Thursday, October 7, 2010

Really? To me? Right Now?

A normal run of the mill call, mid 70s patient, family states pt has a change in mental status with a period of severe cyanosis.  upon assessment pt is complaint free, 12 lead is unremarkable, probably would have released if their bp wasnt under 100 systolic.  So we are riding into the hospital, pt seems lethargic but nothing esle is abnormal.  Suddenly I call the pt's name when I notice seizure like activity, within seconds they are completely blue, as I reach for my phone to get orders for ativan, I notice nothing other than V-fib on our monitor.  All I could think was really? wtf, right now?  A breif second passed as I realized whether or not they die depends on my next actions withing the next few seconds.  I contemplated is being a medic really for me, to be honest I was scared shitless.  Within 15 seconds of noticing V-fib I was able to apply the pads and deliver a 200J shock ( of course all of this happends like 15 ft from the hospital entrance).  With a 3 second pause of asystole i feared I had chosen the wrong treatment, but just as I began to have my doubts, a beautiful text book normal sinus appeared on our lifepak 12.  The pt immediately regained their color, and was able to respond to my questions.  Needless to say the ER did not believe me until I was able to print a code summary.  Since the docs were  busy with another code that arrived just before we did my partner and I hooked the patient up to lessen the load on the ER staff.  I heard later that the pt coded again in the ER and was flow to the local interventional cath lab for 2 stents in the RCA.  They were discharged 3 days later.  A victory against the grim reaper, finally.  I feel like a medic, happier than ever, and wow, I LOVE what I Do!


So lately I have been having good calls when I work the truck.  A few months ago I had a pt under 40, CPR in progress upon arrival.  I was able to get the tube in less than 2 minutes on scene, which always is an ego boost.  We worked the pt for quite sometime, I think around 45 minutes, when I noticed they had suddenly went from asystole to sinus tach... holy cow... upon arriving at the ER, the chaos between the nurses was nothing out of normal, our patient survived a few days from what I understand they were pulled off of life support days later... a victory short lived.

Tuesday, September 14, 2010

Bad decisions...

I think my personality is one that constantly desires achievement.  I gain satisfaction through setting goals and attaining said goals.  For me becoming a medic was an easy decision, I enjoyed EMS but wanted to expand my knowledge and skill base to be able to provide a wider array of treatments to the patients I saw.  Since I did not finish college, I am looking to expand my knowledge even further to become an even better medic.  To me enrolling in a program to get lisenced as an RN was the next logical move.  However, I still need a lot of general education requirements.  Since I work 64hrs every week I do not have time to attend a traditional nursing program.  I opted for a self study program specifically designed for students who work in the healthcare field already.  All of the clinical time is waived provided the student can pass an extensive practical exam.  Seemed like a great idea, I could power through a lot of the classes by studying on my own time and then taking the final exam when ready.  Little did I know how hard it would be to read a 1000 page text book cover to cover...  I am 2 pages in and I cant even concentrate... what did I get myself into?  well back to studying so wish me luck!

Monday, September 13, 2010

Uh Oh

So in trying to prepare to study for my Life Span Developmental Psychology Exam, i was reviewing the outline, and realized I only needed 1 of the 3 books they listed... so I accidently bought like 2 extra texts and 2 extra study guides, hoping I can return for my money back... Also noticed that I have til Sept 30th to take the exam or I have to probably order new books so I am going to have my nose in the book these next two weeks in hopes of acing this exam before sept 30th.  However, I have one small problem known as World of Warcraft... dorky I know but I have been sucked into that game for over 4 years.  Going to do my best to put it aside for the next two weeks so I can study.

Two calls today at work, a fire alarm at one of the local schools, got canceled en route, and a gas leak.  Now for those of you who work out in my area we all know the gas and electric company take hrs usually to get on scene, today it was less than 10 minutes.  Job well done without ever leaving the truck lol. Looking forward to getting back on the medic truck this weekend, No partner as of yet on the schedule so hopefully its a good surprise.

For those of you in EMS, How easy does your area hospitals make it to check up on patients you have had?  Most calls do not bother me, but a few weeks ago I had a pt under the age of 40, cardiac arrest, asystole, CPR initiated by BLS.  I got the tube within minutes of being on scene while my partner started the IV.  family stated possible opiate over dose so we gave some narcan, and two rounds of epi/ atropine.  Now PEA another round of epi/ atropine.  Somehow in the midst of this our line got pulled out so I started an IO.  Some bicarb and calcium chloride later the pt was sinus tach with pulses.  continued the fluid, and transported over to the hospital.  So far great feeling although I dont suspect a good outcome in the long run.  The pt. maintained their own heart beat and BP as far as I know all day without coding again, but since then I havent been able to check up on the pt.  I just wish there was an easy way of following up on patients and knowing their outcome, to see just how big of a difference we made.  After that call, another code, under the age of 40...  what the heck was going on, however this had a much better outcome of A&Ox3 within minutes of being on scene... Narcan... Paramagic... synonyms?

Sunday, September 12, 2010

Catchin' up

So I worked Sat 9/11, a pretty relaxing day for the most part, only 6 calls in 12 hrs which is significantly quiet compared to the 15-20 I'm normally used to.  I got to work with a medic who has been a medic over 30 years, quite amazing actually, to hear the stories of how it was "back in the day".  Inspiring to say the least.  Nothing too crazy, a pretty wicked thumb injury from an MVA and a possible CVA, and a few cancels.  To me its just good to be on the truck out and about knowing there is the possibility of making a difference.

I took off sunday to spend some time with my girlfriend, taking off is a rather rare occasion for me, I love working the Medic units on my time off, but it was extremely nice to veg out on the couch all day with her.  Relaxing but tiring, amazing how doing nothing all day seems to make you more tired than running a marathon, (Not that I have ever run a marathon).

I enrolled in a Nursing program a few weeks ago, waiting on my books to come in so I can begin studying.  Im not sure if I want to be a nurse yet, or what I want to do in the nursing field but I know that I want to expand my knowledge, if only to become a better paramedic for my patients.  So I am rather excited to begin that journey and become a better clinician. 

Back to work at the firehouse tomorrow, hopefully a few calls, or at least something out of the normal routine would be exciting.  I been toying with the idea of sitting and working on my own little medic refresher, a schedule to review all of the pertinent material and skills just to keep it fresh in my mind.  Just dont know where i will find the time with all the studying that lies in the near future. Have a few classes lined up as well to get some CEUs before recerting early next year...

Well its off to bed, G'night all!

Friday, September 10, 2010

Opening Day

Ditch Doctor: (n) a.k.a. "A Paramedic- the closet thing to a doctor that you will find while lying in a ditch on the side of the road."

While I admit that I am not the creator of this definition, I sure did find it amusing, and even slightly empowering.

So I am totally new to this whole blogging idea, and actually never thought I would ever do something like this, but after finding blogs done by many others in my profession's community I thought, maybe I could tell my story, since life itself is a story, an adventure, a book of many lessons with no foreseeable ending.

Before we start I suppose I should give the typical disclaimer I have seen on each and every site I have come across so far.  For the purpose of privacy; Names, Dates, Times, or Addresses will all be modified to protect the privacy of myself and others involved in my story.  The opinions reflected within these posts are the opinions of myself, and do NOT necessarily coincide with the opinions of my employers, or the people of the communities for which I work.  With that said I hope that someone reads this and enjoys my story as a young firefighter/ paramedic in today's society.

And so it begins.  My journey to be a firefighter, began at a very young age, addicted to Backdraft, I fell in love with the idea of being a firefighter.  Though as time went on I always wanted to be in the military.  After high school I attended one of the prestigious U.S. military academies.  During my time at said military academy, I fathered a beautiful young boy which disqualified me from continuing in my journey to become a military officer.  It was at that point I decided to pursue my dream of becoming a firefighter.  I came home with no real work experience or any type of skill that would help be obtain my goals, so I began volunteering for a fire department in my home town, that also employed career firefighters during the day to cover when volunteers were unavailable.  Taking a suggestions from my dad (and I still feel this is the best advice he has ever given me) I enrolled in the accelerated EMT course at one of the local institutions.  A short time later I was employed by a private company working as and EMT-B.  As time went on and I was unsure of my chances at getting hired as a firefighter, I applied for the Paramedic class as a back-up plan incase I did not get hired at the fire department.  About half way through the didactic instruction I had gotten hired by the same fire department I was volunteering for and left the ambulance company.  I was one of the lucky few aspiring firefighters to get hired on their first try!  I began my journey as a firefighter; excited, uncertain, and looking forward to what each day on the job had in store. 

I finished the didactic portion of the program and continued my clinical rotations on the weekend, since I worked Monday through Friday at the fire house.  At this point I began to realize my passion for EMS, and often wonder (even to this day) if I should just focus on being a Paramedic rather than splitting myself between the two jobs.  After a few long months and plenty of time busting my ass, I passed the National Registry and practical exams on my first try, I was and am officially a Paramedic!  I applied to a local company that covers a large area of my state (XYZ Ambulance) and I am currently employed as a per diem Paramedic, often working M-F at the fire house, then Saturday and Sunday as a Paramedic.  I am sure you can now see I have very little time to myself. 

As time continues, I feel as if I have to choose between one or the other.  The fire department I work for pays very well, also including a nice pension and benefits.  I work with amazing people, and the job itself is not overly stressful, or even the slightest bit difficult.  However, I feel as if my intelligence is not being used to its full potential.  Day in and Day out, the weeks go by often with very few calls if any.  I go to work do the same truck checks on the same trucks that never move, I sweep the same floors that are only dirtied by the sand blown in on windy days.  I eat the same meals, watch the same news, and attend the same department briefings.  I find myself looking forward to the weekends, not for the time off, but for the time to work as a medic, to help others, to fulfill that desire which lead me to wanting to be a firefighter in the begining, I find that satisfaction in being a medic. 

Many people say, "if your not happy, leave and do what makes you happy."  I am sure many of you know not only will you not become rich working as a medic, but sometimes it is almost impossible to even just make ends meat without working the overtime just to cover your necessary bills.  I feel stuck, obligated to work at the fire house just to pay my bills, especially in the midst of a heated custody battle for my son.  All the while wishing I could just work as a medic full time, and expand my knowledge, perfect my skills, and make a difference for the people who call on us each and every day. 

routine...same trucks... same checks... same floors... same shit different day...

So, I ask anyone who reads this for advice, your input, how do you continue to love your job when you are on the edge of burn out, when you are tired of the same routine, when you feel stuck? Whether firefighter, paramedic or none of the above what keeps you interested.

  Well being that tomorrow is Saturday, 9/11 albeit, let us never forget the so many brothers and sisters that gave the ultimate sacrifice to serve the citizens of NYC, and for those that continue to serve in today's military to fight for our freedom.  With that being said it is probably time for bed since I am working the farthest unit from my house and I have an hr drive early in the morning.  Hopefully I don't see any of you who read this tomorrow, but if I do, I promise to do my best. 

Good night!