Busy Week
I had a busy week this week.
It started off pretty normal. I was struggling to get more stuff I wanted for our work at The Gate. I actually made progress and got a lot of equipment in. The next step was finding spaces to put it. Unlike civilian ambulances, military ambulances have only rudimentary storage spaces (and suspensions). This means that with every bump in the road, I end up with equipment everywhere. The problem with oxygen masks or 2x2 gauze pads is that they cannot be easily fastened, tied, or bolted down and still be useful. We were able to “procure” some .50 cal ammo cans to put equipment in, and this helped.
I found out that I was the only Line medic who requested any equipment. This made me feel kinda funny. I felt like a jerk for being the only greedy one. Maybe our point was just that run down. I started to maybe feel like I was one of those crazy “Ricky Rescue” guys (the crazy woodsman survivalist of the EMS world). Maybe my co-workers were rolling their eyes every time I called. Then I started to just laugh about it. When we replaced the Screamin’ Eagle, they left me 50 blue lightweight drapes among other oddities. Someone probably thought that they would be useful if we all suddenly ran out of the normal chucks, needed new bed sheets, or wanted cheap superhero capes for Halloween or something. The unit that replaces me probably will hate me for all of the crap I’m going to leave them.
The next day I was talking to one of the local workers when I was told that there was a gunshot victim up at the front. I grabbed my aid bag and zoomed up in my ambulance. The guy had been shot in the thigh, the forearm, and the right abdomen. The guy was brought in the back of a truck and there was a large sticky pool of blood lining the bed. We transferred the patient and started to the hospital. The poor guy had probably been bleeding for 20 minutes and had no significant care given to him.
As we drove, he started to breathe kind of like a fish out of water, each breath coming with a longer and longer pause between them. I checked for a pulse and could not find one. I started CPR while a buddy continued to patch the holes. I pumped the chest as best as I could and breathed for the patient through a pocket mask while bouncing around the back of the ambulance. Bubbles and blood spurted out the hole in the abdomen with every thrust and I knew then that his lung was probably hit. We continued to work and my buddy told me that we actually got a faint pulse back. Before I knew it we were unloading the patient at the ER.
At the ER we all grabbed a bottle of cold water and downed half of it in two gulps. I went outside and began to clean up the mess. The Doc from the hospital came out and told me that he didn’t make it past the OR. With what few details we had given the Doc about the time of his injury and the location of wounds, the Doc guessed that the wounds sustained to the abdomen and to his liver caused him to bleed out. The patient would’ve had to have been at the footsteps of the hospital to have had a chance.
The rest of the week was normal until last night. I was filling in for two-and-a-half hours when I got a call that there was another patient brought in. I went through the same drill and found a frail man who had been treated for some gunshot wounds long ago. But now he was pale, sweaty, and I could hear him trying to breathe nearly 40 times a minute. I grabbed the patient and his brother and loaded up into the ambulance. I gave the patient some oxygen and tried to assess the patient further. I could not find any pulse while bouncing around in the back. I new this guy had a pulse, so I moved on. Both lungs had wheezing sounds, and there was a high pitched sounds (stridor) coming from the man’s throat. The patient’s breathing slowed down with the oxygen on, but I still prepared to intubate (aka: stick a breathing tube in) him because I felt like it was going to need to happen soon. I would not have a long time.
We arrived at the ER and I unload the patient. Within ten minutes the patient ended up being intubated, sedated, and put on a ventilator. The Doc in the ER said that he was decompensating quickly and that we got him there just in time. For whatever reason, the vocal chords and lungs of this patient were having spasms and were closing off.
I did not feel bad about not finding a pulse when I heard that they had to give him an IV in the femoral artery. That is not your first, second, or probably even third choice of IV sites.
I’m pretty happy to have saved someone. I started work today feeling a little more sense of purpose. But then I thought about how two patients, back in MN, is a slow day on the ambulance… Two people in seven days is not really all that miraculous. And the twelve hours of banality at the Gate eroded my sense of purpose back down to a minimal level.
Back to watching birds makin’ sweet love.
It started off pretty normal. I was struggling to get more stuff I wanted for our work at The Gate. I actually made progress and got a lot of equipment in. The next step was finding spaces to put it. Unlike civilian ambulances, military ambulances have only rudimentary storage spaces (and suspensions). This means that with every bump in the road, I end up with equipment everywhere. The problem with oxygen masks or 2x2 gauze pads is that they cannot be easily fastened, tied, or bolted down and still be useful. We were able to “procure” some .50 cal ammo cans to put equipment in, and this helped.
I found out that I was the only Line medic who requested any equipment. This made me feel kinda funny. I felt like a jerk for being the only greedy one. Maybe our point was just that run down. I started to maybe feel like I was one of those crazy “Ricky Rescue” guys (the crazy woodsman survivalist of the EMS world). Maybe my co-workers were rolling their eyes every time I called. Then I started to just laugh about it. When we replaced the Screamin’ Eagle, they left me 50 blue lightweight drapes among other oddities. Someone probably thought that they would be useful if we all suddenly ran out of the normal chucks, needed new bed sheets, or wanted cheap superhero capes for Halloween or something. The unit that replaces me probably will hate me for all of the crap I’m going to leave them.
The next day I was talking to one of the local workers when I was told that there was a gunshot victim up at the front. I grabbed my aid bag and zoomed up in my ambulance. The guy had been shot in the thigh, the forearm, and the right abdomen. The guy was brought in the back of a truck and there was a large sticky pool of blood lining the bed. We transferred the patient and started to the hospital. The poor guy had probably been bleeding for 20 minutes and had no significant care given to him.
As we drove, he started to breathe kind of like a fish out of water, each breath coming with a longer and longer pause between them. I checked for a pulse and could not find one. I started CPR while a buddy continued to patch the holes. I pumped the chest as best as I could and breathed for the patient through a pocket mask while bouncing around the back of the ambulance. Bubbles and blood spurted out the hole in the abdomen with every thrust and I knew then that his lung was probably hit. We continued to work and my buddy told me that we actually got a faint pulse back. Before I knew it we were unloading the patient at the ER.
At the ER we all grabbed a bottle of cold water and downed half of it in two gulps. I went outside and began to clean up the mess. The Doc from the hospital came out and told me that he didn’t make it past the OR. With what few details we had given the Doc about the time of his injury and the location of wounds, the Doc guessed that the wounds sustained to the abdomen and to his liver caused him to bleed out. The patient would’ve had to have been at the footsteps of the hospital to have had a chance.
The rest of the week was normal until last night. I was filling in for two-and-a-half hours when I got a call that there was another patient brought in. I went through the same drill and found a frail man who had been treated for some gunshot wounds long ago. But now he was pale, sweaty, and I could hear him trying to breathe nearly 40 times a minute. I grabbed the patient and his brother and loaded up into the ambulance. I gave the patient some oxygen and tried to assess the patient further. I could not find any pulse while bouncing around in the back. I new this guy had a pulse, so I moved on. Both lungs had wheezing sounds, and there was a high pitched sounds (stridor) coming from the man’s throat. The patient’s breathing slowed down with the oxygen on, but I still prepared to intubate (aka: stick a breathing tube in) him because I felt like it was going to need to happen soon. I would not have a long time.
We arrived at the ER and I unload the patient. Within ten minutes the patient ended up being intubated, sedated, and put on a ventilator. The Doc in the ER said that he was decompensating quickly and that we got him there just in time. For whatever reason, the vocal chords and lungs of this patient were having spasms and were closing off.
I did not feel bad about not finding a pulse when I heard that they had to give him an IV in the femoral artery. That is not your first, second, or probably even third choice of IV sites.
I’m pretty happy to have saved someone. I started work today feeling a little more sense of purpose. But then I thought about how two patients, back in MN, is a slow day on the ambulance… Two people in seven days is not really all that miraculous. And the twelve hours of banality at the Gate eroded my sense of purpose back down to a minimal level.
Back to watching birds makin’ sweet love.
posted by SGT Dock at 13:00
1 Comments:
We have many discs here for you. Sorry we haven't gotten them out yet. Hopefully some of them will put a smile on your face. I'll try to get them out this week.
Baby Kaya is quite sassy and stubborn. She's still not here! She's officially a week late. If she's not here by the 6th of July we'll have to induce further. Today I was induced with sweeping membranes and oh boy.. I'm in pain! Hopefully we'll have photos to send you soon! We think about you all the time!
Lisa, Jake, Ashton and someday when this little poo makes her way into the world.. Kaya.
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