Thursday, October 16, 2008

Huge Pet Peeve

Yesterday one of the guys on my shift did one of my biggest pet peeves which is correcting me in front of a patient. I know that I shouldn't have any pet peeves since I have not been a career firefighter very long but this has been a pet peeve of mine ever since I got into the business as volunteer. I have no problem receiving constructive criticism, but unless I am about do something that is going to hurt or kill the patient, please save the criticism until after the call.

So anyway on to the call. We were dispatched to a house for a women that was dizzy. First of all let me explain that when we are dispatched to a medical call an engine is dispatched from the closest station to the call and all of the ambulances come from the central station. The engine gets on scene first. We arrived in the ambulance soon after. Come to find out yes the women is dizzy but she is also very anxious. We get the woman loaded on the cot and get her out to the ambulance. I told the women that I was going to start an IV and the women freaked out because she did not want to get poked by the needle. When I calmly explained to the women that if she let me start an IV I could give her some medication that would help to calm her down, she agreed to let me start an IV. So as I am starting the IV my partner from the ambulance draws up the Lorazepam that I am planning on giving her. As I sticking the needle into the patient she jerked away, hence making me miss the vein. I attempted to dig around a little bit in attempt to find the vein with no luck, well as I am digging around the patient starts to get very anxious and is asking me if I know what I am doing and asking me if I was a student. I again calmly explained to the patient that I am not a student and I do know what I am doing. I gave up on the IV attempt and I did not figure that the women would be happy if I tried another IV site. I explained to the patient that I could give her the same medication as an injection in her shoulder muscle. The women agreed to let me give her the injection. As I metioned earlier my partner had already drawn up the medication for the IV. Well the IV dose is diluted with saline and the IM injection is not. Plus it takes more medication for an IM dose to be effective and this was a big patient. The guy who was in charge on the engine sees me getting ready to give the injection to the patient, and right in front of the patient that is already anxious and already doubts my capabilites stands up and says stop what do you think you are doing you can not give her that much. I was pissed. This women then says see I knew you didn't know what you were doing, the patient still let me give her the medication and then as I am giving her the injection the ass on the engine is trying to tell me the procedure for giving the injection. As soon as I was done giving the injection I told my partner on the ambulance that we needed to leave. I had to have the guy from the engine get out or else I was going to stoop to his level and loose all professionalism. I am not too big on running and telling my company officer each time some little thing happens but this is not a little thing and this is not the first time that the jerk on the engine has done something like this to me. So hopefully my company officer will take care of the problem. Sorry about the rant but I had to have a source to vent. If any other medics have had the same problem let me know how you have handled it.

Wednesday, October 8, 2008

Ok I promise I will post more often

I didn't realize that it has been close to a year since my last post. My how the time has flown. In My last post I had mentioned how I had gotten hired by the fire department. Well it has definetly been a year of highs and lows. I went from being very excited about getting hired at the fire department and really enjoying the job, to wondering if I was going to have a job. I am overweight, I always have been, but I am in alright shape for my size. Well about six months into the job we had to do one of 2 yearly physical agility tests, and I did not very well on it. The test involves putting on an air pack and crawling around in a maze that is supposed to simulate a house. I used a lot more air than the rest of the crew. I had a big come to Jesus meeting with my Battalion Chief and basically was told I need to step it up with my physical fitness or my job could be in jeopardy. I think my problem was that I became fat and happy. I worked my butt off to get in shape for the physical agility test that I had to take to get hired and once I got hired I slacked off with working out. Don't get me wrong I was still working out but I was not as dedicated as I was before. So my little come to Jesus meeting with my Battalion Chief was an eye opener and since I have gotten back on the work out train and have lost 30 pounds. Now things are great we are getting ready to take the second physical agility test and I feel like I am in pretty good shape right now and I shouldn't have any problems with it. The second test is the same test that I took to get hired which involves an obsticle course where you do a lot the activities that you would be expected to do at a fire scene...I will bore you with the details some other time. Now I am happy as can be again at my job. It has been one heck of a roller coaster ride. I will be happy when my year is up that way it is next to impossible for them to get rid of me unless I do something really stupid.
At my fire department we also have to be on the ambulance. Most of the guys think that I need a mental examination because I actually like being on the ambulance more so than fighting fires. I really enjoy the ambulance because on the ambulance you have to think. Don't get me wrong when you are fighting fires you have to think as well but it is a different type of thinking. On the fire ground you have to think about the stuff that you need to do to keep yourself and the rest of your crew from getting hurt but to solve the actual problem on the fire ground is pretty put the wet stuff on the red stuff. On ambulance calls you have to think about all kinds of things to solve the actual problem. However, there is a much bigger adrenaline rush going into a fire. So no that I sit back and think about I guess it is an even trade off.
Like all good firefighters, I got a part time job for my days off (which for the record, we are off 20 days per month). I am working at a very small hospital about 20 miles from where I live as a paramedic on their ambulance service. It is very different from my full time job as far as call volume. At my full time job we run an average of 14 calls a day and at my part time job we run about 40 calls per month. The cool thing is when we do have calls at my part time job they are usually pretty cool calls. When I say cool calls it is kind of a paradox, for me to have a cool day at work someone else has to have the one of the worst days of their life whether it be a bad trauma or medical emergency or someones home or business catching fire. At the part time job I have got see a patient that had 3 fingers amputated, and I came as close to delivering a baby as I ever want to. We were called to a residence for a woman in labor, when we pulled up to the house a small child comes outside and said to hurry becuase the baby is coming out. As I walked into the bedroom, the baby had just finished coming out so I got to the suctioning an clamping and cutting the umbilical cord. It is a very different job knowing that a lot of the time I am the only paramedic, because most times it is just myself and an EMT-Basic. At my full time job we always send an engine with the ambulance so there are always 3 other paramedics and myself to share the responsibility. I have only been a paramedic for about a year and half and I think that working at the part time job is making me a better paramedic since most of the time I have no one else to fall back on.
So between being a full time firefighter/paramedic, part time paramedic, volunteer firefighter/paramedic in the town I live in, and a reserve police officer in the town I live in I get my fill of adrenaline. I would not trade all the things I do for anything. Thank goodness for a very understanding wife.
I have rambled on for long enough however, let me leave you with the story of one the weirdest calls that I have been on so far which just happened last night at my full time job. We were dispatched for a male subject that needed water for humidified oxygen. When we got the call my partner and I were thinking okay this is strange why would someone call us for this. We arrived at the residence and we made contact with the patient, it turns out that the patient was indeed on oxygen but he did not need water for it at all. The patient was thirsty and needed a drink of water. The patient has terminal cancer and is very weak, he was in a small room that appeared to have been a porch at one time and there is a door seperating the room from the rest of the house. The patient had tried to yell for his caretaker to get him a glass of water. The caretaker had fallen asleep and could not hear the patient so the patient was really thirsty and called 911 for an ambulance. The patient was so weak that he could hardly talk and it turned out that the dispatchers could not understand what he was saying so that is where the water for the humidified oxygen came from. All of got a good chuckle out of this call when we cleared.
Well I as mentioned at the start of this post I promise to post more often. Take care and stay safe.

Friday, November 16, 2007

Long Time No Post

Sorry that it has been so long since my last post. I have been very busy the past few days. I did finally get called with my physical results and I passed. So effective November 26, 2007, I will be a paid firefighter!!! I am really looking forward to it since I have worked so hard to get it. I am really going to miss dispatching. I have made a lot of good friends and had a lot of memorable calls. One of the guys on my shift at dispatch is going to throw a going away party for me which I thought was very cool.

In my new job I will be working straight days 0700-1630 Monday through Saturday. I have to work these hours for 4 weeks. My first 24 hour shift will be on Christmas Day. Once I am on my shift I work 24 hours every other day for 3 shifts and then I am off for 4 days. This ends up equaling out to working right around 10 days per month. This schedule will give me a lot more free time, which I am really looking forward to. Hopefully this will give me more time to blog.

Saturday, November 10, 2007

Fire Department Physical

Yesterday I had go for my pre-hire physical for the fire department. Wow what a day that was. The first portion of the physical took three hours. I felt like I was at some sort of assembly line and I was going to be their finished product.

The day started out with me having to fill out about 20 pages worth of paperwork about my health history. So after I develop carpal tunnel syndrome, they have me change into one of the wonderful gowns. Now allow me to tell you a little about myself. Even though I am getting hired on a fire department, I am not exactly a lean and trim guy. In my house we do not use the f word (f word=fat), so we will say I am big boned with a good deal of meat on the bones. Needless to say I look absolutely horrible in the gown.

The physical was done by a Physician Assistant (PA). I have never had a female give me a physical before. I don't necessarily know if I liked having a female doing the hernia check, but women have male doctors all of the time so I suffered through it. But holy cow, I have never had such a thorough physical in all of my life. My blood pressure ended up being a little high, so the PA told me that they would check it again when they were done with everything else.

So next we moved onto the whiz quiz also known as the drug test. The security for that was amazing. I had to empty my pockets and then they patted me down. I felt like I was going to jail.

I then had to do the hearing test. The lady for the hearing test asked me all kinds of questions about how often I wear hearing protection. I then got a 5 minute lecture about using hearing protection more often around home. I passed that test.

The next part was the blood test which went okay. I will not know the results for a few days. Along with the blood test, I had to have a tuberculosis test. If you are not familiar with the tuberculosis test, they inject some sort of fluid into your forearm just under the skin. I have had TB tests before but holy cow it felt like this lady injected the whole bottle into my arm and wow did it sting.

Next I had to do the lung capacity test. If you are not familiar with this, to make a long story short they have you blow into a tube until you nearly pass out. They do this three times.

After this I had to go for the blood pressure recheck. My blood pressure was still borderline high. The PA tells me that if there is any more than just a small rise during the upcoming stress test that I would fail the physical. She told me to just relax. Wow well that is easier said than done. I have been trying for the last 4 years to get this job, invested $8,000 in paramedic school, and lost 70 lbs, and now I am being told that I am on the verge of failing, and I am told to relax, yeah right!!!

Apparently the PA did not know how to take a blood pressure because when I went in for the stress test my blood pressure was just fine and I was able to pass. The stress test was tougher than I thought that it would be, but still was not all that bad.

So I got the preliminary you passed, but it is not official until they get the chest x-ray, blood work, and the cardiologist interpretation of the stress test back. All of the technician that did the x-rays and stress test said that as far as they could tell everything looked okay. So unless there are some big surprises I passed!!!! All that I can say is WOW what an emotional roller coaster yesterday.

Wednesday, November 7, 2007

New Job

I got called yesterday to go take my physical for a new job as a paid firefighter. I have been ecstatic since getting the call yesterday. I have been a volunteer firefighter for 8 years and I am now going to get paid to do something that I love to do for free. I enjoy my current job as a dispatcher but I know that I am going to love my new job. I will probably be starting at the fire department around the first of December. I know that I will be on the ambulance for several years before getting on the engine full time but I love doing ems calls. I don't have much to say today, maybe tomorrow when I come back down from the cloud I am on I will have something intelligent to say.

Monday, November 5, 2007

Not as Smart as Other Dogs of the Same Breed

We have a new puppy in the house she is adorable, but still a huge pain in the butt. The new dog's name is Ethel. Ethel is a Welsh corgi and is now 4 months old. We are having one heck of a time potty training her. We will take Ethel outside she will do her business outside and then she will come in and pee on the floor. I just want to yell at her and say what are you thinking! Another thing that she keeps on doing is chewing through the phone line for DSL for our computer. In the month that we have had her we have went through five phone cords. I swear I am going to be part owner of a phone cord company.

Ethel is our second dog. Our other dog is Lucy (yes we have Lucy and Ethel *think "I Lucy Lucy" TV show). Lucy is an Border Collie Austialian Cattle Dog mix. I am not sure if my readers are familiar with the size of the two breeds but, Lucy is about 55 lbs. and Ethel is right around 10 lbs. Ethel thinks that she is Lucy's size and can take Lucy on. Lucy is very patient and just lets Ethel play and then eventually Lucy has enough takes a swat at Ethel's face with her paw and will bark at her.

Another thing that Ethel does that proves that she is not the brightest star in the sky, is when she is getting a drink of water she will put both of her paws in the water bowl.

According to this website

Ethel is supposed to be a member of the 11th smartest dog breed. Hopefully she grows into her alleged intelligence. Lucy depending on which breed you chose from her mix is either the smartest or 10th smartest breed. I just hope when Ethel gets older that the two dogs don't conspire against my wife and I since they are so smart. Heck they will probably be smarter than us.

As much as I would like to get mad and stay mad at Ethel for the annoying puppy things that she does, she keeps doing cute things as well. I work the night shift and my wife usually goes to bed shortly before I leave for work and I will go in the bedroom to tell my wife good bye. The other night when I got ready for work I went into the bedroom and Ethel was laying on her back just like a human sleeping with her head under my pillow. There is no way I could stay mad at that.

I must like dogs since we already have one and then my wife convinced me that we needed another dog or rather told me we were getting another dog. Well I best be going because Ethel is giving me the take me outside or I will destroy something look.

Saturday, November 3, 2007

People not Helping themselves

On the volunteer fire department that I am on we also take care of ambulance service for our town. Even though it is in a city of less than five thousand people, being on the ambulance has proved to be interesting through the years. I have seen things that I never thought that I would. Going through EMT and Paramedic class some of things that we would study, I would sit there and think to myself I am never going to have to deal with that. Wow, have I been wrong.

One of the things that really bothers me is when we deal with people that will not take care of themselves. Recently I had to go to a house that I had been to before, and the last time that I went there the conditions in the house were absolutely horrible and that was about seven years ago. The most recent call was for a person that had fell. When we arrived at the house the person was laying outside near the steps. The door to the house was open, and the smell from inside the house was so bad that we had to close the door.

It was pretty obvious that it had been quite some time since the person had last bathed. The smell of body odor was terrible. The person's skin was so dirty that he was almost black with dirt and and he was a white man. As we were putting the person onto the backboard, I happened to notice a cockroach crawling across the front of his pants. The person's skin and clothes were so dirty that when we moved him onto the cot on the backboard our white sheet on the cot turned black.

It is pretty obvious that this person does not have a lot of money. I can understand when someone does not have a lot of money, but a person can at least try to take care of themselves and keep themselves clean.

I think that the most frustrating aspect of this situation and other situations that I have dealt with is that nothing gets done to correct the situation. In our state as well as most others all police officers, firefighters, and paramedics are mandatory reporters. This means that if we see an abusive or a dangerous situation, or even a situation where someone is not capable of taking care of themselves we are required by law to report the situation to the Department of Human Services. To me it seems like almost every time that we report something to the Department it comes back as unfounded.

There is another situation that comes to mind involving people not taking care of themselves. We were called to a residence for a girl that was not feeling well. This was a two bedroom mobile home and there were 2 adults and 5 children living in the home. The house was filthy. There was garbage piled up in the living room and in hallway. As a matter of fact we had to move garbage out of the way in the hallway to be able to get our equipment through. The furnace vents were on the floor however, none of them were covered with grates. We had to be careful to not step in one of the vents and break an ankle. In the bedroom that the five kids shared there was a bunk bed that was in horrible shape. The top mattress was held to the top frame with rope that was frayed. Once we got the girl out of the house and into the ambulance she admitted to us that she was faking because she wanted to get out of the house. I could not blame the poor girl. We transported her to the hospital and called the proper authorities. In this situation human services did do something they threatened to take the kids away if the conditions did not get better. Through talking to some of the police officers it did get better. However, we were at the residence again a few months later and the conditions were bad again, not at all like the first time but still bad. A short time later the family moved out and no one knows what happened to them.

Situations like those mentioned above make me feel horrible. I know that I and other people on the police and fire departments want to help people like this, but there is not a whole that you can do when a person will do nothing to help them self. I guess this is all in a day's unpaid work, as a volunteer firefighter.