Sick

No good calls to write about today. We did some basic transports. One lady was really cute. She was telling me about her husband, and how life used to be. She noticed my ring and asked if I was married. I told her engaged and her face just lit up. She asked about wedding plans, whether I had my dress, etc. She told me about her wedding in 1949 and how her dress only cost $50 and her entire wedding, including the band, only cost $600. We had a good time chatting on the way to the hospital.

I have been sick all week. Today has been no different. I couldn't stand it anymore by like 1500, so I called around and found coverage. She couldn't come in until 2030, but it was coverage none-the-less. At 1930 dispatch called us and told us to head out west for a 2030 call. Great. So much for coverage. I actually threw the nextel and almost cracked the console. Oh well. We got there early and waited for our patient. He was rather crabby and I was glad that it was my turn to drive. The dialysis place we picked him up at is about 30 minutes from my station (without traffic). The nursing home is 20 miles south of that. Not cool. We ran the call. I had one hand on the steering wheel and one hand on a vomit bag. It sucked really, really bad. When I finally got home I collapsed in the bathroom. I don't remember much after that. I just remember trying to find my radial pulse and I couldn't find it. It felt like a dream. I woke up around 0600 and stumbled back to bed.

Closing

I finally closed on my house today. I had tons of papers to sign and I was so ready to just run out the door. But, I did it. It is finally mine. Hopefully I don't find anything wrong with it. I was ready to get home and go back to bed. I had to call off work again. Too sick. I shouldn't have even gone to the signing, but they couldn't postpone it. Oh well. Hopefully tomorrow is better.

Barely making it

I barely made it out of bed. I am thinking about setting up a cot in the bathroom. It would lessen my response time to the porcelain god. I feel like I'm dying. I am definitly not a good patient. I refuse everything. My doctor sent me for tests, etc. She tried to admit me. I refused. She said if I vomit anymore I need to go to the ER. I still haven't gone. I think my blood pressure is slowly dropping. I can't focus my eyes and I constantly feel dizzy and shaky. This is what I think of when I say "circling the drain." I think I am right by the hole. I don't think I am circling anymore. Yuck. Anything would be better than this.

Very long day

I don't even remember half the calls I did today. I have been running my ass off all day. Nothing too great. One lady was funny from one of the psych places. We took her to the ER for agitation. When we were leaving another guy, who happened to be a patient, came up and kissed her. She said that was her fiance. Then another guy said, "no, I saw her first!" Nice. She had a cigarette before we left. I talked to one of the staff members while we were waiting. He has only been working there for 10 days. I've seen him at least 6 times. He knows me by name. I think he requests that I come get the patients. He used to work at a maximum security psych facility in Florida until a patient stabbed him. He decided to hang low and a more lax facility. Wow.

We ran all night. I started feeling sick in the early afternoon. I didn't eat all day. I started vomiting around 1600. Of course we got ran and I ended up running to the bathroom while my partner did the work for both of us. We got back to quarters around 0630. I had one of the oncoming crew members come early so I could get home. We did an MRI that ran late. I didn't get out of the station until after 0730. I feel like I am dying very slowly. My heart is beating really strong and I'm dizzy. Hopefully this goes away soon.

Firestarter

First call was for an ALS MRI. The guy was really cool. He was chatting all the way to the ambulance. We were taking him because he had a seizure. My partner was playing music off of his ipod on the way to the MRI. The song that came on right away was the Beach Boys. The guy yelled, "turn it up!" and was jamming to the music. We listened to Stix, the Beatles, etc. all the way to his appointment. He was having the time of his life. we took him back to the hospital when he was done too. It was the same routine on the way back.

For the rest of the daytime we did mostly BLS calls. Nothing special.

Our first "real" call came in around 1900. We were called to a local nursing home for a patient with tachycardia. We got on scene, to find a man of about 40 dripping with sweat (literally) and extremely pale. The staff said he had an anxiety attack in the morning, and then began to sweat and get pale around 1600. Way to wait three hours to call EMS. We got him moving. Just about everything checked out-we couldn't find any explanation for his symptoms. Another crew took him home in the middle of the night. They said he still looked like crap when they got to him. He was still sweating and pale. Nice to know that the hospital takes care of its patients.

We did another call right after that for a patient with SOB. When we got on scene, we found our patient: a fever of 103, unresponsive, and belly breathing. The nurse said the guy was up at 2100 to get a drink out of the vending machine. She went to check on him at 2245, and this is how he was. We got him onto the cot, hooked up to the monitor, and got him downstairs. He looked pretty good on the monitor. His blood pressure was about 96 systolic. His oxygen sats were kind of low, but came up to about 95% on a NRB. I noted that his pupils were unresponsive. He also didn't have a gag reflex. I put an oral airway in, which he wasn't bothered by. I got my intubation equipment out, had the laryngoscope in, visualized the cords, and started sliding the tube in...and he started gagging. I stopped and put him back on the nonrebreather. So much for that. He didn't become any more responsive than that.

We did a transport in the middle of the night for a psych from an immediate care center to the ER. Nothing special.

We did another psych call around 0400, that proceeded to take up the remainder of my shift. The woman was quite odd. According to the nurse, the lady was found by neighbors on her front porch, dousing it with gasoline, and carrying a few knives with her. They called 911, and they got to her before her whole house was torched. There were several burn marks on the porch from earlier in the day-she tried to torch it earlier, but it wasn't burning properly. That is when she proceeded to get gasoline to do the job. The police also found several more knives on the kitchen counter, including a switchblade, and about 10 cans of lighter fluid (the kind you would use for a grill). Nice.

Around the world in 24 hours

I was everywhere in northern Illinois, except for my area today. First call was for a doctors' appointment. It was going to a hospital just north of Chicago. The lady was really lethargic and having difficulty breathing. We were taking her to her respiratory doctor. I thought we should have just taken her directly to the hospital, but the nursing home disagreed. Her vitals weren't bad enough to go direct. We went to the office, and the doctor listened to her lungs and sent us on our way. We went across the street to the hospital.

Before we even cleared up we got a call for a psych going back up north. The lady was pretty interesting. She was talking to someone named Renee the entire ride back. She was also conversing with Jack, who I later realized was her husband. She kept asking me to tell her when we were half there, and then laughing. A pretty entertaining ride.

We got back to quarters for about 10 minutes. Then we got a call from a local nursing home/psych home going to Chicago. The woman wasn't happy with the place and knew how to play the system. We took her to the hospital and spoke with one of the nurses. The nurse said she also works at a hospital across town...she just discharged this lady this morning. She couldn't have been at the new facility for more than a couple of hours.

We got back up north again for about 15 minutes, then got a call from a dialysis place out west going to a nursing home to the southwest. It took us about 35 minutes to get to the dialysis center. It took us about an hour from there to get to the nursing home. We got lost several times. Our computer told us the wrong address. Our mapbook gave us the wrong coordinates. Our account list gave us the wrong cross streets. Our dispatcher had two different addresses for the same home. We had to call the facility and they gave us landmarks, such as "Walmart." Nice.

We made it back to quarters, once again. It was already late. No sooner did I close my eyes, and we got a call. It was actually in town for a psych transfer from the ER to the psych hospital. End of story. Uneventful. I practically ran for my car this morning when my shift was over with.

No calls

I spent my shift doing absolutely nothing. I was sized for new gear. Then I helped my lieutenant redo our MABAS books, replacing old box cards with updated ones. I studied for HAZMAT for a few minutes. I cleaned-the usual-inside and out. Nothing that great. I was definitely ready when shift was over with. I have a long 24 hour shift ahead of me in the morning.

Slow day

First call was for a fever. Besides that, the guy had an altered mental status and had poor vitals. The nurse said the fever started this morning. The she tells me he fell last night at 2345, unwitnessed. But how she knew it was at 2345 if it was unwitnessed, I will never know. Then I asked if his mental status was like this before the fall, or just afterwards. She said she didn't know-she only worked weekends. The other nurse said that this wasn't her floor. The other one said it was her first day. Yeah, if that doesn't tell you something, I don't know what would. The guy had been up and walking around since, so we didn't board him. He had no complaints, just that he was tired. He was lethargic and confused, and I had no history or events to go on. Gotta love it. The hospital especially enjoyed my report.

Second call was for hypotension. On scene, once again, the guy had an altered LOC. His blood pressure was fine, but is SPO2 was low. We did what we could and transported. He cried the whole way to the hospital because he didn't want to go. He said he wanted his mother. At 69, you would think this was just confusion. But, no. His mother is 101, and was going to meet us at the hospital. Wow.

Our SPO2 monitor stopped working during the call. We went back to headquarters and switched out cords. We fixed it and were back in service in less than 30 minutes.

No calls after that. We almost had one out of the stand-by ER, but we were cancelled. Sleepless night. I wasn't with my usual partner, and the guy I worked with snores and talks in his sleep. All in all it was a good shift. Besides the feeble attempt at sleep.

Firehouse

Another night at the firehouse. I accomplished absolutely nothing all day (go me!). Boring day. We did some minor cleaning-mopping, taking out the trash, and then just sat around and waited for the bell to ring. It never did. I didn't get much sleep-too much on my mind. 0500 rolled around pretty quick. I have enough time to drive home and shower, then head off to the ambulance company for shift.

(back dated)

BLS

Today I worked on a day car with another medic and a third rider that just started at the company. The guy I worked with is in a different system than me, and the gear assigned to the rig is in the same system. In other words, I am the BLS biotch for the day. Great.

Our first call went from a local psych facility to a state psych facility south west of us. A long drive, but it was okay.

We did a call for "generalized pain" on a priority, which turned out to be an anxiety attack. She told me I don't know what I'm doing.

Another call-abdominal pain, on a priority. The woman was just chilling out when we got there. She was sitting in her chair with her feet propped up. She looked completely normal except for her stomach, which looked like she should have been about 6 months pregnant. She had a history of obstructions.

We did a transfer for a blood transfusion. Then a transfer back to the nursing home for a woman who was screaming and crying hysterically. Her son was something else-requesting all our papers and copies of everything. All I gave him was our privacy policy. He asked for the company's phone number and our names. Whatever. As soon as he was out of sight and his mother was on the cot, the screaming and crying stopped. Wierd.

Finally some rest-soon. We got off right around 2300. It sucks that today is St. Patrick's Day, and I can't even go out and have a good time. Damn it.

Fever

Today has been the day of priority calls. Right off the bat we got a call for chest pain at a stand-by ER. The normal chest pain call. The guy seemed to know a bit too much about it, you know, complaining about jaw and arm pain, etc. He had a psych history. The entire way to the hospital he kept saying, "I'm ready for the urine specimen whenever you are." Nice.

Second call was back to the same place for a person with chest pain. My first thought was that the patient we just brought in probably caught a cab and came back to the stand-by ER since he enjoyed the ride the first time. Nope. Different patient. He had chest pain earlier in the day- now he just had numbness to his left arm and shoulder and tightness in his chest. Normal workup and transport.

After that almost all my calls were for a "fever." I think out of four patients, the lowest temperature was 104. Completely ridiculous; not to mention that it wasn't their only problem. Most had really low blood pressure, SOB, etc.

We only did two actual transports other than emergency calls-very unusual. One went to a nursing facility out west-clear across the state. She only weighed about 80 pounds, it was snowing terribly and the roads were slick, so we were moving at a snail's pace. She was in agony by the time we got her there. She said her tailbone was killing her from sitting like that for so long. I also did a transport to a local nursing home. The had fractured her hip a while back and was in the nursing home for physical therapy. She told her therapist that something didn't feel right, but the therapist said she was fine. Needless to say, she broke her hip again-during therapy. She was a very nice lady and she told me about her daughter and how she had bought a new house so she could have her own room and be able to get around better. She was excited to go home soon. We chatted for the entire ride. I plan on bringing her flowers next shift. I told her she was in my prayers.

I was definitely tired when shift ended. No sleep for us. The worst part-I start work again at 0900. It's 0830 right now :(

Back to normal

I'm finally back in the swing of things. I finished just about everything for my mortgage. I can't believe I am finally getting a house. Yeah! The fire department was uneventful so far this week...on my shifts anyways. I am back at the ambulance company tomorrow.

Tonight was positively boring. Of course, as most fire houses are, mine is filled with guys that snore. My shift just happens to be full of them. Our bunk rooms are separate, but we share a common wall. One guy will only sleep in the day room and he snores. Another guy that sleeps in the bunk room snores-probably worse that the day room guy. So, needless to say, I don't get much sleep there. If I do, I am in the ambulance sleeping on a cot covered with MRSA. Nice.

I couldn't fall alseep anywhere, so I decided to go on a mission. I cleaned both ambulances from top to bottom, including the front. I used cavicide first, bleached the floors, then sprayed with a disinfectant that has to sit for 10 minutes. I also organized the cabinets, IV tray, and tested all the bulbs and batteries in the intubation kits. Good times. It took several hours. I had the radio cranked the whole time on the bay floor, but I guess everyone was so busy snoring that they couldn't hear it.

The Terminal

We got up at 0440 to catch a cab to go back to the airport. I looked out the window and realized that we were probably in for the same problems as last night. If anything it looked worse, but I figured maybe the sun would break the fog.

Once we checked in, I got a chance to look up at the board-flights delayed and cancelled all over the place. Ours said 'on time.' All I could do was snicker and curse at the board for telling an obvious lie. I also noted people sprawled across the floor sleeping-most likely people from our flight last night. The waiting areas were all full-people were in line already, only most were lying down or sitting on the floor. The boards started flashing again-delayed...delayed...delayed. I felt like I should be filming the sequel to "the terminal." Someone came over the intercom and said that nobody was coming or going as of this moment. No word on when flights will resume. We got comfortable and figured we were in for the long haul.

Our flight was only delayed for a bit over an hour or so. The flight wasn't too bad, but I was relieved when I was back on the ground.

In the end, I missed my home inspection, my meeting with the lawyer, and my meeting with my mortgage person. Great. I also had to call off work because I was too late to get coverage and I wouldn't be back in time to be of any help. That sucked.

I guess I'll try again tomorrow. Things can only get better.

Cancelled

We bummed around for the majority of the day. Not much to do. It was rainy and cold. We did try to fly a small rubber-band powered airplane through the hallways, and fly a battery-powered airplane in the courtyard. Both crashed and broke. Nice.

We headed out to MacArthur airport around 1700 for our flight. The roads weren't too bad, but there was some fog. We boarded the plane on time and taxied on the runway...and were still on the runway. The captain came over the intercom to tell us the visibility was reduced and that we would wait to see if it would improve. Needless to say, it didn't, and we went back to the gate. We got off the plane, as the flight was cancelled, went to the counter, got tickets for the morning and called a cab. We went back to the apartment and relaxed. Hopefully we have better luck tomorrow. I am supposed to be doing a walk through and home inspection of a house I plan on purchasing at 1000.

St. Patrick's party

What can I say? I just can't get enough of Manhattan. We did another little tour of the city today-upper Manhattan. We did the Central Park thing. The only thing that sucked, once again, was the fact that we couldn't find a stupid bathroom. We walked from Penn station (around 34th street) north of Central Park (around 82nd street), and still couldn't find a bathroom. We walked through the park several times and finally stumbled upon a bathroom-thank God. I thought for sure I was going to burst.

We got back on the train to go back to the island around sunset. We had to go back to the apartment, shower, and head to the fire department for the St. Patrick's Day party.

The party was actually quite large. When I got my wristband, my number was already 1400. Wow. All that at a volunteer department. We had a good time, had a few drinks and headed home just after midnight.

City Life

We got a late start today. I was still an hour behind because I never reset my watch. Damn. We got on the LIRR (long island railroad) around 1200. I absolutely love the city. I just like to walk around and watch people and look at the buildings.

After wandering for a bit, we decided to visit the Empire State Building. Very nice. It was absolutely beautiful. We went to the lookout on the 86th floor, and then paid the extra $14 to go to the 102nd floor. I could have stayed up there all day. I got a really weird photo from the 102nd floor; I was facing in the general direction of ground zero, trying to take a picture of the rays of sun breaking through the clouds over the city. This is what it looked like:



If you can see to the left there are two things that look like towers. Once I got a really close look at the picture on the computer I realized that it was the reflection of the windows. But, when I took the picture, I thought for sure it was a sign from God. It looked like the twin towers. They were just to the left or east of where the reflections are in this picture. Very creepy. All I kept saying was, "holy shit." I just knew I needed to get to Ground Zero and say some prayers.

Our next stop was Ground Zero. The sight was upsetting. To me, it is sacred. It brings tears to my eyes just thinking about it. I was crying the whole time I was there. What upset me the most was how people could just walk by like nothing ever happened. They reopened the subways below and people are back to their normal way of life, not taking a second glance, or even a fleeting thought of the lives lost. Then there were the people that were gung-ho and taking pictures and video taping so they could say that they were there. I just felt like it was so disrespectful.

After about 45 minutes I had to leave. I couldn't look at the gaping hole anymore.

We went out for dinner a while later, and I had had a few too many drinks. We walked around lower Manhattan well into the evening. Eventually, the drinks caught up with me. I had to go to the bathroom really, really bad. We wandered forever, and knowing Manhattan, realized that I wasn't going to find a bathroom. What I did find was a construction site. It had an outhouse; and I used it...sneaking in with a little penlight in hand, going as quickly as possible without falling in the toilet, and running out without even having my pants completely up. It was disgusting, but a toilet none-the-less.

We managed to get back to the subway, back to Penn station, and back to Long Island. It was a long day, but a good one. I have a very deep love for this city. I'm not quite sure why. I just love the way that it is always busy, there is always something going on. It is not so in Chicago-it actually does "sleep." I'm in it for the action. We may go back tomorrow, I'm not sure yet.

Back to New York

We were up at 0400 to start our hike to the airport. We caught the 0525 train to Union Station. We then got on the EL train, of course we accidentally got on the purple line instead of the orange line, corrected ourselves at the next stop, and continued in the proper direction. We got to the airport with time to spare. The plane ride wasn't too bad-thank God. I still took Xanax before we left though.

We arrived in mid-morning, doing our usual rounds of visiting people and wandering around the island. We also saw the movie 'the Pink Panther,' which wasn't as good as I thought it would be. We made the decision to go to the city tomorrow, so we called it a relatively early night (at 0230 or so).

Not much excitement in the apartment building tonight. All is quiet.

Saving the world: one psych at a time

First call was for a psych going to a facility in Chicago. It was an uneventful trip. We dropped her off and headed home. We stopped at a restaurant called Portillos that has really good food. I wasn't in a hurry, so we took the long way home through the ghetto. Good times.

I think I did a return to a nursing home after that-I'm not really sure.

We were really slow in the evening. Of course, that is when my pager for the fire department went off for a full arrest. I was supposed to be there this evening, but I switched shifts at the ambulance company for the day in preparation for vacation, and had to pawn off my shift at the fire department. Damn. I heard from a couple people that were there and I am kind of thankful that I wasn't. The guy was pretty dead, but the crew couldn't decide if he was warm or cool, so they worked him. He was a big guy too. My back is thanking me for taking the other shift.

We did an adolescent psych transfer. Of course me and my partner can't help but mess with people. The kid was 14 and was being admitted with ADHD. We got him on the cot and started strapping him in. He gave me a look like I was crazy for strapping him in-he thought they were restraints. Of course I have to get smart with him,

Me: "These aren't restraints, it's a five point harness like race car drivers wear...you're lucky I'm driving..."

Patient: "Why?"

Me: "Because if my partner was driving, you would have to wear a helmet too."

Patient: "That's not funny."

Me: "The good news is that if we roll the ambulance, you will be suspended from the ceiling like spiderman."

Patient: "You mean crash! You're that bad...um...maybe you should give me the helmet."

Me: "Not to worry. We only get in accidents of Monday nights."

Patient: "But today is Monday."

Me: "Oh..."

Patient: "Are you going to drop me?"

Me: "Nope. I only drop people on days that end in 'y'."

This conversation continued with my partner in the back until we arrived at the hospital. He must have said some other things to the kid, because when we got to the facility he practically jumped off the cot. Yep. Life is good.

Another psych after that to the same facility. This one wasn't too bad-he was relatively cooperative. We had seen him in the ER on our previous visit. We got our paperwork and went into the room. He was sleeping, so I said his name to wake him up-no response. I yelled his name-no response. My partner shook his shoulder-no response. Sternal rub-still no response. I told my partner to check a pulse. The guy finally woke up. That was enough of a scare for me. I thought for sure there was something wrong. I got his belongings together and the psych coordinator handed me a small baggie and said, "this is his prized possession." I said, okay and was on my way. Want to take a guess of what was in the bag? A box cutter. Yeah. Nice. My parter put it on the back of the cot, but we ended up hiding it in the front of the ambulance just in case he went psycho on the ride. It was uneventful.

Another call shortly after for a laceration to the forehead. It was at a nursing home about 10 miles away. We brought everything inside with us-including our backboard, etc. The guy had fallen, unwitnessed and bumped his head. According to staff he fell flat on his face just outside his bathroom. He denied passing out and he was A+Ox3. When we went into his room there wasn't blood anywhere. They had already cleaned it up. The story seemed a bit fishy. The guy's forehead was completely split open-you could see is skull. The actual laceration/avulsion was about 1 1/2 inches long and about 1/2 inch wide. When I dabbed the wound with gauze his scalp moved about a quarter inch or so. The nurse said there was blood everywhere, but it was just oozing when I saw him. Everything else checked out, and according to his mental status, our findings, and our protocol, we didn't have to c-spine him. Another save :).

I did another psych from a government facility to a psych facility. Depression. A quick transport and I was back in bed-for 25 minutes or so.

Last set of calls was for an ALS MRI. We got called at 0445. Pickup was at 0530, but we have to be there 10 minutes early. We got on the floor and the patient isn't ready. We wait. We finally leave around 0555. We get to the MRI at 0610. Nobody is there. We wait. The secretary shows up at 0625 and lets us in. They don't open until 0630-they don't scan until 0700. We wait for the tech, who showed up around 0640 and started up the machines. Our patient finally got into the MRI at 0710. He finished around 0800. Then we had to take him back to the hospital across town. I got done at 0845. Late as usual.

I'm off for the rest of the week. I leave for New York on Thursday morning. I have an appointment to see a house today and then I plan on being a bum for a while. I will try to post before I leave, but if I don't, I will be posting all about the trip once I get back next week.

Circling the Drain

First call, right off the bat, was a return to a nursing home. The lady was the cutest little thing. She had a blast on the ride there; she was harassing my partner the entire ride. When we got to the nursing home, she asked me, "what the hell happened to you?" I said, "um...I don't know." She said, "when did you get so tall?" I told her that possibly I grew on the way over. The lady's daughter piped in, "mom, you're only 4'10"." She just said, "Oh."

Next call was in Northbrook for an "arrhythmia." Wierd. On the bottom of the screen it also included vomiting and diarrhea. Okay, that doesn't sound too good. It was screaming cardiac problem to me. We got on scene and saw the patient. She had been vomiting for two days, not eating, and, according to the RN, had an abnormal heart rate. I put her on the monitor and did vitals and I wasn't able to figure out how she discovered the abnormal rate. She didn't have a radial pulse. Her blood pressure was about 80 systolic, and her heart rate was around 160. She had a history of A-fib. To add to the problems, she was diaphoretic, dizzy, short of breath, had a blood glucose of 372, and I couldn't get a line. She also had stroke-like symtoms of sudden onset during transport-she had slurred speech and one of her eyelids started to droop. She had a history of a CVA, but the RN said she didn't have any deficits. The patient wanted to go to a far hospital, but I was diverted to the closest for obvious reasons.

I couldn't believe what I was hearing when I got to the ER. Our patient was a DNR, but that doesn't mean do not assist, or do not try to help. I was doing everything I could to help her and make her comfortable. I gave my report to the nurse, emphasizing my concerns. This is what the nurse replied, "It's not necessary to get all worked up. Maybe it's just her time to go...her blood pressure is 80 systolic-that's okay...we'll just give her some fluids." I was pissed at the nurse. Besides that it was completely unprofessional to say that it "might be her time," my patient was A+Ox3, and could hear, and understand, everything that was going on. I almost wished I had taken her to the farther hospital. The nurse completely dismissed my concerns, even the possible repeat CVA that could have been critical-and treated right away-considering they didn't start until we were en route to the hospital. This was my first diversion of the day.

I got a call for a patient in respiratory distress at a local nursing home. Once I saw the name of the place on our pager I knew we were in for a treat. The lady was gasping for breath, unconscious, diaphoretic, and pale. She was a full code-a ward of the state. We got her moved into the ambulance and did the rest of our assessment. Her blood pressure was a little low, her heart rate in the 130s. Her respirations I counted at 40. Her spO2 was okay-around 93%. Staff said when they found her it was 46%. Her arms were contracted and we were unable to get a line. I gave her a neb treatment because she was wheezing. She also had crackles, but without her being alert enough to use CPAP, and without a line, I was shit out of luck. I checked her gag reflex while my partner continued his search for a vein. It was there. I checked it one more time before we left the scene-not there. Crap. We got the intubation stuff ready and were set to go. My partner inserted the blade and she started gagging. She had tons of phlegm in her throat that we suctioned. At least she had a gag reflex. Now that my rig was officially trashed-we were ready to go to the hospital. Another desired hospital about 15 minutes away. I called medical control, and big surprise! I was diverted again. She did okay on the way to the hospital. We got her into a room right away and I gave my report. All I had to say was the nursing home I got her from and the nurse was shaking her head. The last I heard she was in the ICU, clinging to life. Or, rather, circling the drain.

There were five other squads at the hospital while I was doing paperwork. One squad alone brought four in.

Another transport for a psych patient. I had taken him before. He was alright-very quiet.

While we were there I noticed another lady, whom I predicted would be our next psych. She stood in her doorway for a few seconds. Then she turned around and went back in her room. She returned dragging a chair and holding a bottle of saline. She put her arms up in the air, as if she was blocking someone. She said, "hello, officer friendly," to a police officer that was standing in the hallway. She tipped the bottle upside down and unopened, and then declared, "oops! I fell." A nurse approached her and tried to get her back in her room. The nurse tried to take the bottle of saline away from her and the patient told her she was thirsty-it wasn't for drinking. The lady proceeded to sit down on the chair, the nurse took the bottle of saline, and the woman spread out her arms and declared, "give me back my normal saline!" I was trying to disguise my laughter as a coughing fit, but I don't think I did a very good job.

Our last call was for a patient with a fever-on a priority. The nursing home is about 15 miles form my station. We got down there and the nurse said the patient had a fever of 102.8. After seeing the patient, I had her take it again-103.2. The patient had wet herself, and soiled herself, she was flushed, diaphoretic, had a low blood pressure, was lethargic, and was oozing copious amounts of greenish brown phlegm from her stoma. Nice. We actually got a line on this lady, which surprised the hell out of me considering my track record for the shift. There really wasn't much I could do for her but wipe the phlegm off that kept running down her chest every time she coughed. I also noticed that she had gotten her stool all over her hands as if she had been playing in her diaper. Yummy. I gave the hospital a two minute ETA. We got her settled in her room. I'm not sure she will pull out of this one.

I was held over again. I got back to quarter around 0830, but it was a good shift. I had a paramedic student with me, so he got some good calls. It's always nice when I actually get to use some skills.

I was off until 0900 (a whole 30 minutes). I got my rig checked out while my partner ran home. He had forgotten his wallet. It was the same partner I just did my 24 hour shift with. We went out to breakfast at IHOP with two other crews and then we were sent to post a local hospital. We sat...and sat. Everybody in the county was busy except for us. We watched a movie about a psych facility called Madhouse. Very scary-I don't recommend it. I was especially stupid to watch it because my quarters are actually at a psych facility. We stay on the second floor of the hospital. Thank God I didn't try to watch it last night. The hospital is all shut down except for two floors. The psych floor is right above us. We were wandering around last night for a bit and ended up in the surgery area. There was mold growing across part of the floor, old beds and tools lying around and even the machines that anesthesiologists use. Very creepy. It looked like an old hospital from a war movie that had been deserted. Anyways, we finished the movie, I fell alseep for about a half hour or so, and then we got our first call-a psych going across town. Isn't that convenient. He was alright, the transport was uneventful and I was glad to finally run a call. We told dispatch we were clear and they told us to hit the pumps and have a good night. It was 1600-I wasn't due off until 1900. Oh well. I was hoping to have a repeat of yesterday, but no such luck.

I am back on shift tomorrow. Another 24. I am dead tired. I barely had the energy to eat dinner when I got home. All I did was throw my uniforms in the washer to prepare for the next round-hopefully a good one.

Uneventful

A very uneventful day. I accomplished very little, and everything I tried to do didn't work. For instance-I tried to buy paint to finish painting the ruined walls of the master bedroom. The paint store was all out of the specific paint I needed. Great. I did get a new tire for my car; it was getting old riding on a spare and having to obey the speed limit.

I'm at the firehouse tonight. I doubt we will run. Oh well. We shall see. Tomorrow is another day.

Hospice

First call of the day was for respiratory distress. The page was an ASAP, but we were told to run hot. I knew the area well-we were responding to a home address in my turf near the firehouse. I got the story from the hospice nurse. Our patient was a 49 year old female with end stage lung cancer. She was going to the hospital because she is getting worse. She gave our patient 120 mg of morphine in the last hour and wanted me to give her roxenol on the way (which I am not allowed to administer). I could hear her breathing once I got into the house; she was in the rear bedroom. The lady was very sick, but I guess this is where I get confused. The lady has been sick for a while, she is in hospice care, and has a DNR. I always thought the whole point of hospice care was so the person can die peacefully at home-not in a hospital. The nurse said we were not to do any interventions-no monitor, no IV, just oxygen. She said they would get a central line at the hospital. Okay...here's the kicker. We weren't even bringing her to the ER. She was going directly to a room. Yeah...I felt pretty silly running hot to the hospital only to unload the patient and bypass the ER. Whatever. I got the wierdest looks from the ER staff. I am walking by with a patient in obvious respiratory distress-tripod position, her lips were a little blue, her skin pale, eyes closed, monitor furiously beeping around 150-and not stopping at the ER. They must have thought I was really stupid. We got her settled in her bed and spoke with the nurse on the floor. I figured our patient would survive maybe a couple more hours.

These are my least favorite calls. Actually, I hate them. I felt terrible for the lady. She was suffering and all I could offer her was a hand to hold. Half of the ride I felt like I was torturing her. She kept pulling off her mask because she was struggling so much to breathe and probably thought the mask was the cause; and I kept putting it back on. I found out from a friend that works at the hospital that she died that evening-alone. Her family was back at home, where she should have been in her last moments, where her hospice care was taking place until we whisked her to the hospital for no reason. Damn it.

I did a call for "wound care." Our patient was non compliant with her care and turning herself at the nursing home, and now her wound was getting worse. Not a big deal, just a little drop off in the ER and off I go. My partner had me start driving while she got vitals. The blood pressure cuff was acting up. I was two miles down the road when it finally worked. Our patient's blood pressure was only 78 systolic. I was at a red light, so I turned on my lights and turned around (this road is hard to explain. You have to drive north to go back south towards the hospital) and pulled over to the side of the road so I could hop in back and see what was going on. Normally, I would let my partner do her thing and just drive, but we weren't going to the closest facility-we still had about 20 miles to go. I must have looked pretty silly. I was just driving along with no lights or sirens. Then I get to a light, put on my lights and sirens, turn back south, pull off the road, get out of the driver's seat and hop in back. Let's just say I had a whole bunch of people staring at me.

Once in back, I took a manual blood pressure (the last pressure we got was with the monitor). I got 98 systolic. Not especially critical, so we could still go to the desired hospital. The patient refused any care-she didn't want an IV. So, basically I got back in front and started driving. By the time the hospital picked up the tele line I was about 4 miles passed our "closest facility" and well on my way to being screwed if our patient started to crap out. The nurse on tele had no choice but to let us come because we were passed the closest hospital, and besides that it would take me longer to get off the highway, turn around, get back on, and go to the closest, our patient was relatively stable (besides the fact that we didn't have IV access). I ran hot to the hospital just for good measure. I didn't want to be caught in this situation if it went sour-especially since our patient was not a DNR. She was still doing okay when we pulled up in the ER-another job done.

I did a psych transfer for a guy that said he was suicidal. According to the ER staff he was playing the system-he needed a good meal and a warm place to stay. This wasn't his first visit. When we arrived in the ER to take him he was wandering around the ER, walking up to patients, sitting on their beds and trying to hold conversations. We got him going as quickly as possible. He kept saying he didn't want to go but he was cooperative for the most part. He told me that he almost tried out for American Idol, but he got bored standing in line. He told me I have to watch next season, because he will be the next American Idol. I told him I would be watching for him.

I did a call from a nursing home for a patient with diarrhea x2 days. She wanted to go to a hospital about 15 miles away. We tried to call report, but they were on full bypass. We took her to the closest hospital. Not an eventful call at all. She complained the whole way about how tight the blanket was and that she didn't like being tied up.

We took a psych out of the same ER as soon as we finished paperwork for the lady with diarrhea. They were pretty busy and the paperwork wasn't ready yet. I was standing chatting with a security guard when a patient stuck her head out of a nearby curtain. She said she wanted a nurse and opened the curtain a bit wider. I was shocked at what I saw. The lady was standing in a pool of blood-her gown was soaked, the bed was soaked, and blood was running down her legs in streams. I figured she was having a miscarriage, judging by the amount of blood. It took a while for the nurse to get to the room, and all the while this girl was standing in a pool of her own blood like it was no big deal. She didn't look scared or upset. She just said she was sick of sitting on a wet bed. Go figure. She was whisked up to L+D shortly there after.

Our psych was finally ready. She was lashing out. She kept screaming to "open the f***ing curtain" and yelling at nobody in particular. She was four months pregnant. Before we arrived, she was standing in the hallway, lifting up her gown and yelling, "that baby's coming! The baby's coming!" We got her moved over to the cot, put her back in four points. That was when I got the first whiff of her B.O. I also learned what I was taking her for-homicidal ideations. Great. She didn't create a scene until we got her to the psych hospital. The only thing she did on the way was hum the song from the Popeye's chicken commercial. Since she was in restraints we took her directly to the locked wing and to a room. The staff made the mistake of telling her she was going to the "quiet room." That started the yelling again. She screamed, "you can't put me in the quiet room! I ain't going there! I have two kids, and you know who they are! I'm four months pregnant, and it's not good for the baby! I need a cigarette! I want to eat everything-ice cream, cookies, candy, chips....I'm not going in there alone!" After a few minutes of listening to this we lowered the cot, undid the restraints and got her on the bed. She stopped making a scene. That was enough for me.

I layed down at 0200.