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One of those days....


Arctickat

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I have a long and rambling story of my day today that I want to share with you, but I'm too beat to type it all down. I just wanted to share this one little bit before I head off to bed.

As we're transporting our stable post Vtach patient to the CCU tertiary facility 250kms away we get notified of a patient being returned to our home hospital that we can bring back since we'll be empty. No biggie, we do it often. Dropped of our cardiac patient and went up to get our return and the conversation is thus:

Nurse - "Oh, the Ambulance Guys are here" (my partner being a 22 year old female)

Me - "Ambulance guys? Now days we're usually known as Paramedics"

Other Nurse - "Don't mind her, it's been a long day, she really is excited to see you."

Me - "That's okay, I know how hard you bed pan ladies work." (As I wink)

Nurse - Dirty look, blushes and buries her nose in her paper work.

Kinda like a few weeks ago...going to pick up a return patient again...

Nurse - "Oh good, the ambulance is here."

Me - (Ducking to the side and looking behind us) Whoa!! Where!!! (regaining my composure) Oh, I thought I was gonna get run over by a crazy ambulance driver or something." "Nope, no ambulance here, just us paramedics. We couldn't fit it into the elevator."

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Wow, you really put them in their place. I hate it when we go to a code on the floor and someone says, "Oh good, the ER guys are here." I'll have to remember this so that I have a useless, yet witty comeback.

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I think everyone has had one of those days. Our most recent one is really up there at least we think so. We brought in a pt who had stroke, we were moving him from the gurney to the cot in the er, and some old guy walks right in the er and told us someone parked a truck at the dock and they needed to move it. We got the pt moved and looked out and he was referring to the amublance, explained to the guy that this was an emergency room and we brought a patient in. Well his wife had a headache and needed to see the Dr. right away and we were blocking their parking space! Oh really? Their parking space. Yep he doanted 50 dollars a year to the hospital and he can park there. Wow. We had not left yet because it was being decided on whether we would take the pt by ground to a major hospital or call in the bird and have him flown. It was determined that he would be flown and the bird was there before we knew it. This same old boy told the pilots that they were too noisey and it was disturbing his wife with a headache. Yep just one of those days.

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Okay, here we go...

Did you ever wake up in the morning from a dead sleep, right out of a dream, and have the tone of that dream set the tone for the rest of your day? It happens to me lots. I'll have a dream of spending a great time playing with my twins, wake from the dream and be in a great mood all day and everything just falls into place to make it even better...Well, not yesterday;

I woke up and the last thing I remember is my dream of a fight with my ex wife. To make matters worse, I woke up right at the point that I was about to win that fight. (remember, it was a dream) That makes all the more frustrating.

So, I throw my uniform on after my shower and my wife tells me I need to change my shirt. Big stain on the front of it. Shrug, no biggie, I'd do it after I have some breakfast and take out the trash. We're on 24 hour call from our homes here, so as I'm taking out the trash my radio goes off. Jump into my car and drive to the station to get the ambulance, call that we're on air and the dispatch location is just down the road for a 60 year old male with chest pain. We arrive at the house to find him on the sofa, alert and oriented, no palpable pulse and I can't hear his BP. Put him on the LP12 and it's VTach. The LP12 gets a pressure of 109/65. My options are Amiodarone or Cardioversion. I opt for Amiodarone because he is currently pain free, just pale and diaphoretic with slight dizziness. Regardless, I have to start an IV. After my second failed attempt I decide to transport him to the hospital 5 blocks away. On the way there I manage to get the line started, but no amiodarone yet we're at the hospital doors.

Pressure is 113/76, HR 185, Sats are 98% on high flow.

We go into emerg and the nursing staff start to evaluate him, I'm looking around like, WTF? Where's the doctor? Nurses do their assessment and decide they'd better go get the doctor, it's their protocol to conduct a patient assessment before they call for the doc. Two docs walk into the room and decide they're gonna cardiovert, at this I quietly suggest Amiodarone, since he's stable. They speak their foreign tongues to one another for a moment, then leave the room. I finish starting a second IV on the patient and go out to do my paper work only to find both docs with their noses buried in the ACLS manual. They decide to call a cardiologist to consult on a treatment plan. While on hold waiting for the cardiologist, the nurse comes in to inform them that the patient's BP is now 79/46. They thank her and sit on the phone while I'm thinking...yeah, now would be the time to cardiovert guys....Cardiologist comes on the phone, they give the history and cardioogist says yeah, you need to cardiovert, his BP is too low for Amiodarone. Docs hang up and tell me they're gonna cardiovert, (20 minutes after we came through the doors) . I'm thinking, no shit sherlock, you have to now.

An excellent example of waiting for the patient to deteriorate to the point where you know what to do.

Fast forward...

I need to change my shirt, swap my partner out for a new one, and fill my coffee mug, I drive back to the office and someone parked their car across our driveway....pet peeve of mine.

Fast Forward...

About an hour down the road my partner turns on the siren and it sounds like a cat being put through a meat grinder, tail first. I'm thinking, great, I have to buy a new siren. 10 minutes later my Amiodorone infusion pump bites the dust. My power inverter is turned on, but the pump isn't getting power....I plug it into a different outlet and it starts to work again. Now I'm thinking "Great, gremlins moved from the siren to the inverter." I managed to get our patient to the CCU without much interruption on the IV pump, but had to get another pump in the hospital because our battery was dead.

From this point on, the day actually improved...We took the unit to the local Demers depot and they determined that our conversion batteries were dead, thus a lack of power to the siren and the inverter when operating under a heavy load. During their investigation the technician asks me if my strobe lights were working. We do daily checks and I know they had been, so he pulls out the pictured fuse and shows me. Then he takes a closer look and the fuse is, in fact, fully intact and functional.

After these repairs we go back to the hospital and pick up our other patient for his return trip which was when the aforementioned encounter occured.

Really, it wasn't a bad day by any means, but it was one of those ones where you begin to wonder what's gonna kick you in the ass next. Today we got almost an inch of rain and I tripped into a pothole and did a faceplant on the street. I picked myself up and walked, covered in mud with a boot full of water to my car.

As I drove home to change into clean clothes and get my spare boots all I could do was giggle...what else could I do.

Edited by Arctickat
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Wow, you really put them in their place. I hate it when we go to a code on the floor and someone says, "Oh good, the ER guys are here." I'll have to remember this so that I have a useless, yet witty comeback.

It wasn't so much as meant to put them in their place as it was to poke fun at ourselves and maybe stimulate some thought at the same time. Most of the time I don't care if I'm called an ambulance driver or the ambulance guy, or anything else unless it's in an obviously derogatory manner. Much of the time I just have a light hearted response, like saying fire truck driver rather than firefighter, or police car driver rather than police officer.

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Let me get this straight: someone complained that the Medivac helo was too noisy for his wife's headache? And the guy was parking a POV in the Ambulance "Dock" at the ER/ED (choose one), and complaining that an ambulance was parked in the "Dock" he had "paid $50 for"? I can be viscious, and might have had his car towed away, at his expense.

I had an experience where, on complaint of the restaurant owner with an "Ambulance Only" parking spot in front of his restaurant, demanded, and actually got, an NYPD sargent to ticket my ambulance for "illegally parking an an 'Ambulance Only' parking zone. This was on a 2 way street, where there was no parking on the opposit side of the street, where the ambulance office was situated.

Then, there was another squad, doing a Cardiac patient in arrest, got ticketed for being at a hydrant, dispite having all 5 red beacons activated on their "Caddy-lance". While doing CPR, they had not followed an NYPD officer's "request" to move the ambulance. (I think the patient survived with good Quality of Life, afterwards)

In both cases, after newspaper press coverage, the Parking Violations Bureau tossed out the tickets.

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