Friday, December 28, 2007

Disaster Night

We were joined by a group of new recruits last month, and Anthony (the training officer)decided to welcome them to the division by scaring the pants off them. He planned a massive disaster scenario, with them as the patients and us as the responders. It was a great idea and a lot of fun, but since only 3 of us showed up as responders, it became a lesson in how NOT to manage a disaster......


John, Shane and I pull up in the truck as we hear Anthony call over the radio, "There has been an explosion in the building, with casualties trapped. Fire has cleared the building so it is safe to enter, but EMS is unavailable due to a massive accident on the highway. Treat and evacuate all patients." Even though Shane and I know this is only a scenario, I can tell we're both excited. John just shakes his head at the two of us, I can almost hear his sighing thought, "Rookies!" We grab the stretcher and our gear and head into the building, the oh-so-familiar building where we've spent countless hours training and otherwise goofing off.

I push open the door and stop in shock - I don't recognize the place. Anthony has done an amazing job, along with his team of moulage artists. I step forward into the darkness, my flashlight beam picking up 'broken glass' covering the floor, furniture strewn about haphazardly and wires hanging from the fallen ceiling tiles. He's found disaster sound effects of some sort, ominous creaking and groaning provides a perfect backdrop for the screams and moans of the casualties. We move forward and find our first patients, an arterial bleed/spinal victim, an amputated hand and a woman in labour. After taking care of the arterial bleed, they leave me assessing the pregnant lady, and move towards the back of the building. An obviously dead woman with grey matter splattering the floor lies in their way, she is quickly moved aside, next to the fractured femur. Upstairs is a severe asthma attack and a few other minor casualties, they have their hands full.

I'm still with the woman in labour, I don't want to leave her - although there are much more serious patients to attend to. Eventually I clue in that I'm wasting time and leave her with a friend who has only minor injuries. It is complete chaos now, John and Shane have stair-chaired the asthma patient down, but since they didn't notice her puffer, she dies before they reach the door. Playing the role of the first responding paramedics, Paul chews them out for bringing him a dead patient before a critical one. They scurry back in, passing me as I quickly treat the amputated hand. Roy and Kyle show up now, still in their EMS uniforms, they both just left work. They just wander around the disaster scene though, not being very useful. Their arrival means EMS has been freed up though, so now we can evacuate more patients.

John disappears into the back room and I join Shane as we board the spinal victim. We're missing straps and he's lying in an awkward position in the dark, backboarding him is a challenge. We get him secured and bring the stretcher close, but Shane disappears around the corner. He returns very quickly, saying that Roy is coming to help lift. "No way!" I say, "We can lift him, just grab the other end, c'mon!" He looks concerned, "You sure?" I just nod and crouch at the head. We count and lift, straight up from the floor and over to the stretcher. Roy turns the corner as we begin to strap him on and jokingly says, "Lift assist for the wimps?" I scoff at him, "Pifft, we can handle it." He disappears just as the stretcher drops - freaking out our patient and both of us. I look up at Shane, "What did you do???" He sheepishly shrugs, "I guess it wasn't locked properly..." Fortunately, the guy we boarded is only slightly fazed, and not a real patient! We wheel him out to the lobby and let him loose, the poor guy has had to pee for the last hour and hasn't been able to leave.

Anthony comes over the radio again, "There is a VIP in the building, the deputy mayor. Have you located him yet?" We all look at each other and shrug, nope. We scurry around, doing another sweep of the building, looking for any patients we may have missed. Finally, one of the guys pushes open the bathroom door - revealing a pale, sweaty man who is clutching his chest. Darn it. Looks like we missed the dude having the MI! After a collective smack on the forehead, we wheel him out quickly and return to collect our last few patients. The scenario ends as the last patient is evacuated, we breathe a massive sigh of relief.


Even though it wasn't real, there were times in that hour and a half where we were flustered, overwhelmed and getting tunnel vision like crazy. We talked it out afterwards, and find a million things we did wrong. Granted, having only 3 initial responders made it close to impossible to set up a triage station and properly treat everyone, but we could've done a lot better. The newbies were impressed, anyways. We're going to do this regularly, with every group of new recruits, there will be another disaster scenario to welcome them to the division. It's something good to get practice doing, and besides, it's a ton of fun!

Monday, December 17, 2007

Amazing Story

My favourite blog authors have come up with another 'Perspectives' post, it is definitely worth reading. Start with Lawdog the police officer, then move to Ambulance Driver the paramedic and Babs the nurse. Make sure to have Kleenex handy, I still haven't stopped crying. Great writing, a touching story.

Monday, December 10, 2007

My First MFR Duty

Well, last night was my first duty as a Medical First Responder, my first duty in charge. It was a great night, with a grand total of.......zero patients. Now, it was a Celtic fiddle concert, which explains the lack of people getting hurt or sick. There really aren't that many ways to injure yourself while sitting still and listening to awesome music! It was fun though, I had a great partner, Shane. We ended up sitting outside the concert hall and talking for the entire 2nd half of the show.

It was a neat experience because my first duty ever was at the same venue, about this time last year. I was so nervous then, pacing around the house for hours beforehand, terrified that somebody was going to die and I wouldn't be able to handle it. I'm sure I drove all my housemates crazy! During the show, I was still incredibly nervous, I would jump every time an usher walked by, certain they were coming to tell us somebody was dying. Every time the radio went off, the same thing. It was a terrible night, I was so nervous that I was a complete wreck by the time I got home.

Last night was very different. In full uniform and with my new MFR epaulettes proudly fastened to my uniform sweater, I strode into the venue with confidence. I knew where everything was, I knew many of the staff members. We strolled around for a while, just getting a feel for the evening, then settled into our chairs to watch the show. The musician was amazing, I got completely wrapped up in the performance, just enjoying the music.

It was really neat to be in charge on duty, although a little scary as well. I've had such an amazing safety net for the past year, John and any of my other partners were always there to catch my mistakes, ask questions I forgot and suggest better ways of doing things. Now that is gone for the most part, I am on my own. True, I have a partner, but they are trained to my level or less. This means it is my decision, my call. I love the new responsibility, but I also fear it. I don't want to mess up, I don't want to let any of those guys down. They have a lot of faith in me, they insist I know what I am doing and can do it well. I hope I can prove them right.

Sunday, December 2, 2007

Medical First Responder

I PASSED!!!!!

I am now a medical first responder, woo! It was an intense course, although not nearly as hard as I thought it would be. This weekend was a weekend of testing, and I came through with flying colours. 93% on the written test, top of the class, I am very happy about that. Skill stations were all perfect, and the scenarios were good as well. There are things I missed and need to improve on, of course, but for now I will enjoy the new certification.

Such a stressful weekend though, my stomach still hurts. My BP hit 134/82 this morning, it it usually around 114/70. I am glad it is all over, glad to finally have the qualification. Next weekend will be my first duty on my own, I am looking forward to it. I love this!

Friday, November 30, 2007

I think we just saved his life.....!

It was yet another football game this past fall, a chilly, windy day. The team is terrible, they are losing yet again. I am partnered with Jackie today, a woman who has been doing this for many years now. She is a lot of fun and we share a lot of common views, it is a nice change to work with her. John and NDP are partners, covering the other side of the stadium, while Anthony is control, sitting up in the tower with the stadium radio.

I'm returning to the truck as quickly as I can after grabbing Jackie and I some dinner, freezing inside this jacket, simply a thin windbreaker. I round the corner and see that Jackie is gone, I instantly assume she is on a call and begin scanning the area. My radio battery had died earlier, so I have no clue what is going on. The motorcycle cop that usually drops in on the games sees me and heads over quickly. "Your partner got a call, she's up there", pointing towards the top section of the stands nearest to us. "You better hurry, I think she needs help." I thank him, drop the food in the front seat of the truck and charge for the stairs. Cops at every turn and landing are urging me on, "Hurry, hurry!" they say, frantically pointing up into the bleachers. I'm now used to cops getting excited about medical calls, but since the police population on this section of the bleachers is easily double what it should be, a little concern creeps into the back of my mind.

Sprinting up the stadium stairs, I reach the last corner and turn into the stands, scanning for the patient. I look up, way up, to the top of the stadium, and see Jackie kneeling, a prone body in front of her. Hmmmm, this actually looks serious. I take off again, ignoring the lascivious jeers of the drunk football fans. I attempt to manoeuvre my way past the police that have clustered around Jackie and the patient, but instead they physically move me forward through the ranks. I feel like a pinball, each cop I bounce into takes me by the shoulders and moves me forward, bouncing me into the next one in line. I finally reach Jackie, she is holding the patient on his side as liquid vomit dribbles from his mouth. She looks up, "Where's John?" I shrug, certain he and NDP are on their way up, and check the patient's airway. The man is cyanotic - blue-grey from the neck up. His airway clear, I turn to check breathing - or lack thereof - as John roars up behind me.

He sees the man, blue and limp, and swears. I think he hurdles over my head, he is on his knees at the patient's head before my mind can even register that he is on scene. With practiced skill and confidence, he rips open his bag and inserts an oral airway, barking at me to grab the BVM and set up the oxygen. NDP helps get it set up, and we hand it to John, who now has a nasal airway in place as well. They begin to bag the patient as I am pushed back slightly. His vitals are bad, and getting worse. His girlfriend says "he got quiet about 10 minutes ago, but I thought he was just sleeping." Duh. She also reveals that he drank a mickey of vodka before the game, and is taking some prescription pain meds. His pinpoint pupils and completely depressed respiratory drive indicate an opiate overdose, as does the history. John tells me to set up the AED, his bp has dropped yet again, and he is still not breathing on his own. It's not looking good for this guy, but for some reason I am perfectly calm. I am not freaking out over this call, I am running through everything I need to do, thinking of what I would be doing if I were running the call. I wish I were running it! Fire shows up but hangs back, asking if we need anything, then running to get a stretcher to carry him down in. I write vitals, switch O2 tanks and keep the equipment organized, anything they need or ask for, I do for them.

Overdose guy has begun to pink up, his bp is no longer in his boots, so John calls me over. He tells me to start bagging as he holds the mask to the man's face. I can't hide the grin on my face or the excitement in my eyes as I do so, this is so cool! I squeeze the bag and watch his chest rise - I am actually breathing for this man! I squeeze again - his chest rises again. Wow, this is so cool! I know I am thrilled at this because I am new and inexperienced, but I really don't care. I love getting to do all this for the first time, it's a magical experience to be breathing for him. His colour has improved even more, he now looks normal. He moves his arm - he's waking up! It is incredible, this man was getting closer and closer to dead when we got there, and now he is beginning to wake and breathe. He moves his head, fighting the tubes and the mask. He begins to get agitated and swings his arm towards me. John orders me back right away, and I reluctantly obey. The paramedics show up, the one woman takes over with an enviable presence. She assesses him, calls out orders and hooks him up to the monitor. I watch her, wanting to be her. I love this, it is exciting, it is amazing, I want to do this. I want to be her, looking confident and attractive in her uniform, running this call without ruffling a feather.

Fire returns with a cloth stretcher, and in one fluid movement, they help John and the paramedics sweep the man onto it. He is continuing to breathing on his own, and is getting rather combative. The cops close in as they begin to carry him down the bleachers, fighting and swinging his arms wildly. The stands are a mess of bags, Fire, EMS and us all have them strewn about. I pick up John's dropped cell phone, NDP's discarded jacket, 2 trauma bags and the AED. Everyone collects a bag and joins the procession, I hand off the AED to a female officer who asks if I need help. I look around, wanting something else to do, wanting to be useful. I see overdose man's girlfriend standing lost and alone, wiping tears from her eyes as she watches the sea of uniforms move out. I may not be able to do anything medically for the patient right now, but comforting people is my specialty. I introduce myself, ask her name, and with a hand on her shoulder, guide her down the stairs. I look below me, and feel enormous pride at being part of this procession. First in line are the paramedics and John with the patient, then comes fire with all the bags. Following them are a mess of police officers, then comes I, little ol' me is part of this - I love it.

Reaching the bottom of the stairs, I see that they have dropped him onto the ambulance stretcher and are fighting to restrain him. The man has gone from not breathing and almost dead to fighting like a madman in less then 10 minutes. It is an incredible transformation, I watch in awe as they load him into the back of the truck, still fighting. Several officers pile in as well, this guy is just nuts.

I drop the gear and stand in the growing darkness, awash in flashing lights. I realize something. I think we just saved his life. I run over the call in my mind - he had stopped breathing, his vitals were crashing, bp was lower then I'd ever seen it. We were on scene for at least 5 minutes before EMS got there, and in that time, we got him breathing again. That's not to say that he might've made it even if we weren't there, but I feel like our efforts saved his life. Lost in thought, I keep watching as they insert an IV and get him fully restrained. Another new thought hits me. I think I can do this. Not only that, I think I really want to do this. I kept my cool in that call, I knew exactly what I would've done if it were my call to run. I really think I want to do this - I think I can do this.

John walks up behind me and lays his hand on my shoulder. Rubbing my back, he asks if I'm ok. I grin up at him. Of course I am. That was incredible. The concern in his eyes turns to amusement and then pride when he sees I am fully composed, merely excited. He tells me I did well, and thanks me for my help. He then freaks out a little, he can't find his phone. I grin again and pull it from my shirt pocket, no worries, I've got it. I think about this call for days afterwards, it amazes me each time. I love what I get to do, I want to do more of it, I want to do it all.

Monday, November 26, 2007

Snippets from my Weekend

I looked up on our way back inside from the call, way up at the beautiful CN tower, all lit up in the night sky. It was incredible, to be on duty in downtown Toronto. It was a bit of a drive for our division to cover the event, but the organizer wanted us, which made it all the more amazing.

The cops there seem to be friendlier then cops here, which I wasn't expecting. I talked to many of them all weekend, it was a lot of fun.

Playing football with a crowd of drunk Saskatchewan fans at 2:30 in the morning while in uniform is not the best idea. It was fun though.

After having a nice conversation with the police officer beside me, I decided to take a catnap on the table. It was only about 10, but I was exhausted, the weekend was long. I can nap very easily on duty now, falling into a semi-conscious state that is surprisingly rejuvenating. I didn't even hear him come in. My partner snuck up on me and flicked my ear, jolting me awake and sending me halfway out of my chair with fright. As I collapsed back down and tried to still my rapidly beating heart, the room erupted in gales of laughter. The cop beside me didn't find it amusing though, he shot Practical-Joker Partner "the nastiest look I've ever seen!!". Haha. Serves him right.

I saw a postictal patient, my first one. After a major seizure, people go into this weird, confused, exhausted state, I didn't realize how out of it they would be though. This woman had never had a seizure before, she collapsed in her boyfriend's arms, seizing wildly in the street. By the time we got there she was done, but barely conscious. EMS showed up shortly thereafter and took her straight to the hospital. I do hope she is ok, healthy young women just don't seize like that for no reason.

I made friends with a police Sergeant Friday. He then proceeded to tease me all weekend.

I saw Don Cherry, Ron McLean, Great Big Sea and Jim Cuddy.

I get silly at 2 in the morning when I'm running on less then 4 hours of sleep and am finishing up my second 18-hour shift in 2 days. Chocolate brownie ice cream probably doesn't help matters.

I learned that drunk football fans like redheads in uniform. It was rather disturbing.

I love my partners.

Thursday, November 22, 2007

Humbled

A quick, intense summer thunderstorm sends us scattering for cover. It is nice having the trailer set up at these festivals, we can take cover from all sorts of hazards; thunderstorms, dusty winds, the sun, noisy crowds, screaming kids....We watch the rain and lightening from the shelter, glad for the brief respite from the heat. The humidity just intensifies though, it's brutal.

A festival employee tears up on a gator as the rain slows and the sun begins to peek through the clouds. "A man is bleeding over in the food tents, c'mon!!" Why is it that people freak out over blood so easily? I guess I really have learned something this summer, people freaking out just seems to make me more calm. I hop on the back of the cart as John and Roy hop in the front. We follow the frantic employee through the crowd, which parts only slightly faster then January molasses. As we pull up to the tent, I quickly hop off - right into a patch of mud. Great start. I dodge the other mud puddles and make it to the patient with only minor soakers. It is an older man sitting on his walker, a wad of paper towels being pressed to his lower leg. Blood is running down his leg into his sock, and the paper-towel holder looks up at me with relief, his eyes begging me to take over. I love that feeling, people looking to me for help.

I introduce myself and my partners and kneel in front of him to take a look. There are a few gouges on his leg, but nothing that should be causing this much bleeding. Further questions reveal that he takes Coumadin, a blood thinner. Bingo. John hands me sterile gauze and I replace the dirty, blood-soaked paper towels. Holding pressure with one hand, I attempt to wrap roller gauze around his sizable leg with the other, smearing my uniform shirt and arms with mud and blood in the process. Lovely. The man makes a snarky comment about my struggles, but I choose not to hear it, I don't really care what he said. John also sees me struggling and bends down to help, together we create a nice, neat white bandage in no time at all.

I rise and begin to take his vitals, the guys usually make me do it. I don't mind, I figure the more bp's I take, the better I'll get, especially in noisy or otherwise adverse conditions. I have trouble finding his brachial pulse, his arm is rather large and extraordinarily flabby. As I wrap the cuff around his arm, he looks up at me with a sneer, "What, have you never done this before? Figures I get stuck with the girl who can't do anything." I look him directly in the eyes and smile politely. "I have done this many times, sir, I know what I am doing." He sneers again and I grit my teeth. There is no need for his attitude, but I am a professional and I will not let him get to me. I pump up the cuff and listen closely, slowly releasing the air. I note the pressure and release the cuff the rest of the way, he starts growling even before I remove the stethoscope from my ears. "That hurt, you didn't do it right. You never have done this before, have you? Silly girl. If you were a nurse you'd be like the one who had to poke me twenty times to get the needle in. Don't know what you're doing, I can tell." I say nothing, just turn and put the cuff away. His words hurt me more then I let on, more then they should.

I take the sterile water and gauze from John and kneel at his feet once again. I gently loosen and remove his blood-soaked shoe and begin to wipe away the blood. I am humbled beyond belief, washing the dirty feet of a crusty old man who has come close to reducing me to tears. I thank God for the love He has filled my heart with, I now see this man as God does. He is lost, bitter and hurt, his heart hardened by the life he has lived. I blink back tears again, but tears for the man in front of me this time, not tears for my injured pride. I begin to replace his shoe, but I have trouble pulling the back of it over his heel, so he yanks it away angrily. "Can't do anything right, silly girl." He mutters as he jams it back onto his foot. I wipe the last traces of blood from his leg, then take his hands and clean them off as well. Looking directly into his eyes as he stands to leave, I wish him well. He grunts and limps off.

I look down at myself. My boots are covered in mud, my socks are soaked, and there is a mixture of blood and mud smeared across both forearms, as well as across the front of my white uniform shirt. Something has changed inside me though. It is hard to explain, difficult to understand. I feel a sense of peace in my heart, I feel like I can love everyone, no matter how they treat me or what they say to me. I have been humbled, and it has brought a joy that I never would have expected.