.
Last update I received had him transferred to Cranbrook Hospital for surgery on the arm, but his back and spine were OK.
Lucky kid. He's probably only going to have a small surgery scar to remind him of his stupidity. Hopefully his teenage invincibility complex fades a little after this one. :roll:
alsfirefighter
11-14-2003, 20:50
33 y.o. hispanic male, struck by 2 door sedan at unknown speed while crossing 4 lane roadway after leaving bar frequented by day workers and other latin american immigrants. Pt collared/boarded by bls upon arrival, CPR in progress. EMT-P acting as an EMT-I unable to intubate prior to my arrival. Pt found to be PEA at rate of 120, pt hyperventilated while attaching leads/pads, pt intubated with 7.5mm ETT with C-spine maintained, pt's pupils 5mm and fixed, quick visual scan (bls had pt exposed) revealed no obvious traumatic injuries, tube confirmed by visualization, auscultation and end tidal CO2 with good color change and strong ETT fogging. (I don't use fogging as a true indicator but I still note that I have it). Tube secured with commercial ETT device. Large Bore IV started by another EMT-P whom is a member of BLS service while intubation occurring. IV Wide Open pt being ventilated at rate of approx 28-30 BPM, capnography shows CO@ out put of 38-44. Pt regained spontaneous strong peripheral pulses after IV/ETI, BP 132/74. Transport initiated total on scene time approx. 9 mins, which was delayed due to traffic. 2nd large bore IV while enroute at KVO, Fluid titrated to maintain systolic of 110, pt BP slowly decreasing during txp. PE> heent: pupils as noted, no deformities/crepitus/bruising, small lacerations to forehead and small avulsion of scalp at anterior most midline hairline, teeth intact, jaw was moderately clenched during ETI attempt, trach midline, no JVD, BLS reported no deformities to entire spinal column prior to immobilization, CHEST: =, l/s clear and = bil. x6, no deformity/crepitus/flail segments, bruising/rib retractions, ABD: soft, supple, no bruising/distension/pulsations/masses PELVIS: stable, no crepitus/bruising EXTR: no apparant injuries/deformities, all bones feel to be intact, unable to assess motor effectively due to unresponsivness, no reaction to tickle reflex (babinski sign) and no posturing noted upon arr. or to painful stimuli. Patient had slow onset of priaprism that was pronounced upon arr to trauma center.
Anyhow, other then the assessments, patient remained the same throughout the txp. trip took 30 mins by ground due to rain/wind, normally can make it in 20. MD's at trauma ctr amazed that patient had no external injuries other then lac's/avulsion to head as I noted and that no other significant fractures to extremities or anywhere other then that of the cervical spine.
Patient expired exactly 1 week post incident with no improvement in consciousness nor neuros.
On a side note we switched to a new tube holder, we had the blue kind like that on ER and they were pretty good but now we have a yellow one and it is 10 times better, easier to get strap around, and the tube holder cynches on the tube instead of that twist screw type.
emmit233
11-19-2003, 22:50
16 year old with stab wound to right thigh. Pt. had several cuts to left upper arm as well. Pt. said it was another ethnic group that did this to him... :evil: Anyway got him into the rig with better light. The several cuts on his arm were hesitation marks..scratches really. He had a nice puncture wound to the right leg with a hematoma forming underneath. Pt. insists that he is a hemophilliac...No active bleeding from his wounds. The best part is pt. insists that someone else did this to him... when we got to him he had his pants down below his knees. Upon closer inspection pt. pulled his pants down and then stabbed himself... :lol: pt.s BAC was .258 :roll: Pt. was treated and released to psych. 8)
emtp2031
11-20-2003, 00:59
Gotta love stabbing calls...I had one the other night...one of our locals..of course always lots of etoh on board..wouldn't know how to treat them if they were ever to be sober :lol:
43yo M yapping on a pay phone..refusing to say he was stabbed..he fell on "glass" he had a nice stab wound just under L breast,wouldn't let us treat him,let alone let me listen to his lungs..he wouldnt stop yelling..I think I got drunk off the fumes..we told him multiple times to let us take him to the ER because he could die..this is how you have to talk to most of our regulars...needless to say refusal was signed and witnessed by police,told them I'll see them again within the hour for this guy collapsing...I wasnt too happy about letting this guy go AMA.Right after this call I took another and while at the ER with my 2nd pt. ..guess who had called his mommy to take him to the ER...needless to say ICU doc dropped a chest tube and this guy was flown to trauma center...and will return back to town in a week or so to do this all over again!!!! :roll: And they arrested his drinking buddy..at least 2 of our regulars are out of town for awhile!!!!
emtp2031
11-26-2003, 01:05
This call I had a couple of days ago wasn't so much a good call but a sad one...50yo F resp.distress was our dispatch.I get there and yes its a 50 yof in resp. distress 2ndary to end stage ovarian CA that has mets,this poor lady was still very conscious and oriented.She had yet to be put in hospice program or had any advanced directives/DNRs....which made my pucker factor increase.Husband is arguing on what ER to take her to..I'm 4 miles from one....this patient is a priority one......I tell my driver to go get stretcher and some other equipment....I cant get a bp manually on multiple tries and I call for emergency manpower assist.My driver says he'll get the stairchair..I tell him NO the STRETCHER!!!!!!..If I had sat her up she would've coded right then and there....Needless to say the guys showed up pretty fast..they know when I ask for emergency assist its bad...As the guys are taking her out of the house I talked to the family and tried to get them to understand that she will probably not survive the night....they didn't hear me..... :( bp 70/? R-26 HR 146 sats ?????ekg -S.Tach
skin- cold/cyanotic in nailbeds,lungs-barely any breath sounds,distended belly,no pedal pulses,took me a bit to find radial,NO iv access anywhere..I couldn't even get an EJ to slightly appear..radio fails for consult/notification....All the time the woman is asking me to save her she doesnt want to die...I go to start bagging her and she refuses it and keeps pushing it away..it was all of a 7 minute ride to ER....right after we move her to their bed I looked at monitor and told the RN's that her HR just dropped 40 points and then she coded.....they worked her for a couple of minutes then called it...they never got a line either....During the ride I tried to comfort and reassure her as uch as possible,for I knew what was going to happen in the next few minutes.But in a way I feel like I didnt do enough for her.This woman was responding to me all the way in the door to ER....she was in so much pain and I couldn't help relieve it :cry:
I hate end stage CA calls .................................................. .I just realized a few minutes ago I was the last person she talked to..her daughter rode in ambo up front..she never got to see her mom to say goodbye........thanks all for letting me vent
emtp2031:
Yep, those type of calls suck. We have been hit hard lately with a ton of late diagnosis CA deaths. It's difficult, especially when you can see the end before the family can.
Thanks for the scenario!!
Medic162
11-27-2003, 23:09
Well... November has sucked. Three full arrests in the last 2 weeks. Only 1 of which made it to the ICU where he later died. Two of these were <50y.o. guys. They say the heart disease capital of the U.S. is the south, I'm starting to see it... Ya'll be safe
:cry: I had my first living pulmonary embolism pt. She was classic. She was 5 days primipara. Tachycardic. o2 sats very slow reponse to nrm. Her sats never got above 89%. I've had codes that had more color. It was obvious PE. I was doing EMTP clinicals at a rural service. We picked her up at a Dr.'s office. And the rural hospital was only around the block. They ended up airlifting her to UNC. Man, she was only 22yo. I found out out a few days later that she threw it two hours later on her way to the procedure room. Now, I've been in EMS, Fire and Law Enforcement for more that 11 years. I had my hands in all manners of human suffering. I have made detachment my middle name. But that woman's face is forever etched in my mind. I've run it through a hundred times; to see if there was anything else that could have done to have given her a better shot. I am at a loss.
Carrie
EMTI- EMTP student ( for 2 more months)
NC
We all have our little faces that haunt us. Good Luck and if you need someone to talk to let us know.
justdoinmyjob
02-01-2004, 22:58
Dont know if you would call these good calls but they made my nights last week interesting.....
FIRST CALL
Call to the police station for a HBD (has been drinking) who is vomiting bright red blood - lots of it.
Ok first there wasnt lots of it and second it wasnt blood. Turns out the guy was drinking red wine. So....
We make him get up and walk to the bed. He is being your average jerk HBD, uncooperative. He told me he has answered enough questions and does not want to ask answer any more. His only real complaint is a headache, yeah well I get a headache when I drink red wine too. He took two of his own daily dose ASA to stop it but then threw up. Vitals are all fine (high BP but the pt has HTN so not unusual). So off we go to the hospital.
Hours later we return to find out that some gungho resident ordered a CT of this guy because he was acting unusual. Apparently he has never seen a drunk before. Anyhoo, CT looks bad, VERY BAD.
Turns out the guy has a HUGE 4th ventricle bleed. HMMMMMMM
SECOND CALL
Called for a VSA to an older neighborhood full of small apartment buildings with tiny elevators or worse walk ups. This particular building had about 20 steps into it and then an elevator that was 4' X 3' with a capacity of 5. No way the stretcher was going to fit.
When we get to the 4th floor carrying all our equipment we find a small apartment. The door swung in and we all had to pile into the living room and close the door before we could pass by into the bedroom.
We walked in to find a 700 lb pt lying on the bed, NAKED (why do people always have to die naked?). From the outset of the code he was asystole. IVe NEVER seen anyone come back from an initial rhythm of asystole. After a great deal of effort and about 15 missed lines we finally get a line (Since SARS we are not allowed to give drugs ETT because of the droplets created). After 2 rounds of drugs still nothing.
In the middle of patching to BHP for a pronouncement someone stays "stop a second" to which my first instinct is to reply "tell me the line didnt fall out!". "No I think I see something on the monitor", then a resounding "crap" is mumbled under everyone's breath.
Now I know we are not supposed to hope that a patient does not make it and I am probably going to hell for even thinking the though, but..... if he had been pronounced we would not have to transport, but now that we have a pulse (and a very strong one at that) its a different ball game. Now we have to figure out how to get this guy into the back of the rig and to the hospital.
To make matters worse at one point I looked up and saw provocative pictures, diagrams, and sayings on the bedroom wall. And his girlfriend (yes he had a girlfriend - about 5'2', 150lbs) continually insisted that he couldnt weigh over 200 lbs!
Anonymous
02-02-2004, 01:46
I bet that was fun getting him down.
How did you do it?
emtbff927
02-02-2004, 02:03
Been up at school for weeks, but finally got the chance to come home last weekend and get my cpr recert. at the station. class ended right as a pin-in was toned out - talk about timing! Actually got to bunk-out and do some patient care. Felt good to jump back into things for a moment, and was releaved to find I hadn't lost any proficiancy over the weeks. :)
Anonymous
02-02-2004, 02:10
I have a hard time with sexual assualt and child abuse calls. They usually don't send me on them, I just can't stand to see a woman or child abused in that mannor. (The same goes for older or special needs patients.)
I guess, and I don't want to sound stupid, but the best call I ever ran was a chest pain call that ended up becoming a 2 hour trip to the patients choice of hospital, some 30 miles away, but with traffic it took longer. He was stable, but he told me how he had grown up dirt poor and I learned a good lesson from this man.
It doesn't matter what you have, who your dating, how many friends you have, as long as your not happy with yourself, you'll never be happy. That you should take your time and enjoy life.
After that call, I stopped trying to have 5 to 10 minute scene times. I would turn down the radio and address the patient and his/her needs first before dealing with a dispatcher that wanted to know what was taking so long. I started having 15 minute scene times with stable patients, and asked them which hospital they wanted, instead of just taking to the closet one.
Oh yeah, and the Starbucks call, that was good.
I have a hard time with sexual assualt and child abuse calls. They usually don't send me on them, I just can't stand to see a woman or child abused in that mannor. (The same goes for older or special needs patients.)
I hear that. Never been on an abuse call, but I think it would get to me. I see it on TV all the time and most of that is fake and it pisses me off. Can't imagine working a real one.
Anonymous
02-02-2004, 02:34
I have a hard time with sexual assualt and child abuse calls. They usually don't send me on them, I just can't stand to see a woman or child abused in that mannor. (The same goes for older or special needs patients.)
I hear that. Never been on an abuse call, but I think it would get to me. I see it on TV all the time and most of that is fake and it pisses me off. Can't imagine working a real one.
Had a lady tell me not to call them victims in a CE class once. That we are suppose to call the heros because they made it through this ordeal. I'm sorry, but why not just call them by their name?
I've seen to many guys in the clubs treat women like meat, and its okay to joke around when your with your buddies shooting the breeze, but I know some girls that have been through this kind of stuff, and some of them are still dealing with it years later.
One of them won't even walk to her car alone at night, she is that scared. I can't blame her, but I make the drive every Wed. to her work to walk her to her car.
In that class I went to, they said that 1 in 3 girls will be sexually abused by the time they are 16, and that over half of those girls will always have trouble with their emtions after that.
I see children riding in cars crawling around, or in their mothers lap in the front seat, no seat belts. I call the plates in and we will usually follow them till PD finds us and pulls them over. In my eyes, its child abuse, even if your not physically beating them.
RescueYou42
02-02-2004, 13:04
I see children riding in cars crawling around, or in their mothers lap in the front seat, no seat belts. I call the plates in and we will usually follow them till PD finds us and pulls them over. In my eyes, its child abuse, even if your not physically beating them.
Have you ever thought that you are not a cop? You're in an ambulance, it's not a smart idea to follow people around unless you are open to getting charged with stalking. Yes, it is your job to report what you see when called upon, but in these cases, you are stalking someone and playing god. Let things work out on their own.
Have you ever thought that you are not a cop? You're in an ambulance, it's not a smart idea to follow people around unless you are open to getting charged with stalking. Yes, it is your job to report what you see when called upon, but in these cases, you are stalking someone and playing god. Let things work out on their own.
I've done the same before, just never followed them. I just take the tag # and call the police with a description of the vehicle.
RescueYou42
02-02-2004, 14:02
Have you ever thought that you are not a cop? You're in an ambulance, it's not a smart idea to follow people around unless you are open to getting charged with stalking. Yes, it is your job to report what you see when called upon, but in these cases, you are stalking someone and playing god. Let things work out on their own.
I've done the same before, just never followed them. I just take the tag # and call the police with a description of the vehicle.
Nothing wrong with calling something in. Nothing at all. Civilians do it every day, why do you think we have dispatchers? What I was saying is that it is not right to FOLLOW the vehicle. I've been with crews that have seen someone drinking and driving while we were headed back to the station. They pick up the cell phone and dial into dispatch through 911 so that it's recorded on the phone, and then it's recorded from dispatch over the radio.
Being a good citizen is one thing, stalking someone and watching them until the PD finds you is illegal. Like I said before, if you're stalking someone, I hope you are ready for the consequences.
Have you ever thought that you are not a cop? You're in an ambulance, it's not a smart idea to follow people around unless you are open to getting charged with stalking. Yes, it is your job to report what you see when called upon, but in these cases, you are stalking someone and playing god. Let things work out on their own.
I've done the same before, just never followed them. I just take the tag # and call the police with a description of the vehicle.
Nothing wrong with calling something in. Nothing at all. Civilians do it every day, why do you think we have dispatchers? What I was saying is that it is not right to FOLLOW the vehicle. I've been with crews that have seen someone drinking and driving while we were headed back to the station. They pick up the cell phone and dial into dispatch through 911 so that it's recorded on the phone, and then it's recorded from dispatch over the radio.
Being a good citizen is one thing, stalking someone and watching them until the PD finds you is illegal. Like I said before, if you're stalking someone, I hope you are ready for the consequences.
I was just saying that I've called in. Not disagreeing with you. However, as a public servant, I would say stalking would be out of the question if your following a drunk driver. Maybe laws in your state are different, but around here the police & prosecutors would be grateful for us following someone to allow the police to find them easier. Now forcing them to pull over or taking them into custody is a different story. Then again, you would have to prove you were following them. For all they know, I was en route to Burger King :D
Just sounded like a personal attack to me rescue. No offense.
btw, you should look up the legal definition of stalking. One cannot be charged with stalking if the perpetrator is committing a felony.
RescueYou42
02-02-2004, 15:49
Something similar to this happened in Vermont not to long ago..
A EMT for a public EMS service was going home from station coverage and saw a car driving wrecklessly and decided to call it in. This person then decided to follow the car until the driver pulled into a parking lot and called 911 for someone following him! The EMT a warning for what I do not know, but the driver of the car wasn't fined. There was no way to prove it in a court of law, other then what a civilian said. I'm not sure if the civilian was picked up after the whole incident with the EMT occurred or not. :shock:
Didn't mean any form of personal attack on you Rob. Just speaking from the experience above. 8)
Anonymous
02-02-2004, 16:43
We only follow in the ambulance or a squad, and only go as far as our district. You'd be amazed at how many drunk drivers will simply pull into a parking lot and wait it out when ever they see a fire truck, ambulance, or cop.
Its a community service thing we do, and falls under "a duty to act" around here. The same goes for if we see downed powerlines, we are expected to stop, direct traffic around the scene till PD can get there to relieve us. (We have a lot of medics that are also cops here to.)
We also do it from a safe distance. If we see a man walking down the street with a 9MM we will pull around, drop back, and keep him in view while we wait for PD, why? So that we can let them know which way they go.
The other reason why we do this is because they might have an accident, and well, we could be questioned later in court as to why we didn't do something about it. Maybe where you are it is considered stalking, but I fail to see how its playing God. Here at least, our police and DA back us up most of the time, and as long as we can justify our actions, it is okay. (As long as we aren't shooting, robbing, and beating people to death.)
...Its a community service thing we do, and falls under "a duty to act" around here...
Oh, Nathan I wished you wouldn't have brought in the "duty to act" clause. :( :x Where in your state statutes or EMS training were you ordered to follow suspected drunk driving, suspected adult/child seat restraint violations, prostitution, etc.
'Duty to act' has nothing to do with any of the things I just mentioned. 'Duty to act' means that if you are responsible for being a primary responder when notified of an emergency, then you MUST respond. Nowhere AND I do mean NOWHERE is it stated that are you obligated to do any of the things you mentioned previously.
Now, if you want to talk moral and ethical responsibilities, then please talk away. But for God's sake, don't ever bring "duty to act" in when you have no idea what those words mean. Sorry Chaplain, about the "God's sake".
Anonymous
02-02-2004, 19:56
A duty to act as in to not turn your back on a situation that is need of fixing. In some places a phone call is okay, here they expect more out of us. Just like they expect that we turn off our lights and siren when we enter a hood or complex. State law says we have to keep them on, but there is no point in drawing a crowd to a chest pain call. When you work in areas with $250,000 plus homes, they expect more. They also have a way of "pulling" or rather *cough* paying off *cough* problems they don't like.
justdoinmyjob
02-02-2004, 21:54
MedicNathan
We dragged him down on one of FD's tarps.
The FD crew first dismantled the doors to the bedroom and the front apartment door. Then they moved everything possible out of the way.
The whole time they were doing this the girlfriend kept complaining that we should be able to lift him afterall he was only 200lbs.....
It got to the point where I finally said "just try not to bang his head on EVERY step on the way down". He fit in the elevator with the smallest person on scene (one of the cops).
We set two backboards up agains the back of the rig like a ramp and just dragged him onto the floor of the truck. Our stretchers are only rated to 400lbs or something like that (old style metal frame 35A). The backboard trick worked really well except the weight cracked them both.
When we got to the hospital we found out that the emergency stretchers are only rated to 500lbs so they brought a bed down from upstairs and we just dragged him back out of the truck and right onto the bed.
We had a fire crew of 4 (I asked them to dispatch a second one but they refused) and about 8 cops. Plus 2 ambulance crews.
It was a sight to see us all dragging this naked (now covered by a light sheet over the waist) large man down the front steps of the building.
Just doin my job
Anonymous
02-02-2004, 22:16
Wow, I've heard of that kind of stuff, never happened while I was on duty. We have had large ones, but we were able to lift them. Our cots are rated at 500 lbs. and we have loaded them up pretty good with stuff other then patients to beyond 500 lbs. and they held.
I take it you had to take the horns and lock out to fit the patient in there. What ever happened with the patient?
HFD had one where they used the lift on the back of a Budget truck to lift the patient into the ambulance.
RescueYou42
02-03-2004, 14:10
Nate, you just said that you’re breaking the law.
State law says we have to keep them on, but there is no point in drawing a crowd to a chest pain call
If State law says one thing, and you do another, if something goes wrong you can be held responsible. The laws were put into place for a certain reason.
What’s this business about “When you work in an area with $250,000+ homes that they expect more? Does that mean if you are in an area that has homes that are valued at 150K that you are not going to provide the same level of patient care as when you were treating these “rich” people? I’m not trying to spark an argument with you, but it seems like you’re selective about what truths you leave in a story. I live in a home that's not even close to being worth $250,000 but if I ever received patient care that was different from what is offered to the people with better homes, I'd definately be calling a lawyer. I have an odd feeling certain truths are being left out here. Maybe we need to install a polygraph machine here at FOOPS. :roll:
State law says we have to keep them on, but there is no point in drawing a crowd to a chest pain call
Well, this is some what true. If you are responding to a "bad" area, then yes, go quietly to avoid getting a crowd together.
As for the rich people comment, rescue your right. No matter how much money one has, care should always be the same and the pt should be treated like all other pt's. Being rich doesn't impress me :D
When you work in areas with $250,000 plus homes, they expect more.
I understand what he means with this statement. The same happens around here. If we are dispatched to a "VIP" they send us a page to alert us and other stuff like that. I always think "Who Cares" but in reality, we are expected to do more and kiss their butt. Do I? I hope to think not LOL He ain't saying he does less, he is saying the people expect more because of who they are.
I have responded to a few celebrity, politician and over all affluent people for medicals before. I have found that most are just everyday people. Now there are a few I wouldn't spit on if they were on fire but over all most were cool. I hope that I treat a "Hood Rat" in the same way that I treated the affluent.
Smurfe :D
Being rich doesn't impress me
I bet it would if you were :wink:
Smurfe :D
I bet it would if you were
Smurfe
Not what I'm saying smurfe. If I was rich and working as an emt...I would have a serious problem lol
But, I wouldn't treat anyone differently because they have money. And damn if I'd strap on knee pads for them.
If I was rich and working as an emt
Totally Illogical statement :!: :lol: :lol: :lol:
Smurfe :D
Anonymous
02-04-2004, 01:45
Nate, you just said that you’re breaking the law.
State law says we have to keep them on, but there is no point in drawing a crowd to a chest pain call
If State law says one thing, and you do another, if something goes wrong you can be held responsible. The laws were put into place for a certain reason.
What’s this business about “When you work in an area with $250,000+ homes that they expect more? Does that mean if you are in an area that has homes that are valued at 150K that you are not going to provide the same level of patient care as when you were treating these “rich” people? I’m not trying to spark an argument with you, but it seems like you’re selective about what truths you leave in a story. I live in a home that's not even close to being worth $250,000 but if I ever received patient care that was different from what is offered to the people with better homes, I'd definately be calling a lawyer. I have an odd feeling certain truths are being left out here. Maybe we need to install a polygraph machine here at FOOPS. :roll:
We trun off the lights and obey the speed limits because there is no reason to justify hualing butt around streets that have children in them. Not to mention that more people will follow an ambulance that is driving like a bat out of hell then one that looks like it is stopping off at a friends house.
People in this area do get better care, why, because they support taxes and other fund rasiers, as well contribute money to aid in the ability to provide them with better Fire, EMS, and Police services. When ever a new wonder drug comes out, all we have to do is say, "It would be great to have this drug." and bam! A check appears. Why? Because they can afford it.
So if a ghetto punk gets hurt in this area, they get the same level of care as J-Lo would. I suggest that you try not reading into something. I have noticed how time after time you have tried to start fights. Check your ego at the door, most runs ran doesn't mean jack to me. :wink:
Plus the level of care is about to go down in this area anyways, HFD is taking over. Becoming incorperated isn't fun. :( I think they will now have everything but Community FD in this area.
People in this area do get better care, why, because they support taxes and other fund rasiers, as well contribute money to aid in the ability to provide them with better Fire, EMS, and Police services. When ever a new wonder drug comes out, all we have to do is say, "It would be great to have this drug." and bam! A check appears. Why? Because they can afford it.
So if a ghetto punk gets hurt in this area, they get the same level of care as J-Lo would. I suggest that you try not reading into something.
I've gotta tell you, re-read what you wrote. I don't care if a person or group makes contributions or not, everyone, even the punk kid living under the bridge should receive the same quality care. Healthcare Professionals. Name says it all. Offering better care to one set of people because they have money is contradicting what EMS stands for. Personally, yes, we all say to our selves (damn this dude is nasty!). But not out loud! I always try to provide the best care in my scope regardless of who it is.
Also, yes I have noticed that people try to start arguments. Everyone just needs to relax :D
Anonymous
02-04-2004, 13:16
People in this area do get better care, why, because they support taxes and other fund rasiers, as well contribute money to aid in the ability to provide them with better Fire, EMS, and Police services. When ever a new wonder drug comes out, all we have to do is say, "It would be great to have this drug." and bam! A check appears. Why? Because they can afford it.
So if a ghetto punk gets hurt in this area, they get the same level of care as J-Lo would. I suggest that you try not reading into something.
I've gotta tell you, re-read what you wrote. I don't care if a person or group makes contributions or not, everyone, even the punk kid living under the bridge should receive the same quality care. Healthcare Professionals. Name says it all. Offering better care to one set of people because they have money is contradicting what EMS stands for. Personally, yes, we all say to our selves (damn this dude is nasty!). But not out loud! I always try to provide the best care in my scope regardless of who it is.
Also, yes I have noticed that people try to start arguments. Everyone just needs to relax :D
Haha, thats what I've been saying, it doesn't matter who you are, you get the same level of care from our service. Its just that the people here expect us to be better then everyone around us. It gives them something else to brag about in their country club.
There isn't a sign that says we accept Visa, Mastercard, and American Express in our ambulance. :wink: Just one that says no smoking.
vBulletin® v3.7.1, Copyright ©2000-2009, Jelsoft Enterprises Ltd.