Category: Schoolin’


Whoops

So, what I was using to remind myself of the ride-alongs has been compromised. I can’t remember what they all are , so, without further ado: Ride Along Two.

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After that quick bite, we get another call and head out.

On scene, we enter a private residence and enter the first room on the left. In it is an older woman complaining of pain and vomiting. She asks us to close the door behind ourselves to secure the home. Part of an EMT’s responsibility is to, within reason, secure the patient’s home and belongings. If we cannot, officers can be called on scene to lock up behind us.

Once on the truck, the patient asks for an emesis bag (emesis means to vomit). Upon receiving one (*gross alert*) she promptly and continually fills it with a somewhat deep and bright green bile. She was sick due to radiation treatments used to cure her pancreatic cancer. Yes, the pancreas has lots to do with bile. While the liver produces bile and the pancreas other digestive juices, they share a duct that takes these enzymes to the stomach to aid digestion. The patient also had diabetes.

In between emesis moments, Kimberly asked question to fill out the PCR and the patient was quite compliant to answer them. However, on the ride to the hospital, she did stop answering questions with words, due to fatigue, and just laid quietly.

Kimberly and I also performed a finger stick to get a BGL (blood glucose level). Kimberly gets two readings when she checks BGL and records the second reading. This is a difference of style, not of substance. Sometimes the patient doesn’t have enough blood to give you two readings.

Captain Holland, when lecturing on the ins and outs of getting BGLs on patients said: “The proper acronym for blood sugar is BGL. We were going to use BS but that was taken for something else.”

This lady reminded me of my Grandma. My Grandma had a cancer that was removed completely by surgery, no other interventions needed or used. This call made me thank God for sparing her from radiation therapy. However, it also made me thank God for allowing healing in this way as well. How worthy the God I serve. To allow healing in many ways, though He owes and guarantees us nothing in the way healthy, easy lives. Praise Him.

My best friend in the class, let’s call her Claire. Claire and I went out to dinner before our ride alongs since they were for the same shifts. We knew we would be in different trucks and areas of the city but wanted to have dinner and breakfast together on either side of our rides. We ate at a local burger joint, so delicious! On the way to EMS Headquarters, Claire vomited. She didn’t feel well on the bus over, but figured it was eating too fast, being on a bus and being nervous. I found out after a few hours that she had gone home sick, vomiting profusely for two hours, only able to go on one ride with her crew. Her ride was rescheduled.

The third call came in as a minor illness. It was at a patient’s home. It was close to where we were, apparently. On the drive over we picked up a pizza Kimberly had ordered and got ready to receive our patient. When we stopped I asked, “Do we get out here?” Braeden responded, “No, we’re being bad. We have a minor illness right up the street.” Just then, all smiles, Kimberly climbs into the cab with a pizza.

We arrive on scene. Kimberly is already at the front door by the time I hit the steps to the porch. We go inside and find a woman holding her jaw. Kimberly says, “You ready to go?” I missed the earlier conversation. The patient responds affirmatively and as we walk to the truck a male from the home says he’s coming with us.

On the truck, Kimberly pulls out the computer and begins the PCR (see previous posts for definition. I know it would be easier to just write it again, but I want you to read all of my blogs. So, scoot.) Kim sits in the tech seat, patient’s family member on the bench toward the cab, patient on the bench next to him and me on the stretcher. I was just sitting on it, not strapped to it, people. Though it is the best seat in the house. Kimberly says, “My partner is going to get a set of vital signs on you.” That’s my cue!

I have to finagle around a bit to get the blood pressure cuff as it was sliding around the bench and ended up behind the family member. I retrieve it and since I have my stethoscope with me, auscultate a blood pressure. Auscultate means to listen to through a stethoscope. I also count a pulse. Which I at first give as 92 but after a few double checks in my head correct to 96. Multiplying by 4 doesn’t seem difficult until you’re doing it while trying to keep in mind the blood pressure numbers and attempting to count respiratory rate on a bouncing ambulance. Which is impossible, by the way.

The patient called because she had a toothache. She was on antibiotics and pain medication already but was in so much pain wanted to see if she could have emergency surgery to have the tooth removed. I thought Capt was kidding when he said we went to toothaches!

Anyway, we transport the patient to the nearest acceptable POE (point of entry-hospital emergency department equipped to handle the call) and head back to the satellite. Once there, Kimberly breaks out the pizza and offers me some, as she says she never finishes her food but usually shares with Braeden. Braeden had come from a barbecue and was full. Something funny about Kimberly: she eats with gloves on. We walk into the satellite and Kim grabs two gloves from a glove box by the door. I question, “Why are you getting gloves?” Reply? “I eat with gloves on. I’m not weird.” …Oh, really?

I accept her offer of food (I was just starting to get pretty hungry, the Lord provides!) and counter with, “Since I’m going to eat Kimberly’s food, I need to eat like Kimberly.” I only ate with one glove, though. After Kim finished, she removes her gloves, “Eat with gloves on, take them off and your hands are clean. No germs.” as she slides her hands against each other and holds them up to demonstrate.

Last bit: It was during this time or before the EDP call that I asked about Braeden and said he didn’t talk much. Kimberly agrees and said, “He’s a holy roller, like you.” I laughed, “That’s the first time I’ve been called a holy roller. I kind of like it.”

My next ride along is tomorrow. I will not finish these before I go to it, there’s just no way. I have eight calls to document! Eight!

I met my crew of two once back from the first call. The woman I already knew because she was one of my class TAs (teaching assistants). The man was new to me, he didn’t speak much. They were getting dressed and readying the truck for calls.

The way an ambulance typically works is this: There is a driver and a tech on each shift. They alternate roles on different shifts. The driver checks engine fluid levels, tire pressure, etc. Anything that has to do with driving the truck and getting everyone from point A to point B is the driver’s responsibility. The tech is responsible for all things patient care. Tech checks supply levels, oxygen tanks, means of extrication on the outside of the truck, etc.

Let’s call the guy Braeden, because I really like that name, and the lady, um, Kimberly, because it makes me happy to put those two names together. Alright, Braeden was the driver this time, meaning that Kim would be the tech. Great! I knew her and she would let me touch the patients. I wasn’t sure what tall, dark and silent over there would let me do.

Kimberly walks me around the truck with her, checking oxygen masks (we needed to grab a few more adult sizes), scoop stretchers and their bags, oxygen level in the oxygen tanks (There are D sized tanks on the stretcher and in the ‘green bag’, as well as 3 back-up D tanks stored in the truck. There is also one main ‘M’ tank that supplies oxygen to the patient when they are within the patient compartment.) We also checked the cab. Kim wiped everything down with disinfectant and took my photo. She gives me instructions and hints about how each call will go, depending on if the patient is ‘sick’, meaning a life threat exists, or ‘not sick’ meaning there is no pressing life threat (although the patient can still be sick by other standards and commonly is. This is just EMT jargon.)

About the patient compartment: When you’re looking into it from the back, where the double doors are, the stretcher/bed is on the left and the bench is on the right. Straight ahead is a clear walking area and eventually the cab of the ambulance. At the head of the stretcher is where the tech sits with really ill patients. Everything an EMT needs for airway management is accessible from that seat. Suction, oxygen, oro- and nasopharyngeal airway adjuncts, and so on. A common mantra is, “If you ain’t got airway, you ain’t got nothing.” Good job patching up that patient’s profusely bleeding bullet wound, too bad he stopped breathing halfway through. As Captain Scarna sarcastically says, with a smirk and a balled fist, “Strong work!” Also on the left wall are compartments with supplies for wound management. On the right side, at the foot of and above  the bench, are supplies like sheets, splinting materials and saline. Nothing used for life-saving situations is on the right because it is far form the tech. Also from the tech seat is computer control of the patient compartment (lights, oxygen, heat and air conditioning) and hands-free communication; the tech wears a headset and the button you push to transmit while you talk has been made into a push pad the tech can engage with their right knee. How cool is that!?

On to the call. We are dispatched for an EDP (emotionally disturbed person/patient). As we head to the call, I sit in the tech seat. Other than the bed, it’s the most comfortable seat in the ambulance. I really have no idea what to expect, dispatch has not given details except that PD (police, EMS loves acronyms, it’s kind of out of control) are on scene.

We find a young adult female sitting down, as well as a young adult male and two PD. The female is our patient. Kim gets the story from PD and we walk the patient into the patient compartment. After an argument with a boyfriend, the girl threatened to hurt herself if he left. Just that statement gets you a ride to the hospital. If the report comes from a credible source, EMTs can not legally leave you alone. You must be transported to an ER and seen. Not only must you go, you will go. If PD has to get involved and restraints are used, you will be transported to the hospital. Capt like to say, “That buys a ride.” The reasoning is, if you kill yourself or attempt to without being transported, that’s on the EMT’s head.

The girl was hostile and had no idea who had called the police. The police, in turn, had called us due to her statement. Questions the patient was asked included: “Have you had thoughts of harming yourself or others? Have you made plans to end your life? Have you made plans to end someone else’s life? Do you see or hear things other people don’t see or hear?” It was so blunt to me, but we’re told not to beat around the bush because the questions have to be asked.

Because the patient was upset and not acutely ill, we did not get a set of vitals on her. We transported to an ER and filled the nurse in on what was happening.

Fun fact: Upon arrival at the ER (emergency room, if you’ve been wondering) we are supposed to transfer care to an acceptable person. Meaning, you can’t dump your patient in the waiting room and go to the next call. Get this: (in Boston) doctors DO NOT count. If you transfer care to a doctor, it’s abandonment! Who knew? The reasoning is that doctors just want to know what’s going on so they can see if they have to be there or not but don’t typically do things that the nurses do to check patients in and start a file. We usually transfer care to the charge nurse (the nurse responsible for the shift). [ A bit about the charge nurse, this person is so BA. They have a few of their own patients, but they also make sure that all the floor nurses have everything they need.  These heroes dictate the schedule, who is admitted to the floor, as well as the complexity level of patients (how sick they are). They are the supervisor/management for the shift. What a huge responsibility. Thank a charge nurse!

After we transferred care, Kimberly finished up the PCR (patient care report), we cleared out of the hospital and indicated that we were ready for another call. On the way out of the ER, I was wearing a high visibility vest, another of my TAs was working and he said, “You look a little too much like an EMT right now? You look official.” Little did I know, that was code for, “You’re only supposed to wear your high viz vest at motor vehicle collisions.” Kimberly explained that once we got into the truck. Needless to say, I took it off.

Friday night I went on my very first ride-along. I will attempt to record each call individually before losing my steam. That being said, here is call one:

The satellite was not very close to a T (subway) station. A classmate and I were driven to our satellites by our dear Captain Scarna. I know photos are expected, but I am keeping all of my EMT photos to myself. Mwahaha. If you want to see them, find me in person. The shifts began at 11pm, Captain asked us to meet him at headquarters at 10pm. Naturally, we were there by 920pm. My classmate and I try our best to overachieve.

The ride there was full of laughs and a bit of information about the radio dispatches and what to expect. Captain dropped me at my satellite about 1030pm. I was alone. Not creepy at all. I was very thankful for the key-card access door. I waited about 10 minutes and when I was in the bathroom, a crew came in. It was the previous shift, coming to stage (wait at the satellite location until another call) before shift change. We watched TV for a few minutes, and then a call came in. The crew was not excited. However, another ambulance took the call and thanks were exchanged over the airwaves. Unfortunately, another call came in for our district not 2 minutes later. There was no one else close enough to take this call for us. Though this was not the crew I was assigned to, they took me with them.

We went to a 911 call for vomiting. On the way to calls I sat in the Tech seat within the patient compartment. This is the seat at the head of the stretcher where the EMT can access both the patient’s airway and any needs for maintaining that airway. You ride backwards in that seat. It was fun to be in the back and watch the traffic pattern. (A big THANK YOU to all the drivers who pull to the right to allow an emergency vehicle to pass. It’s not only the law, it saves countless minutes in the travel to an emergency and to a hospital. Please heed these vehicles.)

We arrived on scene and I put on gloves. We are taught to glove up on the way to the response, but I always sat and buckled in before realizing that I needed gloves. I couldn’t reach the gloves without removing my seat belt. That is a NO NO in the back of a bouncing truck speeding with metal around you. Also, the EMTs would have seen me and I’m sure be none too pleased.

We arrive on scene to find a patient complaining of general malaise and nausea but no vomiting. Now, Boston EMS runs a 911-only system. That means that they only take 911 calls and are not contracted for patient transport between facilities. This turned out to be one of those calls. The patient had been refused access to a facility and instead of arranging for the patient’s transport, the facility called it in as a 911 emergency. Cue sigh.

Upon transport to the nearest emergency department, care was transferred and arrangements begun to move the patient somewhere else. Because there was no medical emergency, the patient could not be admitted to the emergency department. The call took about 35 minutes total. We returned to the satellite around 11:30pm.

I was very calm throughout the response. Our instructor coordinator, Captain Scarna, has drilled into us, “It’s not your emergency.” Not only that, but I was riding third. Meaning that there were two fully trained EMTs on the call and I was not necessary, hence my badge reading ‘Observer.’

Once we entered the satellite, I found ‘my crew’ getting ready for their overnight shift…

Tonight is the night! Yes, this evening I get to do something new! Something exciting! Something that could change lives for the better.

Red white and blue light crew

is it me? is it you?
who is on the light life crew?
what do you see? what do you do?
when you’re on the life light crew?
isn’t there so much to do
so many things to process through
I wonder what it holds for you
when you’re on the light life crew
they’re not the proud
maybe not the few
but, really, do you know what they do
I mean, they are the life light crew
the ones you call when in arrest
and holding them close to your chest
that doors and windows will come through
who else but the light life crew
do you know who would try for you?
or better yet, stave off die for you?
so many things the team goes though
what team, oh yes, the life light crew
assess and manage is the call
to try and save not one but all
and to decide just what to do
after finding just a clue or two
tonight, the crew will be one more
as I will step off from the shore
and hope to help add one to two
this night, I aid the light life crew

And I am so PUMPED!!! It’s an overnight shift, so I stayed in bed extra late, I’m talking noon, here, which was pretty uncomfortable. I am packing snack-ums for the shift, but eating meals right before and after with Casey.

Captain Scarna (so glad he’s back from Italy, that was such a long, long week and a half) will meet us at Boston EMS Headquarters and drive us to our satellites at 10pm. Our shifts start at 11pm and go to 7am.

I have my stethoscope, my pants, my shirt, my snow boots (because they are waterproof and can be bleach soaked afterwards). I am taking flashcards, both with diagnoses on them, as well as blank ones to take notes on the calls.

I apologize for the awful grammar within my rhyming entry, but I will not edit it now: I have a ride-along to get ready for!

On my to-do list:
Shower
Spend time with Jesus
Prepare with a little studying
Pray some more
Pack my (food) bag and kit
Empty my wallet of all non-essentials
Prepare mentally
Not being so excited I miss steps

Hi! My name is Boston Found. (pause) I am prone to over-preparing.

I like being prepared. Whether that means buying groceries not on my list, getting the lowdown on a professor before the semester begins, or double-checking the water level in my humidifier, I like being prepared.

Don’t get me wrong, I’m not sorry about this, by any stretch of the imagination, but I am aware that others are not used to this.

The good news is, I’m beginning EMT-Basic training in less than 2 weeks! (13 days. I’m so ready.) But I know that being ready excitement wise is not the same as actually being prepared. So…I checked out a copy of an EMT-B textbook from my nearest (not really, 45 minute commute away) library. I don’t know if it is the textbook we will use, they will give us our books on the first day of class, but the material should be nearly identical. How much can change about how to bandage a protruding object or childbirth protocols? I checked it out yesterday and last night I read the first chapter…and made flashcards. Tonight, on to the beginning of chapter 2, flashcards to come.

And really, I am so excited. I never imagined myself in an ambulance. I can’t even think about what the daily life looks like. Wow. But hey, what do I know? God knows my abilities because He created me. He’s always right. No matter the call, no matter the patient, God is always righteous. May His mercy grace us all. (You see what I did there? You like how I did that? ‘Cause grace and mercy are different…You see it.)

To-Do

  1. I need to study for my Physics test on Monday.
  2. I need to to laundry.
  3. I need to do my Physics Homework.
  4. I should probably, sometime this year, get around to cleaning my room.
  5. I need to do more quiet time.
  6. I gotta get a money order.
  7. Need to make some dinner.
  8. Need to clean the sink in the bathroom.
  9. Gotta take the trash, too.
  10. Should do my LON-CAPA Pre-Lab.
  11. It’d be a good idea to call my mom.
  12. Need to check myself, cause I’m losing it.
  13. Gotta potty. 😛

Yo yo yo!
I have lots to tell all of you. So, I’m going to do a very brief synopsis of it all.

Prayer: My prayer life has not been my shining glory lately. It’s been pretty good, don’t get me wrong, but I feel like I didn’t pray for some things that God definitely could have used to build my testimony and show me his great power. My devotional time has been a hard fight, and I have yet to back down-nor will I ever.

Visions and such: So, some of you may know that I have seen angels before. And of those few, few others know that I continue to see one angel in particular. Well, I’ve seen him again, and this time I think I know his name.
Also, had a dream last night, a really, really scary dream. The gist of it was: There were demons trying to kill my soul, and get me to let this use my body to do their dirty work. It wasn’t until after I thought about it this morning when I woke up that I realized it. So, guess who’s now really on guard. Thank God for His merciful updates.

Schoolin’: I worked ~ 25 hours a week at Krispy Kreme while taking 2 classes and moving…twice. Anywho, I was taking a First Aid class, and Trigonometry. I worked hard in my classes and at my job. God rewarded me with TWO A’s! (Oh, I can’t seem to locate my First Aid certification card, please pray that I find it.)
And in the coming Fall: I will be taking a 3rd Spanish course, Organic Chemistry, Genetics, a class for my child sciences minor, and, again, Biology II Lab-Animal Diversity. Please pray for me brothers and sisters, that I can be excellent in everything for our King.

Recap: Well, that was pretty much it. I can’t wait to see all of you again. I’ll be coming down the 20th or 21st, so can I get some ground control for safe traveling please?

I am so much better at asking for prayer nowadays. Praise God people!

Psalm 40.

love you all.

lex

  1. Not much has happened today.
  2. Spanish class was skipped because of oral exams and I did mine Monday.
  3. Got up and ate what I thought would be breakfast but Suwanee defined as lunch.
  4. Went to chemistry.
  5. Hung out, studied, ate, studied, talked to Reece and Ross, studied in the SAC office.
  6. Took my Lab Practical Final.
  7. Came to my room.
  8. About to go to a review session for my Chemistry final ~6:30-9:30…Wahoo! Then gonna come home and hopefully sleep.
  9. Well…gotta go get my chemistry on.
  10. I love you all!