On the Way to Paramedic in Northern VA

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Thursday, January 27 2005
On Being Leadethed Beside Still Waters

Shift started at 18:00, but due to my work schedule Wednesdays I can't be there until 21:30. For three and a half hours my ambulance is either unstaffed, or my captain appoints someone from the fire side to act as lead EMT in my place. This is not, as you might know, a coveted position for the fire guys - they'd rather run fires.

This week, the ambulance was staffed. I had my pager, as usual, so I could while at work get a "feel" for what Prince Willy County is up to that day. From 18:00 to 21:30, prior to my arrival, the ad-hoc crew ran:

  • auto accident, "hit and run" (car vs. car, not car vs pedestrian, fortunately);
  • standard auto accident with one person c/o neck pain;
  • fire alarm sounding (for which we hang with the fire guys Just In Case);
  • unconscious at an exercise facility (when laymen report unconscious - could be more);
  • octogenarian ALS sickness (sounded severe);
  • another fire alarm, "house foggy and smells funny";
  • highway accident, 18-wheeler vs. car;
  • auto accident, T-bone with airbag deployment (quite an impact, then);

"Wow, DTs", I hear you gush, "You certainly missed a lot of calls!". Indeed. Whenever my pager buzzed I'd read the message and start dancing from foot to foot as I glanced at my watch, "hurr ree uuuupp 9:00!" - never doing so of course when a patient was around.

21:00 arrives. Since it is obvious, from the way things are going, that I will never have an opportunity to eat this night, I swing by a McDonalds.

I think it's called a "snigger" or "snicker" - that semi-sneeze sound that people make when they cover their mouths while trying to suppress a laugh. Call it a snigger. Above me, then, cosmically echoing, came the first Snigger from the gods of EMS.

This particular Micky's had some sort of convoluted "access road" which didn't access it, and the point where access seemed logical was marked "Exit->". Ah, so desu. By avoiding that and continuing on in search of "Enter->" I was handily thrown right back onto the highway. So long, Micky D's.

Not a problem, that's why belts have notches. Undaunted, DTs arrives at the station. Lo, his crew has not yet cleared the hospital from their last call and have not returned. The Captain wants his fire guy back and the fire guy, now having attended two fire-guy-type calls whilst chained to the ambulance, is in all probability ready to get off the thing. Captain calls the crew on a cell phone: "DTs is arrived; come home and get 'im."

Cheering below decks on the bandaid box as it backs into the station. In moments places are switched, thanks are rendered (me to fire guy - for fire guys, bandaid box duty is an ordeal) and we're Ready.

Fortune smiles on DTs, for the ambulance crew has not yet eaten dinner. Except that it is now past 22:00 - those members who are not "full fledged" for reasons of age or training must depart, to run another day. It is down now to DTs and his trusty driver. "Good golly!" thinks DTs, "With only us two we shall certainly have our work to do this evening!" Fortune's smile grows wider.

Fortune then sniggers as the valiant crew ride off in search of sustenance, figuring Wendy's is Good Enough, and besides they boast we may Eat Late.

Fortune laughs outright. No, actually, we may not eat late, as only the drive-thru is open past 22:00 and ambulances don't fit in drive-thrus. We weren't about to walk through it (it was Damned Cold) and so we went to a convenience store which maintains a built-in Deli corner - normally first choice, but it was farther than was Wendy's.

We arrive, order, and are in the checkout line when the Tones Drop (Fortune, meanwhile, ROFL) and abandon all to save:

  • a 50 yo male complaining of "dizziness" and "nausea" after consuming 26 beers.

I hear you say, "That might be a medical emergency, though, DTs - alcohol poisoning, maybe!" But it wasn't - the time period over which it was consumed, patient size and other factors which made it BLS where the L stands for "space". We transport, however, and return to the Deli, and are finally able to pick up food and return to the station.

Almost. Another call on the way home, which while it takes over an hour ends in a patient refusal. DTs is able to laugh at Fortune: "Ha! The Deli was out of hot roast beef the second time around, Fortune! Mine was a cold hoagie, and my little driver's, too! Calls cannot hurt our food!"

And that was that. Fini. Done. No more calls, not one.

Proving, I suppose, that it is never wise to laugh at the gods of EMS.

Friday, January 21 2005
All Quiet at the It Aint OK Corral

One of the great things about OWL is that they hand out these neat text message pagers. Every time the tones drop, the pager buzzes with the same info we get from Dispatch. On those days I run (especially on weekdays, where I don't run until 18:00) I keep my pager on all day, with the assumption that if the early part of the day is "busy", my shift will be, too.

Thursday tripped me up twice. Firstly, I thought it was being treated as a holiday - Fairfax County, and Alexandria, and other local jurisdictions, were treating the day as such. My Good Guys got the day off school, etc. In holiday situations, we volunteers work the full day (career guys get the day off) and show up at 08:00, same as weekends. So, on that assumption, I arrived at the station at 07:00 Thursday to get the rig checked out.

Mighty quiet by the time that was done - come to find out, Prince Willy did not get the day off. Which worked out, in a way. I went home and did some stuff, but going back in the evening we were ready to rock at 18:00 on the dot.

Second trip-up was this pager I mentioned. It had been going off all day long - furnaces exploding here, inside gas leaks three doors down from that, accidents. "Fear, Fire, Foes - Awake!". The weather turns cold, folks wait as long as possible until they turn on their furnaces, and... there be trouble. I hate that, but if it has to happen, then...

Ah! Distress afoot, and I get to help. Yeah, baby.

Trouble went home with the paid guys. I show up, my driver gets there, we're ready. Tilt hands to ear and listen for the tones to drop: [insert cricket chirping sounds].

The "one" in 911 is the "one" call we got all night, and that one wasn't until 04:00. Medical. Routine (but of this routine, more later. A dissertation, yes, that's what we need!) Well, we did a couple of other calls where we went, waited, and left - they don't count.

We students were told, in the dim and distant past when I first took EMT class, that to be hired in D.C. one had only to be an EMT, "or, write EMT on a 3x5 index card and mail it to..."

Now there's a jurisdiction which gets some action. We shall see.

Wednesday, January 19 2005
I Want A CowCatcher on My Bambulance

First snow of the year in No. VA. And Hoodathunk? Everyone forgets how to drive. We transported three patients today during a 12 hour shift, for a total mileage of 88. Yes, subtract fifteen minutes to package the patient; transport, and fifteen minutes to give report and get back on the road. For three patients, this adds up to 90 minutes. Subtract that from a twelve-hour day and you have eighty-eight miles traveled in 10-1/2 hours. Round it down to an even ten to get an average speed, on Our Nations Highways, of 8.8 mph.

Whee. Me bum's sore.

Darwin, don't fail me now. Tomorrow I get to run 911 for whoever lived through today.

Sunday, January 16 2005
The Fire Guys Can Have Chad Kroeger

I like the way Hollywood portrayed scientists, in the 1960's. Back then, Hollywood scientists wore long white lab coats, smoked pipes, and were always Very Serious. When they went off-duty, usually outside of the laboratory to combat the giant radioactive whatever-of-the-week, they'd change out from lab coat into suit and tie, but were still Very Serious, as befitted the Very Serious Nature of both their work and the crisis du jour.

Now, EMS is serious business - after all, someone is hurt. There is a difference between being lighthearted and caring vs. coming across as inattentive and playing around. Besides, whatever or whoever hurt them may still be there (downed power lines, bad guy with knife or gun, etc.) and goofing off can, in those and many other circumstances, get somebody killed. We do not goof off on scene.

Ah, but, how about on the way to the scene? Our rigs are new-ish and have CD players which so far as I know have never been used. How cool would it be to kick in some Spencer Davis while the big doors are rolling up and we're turning on the lights - opening notes to "Gimme Some Lovin" as we draw out of the house and begin to scream down the road? Foghat's "Fool for the City" seems apropos for I95 Southbound, says I. Soundtracks for real life and be damned to the royalties, says I.

Alas, it is not to be. "Further Information" comes in across the radio and we gotta be able to hear it. Although, if it weren't for that, I'm sure my last crew would have gone for the idea, although what hip-hop monstrosities they, being much my juniors in years, would have inflicted on me is open to conjecture.

Which brings me to my current crew - of whom I've met but one where I had looked forward to meeting three. We had, Friday night, a light call load, which worked out just fine as it was Himself, his driver, and a last-minute rider dipping their toes into EMS before deciding to take the plunge. My driver seems to be a cheerful polyglot - Spanish, French, some Arabic; more DTs cannot say, but that much is plenty as it'll certainly come in handy, my Spanish being the self-taught variety.

Anyway, one trauma and two medical calls do not a good team assessment make. More, I suppose, as it develops.


Thursday, January 13 2005
Feel Like a Number

Well, finally got a chance to compose the following. This is just the 911 stuff, ending 12/31/2004.
Notice that there is not always a 1-1 ratio between a "call" and a "patient" - sometimes multiple patients in a call (e.g. MVC, a car crash) and sometimes the patient doesn't want to go...

Number of calls: 231
Average time from tone-drop to doorstop: 4 minutes

Location Type
Recreation Place3
Public Building30
Residential Institution5

Male Patients118
Female Patients113
Youngest PatientBorn in Ambulance
Oldest Patient95 Years
Average Pt. Age37.68 years
Of These Patients...
Treated, Transported153
Treated, Transferred Care29
Treated and Released2
Patient Refused Care43
Dead at Scene2

Treated, transferred care usually refers to the fact that sometimes (often!) we need a medic to transport the patient (they need IVs, ECG en route, etc.)
Treated and Released usually means into the custody of PD.

Call Types
Medical emergencies121
General Injuries54
Injuries from Fire1
Injuries from Assaults9
Injuries from MVC45

Mechanism of Injury (Non-Medical)
Bicycle Accident1
Drug Poisoning1
Machinery Accidents1
MVC - Public Road43
Pedestrian Traffic Accident1
Sports Injury1

Notice above that we have 8 assaults, but 9 "Injuries from Assaults" - not sure how that came about, unless someone assaulted someone with a bicycle, or what...?

The Biggy - When Do the Tones Drop?
12:00:00 AM11
1:00:00 AM14
2:00:00 AM10
3:00:00 AM9
4:00:00 AM9
5:00:00 AM4
6:00:00 AM5
7:00:00 AM5
8:00:00 AM5
9:00:00 AM6
10:00:00 AM8
11:00:00 AM5
12:00:00 PM6
1:00:00 PM7
2:00:00 PM8
3:00:00 PM3
4:00:00 PM4
5:00:00 PM8
6:00:00 PM22
7:00:00 PM12
8:00:00 PM23
9:00:00 PM11
10:00:00 PM16
11:00:00 PM16

Saturday, January 08 2005
Hooky and Other Multi-Player Games

I should be running on the bambulance tonight, but alas, it is not to be. All is SNAFU in OWL-Land. Only the superstitious would see this as an Omen.

Each year in the first days of January the Mighty amongst OWL switch everyone around, between each of the three stations (Station 2, 12, and 14) and each of the crew shifts (labeled "A" thru "F".)

My station remained the same from last year to this, but my crew switched from "F" to "A" crew. Despite the similarity in letters to the US grading system, this does not mean that DTs has gone from Failing to High Marks.

Of itself, not a big deal, except for this: They Start The Alphabet Over on this Mystery Date. It's easier to explain in pictures:

 Sun   Mon   Tue   Wed   Thu   Fri   Sat 

Here we have a typical week - six crews, seven days, which means that if "F" crew is "on" Wednesday this week, that crew will be "on" Tuesday of next week, Monday after that, and so on. Since "A" crew follows "F" crew, that meant that if I ran Wednesday this week (I did) then, on the new crew, I would run Wednesday next week, and follow "A" crew schedule from then on (Tuesday, Monday, Sunday...)

But they not only change the personnel, they "start over" on a particular day (which is not Jan 01, btw) and so today, Saturday, is now "A" crew's turn, and I'm now on "A" crew.

Based, however, on the understanding (see table) above, Plans Were Made by She Who Must Be Obeyed. Saturday is verbotten

We're also required to run Bingo duties every Wednesday and Saturday (different schedules and crews) and that hasn't changed - but the schedule I have is from October, and is, I am told, wrong. I have yet to receive a corrected version. Instead of working Bingo at some other time, I am also supposed to do that tonight, which ain't gonna happen.

Finally to all this - I find out my assumptions concerning Saturday crew, Next Wednesday, and Bingo are all wrong - Wednesday this week. Testing for "I" was Thursday and Friday, so did DTs have time to drop studying and/or testing and find a substitute for these his duties? No, DTs did not.

I get a new CO with my new shift - whatta first impression this'll make!

Friday, January 07 2005
New Dung in the Old Stable

Well, that was an adventure. But as we all know, "An adventure is someone else having a hell of a rough time, a thousand miles away." This one's not quite done.

The way National Registry testing goes is, one is given a set of tasks or stations. For instance, there is a Dynamic Cardiology station, a Static Cardiology station, a Trauma station, a Medical station, and so on, numbering twelve or so. Each of these stations consists of a series of steps - some contain as many as two dozen - which must be performed to complete the station. Additionally, there are a series of missteps - again, sometimes a dozen - which if even one is performed, automatically negates the whole of the station: you lose.

So, in other words, to do up the station right, jump from one Magic Stone to the next in the correct order, but say the Secret Dark Word and your life is forfeit (odd imagery, but my son's playing a video game in the same room).

Now, do it again for the next station. And the next. And get them all right.

Oh yes - you're allowed to finish, to your satisfaction, each station, and are let to know later, when you're done with all twelve, if you passed or failed any, but if you failed, you must not be told why.

We hates the National Registry, Preciousss, yes we does.

Twelve tasks, each pass/fail, where pass = 100% correct. Okay. Some people actually get through that the first time, but I didn't.

If one misses a station, or two - there's a definite limit - one may retest those stations, either "now" or "later". I had some retests to take, but took one "now" and realized that my brain had fled South for the winter at some point. Instead, I'll retest my few - not all - of the stations at some later point, probably in two weeks or so when I receive the Official Confirmation of my less-than-stellar performance of this evening.

I wonder, of the 70-some folks there this evening, how many are heir to this fate tonight?

As for me, my brain went Walkabout, so I'm filling the space with fumes from a fine vintage, and reading, finally, a good book received Christmas but unopened due to studying...

Saturday, January 01 2005
Pudding Exhibit

Must... Study... Got to... Pass...

In theory, my "I" test comes up in 5 days, leaving me very little time to study for it, for: I work 09:00 to 21:00 Monday, Tuesday and Wednesday, run 21:00 Wednesday night to 08:00 Thursday (Jan 6th) morning - but I believe I need to be at the testing center at 07:30. Hmm. This bears looking into...

If during study I need a break, I might get a chance to include here something I've been considering now for some time. I keep a database of all the calls I've run (with identifying information carefully left out) and might work up a graph or something - x number of auto accidents, y chest pains, etc. Eh.

Posted Thursday, February 03 2005 16:10, Site Meter