Day one. First call goes out as a cva then a full arrest I was like oh snap is this real life so we walk in and the patient is laying there moaning turns out it is not a full arrest. So we get her hooked up to the monitor I start the IV we load her up. The monitor shows a fib with RVR and the patients states no history of irregular heartbeat. From the time we left the patients house to getting her to the hospital she was now throwing frequent PVCs and then they went trigeminal and then she was having couplet PVCs. She was confused the whole time with us and wasn't quite sure of anything going on. Our next call was for a fall I walk in this very pristine vintage home and this patient fell from being dizzy and split the back of her head open. I start going through my assessment and she is very snippy with me. Okay rude I'm just trying to help you out and I want to make sure I don't miss anything. So anyways her snippiness continues and at one point my medic almost had to step in but it was all good. The patient didn’t mean to be. Next call was for another fall and this little lady went to sit down in her office chair and she just missed it and kind of hit her back. She was the sweetest thing but she ended up not coming with us. We get a call for a seizure 16 year old. I'm thinking okay good. Well we get there and fire already started an IV and the patient had a seizure while in fires care so we load her on our cot get in the truck and she fights us a little bit, we wrap that IV so we don't lose it and she starts fighting us more so I start holding down the legs and my medic gets the top half and patient was going crazy. It was like that all the way into the hospital. My hands would slip because the patient was so sweaty which made it tough. We pushed 5 mg Valium in hopes it would help just as she started relaxing we sat down and she went at it again this time we start getting the restraints out and we give her another dose of 5 mg Valium and then we pull into the hospital so we never got the restraints on we are trying to wheel her in while we strapped her legs down good in hopes she doesn't get out of the buckle again and my basic has the foot of the cot I am holding one arm down and pushing the back and my medic is on the other side holding the other arm down and pushing the cot. Dude it was a big mess! That patient was mad strong too and also like two of me! Next call was for a diabetic emergency hyperglycemic. Hey guess what. He was combative too. Awesome! So we wrangle him on the cot strap him in and this time we pulled the kerlex out and restrain him before we left and once we got in the truck we pulled out the soft restraints. Cause me and my medic were not about to fight back again. Next call was for short of breathe history of COPD. So we get on scene and I'm like well hopefully not combative with our luck he will be so I start hooking him up to the monitor an I put the bp cuff on him and he made some statement that he will slap me I thought oh no here we go again but he was a little disoriented. He was not combative thankfully. Load him up and do the whole work down.
Day two. We get a call for shortness of breath and abdominal pain. The patient recently had a colon resection. She really just wanted to get out of the house though. The next call was for a fall. Turns out this patient had drunken about a gallon of listerine and was just a tad drunk also he had broken his hand two days prior an had since taken the cast of himself. His hand did not look too good. And from his fall he had split his head open. We were finally able to talk him into getting everything checked out. A listerine drunk patient is quite the smell! Third call was for a suicide attempt overdose. This patient would only respond to painful stimuli and we were unable to figure out how much of what she took and when she took it. All her vitals were stable and she was breathing adequately. She wasn't in any need of narcan because she was stable and it's no fun dealing with a patient who has narcan on board but as we were pulling into the hospital my medic said the hospital likes when we try it so we gave it when we were almost there. There was not much change. It slowly started to show a change and by the time we were leaving the hospital she was talking some at least. We got a call to transfer a cancer patient on a few drips. After that we got a call for an assault in a sketchy sketchy apt complex! So we stage for a few minutes then get cleared to go in and we have two patients who got the snot beat out of them. The guy was knocked unconscious so we had him back boarded we get him in the truck I do my assessment and start the IV then they bring the other patient in back boarded as well so I do my assessment on her and an IV and we bring them in. They both had swollen faces and it looked pretty painful. We get this call for a patient who fell off his bike ( mind you it is like 1015 at night ) my medic tells me what the call is for an she goes we don't know if it is his bike vroom vroom or bike ding ding. We get on scene and fire says he left we were about to go start looking for him. So we start driving around the neighborhood looking for this patient. But clearly he must not be that hurt. We never found him. The last call was for a fall and this elderly lady was found on the bathroom floor. She was not very enthused we were there she did not like me touching her. She complained of pain everywhere but it was not believable. I finally get somewhat of an assessment done and only found a big bump on the back of her head which was painful to her. We couldn't take her to the hospital until her daughter got there and decided. So meanwhile I had to put up with her repetitiveness and fighting every time the bp went off and if I tried to put the little spo2 clip on her finger she would freak out that it hurt so whatever. Her daughter finally gets there and after 5 minutes they finally decide she will ride in the ambulance. Now that that is figured out we are able to get the show on the road. We were unable to get a sugar or IV on her, which wasn’t a big deal. Needless to say we got off a little late.
Day three. First call was for "man down" that's all we got. So we show up and fire is just all standing around. So apparently this patient was just lying on the sidewalk and fire drove by and stopped. Her blood sugar was low so they gave her some glucose we get there I check her level again and it stayed the same so we try to give her more but by this point she was all sorts of frustrated and angry. We had called her mom and she was going to get picked up. We had to wait for the mom and the patient just yelled at us the whole time she eventually just made herself comfortable on the sidewalk and just laid there till the mom came. Ridiculous. We get a call for a CVA so we show up and this patient is just so antsy and can't stay still and delirious. Since called in as a CVA I go to do a stroke assessment and have him squeeze my fingers with both hands and he had equal strong grip and would not let go. We load him up fast when we saw he was a fib with RVR at 180 a minute. Get him in the truck and I start an IV give him fluids and he won't sit still and trying to take his seatbelts off and he was just all sorts of crazy. He felt warm to us but we don't have a reliable thermometer to check it so once at the hospital they check it and got 103.7 yikes! They give him some Tylenol and started giving him haldol before we even left the room. The last call was just a transfer for chest pain. A whoopin 12 hours and only three calls. Impressive.
Day four. It's a PINK truck day so of course I had to get the pink gloves too! It's fun but it's an old truck so it rides TERRIBLE! So our first call is for short of breath. The patients sats were 84% on 5 liters of oxygen we put him in a duoneb with 6 liters of oxygen and get his sats up to 99% super. He sounded pretty gunky. Poor guy. So after that we were headed to post and a car broke down in the middle of the road so we blocked off the road and pushed the car out if the way and we got a call so once the car was out of the road we booked it back to the truck. Got my exercise man. The call was for a diabetic emergency. Patients’ blood sugar was 31. We ended up giving him an amp of D50 (through a 22gauge unfortunately) and 100mL of D5 and got him up to 159. Apparently this happened last night as well so we said it’s probably time to get him looked at. We get a call for a fever for a patient at the dialysis center who had just had a fistula put in a week prior and the swelling from that has gotten worse. Being that we were right across the street from the hospital we did not have much time to do anything. Next call was for a seizure at a college nearby. When we got there we were talking to the patient and from the way that the patient was responding we don’t think it was a seizure but more of a syncopal episode. We started questioning her and find out that she hasn’t eaten in 24 hours and she had just got home from soccer practice. Crazy I tell you crazy!! So we start attempting for an IV and im sure everyone can guess that didn’t go well because she was so dehydrated. I think after 3 or 4 tries we got it. We gave her fluids on the way in. Our next call was for a possible stroke we get there and this patient checks out fine but she did have an episode where her speech was garbled and confused so at that point we stepped it up a little. We get her to the hospital in that 3 hour window for a stroke patient but to our surprise the family neglected to tell us that they woke her up when this started. What we got from the family was that they had gone in to talk to her and it started and then resolved. So then the real time of her last time seen normal was passed the 3 hour window which was a bummer. We go ask the nurse about that syncope pt we brought in and turns out that patients electrolytes were all sorts of screwed up. Her potassium was 2.48 and normal range is 3.5-5.0 so that is pretty low. No wonder she felt so crappy! Anyways last call for the day and week was for abd pain with n&v. Ongoing pain for the past 6 weeks and tonight was just unbearable therefore we got the call.
Good week. My preceptor
keeps telling me I am improving more and more each day, which I like to hear :D
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