Gotta love overdoses

Sunday was a slow shift. In the evening we were called to "unknown trouble". We were told to wait for the sheriff's officers to clear the scene, and dispatch added that "the caller stated someone was parked in her driveway and not getting out of the car". It took us a while to locate the house once the officers said it was safe to enter. The mailbox was out at the road, but the driveway was a long dirt one, and the house wasn't visible from the main road. We found our patient standing next to one of the officers. There were pill bottles scattered all over the hood of the patrol car. Our patient was an overweight lady in her 40's, whose eyes were glassy and whose speech was slurred. We asked her a couple of basic questions, and she answered with garbled speech that made no sense. One of the guys walked her over to the ambulance as I started looking at the pill bottles. She had about 12 different prescription medications, some filled just 48 hours prior, that were empty. I asked one of the officers if she had any other medications in her car, and we went to go check. In her purse I found a Ziploc baggie about 3/4 full of weed, as well as her pipe, and a few other pill bottles. I climbed into the ambulance and joined the two other firemen and two cops with our patient. The guys had started an IV on her, and had put her on the cardiac monitor. Her pupils were pinpoint, and it was pretty obvious she had taken way too much of something. We gave her a medication called "Narcan" that will reverse opiate overdoses, and she immediately began dry heaving. Her garbled speech began to produce actual words, though none of it made sense. She got mad about something and was pointing angrily to the overhead lights of the truck, and declared loudly "friszhnick verbane?" We all exchanged puzzled glances. She again said something nobody could make out, then "verbane". One of the officers piped up "I've heard of Kurt Kobain" and the other officer began singing "Hey man, nice shot" at which point I joined in the fun, clarifying that although the song was about Kurt Kobain, it was sung by Filter. I couldn't help adding that "I've seen a weather vane" and the other officer chimed in "I've heard of Germane- which is either 'pertinent to the situation' or one of 'The Jackson 5', so which is it?". Our patient didnt get any of the jokes. The nice officers gave her her complimentary DUI citations, and let us go on our way to the hospital. Our patient's speech and mental status improved a little, and we could understand the words, even though the phrases made no sense at all. She became anxious, and was staring at all the compartments of equipment in the back of the ambulance. She bolted upright pointing at one and asked "Is there a dead baby in there?" No, sorry. She then noticed her reflection in the back doors of the ambulance, and could see the other medic sitting behind her, only to her it looked like someone peeking in the back door- while on the freeway at 70 mph. She threatened to kick his tail. I told her it was her reflection, but that didn't sink in either. Telling her the truck had bulletproof glass did though.

As I was putting the leads of the cardiac monitor on her torso, I noticed she had about three dozen pinprick type marks on her belly at her belt line. This is typical of patients who are diabetic and give themselves injections of insulin, but she didn't have any bruising. Diabetics usually have at least one or two injection sites that bruise. I asked if she was diabetic, she actually answered "no. rash." Then lifted her shirt wayyyyyyy up so she could rub her overflowing belly with both hands for several minutes. Gross.

We dropped her off at the hospital and returned to station. As we usually do around the firehouse, we talk to each other about the calls we have run. We told the guys on the engine about all the fun they had missed out on, and they told us about a woman they had run earlier in the day while we were on another call. They described a woman similar to our, with braidable leg hair (when you wear shorts in December around medical professionals trained to examine you in the first 0.2 seconds, don't expect anything amazonian to escape their observation). Our patient had been blessed with extremely furry extremities too. They described the mullet three decades past it's prime. Funny, our lady had a mullet too. Sure enough, they engine had been at her house earlier in the day- but it wasn't for her, it was because her adult kids were fighting with the neighbors. They spun a colorful tale of an altercation among neighborhood inhabitants, and several arrests. Suddenly my own "weird" family seems "normal"!

Working on Christmas

Working on Christmas isn't as bad as it may sound. I get the kids up extra early to see what treasure await them, then I go to work. For the last week or so a lot of the neighbors and people of the community have been bringing by every type of sweet treat imaginable. The counter tops are filled with cookies, candies, brownies, cakes, and enough to make your dentist lecture for an hour. Working on Christmas does have it's drawbacks- no grocery stores are open! Lunch was a burrito from a local gas station- gross. We polished off some chex mix, and nibbled the heads off a dozen gingerbread men. One of the guys had split the shift up with someone else, so he was coming in for the night half. we talked him into bringing leftovers for us to eat, since the sweets were too much. Thankfully he obliged, and we all had a grand feast of ham, turkey, beans, and the likes. To those of you who brought goodies by the station- THANK YOU from the bottom of our heart. It feels really good to be appreciated, and we do recognize the effort you all went through to take time out of your busy day for your local fire station. For future reference though, firefighters will polish off a veggie tray just as quickly as those brownies- we never turn down free food of any type!

1 broken finger and 7 stitches later...

I was on the ambulance yesterday, and we didn't have many calls to start off with. By 3 in the afternoon we were going stir crazy. The battalion chief came by our station to see how things were going, and as he was leaving the radio let loose with three beeps. Three beeps means a fire, and all conversation stopped instantly. They advised who would be first in on it, and it was only about a mile from our station. Everyone scrambled to jump in trucks and bunk out in their gear. We fight fire from the ambulance as well as the engine in my county, so I grabbed my gear from the outside compartment and slammed the door. I tried to run around to the passenger side to get in, but my pinky had gotten caught in the door. There was no pain initially, just a pinch of the tip of my finger. I gave it a good tug and it wouldn't come out of the door. I reached with my other hand and opened the handle, but it wouldn't budge. I gave it a good yank and the door opened. I shut it again, and grabbed my gear while scrambling to jump in. My partner tossed me the map book, telling me the coordinates of the street. I felt some pain in my finger, and looked at it, only to see it bleeding like mad. My fingernail was a bit mangled, and the tip of my finger was blue and flat. Great. I again turned my attention to the map book, but was suddenly hit with a hot flash and nauseating wave of pain. M finger was throbbing, and I got a little dizzy. The ambulance was trying hard to keep up with the engine and follow them to the scene, and I was suddenly having a major hot flash, so I asked "Can you just follow the engine?" as I rolled my window down and hung my head out the window. My finger was screaming at me, and bleeding like mad. The tip was bent at an odd angle, was all smooshed, and turning blue and purple. We were on scene of the fire in 2 minutes, and I had to get it together! I sat in the truck for a second regaining my composure, then got out, and put my gear on. I grabbed an air pack from the truck and went towards the commanding officer. I didn't have my gloves on just yet- this was going to be painful. The officer announced over the radio that the fire was out and other responding units could go back in service. It had been isolated to the stove, microwave, and a couple of surrounding kitchen cabinets. The homeowners had put it out before we got there, but the smoke was slow to clear. The microwave handle had melted and dripped down, making interesting shapes and swirls as the molten plastic hardened and cooled. My officer told me I could take my gear off, and suggested I show the chief my finger. I didn't want to take of my gear. I wanted to go inside and help with clean up. It's hard enough being a female firefighter- the guys I work with have never given me the impression that they think any less of me in this male-dominated profession, but I always feel like I need to work ten times harder than the guys to prove myself equal. The last thing I needed was anyone cracking jokes about "what- you can't fight fire cause you broke a nail?" or anything of that sort. By God, I was dressed and ready to play, bloody or not. Reluctantly I approached the chief and told him about getting my finger caught in the door. He suggested that I go to the emergency room to have it checked out. I protested heavily- I have been doing this almost 8 years, and never had any real on-the-job injured before I landed on my head 6 weeks ago, now this? It's no secret that I have three left feet and am the biggest klutz on the planet, but the finger just needed a band-aid or something. Chief wouldn't hear of it, so up to the hospital I had to go. He explained that it was county policy to cover the department, and I understand, but I hate having anything slow me down, and hate going to the ER for what seemed minor. 1 broken finger and 7 stitches later, I was leaving the ER with my finger all wrapped up. The doc was pretty cool, and had to completely remove my fingernail, sew up the nasty cut, then sew the nail back on in hopes of leaving the nail bed open so that a new nail will grow back. I finished out my shift with a huge throbbing finger, and on our other calls had to oh-so-carefully put on gloves that fit over the gauze, but I stuck it out. I am still pretty angry at myself for the whole thing.

This was in the ER yesterday. Note the interesting little angle- it used to be straight!

Bleeding has slowed, going to need a new manicure!

And today it has taken on an interesting blend of colors!

The piece that broke off the tip- it isn't one solid piece- it's actually several small shards that are floating around, but I can't get a good pic of the other angle off the x-ray film.

Oh what a wreck!

Yesterday was a busy day. We ran ourselves silly from 6 minutes after our shift started, until after midnight. None of the calls stood out as being spectacular, or even really memorable now that the shift is over, except for the last one. That last call was a doozy. We were on our way back from the hospital, and almost back into the county when tones dropped for another ambulance to respond. We were geographically closer than the other ambulance and the call was in our territory anyway, so we picked it up for them. It was a wreck and the engine was already on scene. They advised "3 foot intrusion". That certainly got my attention. Usually cars will hold up well to wrecks, and there needs to be significant force in order for intrusion to occur. Intrusion is when the outside of the car caves in to the passenger compartment. Usually it is measured in inches. Most cars are only about 4 feet wide, so a 3 foot intrusion.... was it even possible? We arrived on scene and surveyed the damage. A car had been traveling down a 4 lane county highway, and had made a left turn in front of another vehicle that was probably traveling around 60 mph. The other vehicle never even had time to hit the brakes, and broadsided the turning vehicle on the passenger door. Our patient was the driver of that vehicle. In looking at the car, the driver should have been dead right there. Nobody should have survived this wreck, in this vehicle! The driver had not only survived, but had gotten out of the mangled mess on his own and walked away! His seatbelt saved his life last night, no question about it. We took him to the local trauma center, but he seems to only have a cut to the back of his head, and a banged up knee.

In some spots, his car was only 6 inches wide after the wreck! He was in an older ford of some sort, and the car that hit him was an early 90's honda accord that held up very well considering the impact. The occupants of the honda were also wearing their seatbelt, and walked away uninjured. I told the 25 year old kid that was drivng the ford he needed to go buy a lottery ticket as soon as he left the hospital. These pictures don't do it justice, and to see this car in person, to really see just how far the passenger side got pushed in- is absolutely amazing.

(I went to the tow yard this morning to get better pics. I got some last night from one of the other guys on scene, but being dark and rainy you couldn't see terribly well).

Musical Engines

Our regular engine is one like this:

It is nice and shiny and new, despite the quality of the above camera phone pic. Something broke on it, and we had to send it to the shop. It will be a while before we get ours back, so in the meantime, we have to play musical engines. First they put us in the hurricane- this lovely green gem with an open back (so whoever the third crew member is freezes their tushy off, and gets covered in road grime and grit. Sounds fun, huh?)

But this old truck started leaking fuel all over, so they had to put us in a different old truck. A manual one. The "knuckle buster"- so named because in order to reach third gear, you had better have your knuckles out of the way or prepare to dig them out of the dashboard. The next shift they had fixed the fuel leak on the green one and we were back in it. Today, they decided they wanted us in a different engine, seen below:

It too has an open back, and allows for only two people to stay warm and dry at a time. I am so thankful I get to drive today. Don't get me wrong though, the county has recently bought a lot of new engines and equipment, so we seldom have to go into our reserve equipment. When we do, it's always an adventure!

Random comments and a suicide

I like to cook. I really do. At my house, it's usually me and the kids, so coming up with elaborate culinary masterpieces is either out of the question, or completely unappreciated. At the station we have one guy who is a health nut to put it lightly, so cooking elaborate culinary masterpieces usually involves chicken breasts and broccoli. There is only so much of that one can take. I am working today, and our health nut has the day off, so I got on my absolute favorite website/blog http://www.thepioneerwoman.com/ and looked up some new recipes under her "cooking" section. I tried this one today- http://thepioneerwoman.com/cooking/2008/02/apple_dumplings/ and it is absolutely the best thing ever! I couldn't believe how easy it was to make, and how perfect they turned out for the first try. Usually when I try something new at the station, it is followed by the phrase "sorry guys, I tried" as something gets scraped into the trash can. (I said I "liked" to cook, not that I had any skill at it). Here is how ours turned out- they looked different from PW's blog where I got the recipe, but they are oh-so-good nonetheless.

Then, because I was on a kitchen kick, I made up a batch of super healthy sausage and cheese balls that disappeared quickly.

For now I think I am done with the domestic kick. I am on the engine today, and so glad too! The ambulance crew has run their tails off. They left around 7:30 this morning, and didn't get back until around 2. They ran several calls, including a 2 month old baby in cardiac arrest. Later in the afternoon, tones dropped for the engine and the ambulance, sending us to an address right around the corner. We arrived to find one sheriff's officer standing in the driveway, and a woman running around hysterically in the yard. The officer asked for someone to go inside to check our patient. I was first in the house, and followed the officer to the basement. Our patient was seated inside his vehicle, and was deceased from what appeared to be a gunshot wound. I told the officer there was nothing we could do for him, and turned my attention to the family that was gathering outside the home. The patient appeared to be in his mid to late 30s, and his friends and family began arriving. I don't know what type of troubles he was having, but if he had seen the grief and pain he would put his family through, he wouldn't have done it. I don't understand suicide at all- it's a permanent solution to a temporary problem!

Classy lady at the bowling alley

Tones dropped for a "domestic dispute" at the bowling alley. This usually means a fight between two people of some sort, related or not. We arrive, and 4 police cars plus the local fire station's rescue truck are already on scene. We are directed to our patient. She is in the back of one of the police cars, handcuffed, and is extremely drunk, and writhing around like an earthworm in the sun. Her lower lip is cut and flapping. It appears that her teeth went completely through it. She has a cut on her nose, and a bloody spot on her elbow. The story comes out that she passed out at the bar of the bowling alley, and was face down on the ground when the cops got there. She decided she wanted to fight anyone and everyone, so she was taken into custody. Now we get to remove her from the police car and put her in the ambulance. Oh joy!

They stand her up and begin walking her towards the squad. I run ahead and get the restraints ready, as she lets out a stream of threats and expletives directed toward everyone within earshot. They tie her to the stretcher, as she tries to punch and kick and bite anything that comes near. Her lip is bleeding, and I can see the wheels turning in her head. She sucks hard on the injured lip, and spits a huge glob of blood and spit at the firemen tying her down. Oh I don't think so! I am not going to be exposed to whatever you have, not tonight, not ever. I get an oxygen mask and put it over her mouth and nose. Now try spitting! Someone asks her what her name is, and another string of muffled expletives explodes from the oxygen mask. I wonder to myself if that name might be hyphenated. She is restrained, and still screaming and carrying on and thrashing about. Time to bring out the big guns! I get a syringe and needle, and crack open the drug box. With a little help from some haldol and versed, she becomes much quieter. I didn't give her enough to completely knock her out since she had been drinking so much, and had god-knows-what-else in her system, but just enough to take the edge off the potty talk and flopping. An extra fireman and I enjoyed our ride to the hospital a bit more than the rookie cop that had to ride with her. She kept grabbing onto his pants leg with her bloody hands and crying and sobbing then screaming a little. Someone must not have told him that hepatitis lives for 2 weeks in dried blood, because he didn't seem to mind. Me, on the other hand, I won't let ANYONE put their hands on me. I have learned not to trust any patient, they can snap on you in a heartbeat, and I have to look out for numero uno above and beyond all else. We got her to the hospital, and were greeted by several neckless security guards who put her in the concrete room. She decided to play a little nicer with the nurses when they presented her with a choice for her temp- oral or rectal! I hope she sobers up and gets the help she needs, or at least moves on to someone else's territory.

Chock full o' nuts!

What a weird shift. First let me update the last post about that semi wreck- it's funny how hard it is to stop one of those big rigs, in the dark, in the rain, when you are still doing between 60-70 mph at the end of the exit ramp, and you *might* just be three times the legal limit for intoxication! Now I am not saying anything is "certain" but one could only assume just how hard it would be to stop if that were the case. I got an update on our patient- the hospital we took him to is a level 2 trauma center- meaning they can handle trauma, but have to call a surgeon in. A level 1 trauma center would have every type of surgeon in the building at all times. Level 1 trauma centers are few and far between here. I think there are only 2, maybe 3 in the entire state. Our patient got stabilized and shipped to a level 1 center. He ended up having (drum roll please) a torn abdominal aorta. The aorta is the largest blood vessel coming out of the heart. It sends the blood to the rest of the body. It's just a little important, and his was ripped. Obviously it wasn't completely sheared in half, or he would have been dead before we got there, but that explains the ever-expanding belly. He had bilateral (both-side) hemo-pneumos. That is short for lungs full of air and blood where it doesn't belong. He got two chest tubes and they drained a lot of bad gunk out of him, letting his lungs and heart expand as they need to. We knew he also had a head injury that would need to be addressed, but we had no idea how bad it would be. His brain was bleeding in so many spots on the surface, that they had to completely remove the top half of his skull. (Don't worry, they can put it back on if he pulls through). This gives the surface of his brain room to swell. Otherwise, the brain swells but the skull confines it, and it forces bits and pieces of the brain stem out the foramen magnum- or the hole in the bottom where the spinal cord comes out. The brain stem isn't like a vegetable stem and easily removable- it controls trivial stuff like breathing, hence the desire to not cause it to herniate. At last check he was in critical condition, but I am thankful he is even alive.

We had a couple weird calls yesterday though, and I am dying to get them typed out so I will stop laughing to myself and getting strange sideways glances from strangers in the grocery store. Actually, I am pretty sure I will always get sideways glances when I chuckle to myself in public, but that's OK. You should try it some time. It makes people really wonder what you are up to. Anyway, the reason I have to chuckle is because we had a wreck where it appeared someone failed to stop, and read ended another vehicle, pushing it under a large pick up truck. There was decent damage to the middle vehicle, but there was no airbag deployment, so I am betting they were either stopped or just starting to go when it happened. Everyone was out walking around, staring at the dents and dings, shaking their heads, and hunting for long lost insurance cards. Everyone except for the lady in the middle car. She is sitting in the driver's seat, and appears to be- for loss of a better way to say it- completely freaking out. We ask her what happened, and she can't answer direct questions without going off on a tangent about her brother's priest and some credit cards. We put her in the ambulance to evaluate her, and though she doesn't have a scratch on her, she says her chest hurts. OK, I am sure it does, especially if the seat belt locked on impact. One of the guys asks her date of birth, and she strikes a pose like a squirrel in the headlights, and rambles on and on a million miles an hour about random thoughts and absent ideas. She asks one of the firemen if he can get her purse out of her trunk. He disappears, and returns a few minutes later with a small, fuzzy, leopard print purse with pink trim. It was the kind you find in one of those el-cheapo teeny bopper stores in the mall. The lady doesn't bother to say thank you, instead she begins to try to pull the stickers from the cardiac monitor off her chest. She says something about how she has credit cards in the trunk and doesn't trust anyone- police, firemen, anyone- and absolutely must get them right now. So glad to protect and serve today. The fireman explains that her trunk is jammed shut, and that they won't be cutting it open. Insurance companies really dislike that unless you are trying to get to a live person. The lady begins to full-fledged WHINE and says in her best bratty 3 year old voice "but I haaaave to get in my truuuuunk!!!" then she looks straight at me, and pushes her bottom lip out as far as she could while batting her eyes two or three times. I was absolutely flabbergasted. She is about 45 years too old for this act. She looks at the fireman at the back of the truck and continues "weeeeeeeellll, can you at leeeeeeeeast tow the car to my hooooouuuuuuuse?" He gets mad and declares "lady- I'm a fireman!" before walking off. I had enough of her dizzying thoughts and childish behavior, and got out of the truck, leaving the other two guys to finish checking her out. I found the tow truck driver, directed him to the back of the ambulance, and talked to one of the police officers for a minute. The tow truck driver returned in record time, red in the face with one vein throbbing out on his head. He declared "she's all yours!" before storming off.

We had been on scene a long time waiting for the princess of pout to decide if she needed an ambulance or not. I lost my patience a bit and finally blurted out "OK, this is an EMERGENCY vehicle, you need to decide if you want us to take you to the hospital or not, because other people need help too". It never sunk in, instead she said "oooh, I know- can you take me to my house first and then let me decide?" um, no. Last time I checked this was a large red truck, not a small yellow sedan. She finally decided that she needed a chest x-ray, so I got up front and headed towards the hospital. The entire ride, my two partners were shooting me dirty looks and rolling their eyes at her tiresome ramblings. Each yes or no question asked of her got a long drawn out story sure to make your head spin, all the time she avoided answering the question, leading to it being asked again. I mentally pictured her owning at least six cats. We were almost to the hospital, when I heard her yell out "Ten YEARS!!!". I glanced in the mirror and everything appeared OK, so I kept driving. Later I asked the boys what that was all about, and one just giggled and said something about a boyfriend doing time in jail for killing his last girlfriend, a Rabbi, and a Priest. I waited for the punchline but realized he was serious. We put her in a room at the hospital, and warned the approaching nurse that if she had any xanax, SHE might want to take one before going into that room! Wow!