Wednesday, September 14, 2011

First week, done and over!

This week was my first week doing my ride-alongs with EMSA in Oklahoma City. I got assigned and awesome preceptor (this is what you call a paramedic teacher). She is super nice, but you can definitely tell she's the type of person you do not want to get mad! My shift starts at 6:15 in the morning and runs for 12 hours straight. In between emergency calls you sit in an ambulance at a random location, usually gas stations and "post" (meaning that you wait for the next call). At times you wait as little as 5 minutes before you get the next call and at other times you can wait for as much as an hour to even 2 hours.

This week I ran probably a total of 20 calls from a range of basic patients complaining of really bad headaches to advanced cardiac arrest calls. Its funny to think that my first ride-along at BYU-I was on the day of  9/11 at the Idaho Falls Fire Department. I remember being super nervous and anxious and not knowing what to do. Well now its been a whole year and the process begins all over again. My first day of ride-alongs in Oklahoma happened to be on 9/11 again, and the nerves and anxiety are still there. However, now i know what to do and actually be helpful to my patients.

The first call I ran was a DOA (death on arrival), usually we get these calls early in the morning when people get up from bed and realize that their significant other or the person they take care for does not wake up. What we do as paramedics is we try to determine for how long they have been dead and connect them to the heart monitor to confirm the death. Its really sad, but i kinda have an awkward story to share. So we are at the scene of death and the family members are just heart broken. Well some one decides to let the dog in and all the dog wanted to do the whole time was to go into the deceased persons bedroom. So I am trying to run around the whole house trying to catch this dog so that that he doesn't do anything to the body, and the dog thinks its a game, so he runs away from me. So im running around like a crazy chicken,  and all this is happening while the family is in the other room mourning. Can i say AWKWARD! Finally i was able to grab him by the ear and put him in the bathroom. Oh man! *note to self, keep some dog treats in pocket, you never know when you need to chase a dog.

Later that week

I had, plenty of over-doses usually on narcotics or alcohol. Respiratory distress, patients. Falls at nursing homes and plenty of seizures. Seizures are very popular during this time of year here in OK. So question? How many personel does it take to take down a patient who is combative after a seizure?..................Answer: A whole lot!! (5 Firemen, 2 Paramedics, and and EMT). Story- After a person has a seizure this phase is called the postictal phase and they can be disoriented. Our patient was super combative and very, very strong. I literally had to sit on top of him so that he could stop flailing and kicking his legs. We where able to restrain him on a backboard after half an hour of struggling with him, which seemed like forever! But he finally started gaining consciousness with a treatment of Valium.

But the call of the week happened today, just a couple of hours ago! We were called to a fall at a nursing home and on our way there we got cancelled on that call and reassigned to a full cardiac arrest. So we drive "hot" (meaning full lights and sirens) there and get to a patient who has been in a-systole "flatline" for a while. We started doing CPR and in an a-systole heart rhythm as much as the movies have ingrained in our heads that we shock them, WE DO NOT SHOCK THEM! or else you will definitely kill the patient. So i was able to do chest compressions, bag the patient and drum roll please!...........INTUBATE them. Intubating means that you assist their breathing by inserting a tube down their trachea so that you can breathe for them. This is a paramedic's MOST shining moment. I was successful and we drove our patient "code" (CPR in progress)  to the hospital. I had to ride the stretcher doing CPR while we wheeled into to the hospital. That was pretty cool. We didn't think she would make it, but she got a spontaneous pulse return and currently she is in the ICU. Im crossing my fingers for her!
An example of what an intubation looks like
What running "code" means.
Overall this week was fun and exciting, i was able to put my skills in use and get the groove of how things work at EMSA. Hopefully by the end of this internship all of you will be able to understand paramedic lingo with a little bit of help from me. Till next week!

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