Welcome to the new age.

It would not be a normal day if someone didn’t have a fatal dysrhythmia.  So of course, it should have been on the oldest, fattest, most out of shape patient that I would have had all day.  With that said, it was the youngest, healthiest patient that we dealt with all day.

Ventricular Tachycardia is a fabulous heart problem that can and usually is fatal.  It is a very fast rhythm that does not allow the upper chambers and lower chambers of the heart to effectively push blood into the vascular system.  It will kill you if it is not treated quickly.

Without boring you with science, lets move on.  It is bad.

So i get called to a bull crap mid twenty something kid.  He was complaining of chest pain.  So of course we think this is an “I need attention call.”  It is my job and I am pretty good at it.  I am to throw out perceptions.  Treat all chest pain calls like they are having a heart attack until proven otherwise.

So I am chatting with this kid, and we is chatting back.  He denies alcohol, drugs, smoking and states that he has no medical history.  He is on a continual cardiac monitor.  He is in a normal rhythm and his heart is beating along at 76  beats per minute.  He does not appear to be having a STEMI.  He does not have a complaint of shortness of breath.

We are rolling to the hospital and in mid sentence, this guy stops talking.  He appears to hold his breath and in a brief second and right in front of me, he goes unconscious.  As a paramedic this sucks, it is now game on.  I check the monitor and notice he is in this lethal dysrhythmia.  I do my paramedic thing and since he is unconscious, I can swear out loud.

I throw on the big pads, and prepare to do the hollywood and weld (shock, defib, cardiovert) and as I watch 20 seconds and all the alarms are going off, this guy looks at me through pale eyes and says in a weakened voice “I don’t feel so well.”

So he has regained consciousness and at the same time he has converted out of the rhythm.  By this point I am already sweating and had throw some stuff around in the ambulance like a mad man.  My partner asked me if we should pull over for rescue to help us.  I of course paused for a brief second then said “uh no we are good”

So for what seems like a billionth time recently I have had the very paramedic level calls and felt like I was actually making a difference.  I am mostly glad though that I have the next four days off from being a medic on the streets.

Ice cube the prophet said “today was a good day”

Today was just another in a series of unfortunate events.  I just keep ending up involved in the end game of peoples lives.  I can honestly say that we saved at least three people today.  I’m not saying we just gave people a ride, I truly mean that we made a difference.

It is not everyday that you come home in the EMS world and can claim that you accomplished something.  I am flat out exhausted, but I do feel I made a difference today.  Today I am reminded that I am a decent medic.  Today I was reminded that my life is not that challenging and that I am good at this job.  

We ran quite a few calls and in the extremes I had a very fast heart rate patient who required als meds.  I had the very slow heart rate patient who required ALS meds.  We had the patient whose blood sugar was lethally low.  We had the atv accident, we had the whole gamut of calls.  From trauma centers to AMI’s today was an als day. 

Overall today was a good day.  

Plus nobody I ran died in North, East or South Vegas 

TODAY was a good day 

A depressed skull fracture, a little atropine and of course a few drunks

Today started off with realizing that I was going to be busy.  I knew this because we actually sat around and I managed to read ten pages of a book I brought.  Dispatch never disappoints and today was no exception.

Our day started off with the little atropine call.  Older guy heart rate of 48 and the fire medic wished to give atropine.  This of course would be an excellent course for a symptomatic bradycardia.  If tou are not fluent in sarcasm, I am going to come out and say it, “This patient was not symptomatic.”  He was awake and alert, had a decent blood pressure and stated verbally that he had no complaints.  It is not that the fire department treatment was blatant or wrong, maybe just maybe they saw something in this patient that I did not.

The next few calls were the typical Vegas drunks.  There was nothing special about these calls.  I will not bore you with the details of those.  Just the typical EMS BS that we all have to deal with.

The truly important call of the day was the a trauma.  I usually don’t get too excited about trauma.  I have usually seen it or at least the end result.  Today though I actually used the phrase “depressed skull fracture.”  This is pretty rare at least for me, but it was pretty obvious.  No radiology needed.  The dude’s melon was dented.

The day ended with a late call.  For those unfamiliar, this is just pure evil.  This means that you are going home late, wasting your precious time off.  We sign up to do our job.  I am not saying I will not do my job, I just want to go home on time.  I sacrifice enough.  My company is just unable to fill all of our open shifts.

Moral is slightly low and call offs are on the rise.  I do not use my sick days for mental health days.  I like many cannot afford to.  I try to only use sick days for actual sickness.  I used one day last year at my Vegas company in 7 months.  I think I used one other day in Colorado.  i guess I have a different work ethic.  The culture is different here.  People here call off almost to the point of being suspended.  I can never imagine that.

So today was yet another day that had me thinking of a new career.  I am getting a little to old to think of that, but it has crossed my mind.  It just keeps coming up.  I am paid decently, but it just seems like it is never enough.  It is also just so frustrating that I hear the security at resorts that are making more.  I see busy nurses making astronomical figures in dollars.  I also deal with government based firefighters who are making six figures a year.  I call it the school teacher syndrome.  Just like a school teacher, we are just severely underpaid and thrust off as if we are clueless idiots.

We are just technically insane.  We keep doing the same thing over and over again.  We keep showing up to work.  We do what the voices tell us to do.  It is just dispatch, but still.  We see people at their worst and somehow we still pick ourselves up every morning and head into work.

Sorry for the ranting diatribe, I guess I just needed to vent a little.

Drunk vs. Sober yet frustrated medic.

Yesterday we were called to the ghetto.  Forty ish year old male, “unconscious”, breathing and reportedly hit his head.  The wonderful “missing teeth” couple was in a block style house, assuming it was government subsidized.  The house was clean the yard was nice.  These people probably even had a fully stocked fridge and their bills paid.

Arrived to find drunk concrete cowboy on floor of his home with his hysterical wife.  She says that he has never done this before, blah blah blah.  No recent illness, no reportedly history other than being grumpy and having high blood pressure.

It takes milliseconds to smell the alcohol.  This dude is seriously drunk.   His wife says he gets very violent when he wakes up.  He cannot answer questions and he barely moves to a firefighter sternal rub.

We do our job, we load him up and off we go.  I had a paramedic partner so he attended.  I drove us to the hospital and we didn’t seem to be having any kind of problems.  This cowboy had stable vitals and a normal blood sugar.

Arriving at the ED, he remained “unresponsive”.  He slept quietly on our gurney.  It was not until we needed to move him to the hospital bed that all hell broke loose.  He went from passed out guy to street fighter in just a blink of eye.

If he would have been left handed, I would have taken a tough one to the jaw.  If I hadn’t had the thought to be nice because he was drunk I probably would have caused him some serious harm.  He of course rips out his IV in the scuffle.  Blood is literally flinging everywhere.  This idiot is still screaming and yelling as everyone grabs a limb and tries to restrain him.

From a distance, the doctor yells to call the Metro Police and to take this guy to jail.  At the mention of jail, this dude chills out, and starts apologizing to people.  He claims he has no idea what just happened and that he was truly out of it.

This idiot was fighting us.  He didn’t get punched kicked, spit at, or physically harmed in any way.  Metro never came because the doctor cancelled them.  I could have been seriously injured.  I am just a paramedic delivering patients to the ED.  I my job training never included hand to hand combat.

I am truly pissed.  I do not make enough money to constantly deal with these idiots.  I truly guess that no amount of money will be enough.  You can say he didn’t actually hit me. If you believe that,  you better unfollow me..  I can’t say that I was afraid of him once the punches started flying, I was actually afraid for him.  I was truly afraid that I was going to be the worse man. I wanted to knock him out.

This useless human drinks all the time, feels entitled to do what ever he wants and gets away with it.  He will not face any charges.  There were no consequences.  Had I laid one hand on him in anyway, I would have been fired. He could have sued me.

This bastard had no true medical problem, he obviously was faking being unresponsive.  I can tell and so can veteran medics.  He had no trauma, he was just a drunk asshat.  He was discharged from the hospital before we finished our report. After the scuffle he became truly awake and aware enough to sign out AMA.  So this drunk idiot gets to go home.  He got away with assaulting EMS.  I can’t even call him out by name, address, or I’d face consequences.

This is not an isolated incident.  This is just one that reminds me how selfish and spoiled this forsaken town is.  When you get away from the strip, it sucks.  The tourists have no clue.  The local drunks are belligerent asses.  Fights and stabbings happen all the time.  I’ve been assaulted more here in 9 months than in the last 9 years in Colorado.

As an added bonus to that day, as we drove home, I received multiple text messages and emails asking people if they could come in and help tomorrow.  Today was my day off.  I am enjoying it safely and soundly in my own home.

Rainy day in Vegas as a day off, it’s just not fair.

Today was my first day off in about 5 days.  I also do not like the fact that I only have one full day off.  I normally have at least two, but this week I must attend a refresher PALS class.

 

It is not that I am afraid or worried about the class at all.  It is just a time consuming mess.  5 hours to relearn stuff that hasn’t really changed in two years.  IT is not like some groundbreaking science happened.

 

I am tired of constantly feeling like I need to be at work.  I barely see my kids and I am still wasting my day off trying to do online employee compliance training.  So my one day off is interrupted by stupid videos of how to use a fire extinguisher and crap.

 

You may ask why we cannot do this training while at work?  It is simple, we as field crews are just too busy.  Our call volume is up, our sick call offs are up and our pay hasn’t increased.  I’ve been tryg to do a bunch of overtime, so the wife can afford to go to nursing school.

 

So I’m tired, I’m exhausted and it just seems like I haven’t had any time to have some fun.  I haven’t really stuck to a workout plan, and I’ve eaten way too much the last seven days.

 

I am hoping to do much better today.  I know which workout to do, I can control my eating.  There’s already a dinner plan.  I don’t have a bunch of junk food, and I am motivated

 

Hoping I get a break soon as this is really a drag.

Como se dice “screwdriver”

Today’s last call involved a fun little mix.  This is not a joke and you cannot make this stuff up.  

We pulled up to a call.  There was a car, with a little Mexican driver.  There was a motorcycle with a rather large caucasian.  It was not an accident, the call came in as an assault.  

I figured we would clear quickly as it didn’t seem that anyone was truly injured or wanting our attention.  Of course I was wrong.  He had to check out the driver of the white car.  He spoke only Spanish.  The firefighters do not speak Spanish.  My partner does not speak Spanish.  So guess who is left to translate?  Oh yea me.

My Spanish is rusty, and usually filled with cuss words and not so PC so it was perfect for the drunk dude. I guess I forgot to mention that.  Anyway, the driver was rapid fire Spanishing about getting hit in the head after an argument with the biker, whom it sounds like that he cut off in traffic.  

Witnesses.  Ugh there are always witnesses to this crap.  They stated that they saw the biker get mad, flip the driver the finger, and that this mini road rage got worse.  The driver stopped in traffic, exited his vehicle and started yelling at the much larger biker.  The biker had dismounted his hog and walked toward the small little man.  The driver poked the biker in the chest.  The biker reportedly hit the driver, full force with a screwdriver.  

Most bikers that I know don’t normally thump lil annoying drunk driver with screwdrivers.  There are usually better methods for getting your thoughts across.  There seemed to be a discrepancy.  

I realized that for the first time in my career or life, I was going to ask in Spanish “Did he hit you in the head with a screwdriver.”  It suddenly hits me, I don’t know the word for screwdriver. So I ask the fine drunk.  

“Como se dice “screwdriver” 

Without a pause he says to me IN PERFECT ENGLISH

‘Orange Juice and Vodka, but I drank beer.”

I couldn’t stop laughing, but I did regain some composure.  Ok guys, he’s fine, it probably wasn’t a screwdriver, and I think we can let PD sort this crap out.

Back to normal

Started out this morning doing a good deed. My fluency in drunken came in handy.

Called to the 17th floor hallway of a resort for a young man. This young man was quite drowsy. Ok, he was just drunk. He was very confused about where is was. He knew he was in Vegas and was pretty sure he was in the right resort.

Being the kind soul that I am, I translated for security and we were able to reunite this individual with his friends. They were 12 floors below half drunk themselves.

What a fun way to start my 12 hour tour.

First Day Back review

So I made it into work.  The overtime extra shift was two hours earlier than my usual shift.  This shift was also after 9 days off.  So imagine if you will a medic, exhausted and his face was on fire.  I hadn’t shaved for about 10 days and knocked it all off last night.  So I pretty much looked like I had a hangover this morning.  

The first couple calls were frequent flyers.  This was not a good start to the day.  It was followed up by hearing the other crews run real calls. I was not upset though, I needed the easy day.  

Our third call actually made me think.  Young teenager + trampoline = broken arm.  We arrived to find the kid remaining overly calm and collected.  As a young teenager he was rational.  He kept saying how this would probably sink his family.  He understood that this was at least 700 dollars for the ride, and thousands in care at the ED.   

THIS IS NOT A TIME FOR OBAMA CARE OR POLITICS JUST KEEP READING>

He had a ful radial/ulnar fracture, no x ray needed.  This kid needed an ortho and quick.  He actually said that he would rather ride with his mom.  This kids understood the concept.

Now this was fine and dandy, I am quite laid back.  I like rational people.  I can splint this arm and help if his mom is close by.  

TOO MANY CHIEFS< no one listens to the indian.   The fire department that arrived with us had other plans.  They are a non transporting agency, but in theory and when they feel the need, they have scene control.  They insisted that he get narcotics, splinted and transported by ambulance.  

So of course I do what is “best for the patient”  We of course load the kid to the gurney, and roll down the road.  The Fire Department had contacted the mother (she was rushing to the scene) and told her flat out that he needed an ambulance.  

I truly am just venting, but this sucked.  This kid wasn’t screaming, he wasn’t bawling, and he was being rational.  Did he really need the ambulance ride?  Did he really care about an expensive ambulance and ED bill?  Short of low dose morphine, all we did was give the kid a ride on the bed.  I believe that he would have been fine without the narcs.  I believe he would have been fine in his mom’s car.  

I am not sure how to sum this up other than:  I feel that this kid would have been fine in mom’s car.  We just racked up a bill for this family.  Yuck.  

Yes I work for a private ambulance that is paid for transporting.  I am not anti fire department.  I am not burned out enough that I don’t want to transport.  

OK long enough ramble.  Tomorrow is a new day.  Thanks for listening.  

Back to work

I guess my vacation couldn’t last forever. I’m back and more than halfway through today’s shift. The vacation didn’t help too much. I still just want to go home.

I still enjoy the job, but today hasn’t been terribly exciting. I haven’t even started an IV.

In the weeks preceding my vacation, I was the trauma guy. In a three week period I transported at least one legitimate code three return each shift. I’m not bragging. I just kept getting the calls.

I’m thinking today is the warm up for the next few shifts. I think I’ll be back to my crap magnet ways soon.

Time off

I’m truly enjoying my days off. Multiple days off with no thoughts of paramedicine. Pretty sure this is a great mental health break.