On the Way to Paramedic in Northern VA
I admit it - I "over tool". And while it isn't always possible to arrive at a 911 call and whip out a Handy Dandy Pocket Defibrillator, still, there's a reason that dispatch gives you more information than just an address. It's always, "123 Wombat Avenue, possible stroke," or "22 Didjeridoo Lane, chest pain." This allows one to at least prepare for the initial patient contact with a good guess at the proper equipment.
Transports usually provide even more information. After all, the patient is usually in a free-standing ER and going to surgery - or whatever - and initial assessments and diagnoses have been made by the docs and RNs at the facility. Still, an assessment by the transport medic should be de rigueur.
DTs exited the ambulance and brought forth the Cot of Transport recently, then - "Crike!" - rushed back into the cab for his Stealthascope.
A ridealong asked, "What was that all about?"
"Have you ever called a plumber to your house?" asked DTs.
"Well, did he show up with his hands in his pockets, or with his tools?"
Unless you're performing CPR or otherwise engaged, it is not neither too hard to lift the darned wheels over door thresholds. Oh - thought I'd mention that "the characters depicted or described herein are purely fictional and are not meant to reflect real people; any similarities to persons real or imagined is purely coincidental."
At the station we have white boards posted outside each bunk room, indicating male or female (different shifts prefer different rooms for either), and who it is sleeping in each bunk. Little squares indicate beds, write your names in if you want the bed, you know the routine.
"DTs" occupies his bunk space, but feels compelled to write "Monsters" in the space beneath the bed. Did so at first, months ago, for the chuckle factor. How many other providers reserve monster space, making certain that his monsters have a place to crash between calls? Gotta keep a sense of humor.
Mine are tame, however, and quite unlike the wild variety which inhabit these-here parts.
The call was for an inter-facility transport for a seven-month old, "skull fracture". Could be anything from playground to MVA. The crew briefed en route by DTs, the "AIC", on what equipment to bring, we arrive at the facility, and the bed was visible down the hall.
Medic Sense tingling, DTs announces to his Merry Crew, "Hey - something's not right here."
"Yeah, there's the bed down there, that's the room," says Crew Guy.
"Uh huh. Where's Mom? Where's Dad?" We could see the bed, the small form in the center - no mom, no dad in the room or in sight.
In the room we find the child, CAO, idly observing the new strangers, a band-aid above one eyebrow and one leg splinted. He begins to fuss.Crew Gal offers him a bottle we find in the bed and he sucks greedily. He looks to weigh about 8kg, and does not seem to be a "preemie" - just a hint: For that age, that's a low weight, folks.
An RN comes into the room.
"Okay," says DTs, "What's the story?"
"Depends on who you ask," says the nurse, who is grim indeed.
Our patient had "fallen off the furniture" - according to one story - and sustained a skull fracture, five broken ribs, deep bruising to the soft tissue of the abdominal area, and a distal femur fracture. This was the initial assessment in the ER - a more detailed assessment was needed for "other possible trauma". We verify that there is no C-spine compromise and carefully move the child onto our cot (outfitted for pediatrics for this call). He's fussing, and Crew Gal asks if we can give him his bottle, which is pretty much all he has in Personal Possessions.
"Not while strapped down," says DTs. "Pacifier?"
"None," says the nurse, who brightens. "Hey! They sell 'em in the gift shop!" Dont you just love nurses? I never would have thought of that.
"Here," says DTs to Crew Girl as he fishes through his pockets for cash, "Go to the gift shop and buy a pacifier if they have one."
"Make it blue! And I want change!" he shouts to her retreating form. The nurse guides the way.
DTs plays "grab the pinky" with the patient until the RN and Crew Girl return with a pacifier. Note to EMS: Do not play "grab the pinky" with patients over a certain age. Make that most of your patients.
Our Heroes return triumphant, pacifier in hand. The patient is once again happy.
To the RN: "Let's step over here and talk about this."
I expect anger. I expect outrage. Protestations of disbelief. All, of course, from myself. I am therefore surprised to hear myself asking, "Any previous medical history?"
"None, except some old fractures on X-ray," says the nurse.
"None that we know of."
"Any heart or respiratory problems - history of meconium aspiration, fetal heart problems, anything like that?" asks DTs.
"Nope," says the nurse.
"Given any medications?" Meanwhile, internally, I'm thinking: This is unbelievable!
"None so far, he's stable..."
"Say..." says DTs. The nurse looks up and raises her eyebrows.
"I should be wanting to mess somebody up right now. I should be quite pissed off, but... I'm not. Any ideas, here?"
"You have a job to do right now," says the nurse, "And you're doing it. Just like me."
Glimpse of the Professional, and I could see the words "Later, though...." behind the look.
She's right. I'm gonna do my job and take care of this little person as best I know how. That works.
But next duty, I'm gonna write "My Monsters" for the space under my bed, just to differentiate.