Who’s Nelson Mandela?

I promise, I don’t plan on making this a waitress blog. I would hate to incur the wrath of Springs1…just…no.

Anywho, I will relate the more bizarre tales as I need some place to let them out. Tonight, it came over ESPN than Nelson Mendela had passed away. Very sad. I went to a table of adults…all were over the age of 40 to include military personnel. I looked at the table and made a remark about how sad it was that he passed. The person sitting next to me, a Captain in the US Navy, looked at me and said, “Who’s Nelson Mandela?”

I nearly dropped the beer I was holding. Who could not know who Nelson Mandela was?! I go over to the computer to enter in an order and one of the servers asked me what was wrong, as I was grumbling to myself. I looked at her and said, “This guy didn’t know who Nelson Mandela was!” She looked at me with a vapid expression and said, “Who are you talking about? I have no idea who that is.”

I have lost all faith in humanity today. I will now continue to assault my liver and kidneys with a few more glasses of Jameson… two fingers, neat.

Have fun and be safe.
MT.

What’s Ahead…

Hey everyone!

I just wanted to give everyone an update about my life and what’s going on with me.

In a few weeks, I’ll finally be done with all this back injury bullshit. I have to thank my lucky stars that it’s done. I’ve never been so frustrated in my life with this process, but it’s done.

What have I been doing? I’m currently working as a waitress at a sports bar. Do I like it? Meh. It’s kind of like being a Paramedic, actually. You have to be on your toes and things are constantly changing and I need to adapt at a moments’ notice. I don’t like what I’m doing because…well…I feel like a dancing monkey; I need to be this happy go lucky person basically making the person I’m serving feel like they are the best thing on the planet so they give me an extra dollar when tipping me when they are done. It’s not hard when the people are nice and they interact with you. I get the ones who snap their fingers and yell for me from across the bar. I also get the super needy ones who modify everything on the menu: “I’ll take the Grilled Steak Wrap, but sub the steak for chicken, no cheese, lettuce, tomatoes, or onions, but add the Pico de Gallo and Ranch dressing. Oh, and cut it into eight pieces, not four and box up four of the pieces.”

Speaking of ranch dressing. I now officially hate that stuff. I think customers drink it, honestly. We serve GALLONS of this stuff and no one can ever get enough of it. I served someone 18oz of Ranch; six 3oz cups for less than 10 wings. By the end of the night, this is what I was thinking of:

 http://www.metatube.com/en/videos/77110/Melissa-McCarthy-on-SNL/

So…what’s ahead for me and the blog:

I plan on going to EMS Instructor school so I can teach the new crop of students. I’m still teaching ACLS and PALS classes, which I’m having so much fun doing. I usually teach nurses and doctors, but when I get a few Medics in the group, I have way too much fun. The last class I taught, I met a Paramedic who moved from New York to BigCity. We spent several hours talking and we ended up going out to a bar for Happy Hour to grab a bite and a drink. Happy Hour turned into standing on the bar singing “Piano Man” and “Don’t Stop Believin'” with the entire bar. I also found myself drinking shots with great names such as a Flaming Orgasm, Statue of Liberty, and my favorite, the Blow Job. He will be joining me this year at EMS Today. Should be fun! Speaking of EMS Today, I will be there with Hawkeye and we will be trying to regain our status as Best EMS Chefs for the EMS Today cook-off. Our recipe is top secret, but it stands to be our best recipe yet. I have to give thanks to Papa Trommashere who kept me from making a major cooking faux paus when I had him glance over the recipe to make sure it looked edible.

I also plan on making a return to EMS in some capacity. I don’t know what that’ll be yet, but I plan on getting back into “Truck Work” at some point.

As for the blog…I’m going to try something a bit different. I spent the last few months helping a Paramedic student get through her class and National Registry. She did all the hard work and graduated, but I had a lot of the lessons written down. She was the one who gave me the inspiration to bring them here and share them with the world. So, mixed in with war stories from the truck and from the eatery, I’ll throw in a few lessons here and there to see what happens.

Other than that, it’s been an eventful year. The Stupid Puppy passed away last year, but I added a Foster Failure to the group. I now have The White Pup and The Crack Puppy. The Crack Puppy is just under a year old and she is a Pomeranian. I love her to pieces and she is making herself out to be a great addition.

Anywho, I’m going to finish off my beer (I <3 Flying Dog!) and I’m going to hit the sack.

Have fun and be safe!
MT

The Biggest Mistake of my Career

I have never talked about this call…ever. It shows my humanity, how even I, Ms. Super Medic, could make huge mistakes. I owned up to it through Medical Command and a Medical Review and I didn’t even get a slap on the wrist due to the circumstances. What remains is that, I could have very easily killed someone and I was damn lucky I didn’t.

The call started out on a bad day in January. I got into work on a blustery, rainy morning and I had come in early because we were supposed to get slammed by a bad snowstorm. I didn’t have a four wheel drive vehicle, so I wanted to avoid the slick roads. By 0900, what was supposed to be a snow storm ended up being an ice storm. The roads were coated in a thick sheen of ice. I could hear accidents going out all through the area, but for some reason, our 5 miles of highway and side roads remained free of accidents. Around 1000, we got dispatched for a female complaining she was dizzy.

The distance from our station to the scene was no more than a quarter of a mile if that. I could see the freaking apartment building from the station. I called the dispatch center and told them to relay to the patient that it would be a minute; we couldn’t even get out of the parking lot because we were just slipping and spinning on the ice. Once we got on scene, I remember getting out of the truck and immediately face planting in the parking lot. I smacked my face off one of those parking berms and I gave myself a black eye and nose bleed. My partner slipped on the ice and fell on his back; he ended up having a bruise the size of a Cadillac on his ass. It extended from the top of his butt and halfway down his thigh. Trying to walk the fifty feet to the front door had us falling twice more apiece; I added a bruise on my side after I slipped up the concrete steps where I thought I broke a rib and a fall on my butt, but because of the junk in my trunk, I was fine. My partner fell on the same spot both times which contributed to the bruise. Once we got to the apartment, we both looked like hell. I had already shoved a 4×4 up my nose to staunch the bleeding and my partner was limping. When the woman answered the door, she smiled smugly at us and said, “Took you long enough. You went en route fifteen minutes ago.” I apologized, saying we had to drive very slowly through the hilly, cobblestone streets and we had slipped and fallen outside. She rolled her eyes and told us to come in. We walked in and she sat back down on her couch. I set down the ECG (A LP-10. This is very important), my House Bag, and the O2 tank. I sat next to her and went into my normal conversation; I introduced myself and my partner, asked her what was going on, all the while I had gently taken her wrist and began to feel her pulse. It was fast under my fingers, but I caught it at between 100-110bpm. The patient told me that she had woken up when she heard her scanner going off and she sat with a cup of coffee listening to everyone run around. She admitted that she had stood up too quickly when she heard that a cop car had wrecked at the bottom of the hill and she felt a bit woozy, but she felt fine immediately. I took her blood pressure, which was normal and I put her on the monitor. The rhythm was Sinus Tach, but the rate number was flashing and kept going back and forth between 110 and 240bpm. I printed out a strip and counted out the QRS complexes manually and I got 118. As I was working, I asked her if the dizzy spell was why she called 911. She then admits that, she wanted to see how quickly we could get there in bad weather, so yes, that was why she called. I remember wanting to throttle her at that exact moment. She was feeling fine, no ill effects, and she called 911 to see how fast we could get there. I held my composure and asked if she wanted to go to the ER and she rolled her eyes and said, “Well, duh. I’m not paying taxes and your salary just for you to check my blood pressure. I paid for your truck, lady.” I was itching to tell her that none of her taxes went to paying for our ambulance as it was purchased in the early 90’s at an auction in Texas. The funds were raised from various bake sales and private donations, but I bit my tongue and asked which hospital she wanted to go to. I cut her off immediately by saying that we couldn’t go to one of the hospitals in the city due to the road conditions; we were more likely to crash than to make it, but she had the choice of two community hospitals, one of which was a cardiac center. She chose the cardiac center. I asked if she wanted to walk to the ambulance; she had been walking around the apartment putting food down for her cat and dog, getting changed into clothes, and tidying up in the kitchen all the while ignoring our objections. She gave us the line that she paid for our salaries, so we needed to do our job correctly. She then began demanding oxygen because “my taxes paid for it”…even though she sat’ed above 98% the whole time. We put her in the stair chair and wheeled her to the lobby where we left the stretcher (stretcher didn’t fit into the elevator, even broken down). We lowered the stretcher and placed it right next to her chair. I asked nicely for her to stand and pivot, then sit on the stretcher. She crossed her arms over her chest and stared at me with this evil, soul stealing gaze, so we picked her up and put her on the stretcher.

I had the LP-10 slung over my shoulder and I kept looking at the rate; it never popped over 110. We wheeled the stretcher outside, managing to not kill ourselves, and we loaded it into the ambulance. I did a quick IV and hung a bag of saline KVO while I fitted her with a nasal cannula at 4lpm. It took us over 20 minutes to get to a hospital that usually takes us less than 10 without lights and sirens. We slipped and slid all over the road…at one point we spun out and I remember looking out the back windows and I realized we were sliding backwards down this little hill. The woman kept criticizing us; we were horrible ambulance drivers and she couldn’t believe we were having that much trouble driving. What she didn’t realize and what she couldn’t see is that my partner managed to keep us from wrecking I don’t know how many times. I remember looking up front and the MPH gauge was below 5 and my partner was sitting funny. He told me later on that he was standing on the brake, yet we continued to slide on the ice due to forward momentum. The entire time, I kept her on the LP and it kept up a steady rhythm at 110. The pulse ox, which had its own pulse monitor had her at 99% and 112bpm. Feeling her pulse, I got her at 110. Her BP never wavered from the 130’s systolic. We got into the ER and out of pure habit, I hooked her up to the hospital monitor while waiting to give report. The hospital machine started alarming and I looked up; she was in a full SVT at 198. A nurse ran in and started yelling at me; this wasn’t a dizzy spell, this was SVT. I grabbed the Adenosine from my house bag that was on the stretcher and the nurse grabbed it out of my hand and pushed it for me. I remember standing up against the wall, not sure what to do.

Boy, did I get chewed out by the nurse, the patient, and the ER doctor. I swore they were going to cut up my Medic card right there. The rhythm broke with the first dose of Adenosine, but I handed them the strips I printed out; all the strips were time stamped as well as marked with the BPM: 110. I told them I never felt it go above 110 and I don’t know why I didn’t see it.

Several weeks and several meetings went by. Come to find out, the patient went back into SVT while in the ER. The nurse was manually feeling a pulse and she herself didn’t feel a rate over 100. The patient never became symptomatic and it was documented in her chart that she had a history of Asymptomatic SVT. It was also found that the monitor was malfunctioning, but I was never told exactly how.

I honestly feel that this was the biggest mistake of my career. For weeks, I felt so ashamed, as I had done something horribly wrong. At the time, I was a pretty new Paramedic, but I was making one heck of a name for myself by being spot on with every differential diagnosis I made. I felt that my reputation would be tarnished by what had happened. What I didn’t realize was, these things happened. Several of my well seasoned partners came out and told me their “newbie” mistakes; forgetting to take Nitro Patches off while administering Nitro, using Latex gloves on a patient with latex allergies, and even worse things that I refuse to even write about.

Once I was vindicated, I remember being almost neurotic in my actions afterwards for several months. I was double and triple checking all of my actions, my vitals, everything. I became a scared Medic, which is never a good thing. I would hesitate before doing something without an okay. It took one of my command physicians who was a dear friend and mentor to sit down with me and go over every one of my cases with me. He showed me that, outside of that one thing, I had made no mistakes. He even pulled up a case that had been used in Grand Rounds, showing how I identified that the patient was having an Antro-Inferior MI; the monitor printout showed Anterior, but the patients’ BP and heart rate had me wondering if the patient was also having an infarct of the Inferior wall. There was ST elevation in V2-4 as well as II,III, and avF. It was a weird presentation and I remember pondering why I wasn’t seeing the reciprocal changes in II,III, and avF, but I saw the reciprocal in I, avL, V5, and V6. Med Command told me to follow the print out, but I told them that due to low BP, I couldn’t follow protocol by giving Nitro. Once in the ER, I got my butt chewed, but I showed them both the strips and my vital signs. My command doc gave me huge kudos for knowing the different STEMI’s and used my case in presentation to show how the print out and subsequent transmission of 12-leads could lead to mis-interpretation.

I realized then that mistakes were a part of the business. I’m not talking about giving the wrong drug or doing a procedure wrong, but shit happens on scenes and all we can do is fess up immediately and try to move on. I’m sure all of us can talk about an instance where our equipment failed us and we went about, doing our thing, only to find out later that the ECG failed us or the BP cuff had been damaged and the needle didn’t go past 130 or even the Glucometer wasn’t working properly and was giving false highs and lows even after a proper calibration. As careful as we are with equipment checks, sometimes Murphy’s Laws of EMS come into play…there’s nothing like losing all power to the ambulance during a Cardiac Arrest while you are on some road in the middle of nowhere…and it just came back from the shop.

If you learn anything from this, I hope you learn that a mistake isn’t the end of the world as long as you are willing to step up and own up to it immediately.

Have fun and be safe.
MT.

I was going to come on and complain about my neighbors deciding to re-do their deck and how work started promptly at 0700 this morning and start a series on how not to make the same mistakes I have recenty, both with my back, and how to make moving to a new state and restarting your EMS/Fire career a bit smoother…

But what happened in Colorado makes getting little sleep and the crap I’ve gone through seem like a walk in the park.

My heart, prayers, and deepest sympathies go out to the victims and families who were injured and who lost their lives last night. I also want to extend my prayers, thoughts, and long distance hugs to all of the first responders who decended on that scene last night and the providers in the Emergency Rooms, Operating Rooms, and Hospitals. Thank you for doing what you did under the most crazy of circumstances. You did the best that anyone could ever ask for you to do. My thoughts and prayers are with you.

All my love,
MT.

http://lookingthroughapairofpinkhandledtraumashears.com/2012/07/20/333/

End of an Era.

So, I received some rather sad news today.  The department that I cut my teeth on, learned how to be a semi-decent medic, closed its doors.

It had been open for over twenty years, first as a BLS Volunteer Department, then as a Combination ALS department.  We didn’t have the best trucks, the best equipment, or even the best base, but we loved that place.  I remember sitting out in the parking lot in the middle of January grilling steaks while we hung with the guys from the police department and the fire department.

If the garage could talk…the stories it would tell….I’m sure I’d go to jail over some of them.

I have to admit, I did have mixed feelings at first.  I didn’t leave there under the best of circumstances and deep down in the places I don’t talk about at parties, I kind of wanted them to fail epically, but in the end, it wasn’t about the service, it was about the people.  I worked with people who I will never forget. They happen to be some of my closest and dearest friends. The memories we have; my very first arrest as a medic that prompted the quote, “What do you mean she’s in Cardiac Arrest?!”, my first shooting that became the county record for fastest incident-to-door time for 3 years running (23 minutes, 45 seconds), fastest on scene time ( 3 minutes, 10 seconds), and being the Medic who got a patient to rap their ABC’s.

The bad; we lost a lot of good people in a very small amount of time, some to LODD, others to the passing of time.  We also had so much drama going on that we all threatened to write a book called, As The Siren Blows…yeah, take that however you want.

I learned so much in my time there.  I learned very quickly that just because I don’t get paid well, doesn’t mean I won’t love it more than the best paid service.  I grew my thick skin; only so many people can call you outside your name before it rolls off of you.  My fighting spirit grew; I can throw down with the best of them.  I don’t shy away from the fight, I jump right into it.  I got to learn how to be a leader, how to deal with the public, the politics, and the media.  I learned that it’s not what you say, it’s how you act.  I also learned that, yes, a little 80 year old woman can and will level a Taurus Judge at you because she’s so out of her mind she thinks you’re breaking into her house.

I left a lot of my soul there.  On the bridge on 890, I left a bit.  In the garage where I tried my first cigar, (loved it), and in the ambulance I had the honor to shroud three times and make ready for a casket, I left my blood, sweat, tears, and soul.  In the trailer where I cooked three Thanksgiving, Christmas, New Years, Super Bowl, and Easter meals, and in the office where I wrote some of the hardest reports of my life and where I received some of the greatest news.

My bosses, for what it’s worth, were fantastic.  Every two weeks, without fail, our paychecks were mounted on the door.  I then found out that, quite often, our bosses went without checks themselves, or even falling behind on a personal bill just so we could have our pay.  The one time…the one and only time we went without, we got extra in our next check. That was the period where it was between repairing our one and only truck so we could stay on the road or getting a paycheck; we all voluntarily gave up our checks just so we could stay in business for two more weeks.  Every bad call we had, they met us at the station for a bull session.  They even came in with extra people to man the trucks so we could sit out for as long as we needed.

This is where I learned the lesson, “No matter what happens, as long as the doors go up and the trucks roll out, it’ll all be okay.”

Today is the day where I remember from whence I came.  I salute the good times, mourn the bad times, and laugh at everything else in between.

To the crew. I love you guys.  You know who you are.  I miss you terribly.

Much Love,

MT

Happy Birthday to Me!

Yes. It's a picture of me.

So, I’m doing this early.  My second Blogaversary will be on June 12th, but since I will be in the midst of recovering from back surgery, I’m going to go ahead and do it early.

I didn’t do one last year; too many things were going on that I was unable to be officially reflective on what happened during the year.  With the sudden illness of my grandmother and several personal issues going on in my life, my post would’ve been nothing but a rant about how horrible my life was at that moment, instead of looking back on the good and bad of the entire year.  So, without further ado, here it is.

 

My first year was overall fantastic. The warm welcome from both established bloggers and ones who were just as new as me was a very wonderful experience that I will never forget. The friendships that I made, some closer than others, will be cherished forever.

This year has definately been marred by several bad experiences: my injury, losing my certification, the lost of loved ones and the deaths of patients that I will never forget would make me want to say that overall, this year was a bust. At the same time, I realized just how much I grew this year.  In years past, I’m pretty sure…no…positive, that the loss of my certification after I worked so hard to get it would cause me to go find the most secluded place I could and I would conduct an experiment to see just how gunpowder tasted.  That was how vitally important being a Paramedic was to me; without it, I felt like I would be nothing.  I still feel like I’ve lost a body part or broken up with a long term lover, but the sting of failure has gone away, a little each day.

It’s been almost a relief actually, in a very round about sort of way.  The rules here are very specific; long story short, you have to be actively serving as a Paramedic, actively meaning keeping up with a normal schedule of working as a Paramedic, to keep your certification. If you are injured, or for whatever reason out of work for an extended period of time, you will lose your qualifications and have to recert through the entire process to become a Paramedic again. If I wasn’t injured, I would be pulling my hair out, stressing about attaching myself with another service.  Now, I can take it easy and decide if staying here in SmallTown is a good idea, or if moving somewhere else is in my best interest.

I think the theme for this year would be growth. I’ve grown so much over the past 365 days, some of it good, some of it bad. I will say I’m less open emotionally, but that has stemmed from discovering that the people whom I thought were friends really weren’t. It’s not uncommon for me to close myself off after an emotional blow like this, even to the people who have always been there for me, so to anyone who’s noticed my aloofness or that I’ve not been as friendly or as open, I’m sorry.  I’ll come around, eventually.

My faith has grown because it faultered; there’s nothing like questioning the existence of a higher power because of how hurt you feel and how alone you feel, wondering how a ‘good and all powerful being’ could allow someone to feel such pain, and during the next day, hearing of a friends’ child, who was very ill and was given absolutely no chance of survival after a horrific, lenghty illness, to suddenly become well.  It’s just not my time, it’s in someone elses time, and I’m okay with that.

Emotionally I’ve grown because I’ve relearned something I’ve known all along; the world won’t end just because my life sucks.  I decided one night that, I wasn’t going to get out of bed. My world had stopped turning, so my part in everyone elses world would have to end as well. I was taking my toys and going home. No one elses world stopped, though.  I had a dog to handle and for him, his world revolved around me.  If I didn’t insert myself back into his world, he wouldn’t get trained, so I had to do that. As much as I wanted to, I couldn’t hide out.  Too many people wanted to be a part of my world, no matter how bad mine was doing at the moment. I had friends and family who still relied on me to be me, no matter what. I had to put on my big girl panties and deal.

I did have some wonderful times this year.  I got to be a part of something bigger than me. I talk all the time about wanting to leave a footprint, to work on something that’s bigger than myself and to be a part of something.  I got to do that. Even though my name will never be up in lights, I’ll never be the biggest or the best, but the things I got to do this year; become a Godmother (yay!), I became an Aunt three times over (not biological sisters, but we’re close enough we should be), got to watch TWP do his first long distance search and he did extremely well for it being the first time he ever put all the pieces of a search together (yes, I had a proud mama moment!), helped to get the framework together for a friend to begin working as the owner of their own EMS service, and all the little moments; the smiles, the hugs, the handshakes, and the gratitude I got from the patients I worked with.

Along the way I made new friends, reconnected with others, and even found myself letting a few go in the interest of the greater good.

I don’t think I’d change it for the world.

So, happy birthday to me and I hope everyone is having a great summer.

Have fun and be safe,

MT

 

EMS Week.

Wow.

So this years’ EMS week brings me to a whole new front. I am no longer a Paramedic. Through circumstances way beyond my control, I no longer have a State Paramedic License. I am not going to go into the whole thing now; I do not have enough liquor left to dredge up every emotion that I went through in the past twenty-four hours to try and stop the hurtful and hateful thoughts running through my head. I don’t know if I’m going to go back through the drama to get my state license back either…I may just hang up my shears and stethoscope and move onto bigger and better things.

This years’ EMS Week theme is EMS:  More Than A Job. A Calling.

That statment pretty much encompasses why we do this. From a very young age,  I wanted to do this job. I can remember the first time I ever saw the inside of an ambulance. I was no more than six years old and the babysitter’s house I went to every day was across the street from an ambulance station. Playing outside, I would watch in awe, the Paramedics and EMT’s washing the trucks, playing Basketball, screaming past the yard on the way to a call, and doing their daily routines. I will never forget the day they started to hang out with us; we were selling Lemonade and I thought it would be nice to go over with some Lemonade and Rice Krispy Squares.  From that day forward, each shift would take a few minutes out of their time to stop by and let us run through the trucks, would let us come and help wash the trucks…basically, they let us be Junior Junior EMTs.

I still remember that.

Monday, while on the way to an outing with friends, Capt. Smurf, Hawkeye, and I watched an accident happen before our eyes.  Two cars collided, rolled, and one caught on fire. We instantly engaged into EMS mode. Prior to the arrival of Fire or EMS units, the patients in the car that was engulfed in flames were extricated and the other victim in the other car was extricated as well. I never put my hands on a patient, but I organized bystanders to direct traffic, to get a heavy object which ended up being a T-Ball bat so that Hawk could bash open windows to get the patients who were in danger of being burnt to death out, and just being a calm voice in the midst of extreme chaos.

EMS has always been my life. I have given up years of my life for this job. I’ve missed many family get-togethers just because I got off work late, or I decided to fill a shift. No one does this job for the money, they do it because it’s in their soul.  Not running on an ambulance just kills me. I hear the sirens going past the house and the hair stands up on the back of my neck and I try to figure out and wonder what is going on.

EMS is a calling.  I believe every EMT, Paramedic, Ambulance driver, Flight Medic, Critical Care Nurse, Flight Nurse, whatever is set apart for this.  Everyone has read the poem, “When God Made Paramedics.”, if you haven’t click the link. In it, it shows how we had to be set apart, made from a completely different mold.  All of us have the drive, the want, the desire to do this. Any of us who have been out of the field due to injury or illness knows the unsettling feeling when we see an ambulance pass, and we have that urge to get back on and do what we know.

For this EMS week, all I have is a wish. I wish, each and every one of you, fulfill your calling to the fullest.  You fulfilling your calling may not be doing the big technical rescue, or paying the ultimate sacrifice, but your answer to your calling may be nothing more than just holding someones’ hand to help them through the worst moment of their life, or to even get someone else into the field, help someone else realize their calling.  We are truly stewards to our profession.

For me, go out and do the best you can do. Show the world why we do what we do, why we sacrifice so much for this job, why our brothers and sisters make the ultimate sacrifice and we salute them for it.  EMS is not a job, it’s a true calling.

I love you all.

Be safe.

~MT~

EMSToday 2012 Recap.

EMSToday 2012. I had been looking forward to that week since the previous year when The Bandaid Brigade won Gold Passes for the following year.

We practiced our skills, preparing for The JEMS Games and The Cook Off, then it happened. For those that I didn’t get to talk to in depth, here’s what happened.

On the 22nd of January, I got hurt. I herniated and tore a disk in my back (L5/S1) and screwed my pelvis and my hip up about three different ways. To say I was in pain was an understatement. I was playing Paramedic at the time and I won’t bore you with the details, but, I would do it again, even knowing what the end results would be. I would never ask someone to do something I wouldn’t do on my own, so this is where I ended up.  I’ll apologize now. I have been living the life of ‘Better Living through Chemistry’ the last few months and will continue at least for a while longer. If something doesn’t seem right, or it just seems disjointed, it probably is, but hopefully I’ll be back to my normal self soon.

So, I went into EMSToday pretty down on myself. It would be the first time I wouldn’t be leading a team in the JEMS Games and just with an overall feeling of just not being well added to my blue mood. I was attending, once again, with a very close knit group of friends, which made everything that had to get done much easier. The cars were loaded up, animals were kissed goodbye, and off we went.

Once in Baltimore, it was like being home. We arrived on Tuesday; earlier than most, but the city was still swarming with people with Stars of Life and Duty Sweatshirts.  That first day, on our way for dinner, a cop stopped us and asked what was going on; why were there so many ‘Ambulance Drivers’ in the city.  We explained about the convention and the cop began to laugh.

“Guess we’re in for a long week.” He said as he motored off on his Segway.

***********************************

The JEMS Games were different this year. They introduced the wireless Sim Man and a scenario based event versus the mega code on crack format they used to have.  Personally, I enjoyed the new version better than the code driven scenario; the scenario based idea makes those running the call have to stretch their abilities further.  In the code based, it was easy; push enough drugs and do the right things and you could move on to the next station. With the scenario based, it is forcing providers to use medications that they may not normally use in their jurisdictions and making them learn how to use them. I can honestly say I’ve learned two distinct styles of treating Asthma patients and the JEMS Games provided me with a third. While I may not be able to use the drugs, I can certainly use the techniques that I learned to help out.

The Cook Off…I must doff my cap to the winning team. We came in second and it was a great fight. I must admit, I felt quite horrible trying to cook along side our favorite Ambulance Driver trying to give a talk on Sepsis. I enjoyed listening while chopping vegetables.  The comment about ‘beef broth and sea monkeys’ had the entire table giggling, which helped to break up the tension in the group.

The best part about the week was probably suprising Double D with his wife. Double D had long wanted to have his wife attend an EMSToday conference, but this year, it fell near his birthday. Eight months of cloak and dagger planning culminated into one night where the Mrs. Double D and their daughter, Widget, appeared in the hotel room. This year was definately more subdued due to not being able to really go out and party, but what we didn’t do at one of the local bars, we certainly accomplished in our hotel room.  To say that myself, Hawkeye, Double D, Frosty, Mr. Macs, Capt. Smurf, Mrs. DD, Trauma Eagle, Butters, and FNG didn’t have a blast would be an understatement. My apologies go to the people in the room next to us; we were loud and acting crazy, but we don’t get to let our hair down very often, so thanks for not calling the cops on us.

Getting to meet Randolph Mantooth was also a big thing for me. His keynote address was truly phenominal. So many of the things he said rounded out my entire career. From his speech, I finally felt better about myself as a whole; if my career ended tomorrow, I would be content with where I am at now.  I am content with whom I’ve left pieces of my soul with.  I was thrilled to be able to have a picture taken with him and to get the opportunity to speak with him for a moment. I will remember that moment for the rest of my life.

All in all, Baltimore was fun. I wish that I got to hang out with those that I get to see on such a fleeting basis more, but I hope you accept my apologies for not being more social and outgoing; a lot of times, by the end of the day, I wanted to do nothing more than to curl up in my bed and go to sleep.

So, my hat is off to EMSToday 2012 and I am preparing for EMSToday 2013.  Depending on how I feel, we may even try to venture to NOLA for EMS World…who knows.

Have fun and be safe.

~MT~

Helpless.

“Ugh!”  I threw my gear bag into the back of the ambulance with an angry grunt. Just that last Saturday, I was supposed to sit for my turnover board; the thing that would make me a ‘Real Medic’, but instead, almost six hours before I was supposed to go, my insides thought differently and decided to play havoc on me. Going pale, sweaty, and doubling over in pain in a house full of Nurses and Paramedics does not make for the decision to, “play through the pain”, considering I couldn’t even speak because I was in so much pain. Once in the emergency room, pumped full of Fentanyl, a gift from God I might add, I wanted to still go to my boards. When I couldn’t even form a coherant sentence, much less remember the dosage for Zofran, another command decision was made; I couldn’t go.

 

This shift was going to suck.

 

I sat in the crew room brooding. People passed before me, excited to get into the ambulance to find out if we were Paramedic ready; we weren’t. The tools of my craft sat wantonly in the closet no more than fourty feet away from me.  I was working with one of my favorite EMT’s, Jake.

“Hey, babe.”  He sat next to me, pulling out his laptop.

“Hey…”

“I heard.”

“Good, don’t want to talk about it.”

Immediately we began figuring out the plan for the night, The Princess Bride followed by Blazing Saddles, History of The World: Part 1, SpaceBalls, and then finishing the shift with Young Frankenstein. It was set to be a good, easy night.  Making it through The Princess Bride and halfway through Blazing Saddles, with the entire crew acting out their favorite parts as we went, our tones dropped.

“Responding to an unknown age female, unknown medical problem, unknown if breathing, cannot understand caller.”

I threw my stethoscope around my neck and ran the address through my mental address book; it didn’t click with any address I had been to before. It was barely two miles away from the station. As we got on our way, I was asking the crew in back to get things ready for me; getting the portable suction set up, grabbing the oxygen tank, and BVM. With having an ALS SUV on their way to us, I had found, through experience, that the less bags we as BLS had sitting around, it made it just that much easier to get out when we needed to get back to the ambulance carrying the patient and all the ALS gear while the Medic got into the ambulance, unburdoned, yet screaming at us to hurry up.  For some Medics in our county, ALS also stood for ‘Ain’t liftin’ shit’.

We turned into the complex when another set of tones went off and the radio squaked at me.

“Ambulance 890?”

“Go ahead.”  I stared at the mic, holding it loosely in my hand.

“Police on scene stating it’s a 4 month old male, unresponsive, not breathing.”

“Received.”

I whipped my head around as our driver hit the afterburners.

“Grab the peds BVM and the Frenches out, we’ll meet the Medic enroute!”

As we neared the building, our driver stopped, “Get out, I’ll turn the unit around.”  I hopped out the truck and sprinted for the crowd of people growing near a particular door. Some people were screaming and wailing, others just stood there, smoke curls from their cigarettes wafting lazily in the air. I ran through the crowd like a linebacker after the man with the football.  As I entered the house, I saw a young cop, his flashlight on a lifeless form on the couch.  The mother hovered over her child, screaming, “Oh God! Oh God!” I gently moved her out of the way.

“What happened?”

“I don’t know!”  My hands flew over the child. I could feel no pulse, no breathing.  Around his mouth was spit up formula. I picked the child up, giving it a good whack on the back. Just be choking, just be choking…please God, just let him be choking.  I felt my shirt get very warm.  I looked down to see my shirt covered in vomit.  I took my sleeve and wiped off the rest of the vomit around the mouth and I gave two quick breaths.  I cradled the child and began compressions as I went to the door.  My crew and the fire department were just walking into the small room.

“Make a hole!” I screamed. “Get back in the truck, NOW!” I ran past everyone, pushing past bystanders.  “Open that door! Get it open NOW!” I yelled at a firefighter standing by the back doors of my truck. He flung them open with a quickness.  I jumped in as the rest of the crew was climbing in the truck.

“Let’s go! Cat 1, CPR in progress!”

The truck lurched into action.  Jake looked at me from the airway seat.

“What do you want or need?”

“Suction him, get my tube kit, put my leads on, and set me up for a line and IO.”  He looked at me as I continued with compressions. Aimee, another crewmember next to me, took over ventillations.

“Shao.” He said it very gently, “You don’t have that stuff.”

In that moment, I felt the blood drain from my face. I looked down at the lifeless child on the stretcher. I felt helpless. My eyes darted to the tube kit sitting in the cabinet. Each BLS ambulance had a tube kit in it in case the ALS gear set failed. The words of my Medical Command Doc went through my head, something he told me almost two years prior, ‘Only use ALS gear if there is no ALS available or they cannot get to you before you get to the hospital and ALS is needed, like an arrest or something like that. Until you are turned over, I can protect you only under those circumstances.’

I took a deep breath; I needed to calm down, to think. I had never had an arrest as just a basic; I always had a Paramedic with me. ALS can only work with good BLS first. My mouth was moving before I knew what I was saying, “Suction, get an oral in there if you can and continue with compressions.”  I looked into the rear view mirror. Lynn was darting her eyes from the road to the mirror, watching all that was unfolding.

“Find my medic!”

Her hand flew to the radio as I wrapped my hands back around the childs’ chest. My thumbs met in the middle and I began compressions again. Lynns’ voice floated to the back of the rig.

“We’re gonna meet ’em up here! Less than two!”

I played musical chairs in the back of the ambulance. I moved from the bench seat to the stretcher and Jake moved from the airway seat to the bench seat. As the truck slowed, it never seemed to stop as two Medics jumped on and we began moving again.  The two weren’t exactly my two favorite Paramedics in the world, but they had the tools…my tools.  I let Aimee continue with compressions as I unzipped the monitor, rattling off what I knew. I snapped the leads on their cords and they were taken away from me.

“Just do basic stuff, we have everything else.” One of the Medics looked at me and jutted her head to the side. I moved from the stretcher, standing between the wall and the stretcher as she moved over to do the IO.  I felt my hands ball into fists at my side. As tools were called for, I could orchastrate my crew around me to find what was needed, yet not having any hands on was just killing me; how could I say I did all I could do if I couldn’t do what I was trained to do?  I knew everything was being done to the extreme; tube was in and good, lines were in, drugs were being pushed, Aimee was doing her thing with compressions, switching off with Jake, and they were being done well, yet I felt like I had done nothing, like I had let the child down.

As we pulled into the hospital, I was given the dubious honor of bagging while we picked the child up and just ran inside. The other Medic and I couldn’t get a good rhythm moving with one another. He was well over six feet tall and I was reaching up to bag and trying to run sideways at the same time while he was using huge strides to propel himself into the emergency room. As we got through the doors, one of the nurses took over and as I was turning around a woman walked shaklily through the doors. It was his mother.  She looked damn near ready to fall over, so I went to her, holding her up.  Wordlessly, I walked her around the ER, avoiding the room her child was in, taking her to the Quiet Room just off to the side of the waiting room.  As I walked her in, she spoke to me for the first time.

“They only take you in here if they’re dead…like on TV.”

I turned on the small table lamps and gestured to one of the chairs.  When her back was turned, I flipped the switch on the wall that turned a small green light on outside the door.  It showed that there was someone in there.

“I figured you would need to call people, so I didn’t think you wanted to do it out in the general waiting room. You can sit out there if you’d like…if you’d feel more comfortable.”  I didn’t want to tell her that, yes, her child had been asystolic for a twenty-five minute ambulance ride and we weren’t exactly driving just ten over the speed limit, so the chances were slim to none and slim was on vacation, away from this nightmare.

“Can I smoke in here?”

“No…and please, try not to go outside unless you absolutely have to.  If you do, let the nurse at the desk know exactly where you are going. Is there anything I can do for you? Before I leave, I mean.”

The young woman shook her head and I saw a set of Rosary Beads in her hands, “Would you like me to get a Priest…to pray with you?”  She looked at her hands and nodded.  I bowed my head slightly and I turned to walk out the door.

“Hey…”  She called behind me. “Can you throw one out there as well…a prayer? I’m sure He’d listen to you before He’d listen to me.”

I nodded, “We are all the same. I’m sure I don’t get any extra credit just because of this.”

Walking out, I felt the adrenalin fall away from my body as if it finally pitched over a waterfall. I went into the Medic room, sat down at a table, put my head down, and cried for all I was worth.  I was helpless, once again. My body shook with every sob. I was alone and helpless. As I was walking to the Medic room, I saw the curtains drawn, but no activity behind them. A nurse asked for the number for the coroner; the one that was on the list was wrong. I knew it was over.  I felt like it was my fault; because I hadn’t started pushing drugs or getting a definitive airway, or doing anything more than what I did, that my inaction caused the death of that child.  What good was I when I could do nothing more than what amounted to a bandaid?

I heard the door open behind me and I sat up and wiped my eyes and nose with a 4×4.  I fumbled around, acting like I was trying to clean off the stains on my shirt.  A shaky voice called to me.

“S…Shao?”

I turned in the chair. It was Aimee.

“Please tell me he made it.”  I stood up.  She had never worked an arrest before this, I knew that much.  She had a little one at home as well, probably not much older than the one we just worked.  I stood next to her.

“No, he died.”

Her face scrunched up and the tears began to flow.  I pulled her to me, resting my chin on the top of her head.

“Why?!” Came the muffled cry.  I let her bawl it out on my chest for a few more minutes before I spoke to her.

“Listen to me. Here it is medically. Peds are hard.  They compensate for so long, then they just fall off the edge. Who knows what was wrong, medically.  Who knows how long he had been down before mom found him.  We were well behind the eight ball before we even got there.  Non-medically…” I took a deep breath, “because it happens. There’s no logic behind it, it just does. Babies are born, babies die.  It happens.”

She looked at me and I began to feel uncomfortable. “You don’t believe a word you just said, do you?”

“I have my own demons to fight in this one. If nothing else, you did everything you could. Your compressions were great and you didn’t get flustered when the shit hit the fan.”

“I thought you could fix anything, Shao. You’re a Paramedic, right? You were taught how to fix this. Why didn’t you?”

“Aimee…”

“No! You didn’t do what you were supposed to do! What kind of Medic are you, that you can’t save a child?!”

Ouch.

“You did nothing to fix it! You…”

“I can’t fix dead, hon. I can’t.”  I then remembered where she got the idea. Her father had collapsed due to sudden cardiac arrest, but the planets were aligned that day and he survived. In her eyes, Paramedics could fix dead.  It was why she became an EMT. She saw a Paramedic save the day and she wanted to do the same.

“You can, but you didn’t.” She turned on her heels and walked out.  I stood in the silence for a moment.  I thought back to Medic class, when we were going through PALS, how the instructor said, at the end of everything, ‘It’s calls like this that make even the most level headed Medic contemplate going home and eating their own gun. Everyone has a hand in it when it goes right, but when it doesn’t, you will be blamed for something that you had no control over. It’ll be your fault, in their eyes, and yours alone.’

I fired off a quick text to our Cheif, telling him that it was a Peds arrest and that the crew needed to talk it out. He replied he had heard the call and was already waiting. The ride back to the station was a quiet one.  Jake popped his head through the birth canal and touched my shoulder.

“Can I ask you something?”

“Sure.”

“Would…could you have saved the day if you had your stuff?”

I shrugged, “Probably not, but that’s water under the bridge now, hon.”

We were going back out of service. It was a rule. Any bad call bought the crew an hour out of service to breathe, talk, smoke, or to do whatever would made them feel better.  We could get longer if we needed, but no less than that.  As we pulled into the station, on the side of the building was a big, red fire engine and more cars than there were before we left. A horde of people stood by the ambulance bay.  We got out of the truck and the mob decended on us.  Each one of us were pulled a different way, to be able to let whatever we felt out without our partners overhearing.  I kept my head down.  There were fire fighters from my home station; guys who wouldn’t be caught dead in an ambulance station any other day.

“What are you guys doing here?”

Brian, one of the lieutennants, stepped up, “We heard our little sister was having a bad day, so we came to help her.”  They all hugged me, telling me I had done everything that I could, yet hearing it didn’t make me feel any better. It was amazing how deeply Aimee’s words cut into me.  Not being a ‘Real Medic’ had already left its own wounds, but this was even worse.  I nodded and smiled, even laughed, in all the right places, but my heart wasn’t in it.  As the crowd began to thin, we were left with ourselves, our Cheif, and the company CISD person.  Aimee still wouldn’t look at me, doing her best to stay as far away as humanly possible.  I cited ‘womanly issues’ and excused myself inside.  I locked myself in the bathroom and just sat on the floor, letting my mind wander through the call.

When I finally came out, Aimee was packing her things; she was leaving early.

“Aimee. Wait.”

She glared daggers at me and I held up my hands, “Look. Your family got lucky. You don’t realize how lucky, but you did. That was pure luck your dad survived. It doesn’t work like that in this job all the time. If you would go and ask those Medics now, just how many saves they’ve gotten since then, I would put down a hundred dollars on them saying any number less than two.  So far, I’ve had two cardiac arrest saves in almost ten years. Do you know how many I’ve had die on me around that? A lot more than two.  I’m sorry this one didn’t survive, but you can’t blame me for it.”

Wordlessly, she picked up her bags and left.  I stood in the empty room, alone.

*************************

A few months later, I’m washing the ambulance. As I sweep the soapy brush over the windows, I hear a small voice behind me.

“Excuse me, miss?”

I turn around. It was the mother from the arrest.

“Yes, how can I help you?”

“I saw you out here as I was walking past. I just wanted to say thank you, for everything you tried to do.  You guys really are angels. Thank you.”  With that, she turned and walked away.

“Your welcome.” I called after her. She never again looked back.

Bad Reviews

So, I got my first bad review on anything EVER a few days ago. I was checking out the articles I had written on EMSWorld.com and for the first time ever, I found a bad review. The review was only two sentences long, but said quite plainly, “This is the worst article I’ve ever read.”

I stopped for a moment and really processed the comment, “Worst Article Ever.” I’m sure it wasn’t that bad. Sure it wasn’t my best, but it didn’t suck that bad.

Anywho, the only reason I’m even writing about it is the sheer fact that, even though I got slammed like there was no tomorrow, it’s a measure of how much I’ve matured since I’ve started writing that I just didn’t care. I shrugged my shoulders, made a mental note about the things that the commenter didn’t like, took it as constructive criticism, and moved on.

Not everyone is going to like every little thing that comes from my brain to my fingers, but I can say the hundreds of good comments never go unnoticed or unappreciated.

So to those that enjoy what I write, thank you. To those that don’t, thank you as well. In the end, it’ll make me a better writer all around.

Have fun and be safe.
~MT~