Sometimes I Wonder

I was fast asleep dreaming of warm beaches and sunny skies when I was rudely awakened by the pager. I scrambled out of bed, stubbing my toe and trying not to swear loud enough to wake the neighborhood, fumbling in the dark to pull my uniform on and not miss any buttons. I ran out the door into the snow nearly slipping on the sidewalk as I jumped into my car and sped off. A minute later we were enroute. 16 year old male, complaining of abdominal pain. We arrive to find an abandoned house and the patient was lying outside in the snow with hardly any clothes on. We approached him cautiously, something just didn't seem right. He jumped up, scaring the living daylights out of us, screaming incomprehensibly. We called for police back up and waited for them to arrive, all the while staying as far away from our patient as possible. When they arrived he seemed to calm down and he told us his stomach hurt. So we invited him to come into the ambulance so we could check him over, and hopefully warm him up a little because by this time he was shivering uncontrollably. The police had no outstanding warrants so they couldn't take him in - instead one of the officers joined us in the back, "just in case". Within a few minutes we were glad he had come along as our patient was thrashing about, trying to empty all the compartments, throwing supplies around and landing a few solid punches. Once he was restrained he started yelling, and didn't stop. After a while he calmed down again and we took this opportunity to try and get some sort of history. He wanted his mom. So I offered to call her for him. We ended up calling three people out of bed, none of whom had a son his age. Oops. Then he claimed his leg hurt. When we went to check it out he would yell at us not to touch him, and say something else was sore. Our patience was wearing awfully thin when my partner asked him how much he had had to drink that night as the ETOH odor was absolutely foul. He said he didn't drink - the stuff was poison. A minute later my partner asked him what kind if beer was his favorite to which he replied, "Beer? Hell, no! Vodka, man! Vodka! I had, like, an entire 60!". Well, that explained it. We called dispatch to let them know we were taking the patient in, and the dispatcher said he would call us on our in-unit phone. I answered, and my jaw dropped. Apparently our patient had called 911 earlier in the evening and asked for a ride back to his hometown, two hours away. The dispatcher replied that we are not a taxi service, that he would have to call someone else. A couple hours later he had called back complaining of abdominal pain, at which point we could no longer refuse him a ride to the hospital, at least part way back home for him! I gotta give him credit - smart kid. By the time we arrived at the hospital our patient had admitted to various substance and alcohol abuse that evening, not surprising us at all. The ER doctor came to see his newest patient right after we had him settled on a hospital bed, at which point our patient resumed his wailing and asked the doctor if he had anything to make his stomach less sore. To which the doctor replied, "Yeah...stop drinking!". In a way it made my day to see that the doctor wasn't going to cater to this fellow who was obviously abusing the system. But on the other hand we see situations like these far too often. This kid was two hours away from home in the middle of the week lying in the snow in front of an abandoned house. The first question that rose in my mind was, "where are this kid's parents?" I mean seriously. People can complain all they want about the youth of today and how us young people are always up to no good and have no work ethic. But if you ask me the biggest problem in cases like these are the parents. Where was his mom?

It's Here!

Happy Medic and Medic999 are in San Fransisco filming the first part of The Project. I'm very excited to read and see all the updates and can't wait to see the differences in patient care between America and the UK. And I'm sure I'll notice additonal ones since I'm from Canada. Way to go, guys! Needless to say, I'll be keeping tabs on those two.

Time to Breathe

I've been extremely busy the past few weeks. And it's not going to let up anytime soon. My EMR (EMT-B for you Americans) course has been going well - I'm learning a lot and I'm finding Anatomy, Physiology and Pharmacology the most interesting and the easiest so far. Call me crazy! I wrote my first exam last week and scored an 88. I would have gotten 92 if I hadn't started to doubt myself and went back to change some answers after I was finished - all of which then ended up being wrong! Gut instinct = best. But I have a question for you folks: is an open femur fracture a contraindication for a traction splint or not? We had a good discussion in class weighing each side of the question. The instructor said it was best to use it with a closed fracture but if absolutely necessary an open fracture could be splinted that way as well, but there is a greater risk of infection. I personally am not sure what I would do if faced with the situation. I'm imagining rolling someone onto a spine board without it being splinted and the thought alone makes me want to hurl. I'm looking forward to your opinions! And now it's back to the grind for me - I'm on call this week so if I get some good ones I'll be sure to post. Thanks for reading,
Just Me :)

To Be or Not To Be...Safe

It was a beautiful day.
The sun was shining and there was hardly a breeze. Fall was around the corner so everyone was busy mowing lawns, trimming hedges, and pruning trees. I had just gotten home from work and was changing into my on-call uniform for my evening shift when the tones went.
"Child with extremity caught in farm machinery."
We raced to the scene, a good 20 minute drive since our area is so big. We arrive to find a 10 year old boy, fully conscious and oriented with his arm stuck in some machinery. The parents were nearby along with a sibling. They had all been working outside cleaning up and getting ready for fall, and he was operating a gardening machine of some sort when something jammed the machine up and it took off on him, dragging him behind. As he tried to stop it his sleeve got caught, pulling his arm into the machine up to his shoulder.
Before we even got on scene we called for Paramedics from the city to come out and help us since they can give pain meds other than entonox and we can't. They arrived shortly after we did and we managed to get him fairly sedated. Then came the task of transporting. We tried to lift him along with the machine onto the stretcher but the thing was fair-sized and awfully clumsy. We ended up getting the jaws out to hack parts of it off, leaving the area that his arm was wrapped around on, and transporting him that way.
When we arrived at the hospital the nurses (who see this type of thing more often since we live in a farming community) turned green and most of them left. We were left with two nurses, myself and my partner, and a doctor. We put him under and loosened the bolts on the machine to take the whole thing apart. We unwrapped his arm from the steel shaft on the inside. It looked like hamburger held together with elastic bands. Literally.
I don't get sick from things like this. They don't even make my stomach lurch. But that was disturbing. I saw this beautiful little boy with such an innocent face, seemingly asleep on a bed. And right next to him was a bloody mess.
That little boy lost his arm that day. And he still has a lifetime ahead of him. I suppose there is that fact to be thankful for as it could have been so much worse. But still. And all because the safety stop feature on the machine was considered a pain in the ass by the adults on the farm. Some days I don't think we're any smarter than our kids.

I'm still here!

I haven't fallen off the earth or anything, honest! I've just been beyond busy and am trying to get a grip on how to juggle all of my responsibilities right now. The EMR course hasn't been overly difficult, it's just time consuming. I'd rather have it the other way around. Difficult I can handle - spare time is a scarce commodity. I do my section 1 exam next week, mostly anatomy and physiology, which so far I haven't had a problem with. I actually even enjoy it while the rest of the class moans and groans and complains, much to my amusement. Aaaaaaaand I made my classmates haul me up the (steep and narrow) stairs at the fire hall in a stair chair. I am no 130 pounds. I gave them a workout *hehe*. Priceless! I've had a couple good calls recently too, more on those later. I'll post again later this week, promise! Happy Tuesday!

I Love Her...But I Don't Know Her Name!

Quite some time ago, before I joined the Fire Department, I was enjoying dinner out with friends when my cell phone rang. It was my husband. He had a buddy over to watch our daughter just in case he got a call until I got home. Turns out he did get a call. He was calling me to let me know to meet him at the hospital. Sheer panic was the only feeling I felt right at that moment and as I asked him why, the connection cut off. I left my tapas and my cheesecake right where it was and ran out of there, throwing some cash on the table as I went. The hospital was about 12 blocks away and I got there in record time. I was there before the ambulance got there, but I was just in time to hear the medic's patch to the ER. "17 year old male, victim in a 2 vehicle MVC, bilateral femur, tibia, and fibula fractures, bone is visible in two areas. 12 year old male, possible neck injuries..." The rest I don't remember. My husband stormed through the door hauling the stretcher behind him as the other medic brought up the rear. They slid the patient into Trauma 3, pulled the curtains closed, and brought the nurses up to speed. When my husband came out of the bay to write his PCR he was white as a sheet. I ran up to him and asked him what happened and he said, the guy I just brought in hit Steve's truck...Dave was with him...they're on their way here in another ambulance. Turns out hubby got called out for this MVC and when he got on scene he recognized his 17 year old brother's truck. He yelled at him and his brother yelled back that he was okay so he went to the other guy just to keep some distance because he knew his vision would be too clouded to focus on his job if he would have stayed with his brothers. It already helped that Dave was out of the vehicle. We sat together in the emergency room waiting for the second ambulance. It felt like an eternity. After ten minutes I had the presence of mind to ask if the first guy or one of his brothers had the bilateral breaks - and of course it was Steve. He had been pinned under his dashboard and had to be extricated. We waited a full 45 minutes for the ambulance to arrive. When it did, we waited for the medics to give report and we rushed in to see him. I checked to see if he was still breathing and he seemed stable enough, so I ran through to the next bay to check on Dave. He was full of adrenaline and not in pain at all. He just needed some xrays to verify that he was okay to go home. The paramedics that brought him in came in to get his statement along with a police officer. Turns out when the vehicles hit (the other guy tried to pass a semi truck in the fog and hit Steve and Dave head-on) my husband's younger brother managed to climb out and pried open the drivers side door and started pulling on Steve's arm. He wouldn't budge, and then he noticed a fire under the hood. He had the presence of mind to use the floor mat from his side of the truck to scoop dirt from the ditch onto the hood of the truck. At one point Steve's feet were getting hot - his shoes were melting. However when EMS got on scene the fire was out and there looked to be a couple wheel-barrow's worth of dirt on the hood. How fast he must have ran I can only guess. I left him to give his statement and ran back to Trauma 2. My husband was still there, arm around Steve as best he could given the splints, spineboard, c-collar, tubing, etc. I asked if he needed anything and he said he was thirsty and it hurt. I asked one of the nurses if I could help as they were very overwhelmed in the ER that evening. She handed me a sponge-stick and a cup of water, injected some morphine into the IV tubing and left to attend to someone else. I stood there and dabbed lemon flavored water onto my brother-in-law's lips, covered him with warm blankets, removed his bloody clothing, and wiped his face with a cool cloth while my husband went outside to make some dreaded phone calls. I went along to x-ray, helped the nurse position him correctly, made sure I always stayed in his line of sight. When the xrays came back we were shocked. His legs looked like pulp. Would he ever walk again? Thankfully his upper body and head were all perfectly fine. We spent the next two hours racing between emergency bays attending to both brothers while the nurses made the necessary telephone calls and did the paperwork to get Steve sent to a larger center for surgery as they felt it was much too severe to be handled in our hospital. The nurse we dealt with was absolutely amazing. She was kind, patient, caring, and a geniuinely nice person. I don't know her name, but I would recognize her if I saw her. Whenever I am in the ER on a call I always look for her. When I see her, I will thank her and let her know that Steve is doing well - after several surgeries to insert pins and screws to hold his legs together, he is back at work and only needs one more surgery for some bone grafting before he is good as new. She was the one who gave my husband and myself stuff to do so we felt like we were helping (maybe we were, maybe it was for our own peace of mind.) When I grow up, I want to be like her. Next month my husband and myself are taking Dave to a ceremony at City Hall. The Little Hero's Awards. The paramedics were astounded that he managed to get that fire out and so they nominated him for an award. The little guy asked if we'd take him. I'm honored. It makes me feel like maybe I did something good that evening. Something they appreciated. Hopefully I can make that impression as an EMR as well. My course starts tonight. Do you think they'll teach us to be like Wonder Nurse? I hope so.

Never Forget...

I woke up this morning, it was still dark. I showered and got myself and my daughter ready to face the day. I dropped her off for the bus and I drove to work. I turned on the news. I can't believe it's been eight years. I remember that day vividly. On my way to high school - grade 11. I was listening to the news in the car and I thought I heard wrong. At school the staff were shocked and it was all the entire student body could talk about all day. That evening I went to babysit with a friend of mine and once the kids were in bed we sat in front of their tv. Watching. Horrified. Crying. Angry. Furious, in fact. How dare they? What did the USA ever do to them? I may be Canadian but that was something that transcended borders. Subconsciously that may have been the first time I was bound and determined to one day become one of "them". Brave. Courageous. Selfless. We watched, dumbstruck, as the New York Firefighters rescued dozens of men, women, and children from the wreckage and the heavy dust. The Police Officers directing traffic, helping with rescues, keeping bystanders at bay. EMS personnel doing their utmost to save lives and comfort the dying. Wives, Husbands, and Children of these heroic brothers and sisters devastated with their own losses when the second tower fell. I salute you, siblings in EMS, Law Enforcement, and Fire/Rescue. I salute your courage and your bravery and your selflessness - wherever you may be stationed. Be it Canada, the US of A or Europe. We all have the same drive. We all do this for a reason. Let's not let borders impede us from supporting each other. We are One. I salute the family members of everyone who passed as a result of this tragedy. You have been strong. None of us can imagine your pain. But we are here for You. Never. Ever. Forget.