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.

Monday, November 12, 2007

A Fun Weekend

This past weekend was a lot of fun; a lot of laughter, a bit of pain, and a lot of experience gained. We covered a massive martial arts tournament, which is a totally different world, seriously. I had never been to anything like it before, it was amazing what these guys did to each other on the mat, and even more amazing that they'd hug, shake hands and chat when they finished.

I was partnered with John and Roy on Saturday, it was one of the best duties I've been on in a few months now. We had very few patients, as the kids were fighting, and they don't usually make enough contact to really hurt each other. There were mostly just skill demonstrations against invisible opponents. The weight room just off the main gym was our first aid post, and I got the bright idea to try out all the machines. Of course, they're all huge, scary, completely foreign looking things, so the guys taught me how to use them all. I'm not as strong as I thought, but I'm stronger then John and Roy thought, so that at least is a nice feeling. I found out I can lift over twice my weight with my legs, but can barely bench-press a pillow. I won't even mention how weak my triceps are.....

After trying out all the machines, I decided that I wanted to learn how to punch 'properly', and as John was on the boxing team in college, I got him to show me how. I went at the punching bag for a while, all three of us were laughing as much as we were fighting, it was hilarious. One of the men in charge is on that 'Ultimate Fighting Champion' show, apparently he was watching me punch and laughing his butt off. Ah well, I figure a guy like that has every right to laugh at my fighting skills - he could probably kill me with his pinky! I really enjoyed learning how to punch and fight, it was quite entertaining and we had a lot of fun. We were interrupted when a woman stuck her head through the door and hollered for us, so John and I ran off to treat a little boy who had gotten hit in the ribs a little too hard. Sweet kid, he was ok, just a little winded. Those kids are awfully tough, they knocked each other around pretty good!

Sunday was a lot busier, we were run off our feet with a steady stream of patients. Anthony and NDP joined John, Roy and I, which was definitely a good thing! Anthony and I ended up working together, we treated probably around 20 patients throughout the day. The injuries were all identical - it was really weird. Different person, different tattoos, and different body part, but they were all the exact same injury, something was always torn, banged or bruised. The men would limp through the door and ask for ice, I came very close to responding, "Let me guess, somebody beat you up, right?". Some of them were really nice, realizing it was part of the game, while others were serious pricks about it, swearing and angry that they were out of the competition, barely sitting still long enough for me to assess them and throw on some ice.

I'm not even sure why this event was so much fun, the same partners and same routine as usual, with no memorable calls. The organizers treated us like royalty though. Their insurance policy says they can't run the event without us, so since we are volunteers, they bend over backwards and give us anything we ask for and more to ensure we come back with a good team next year. We asked for sandwiches at lunchtime, they returned with fruit, water, pop, chocolate bars and sandwiches. The UFC fighter kept coming over to chat, and his Dad brought us all event t-shirts. The weight room kept us entertained, and we had front-row seats to watch the bloodbath if we so desired. It is really nice to be appreciated and it was a very good weekend, even if my knuckles are killing me and every muscle in my upper body is still aching. Haha, I guess I should lift weights and punch things more often, I obviously need the practice!

Tuesday, November 6, 2007

Another view of old

It is day 3 of a 4-day festival, and though fun, it is beginning to take a toll on me. I am used to my 8 hours of sleep, so working for 6 hours, then volunteering for 10 on only 4 hours of sleep is rather exhausting. I wouldn't trade it though, and I know none of my partners would either. We’re having too much fun, playing cards, watching movies, eating yummy but oh-so-unhealthy festival food, and oh yeah, treating patients. A lot of patients actually, it has been a very busy weekend.

John, NDP and I are tooling around in the golf cart - it even has lights and a siren, although I must admit that the siren is rather dinky, it sounds more like a bike horn. Nevertheless, it is a very cool cart, we can scream around the park rather quickly if needed, with a stretcher on the back to transport patients to the waiting ambulance or just back to our post. John is talking with his former preceptor at the edge of the park; we're just wasting time, since we have a lot of it. Sitting on the back of the cart, I look over the crowd, milling about in the summer sun. I love knowing that I am here to help these people; it is a really cool feeling to be the one that people call for help. I hear Roy call us over the radio, but neither of the guys hear him, so I answer. "There is a woman bleeding by the washrooms on the East side of the vendor area." He responds. "We're on our way,” I answer back as I shout to the guys that we have a call. They saunter over and I tell them what's up, not that I can give them any details. Flicking on the lights, we cut through the crowd to the other side of the park.

There is a small crowd there; I pull on my gloves as I hop off the cart and head towards them. The woman in the centre is very old, but stands straight and tall as the blood drips down her leg. Her daughter, who is also quite old, hovers around nervously, much more concerned then her injured mother is. As I have her sit on a chair borrowed from the nearest tent, I ask her what happened. "I was looking at the beautiful roses, see, and I wanted to get close enough to smell them. You can't go through life without smelling the roses you know; I just failed to realize they were quite so thorny. It really isn't that bad, not worth all this trouble, but I can't seem to stop the bleeding." She speaks very properly, almost regally. I wipe the blood from her leg and hold pressure on the deepest wound, but she firmly declines my offer to wrap it. "I'm 86 years old and this is nothing, dearie." I suggest she see a doctor if she has any more trouble getting bleeding to stop, which she also firmly dismisses, "Look at all of these, " she says, pointing to numerous scars, "I never saw a doctor for any of these - look at that one - this is nothing compared to that one." She is incredibly wrinkled, but there is a healthy confidence about her, I get a sense that she has lived a very good life.

As she waves her hands around, I notice the rings. Oh wow, look at all the jewels. Massive diamonds glitter on her fingers while gold bracelets studded with gems circle her withered wrists. A gold chain hangs about her neck, diamond earring stud her ears. They are all very real and she wears them well, there is no gaudiness to her attire. She is full of spunk, laughing and joking about the fact that my male partners are not treating her, she expresses her disappointment clearly. She speaks of her love for roses, how she simply cannot resist them, even with all their thorns.

I hold pressure for a few more minutes as John fills out the paperwork, then with our release, she walks off on the arm of her daughter, her head held high and her back straight. John and I discuss her several times over the course of the day, something about her made an impact on both of us. Her manner of speaking, her attitude, her appearance, her daughter's obvious love and careful attention. She is an incredible woman, we only hope to be half as spry when we reach 86.