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Hey Guys!


mrsbull

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I know it has been a while since I have posted here. I hope to post more often. I had a Tummy Tuck 2 weeks ago and am doing fine. Just some residual shooting pain from the incisions and nerves healing that hurt like hell.

I have moved into a new place and am trying to get it together. It is kinda hard when you cant lift more than a gal of milk (hell that is still hard).

My son is coming for Christmas from Ohio and I am so thankful for that!!

My tummy is flat and I am thankful for that too :P.

I have a new home and a great daughter who is healthy and alive as well as a bf who is the same. I again am thankful.

My last week of work before my TT, I had 2 kids code on me. As some of you know I work on the top of a mountain. We have 2 ems providers up there (usually) sometimes were alone. I was thankful enough to have my awesome partner up there with me when both of the kids went down. A 2 yo and a 7mo both girls. Both of the kids got to me emotionally. Nothing like seeing a parent beg and plead for us to "do something". Both kids are fine (that I know of) breathing and crying when transferred to local EMS who take out pts to the ERs because by law we HAVE To be on the summit for it to be open.

The dad of the 7 month old. Was a fellow brother to us in the EMS field. He is a FF and an EMT as well. My heart truly broke for this man. However I realized just how important it is to be able to work on a baby ALONE but having "jobs" for the parent to do. For example this dad was an EMT, I had him do some "chores" as well as writing vitals down for me while transport and him seeing the trending upward of his child helped to calm him down and be a better (and more rational) support for his daughter. I dont have many peds pts. The occasional vomiting kid or bloody knee from running on the top of a mtn. But to have 2 codes in 1 week just before Thanksgiving has made me a different person and a more compassionate provider as well. I think this comes from me "being there" as a parent. I have posted before on a why I became an EMT topic so I will not go into it.

As providers we often forger it is not ALL about treating the pt. It is about making a difference. I have also recently gotten my first "thank you" card from a pt. It meant more to me than any other metal or commendation, good grade, thank you or anything I have ever had. I can look it at anytime and be able to remember that I meant something to someone and I will likely never see her again. That is just one of the sweet parts about this job. It is nothing to someone but to me it is the world.

Take Car ya'all Happy Holidays.

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Yes both kids were "saves". Nothing like seeing a blue baby on the ground. Scary. And Thanks!! :)

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Both of the kids were not breathing when we got to them. Baby was brought to me by a freaked out daddy.( to a freaked out but calm EMT btw) On vacation :( baby was drooling and blue, resp of maybe 1 (attempted by pt) I didnt really count, cpr was initiated on both kids (DUH). Baby #2 (2 yo) was down and blue prior to assist ventilation's. It was then when we realized SHIT my job does not carry Peds masks. Although we had a peds BVM. WTH!! I was unable to get any sounds AT ALL, although rise and fall was ok for me at the time. Baby #2 and #1 were both attached to pads. (Also at this time I was cursing my job in my head for not having peds pads or peds settings) Every time I would begin compressions her HR would go from 20s to 140, she was closely monitored and breathing improved with bagging then blow by (per my partner during transport).

On calls like this we transport ALONE, 99% of the time it is with a freaked out parent or FM. An adrenaline filled ranger to take us to meet with ALS. It's a scary ride on a mostly guardrail less mountain. Thank goodness I do not tend to get carsick while providing pt care. I am too focused, however I can not sit in the back of a vehicle during a trip.

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Sorry babe, but I don't see the codes or the saves here.

It sounds as if both kids improved with CPR and vents which likely makes these a bradycardic/respiratory issue more likely, and not cardiac.

I don't mean to be a downer, but want to keep things real and in perspective for those new to the field.

Dwayne

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Then again, a save's a save either way. Wish we could have more saves. The one thing I always tell the newbies is that you'll loose more than you save and in 20 years, that has borne out.

It's different when the patient is a kid, that's for darn sure. When I was a CC here, we had a call for a 2 yr old who seized and stopped breathing. Febrile seizure in June, our response time was under 2 mins as we were right down the street doing a traffic detail for the local high school graduation (FD had a Non Transport ALS Rescue at the time). Turns out when she seized, she partially aspirated a french fry. Suction removed it and I think we all about balled our eyes out when she started screaming. Resp's were 0 on arrival and she was up and crying and all when handed over to the paramedic on the ambulance. We counted that a save and it's one that we'll never forget.

Peds saves, for some reason, tend to hit bigger than adult saves. I know the basic psychology as to the why, but still.

That's a great way to head into the holiday season there mrsbull!!

Happy Holidays to you and yours!!

Jim

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Then again, a save's a save either way.

I very much disagree. In the context presented its in reference to the saving of two pediatric cardiac arrests, a very different context than to say that "I helped save a distressed child."

I truly don't enjoy being an ass in this, believe it or not, but I do believe that we have an obligation to teach when we can, even when the teaching may be hard on a good story. The City is first and foremost an educational platform, by it's own definition. These calls don't speak to cardiac arrest, at least not as presented, they speak much more to respiratory induced bradycardia, which is a different animal all together. Combine that with the fact that Mrs. Bull works at a popular tourist attraction above 14,000 ft and the theory gets a bit stronger still.

Does that make the care given, and the ultimate outcome less enjoyable? Not for me, no, but for many, yes.

I gently challenged the calls not because I dislike Mrs. Bull, in fact she and I have been acquainted for quite a while and visit sometimes. I make the possible corrections (as I of course don't know if I'm correct either) because if we allow respiratory arrest to be described as cardiac arrest its not long before the forums are full of, "I had a call the other day where a woman had, you know, vaginal pain? And while we were taking her to the hospital, I looked down 'there' and it looked like she had vines growing out of the opening part? And, like the ER told me later that she'd put a potato up inside her thing, and it had started growing!!" And these posts will be met with a rousing chorus of, "OMG! I had a call just like that!!" If you stay here long enough you'll see what I mean, I promise.

Honesty is sometimes hard on a good story, but hopefully the knowledge gained by picking calls apart becomes more valuable than the dearly held, though most often fictitious, miraculous victory.

Thanks for taking the time to post. I look forward to your thoughts.

Dwayne

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Sorry babe, but I don't see the codes or the saves here.

It sounds as if both kids improved with CPR and vents which likely makes these a bradycardic/respiratory issue more likely, and not cardiac.

I don't mean to be a downer, but want to keep things real and in perspective for those new to the field.

Dwayne

I disagree Dwayne, but then I define "save" in pretty broad terms. To me, if it is likely that a patient wold not survive WITHOUT our intervention, I call it a save. That could mean something as simple as opening an airway, or as intensive as dumping the drug box into someone on a complicated megacode. Yes in strictly clinical terms I suppose we could say that the only way to define a "save" is when you have ROSC, but we could also say that would be defined as a successful resuscitation since a person is in cardiac and/or respiratory arrest.

Semantics? Maybe.

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Semantics? Maybe.

Semantics? Yes… I have to agree with Dwayne on this one… we could consider lots of calls we go on “saves” in the broad sense of the word, but to me, a true save is when the person is apneic and pulseless and we have ROSC. I deal with serious trauma calls on a regular basis where my interventions save their lives, but those to me aren’t “saves” in that they were never clinically dead when in my care. When I go to an unconscious hypoglycaemic person, my interventions save them, but I don’t consider that a “save.”

I am not saying that a peds call where the child is blue is not a scary call, and that the provider shouldn’t be pleased and proud that they were able to stabilize that child. Most of us have probably had some pretty scary peds calls that had good outcomes.

It would have been nice to get more details on the calls in the original post – vitals, past hx – that would have given us more to go on, and made this more of a learning experience for the rest of us. Given the limited information provided, I too think that the calls were respiratory, not cardiac in nature.

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