Sometimes the calls find you.

Yesterday was an average day. From the time our shift started we only saw our station for about ten minutes till 11 at night. It wasn't that we ran a lot of calls, it was that they were spaced out juuuuuuuuuuust right. We had to take the truck to the shop to get a piece of equipment fixed, and just generally had a great, busy day. We were on our way to the hospital with a little old lady who had fallen, wasn't injured but did take blood thinners and wanted to err on the side of caution, when I felt my partner driving slam on the brakes. The back of the ambulance swerved a tad as we decelerated, and I heard a lot of gravel pelt the truck. We were enveloped in a cloud of dust and as I looked out the side window, I see a U-haul trailer rolling repeatedly into the kudzu on the side of the interstate.

My partner stopped to make sure that nobody was dying. The driver said he wasn't sure what happened, that the trailer might have disconnected. His SUV rolled a few times and landed on it's passenger side, facing oncoming traffic. The U-haul trailer landed on top of his vehicle, perpendicular to it. A bystander pulled the shattered windshield off the frame of the vehicle and the driver climbed out. We had reported the wreck as it happened in front of us, and it took the local police fire and EMS no time at all to get there.

An interesting query

I have recently polled other EMS bloggers to ask where they draw the line in what they post and what they don't.

HIPAA is always a concern, so let's take a look into the in's and out's of HIPAA:
What is it? http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act
The purpose of HIPAA was to put an end to health care fraud. Or to at least curb it's rampant practice. It seems that in the day and age of identity theft, your credit isn't the only thing crooks are after- Aunt Edna's medicare number became a valuable commodity as well. The long and short of it- you can't share any individually identifiable information about anyone. I can't blog about an awesome wreck we ran and tell all you out there in cyberspace that we got called to Mr. Inglebert Humperdink (name used for illustration of a point) at 3198 Santa LouisaMariaHernandez Avenue, with a date of birth of 22/48/37 and a social security number of 463746374836582949. Then again that should just be common sense. Most of what I blog about is already written up on our county website and can be read about there. Wait- I don't say where I work. Let's leave it at that.

Now, since we are looking into an interesting query as well, let's examine the FIRST AMENDMENT: http://en.wikipedia.org/wiki/Freedom_of_speech_in_the_United_States
This includes but is not limited to the freedom of expression, freedom of speech, and is protected by congress. That doesn't mean common sense should go out the window.

Now of course if you blog about anything, you open yourself up to cyberstalking: http://en.wikipedia.org/wiki/Cyberstalking
This can be online, but can also extend to text messages, phone calls, blog comments, emails, and other forms of harassment (all traceable).

I have quite a few links off to the right of other medical and EMS blogs. Most of them are tastefully done. Some do include choice language and a bit more venting than I usually do, and others are "just the facts, ma'am". I guess that's what makes blogging so interesting. It makes a great outlet and lets us all bounce ideas off each other. Off to read some more funny, witty, sad, gross, exciting, all-of-the-above stories.

I need to buy a lottery ticket

I was working an engine house that is usually fairly slow. It had been a full day of yard work and the like, so we turned in early. We were up within a half hour chasing a car wreck that didn't exist. We went back to bed when we returned to station, and it took a few minutes for us to go back to sleep. As we were all settling down into our beds. I asked the senior crew member if we were done for the night, and he said "yeah I think so" as he climbed into his bunk. I replied "Oh I don't know, I seem to be the queen of weird stuff. Not necessarily bad calls, just weird stuff". At 2:30 that morning I was eating my words as we went to the scene of a motorcycle versus deer on a residential street. The motorcycle won, and the deer got a broken neck in the process.

The next shift we went to training. There was limited parking, and I arrived in my engine just behind the new ladder truck. I asked my partner if we should ask the ladder guys to let us park behind them in case they caught a call during training. "Nah" he said, "we won't be here that long". No sooner had we parked in front of the ladder and walked into the station than three beeps silenced everyone in the building. A fire. On the south end. I'll go move the engine so the ladder can get out.

My "weird calls" streak continued for several shifts, but that may be another post.

Is it a full moon?

Some people have a natural lack of common sense. Take individual number 1. He decided to go to the pool of a super fancy schmancy subdivision, wander on over to the deep end (the really deep end- like 13-14 feet, big high diving boards over there and all deep end, not the 5' no diving here deep end) and remove security tape and markers restricting access to said area. When life guards instructed him to back away and leave it alone, his basic response was a big fat "you can't make me". Probably true, but the lovely officers in brown that showed up have amazing powers of persuasion. Now individual number 1, being of not so sound mind and body, recognizes one of the officers as a foe from a previous encounter, and pretends he wants to speak calmly to him, only to attempt to shove Mr. Officer into the really deep end of the pool. Had he been successful the outcome would have been rough, as the officer had on full vest and duty belt full of heavy stuff and all. Pepper spray ensued and then of course individual number 1 turns into a snotty slimy ball of "I can't see!". Enter the local fire brigade. We show up and wash him off. We are professional and polite, despite his antics. I dunked a towel into our water cooler to drape over his head since it was really hot out and pepper spray stings. Despite playing nice, he wants to see just how many resources he can waste in one day, and begins to hyperventilate. "Slow your breathing down, you'll make yourself pass out" instructs one of the boys in blue. That was exactly what individual number 1 needed to hear, and he began panting like a puppy in August after an hour long game of fetch. Sure enough, he passed out, slumping off the back of the fire truck. Great, now we had to take him to the hospital. Even though we all knew he was playing games, he was doing a little too good of a job and I wasn't about to say he was OK enough to go straight to jail only to get burnt by him when he fell down there and cracked his melon. We loaded him up and transported him to the hospital. He refused to give us any info- no name, no age, no nothing. Now he could hear us just fine, and he could speak well too. He gave the friendly officers a dissertation on what they could shove where, and though it may not be anatomically possible, he proved his airway and cognitive skills patent. I gave up and just monitored his vitals on the way in. He was put into the system as john doe until we can find out who he is. In either case he gets to go to jail for a while.

At 2 a.m. we had the pleasure of being called to individual number 2. Now individual number 2 has a need for attention that is bigger than any rational thought, and he decided to send a suicidal text message to a friend. Well yes, you will be taken seriously when you do something like that, so the full gamut of vehicles with light bars was dispatched his direction. Any time the scene may not be safe we wait for law enforcement to get there first. Dispatch had advised there was a gun in the residence, so we parked it at a local gas station and waited for the all clear. Apparently individual number 2 was diabetic. (When someone is diabetic their body can't process sugars and they must take insulin or other medications to control it. If they don't their sugar will go higher and higher and they can slip into a diabetic coma. This usually takes several days to progress to that stage. If they take too much insulin or don't eat enough, their sugar drops. If this happens it does so rapidly and they can be unconscious in a matter of 10 minutes. All this background info is moderately useful to keep in mind for what dispatch had to say next.) Dispatch came across and informed us that "the patient is a bad diabetic and is threatening to eat sugar until he goes into a sugar coma and dies". I lost it. At 2 a.m. I had tears rolling down my cheeks from laughing so hard. It would be much easier for him to overdose on insulin and be unconscious within minutes, but if you want to gorge on snickers and pepsi have at it. We never had the joy of meeting individual number 2, they told us we could go back in service, we weren't needed there. I laughed all the way back to station, imagining someone holding a ho-ho to his mouth, threatening "don't make me do it!"

You win some, you lose some

The call initially went out as "unknown trouble" and was changed to "49 year old male possibly fell down stairs". It was a sunny afternoon. We assumed it was either more heat exhaustion (it was over 95 and we had already ran one heat exhaustion) or maybe one too many on a pretty weekend. We neared the house and saw a kid about 12 or 13 jumping up and down, waving his arms. We parked the truck and my partner grabbed the jump bag as I got a backboard. The kid was frantic and pale. "please hurry!" he begged. I tried to calm him down and asked him what was going on as we headed into the house. He said his dad had been working in the yard all day and now couldn't get up. I made it into the house and saw the dad laying on the living room floor. He made eye contact with us, then took two breaths, and died. My partner had been getting the equipment out to check a blood pressure, but when I walked in and saw that this man was purple from the collar bone up, I said "just get him on the backboard". We put him on a backboard and carried him to the truck, and started CPR. His wife had asked if she could ride along, but I don't usually let family ride during a full arrest. Experts and researchers have said that for families to witness a loved one being "worked" it can help them find closure, and accept the reality of death. Experts and researchers haven't been in the back of an ambulance when a previously calm family member freaks out and hinders your attempts at patient care.

There were only two guys on the engine that responded that day, I took one with me, but could really use an extra set of hands (and the other had to stay with the engine to drive it back). I yelled up front to my partner driving to notify the closest station- we were coming in hot. We drove through their bay, another firefighter jumped in, and we took off for the hospital. We secured an airway on our patient, got IV access, pushed epinephrine, atropine, sodium bicarb, some D50, more epi and atropine, did CPR, and ran the full gamut of treatments. It wasn't changing his condition. I didn't expect it to. Usually when someone turns that color from the nipple-line up, they have a blood clot. The tiniest of clots can get into the wrong blood vessel and end your life in a hurry. They can stop the flow of blood to the heart, lungs, or brain, among other vital organs. We got our guy to the hospital and the trauma team took over. We stayed in the room and helped with CPR, and watched as a room full of doctors, nurses, and specialists tried in vain to restore blood flow to organs that were resisting. They worked and worked on him. Everyone did CPR so effectively that he even tried to breathe on his own around the tube a few times. His heart remained in a rhythm that had electrical activity, but no actual physical movement with it. An ultrasound technician came down and looked at the man's heart- he confirmed it had stopped. Usually we will work a cardiac arrest for 20-25 minutes before exhausting all possibilities. As they called time of death for him, it had been an hour and 15 minutes.

They disconnected the tubes, covered him with a blanket to make him appear to be peacefully sleeping, and let his wife come in to say goodbye. She already knew he was dead. She had known he wouldn't make it from the time we rolled him onto the backboard. She came in and saw him laying there and her world crumbled around her. She ran to his side, took his hands, and begged everyone in the room to make things change. She begged him to wake up, begged him not to leave her. She begged someone to wake her up and tell her she was just dreaming. I had to leave the room. We had done all we could. We had only been on scene 6 minutes. It only took us 12 to get to the hospital. We had done all the drugs and all the CPR textbook perfect, but you win some and you lose some. It isn't your call to make.

Hey Mister!

Hey mister- I'm sure you had a good time at the bar. You probably chatted with your buddies and checked out the waitress. You had a few drinks, had a good ol' time, and had a few more "for the road". Little did you know the road bites back. You missed the curve. You never hit the brakes. You moved a telephone pole over ten feet. You knocked out power for several miles, resetting alarm clocks, making people late for work. You set off alarm systems of nearby apartment complexes. You shut down the road all night.

There are some things you didn't do as well. You didn't listen to the little voice that said "maybe I've had too much". You didn't sober up. You didn't slow down. Thankfully, you didn't kill anyone. You didn't wipe out an innocent family. Let this be your wake up call.

Don't text and drive!

I was on my way home from work last week when I was involved in a wreck. I was doing about 45-50 mph down a 4 lane divided highway when I saw it. A young girl texting on her cell phone, pulled her vehicle into the intersection to turn left. She looked up in time to realize that it wasn't clear, freaked out, and stomped on the gas. I had slammed onto my brakes to avoid it, but she T-boned me, spinning me 180 degrees. My vehicle stopped about 40 feet from the original impact. I sat there, dazed. It all happened so fast yet in slow motion at the same time. The side curtain airbags had deployed, uncurling downward from the roof line. They were in place before my head hit the glass window. The brunt of the impact was at the driver's side sliding door of my minivan. The frame and axle were both bent (if I had a shot of the back wheels from behind the vehicle, you would see that the tire is leaning inward at an angle.) The vehicle wasn't drivable. Her insurance company rendered my vehicle totaled (because the frame is bent, the back door doesn't open, and the opposite side of the vehicle has damage to it as well from the entire rear of the vehicle shifting over. Repairs stopped being estimated when they hit $15k, and they weren't done adding yet.) The driver was only 16, and had only driven without her parents 3 times.

For anyone interested, here is how a top of the line 2007 Toyota Sienna XLE limited (yeah, the one with the bluetooth and navigation and whole nine yards) holds up in a decent little wreck- it fared surprisingly well for the impact it took:

The car seats MUST be replaced. They have been subjected to the forces of the collision and even though the kids were not with me, the seats must be destroyed. There is no guarantee what they would do in another wreck, and I am not about to risk their safety for it.

My "baby" is two and a half, but only 26 pounds. Her car seat allows her to ride rear facing until 33 pounds. Think that's crazy? The AAP has said since 2002 that it is optimum for children to remain rear facing as long as possible. Find out more here: http://joelsjourney.org/ and see for yourself the difference it makes in a crash here: http://www.youtube.com/watch?v=kRP7ynNI8mI

OK- done with my soapbox.