Thursday, November 26, 2009

Shift 2: In Which Red Actually Does Stuff

1900: Arrival, sent to rural base 2

1925: En route code 4 to chest pain/SOB. Tearing down back country roads in the fog and rain with lights and sirens blaring is fun - not knowing where we are going makes it feel faster than reality. Assisted with 02, vitals, cardiac monitor and stretcher lifting. ACP partner did 12-lead ECG, gave nitro and put in an IV. I can't watch needle sticks on TV, but in real life I find it fascinating. Monitor shows 3rd degree heart block.

2100: City base 2

2115: Code 4 to SOB/severe headache. Pt. felt a headache come on 'like a sledgehammer' and then started to experience chest pain. No physical evidence of a stroke/TIA, although he has a past history. Monitor, nitro, 02, IV. Monitor shows Atrial Fibrillation with a very irregular beat and 2nd degree heart block. Very sweet, 'pleasantly confused' old European man who tells me the same stories multiple times, calls me beautiful and kisses my hand when we part.

2300: City base 2

2330: Code 4 abdo pain. Moronic drivers stop in the middle of the road and try to race us through a light. I learn many creative sentance-enhancers from my preceptor, who is driving. Code 3, CTAS 3 on the return, walked pt into the waiting room. Possibly cancer-related.

0040: Code 4 overdose. Teenager takes a bottle of Tylenol 3 leftover from a family member's surgery. Worried parents hover as we assess their drowsy and lethargic daughter. She vomits - straight up, and I find myself impressed by that as I step out of the way, hauling the 02 bag with me. She is much more alert now. My ACP preceptor calls me his partner as he steps out of the room to allow me to change her shirt, that makes me smile - internally. Assessing further in the truck, her BP is almost unpalpable and he starts 2 large-bore IVs to push fluid in. He considers Narcan but doesn't want to make her vomit more since she is in no immediate danger. BP has risen to almost normal levels upon arrival at the hospital. Once transferred to the hospital bed, her father asks me about her enlarged lips. I realize they have swollen up since we first saw her, and her eyes are starting to puff. Pointing this out to my preceptor, he informs the nurse of a possibly codeine allergy. After cleaning the stretcher thoroughly, we once again head off into the night.

200: Main city base

430: City base 2 - the guys get the recliners, I sleep in the back of the truck. Ahh, the life of a lowly student.

646: I wake up as the truck starts to move, we're headed back to the main base to clock out.

700: Another positive evaluation in my book and I'm off, sad that rideouts are over but thrilled about the experience.


Capt. Schmoe said...

I read your last two posts with a smile on my face. Things usually slow down when there is a student on board, especially when the student is only there for a few shifts. I am glad this one worked out for you though.

Good luck.

Red said...

Thanks, Capt. Schmoe!

I hope I'll get calls eventually...