December 28, 2006 Ambo-Virgin no more!

Was out at Camrose EMS yesterday for the day. All I have to say:

AWESOME!

The two guys I was with for the day rocked! One Medic who's been doing it since he was 40 and switched from farming...and another much younger dude who was actually just there filling for the regular guy who was out with pneumonia...22ish I think...full time fire fighter in Leduc, EMT on the side. Excellent pair to ride with for sure. Very much wanting to give me the absolute most for the experience!

The Medic I was with turns out to be quite the 'celebrity' out there. Of all the staff, he's the only one that's had a chance to TNK any patients ...in fact 3 different times! Even the hospital is amazed and joked about our first call yesterday and how he (the doc) had beaten the Medic to it. I totally lucked out here...best Christmas gift I could have asked for short of MVC calls.

I'll share a few of the calls with ya...the ones that I recall best and that I have the best observations from...

Call #1
We had a busy day...by their standards I suppose. Toned out at about 0830h for an ALS transport from St. Mary's Hospital to U of A Hospital. 47 y/o male chief complaint 'chest pain' x 4 days. Pain had gotten so bad that morning he finally decided to go into the hospital. Like 5 min. after arriving he collapsed. Some clot busters and a good shock and he was back...time to cart him off. Pleasant man.

Transport was uneventful. Patient was alert and oriented x4 the whole ride. Medic on board let me play a little for vitals and I enjoyed chatting with the patient. We rode hot to the city and I barely even noticed the sirens. I did however notice quickly my sympathetic nervous system kicking in LOL. Ambo-virgin I am no more! I was sitting in the back and suddenly realized my stomach was doing weird stuff... All I could think about was 'dear God don't let me get sick!' but I wasn't nauseous. It was a totally different feeling that I'd never felt before. All good. No cookies tossed. Not even close. Just me totally pumped.

This patient had brought himself to the hospital alone. He was more worried (verbally) about his boss who would be mad that he was missing work.

The upside to our transport was that we got to just head straight to the critical care unit...so no 5 hours waits LOL. I was wondering if at some point I'd see anyone I know...instructors or something...no such luck.

What did I observe/learn? Just the process of the transfer...from the hospital to the Medic and back to the receiving hospital. I got to look at all the paperwork on the drive out, and the Medic explained some of the stuff on the ECG to me...diagnosis anterior myocardial infarction. Patient's mother died of a 'heart thing' at 42 y/o. Patient was not the example of good health.

Blood pressure on car...yes challenging...combined with my nerves. Couldn't get the patient's but did sorta get the medics (the upside to long transport time = practice time!). I was introduced everywhere we went...at the hospitals, to the patients...."this is Heidi...she's in school doing her EMT and is out getting some exposure to help figure it all out...do you mind if she _____". The nurses at St. Mary's were nice! Sympathy I suppose for having to tolerate the Medic I was with (he's a bit of a jokester). Those at U of A...too busy to really tell but I'm sure they're all good (even the murses LOL).

Extra 'bedding' on car is a good thing. We had extra blankets and what not...but not all the items to totally remake everything which (while waiting briefly for the Medic to finish his PCR) would have saved us the 2 min when we got back to base. No biggie...just mental note.

Call #2
So then we got back to base and were back in service we sat in the station for maybe another 20 min before the next tone...this time apparently a regular: 67 y/o male chief complaint 'fallen and can't get up' --> obese. So we go. This call was given to the EMT to take seeing as it was BLS.

The EMT being just casual hasn't met this patient before so on the short drive to his home the Medic (driving) gave him the run down. Equally so they filled me in on what we'd need to go in, and what the situation probably was. It was a quick call. Helped the man into his wheel chair. He weighs probably about 350lbs. Talked to him to make sure nothing serious...pains, etc. This patient particularly doesn't like to be transported so just verified that he really was okay. The topic of a personal directive came up and they boys explained what it meant, and that if the patient was serious about not wanting anything done to revive him he should talk to his regular doctor about it.

This was at the patient's residence where his son, and another woman probably wife or something were.

What did I observe/learn? Just the ease with which they entered the house not worrying about much because it's a regular call. A classic example of real world versus scenario land. Oh and the EMT getting one set of vitals for his PCR...using his glove for notepaper: "handy" LOL (pun intended).

Call #3
So while we were there we got toned for another call. The EMT took lead on this call too. Another male approximately 45 y/o chief complaint 'fallen and can't get up'. Different situation though. Patient is home from surgery x 3 days (something with his left foot). Had complication/error from surgery...apparently, they gave him too much Morphine and it was documented (Not sure the implications of this perhaps someone can explain). Patient is diabetic. BGL is good. Confirmed upon our arrival. Patient had been experiencing bouts of dizziness and 'rubber legs' since surgery with little to no warning prior to collapse. Patient requested transport to St. Mary's because he was concerned that this was still happening.

Patient had collapsed in the hallway and had slightly slowed his fall but not really. Typical bungalow hallway so I was sent back to get the scoop and stretcher (I'd played with the stretcher by now) and brought the stretcher to the door, and the scoop inside. We got the patient loaded and off we went.

The patient's daughter arrived at the hospital shortly after we did.

Call #4
On arrival at St. Mary's we were also toned out for another ALS transport. Our back up crew was already at the base but because we were already at the hospital we would take the call. This latest call was urgent. Quickly we transferred patient care while also getting the newest patient.

80 y/o female chief complaint 'suspected stroke'. Obvious left sided droop. Onset 15 min prior to arrival at the hospital. Daughter was driving mother home after Christmas visit in another town. On route, patient began to feel ill, numbness in tongue, upper lip, left face. Vomited small amounts of breakfast x 3 at which point daughter decided to bring her to ER. Past medical history includes CVA more then 5 yrs ago, colon cancer; carotid embolectomy / endarterectomy <--we aren't sure about the procedure because in the 4 instances of it recorded in the paperwork, none of us could decipher the hieroglyphics but it started with 'e', ended with 'ectomy', related to the carotid artery, and was mentioned in conjunction with the previous CVA. I'm guessing at the two possible procedures based on that and what I found in my dictionary LOL. This was another hot transport to U of A..

What did I observe/learn? This was another good call! First...clot busters couldn't be given because it couldn't be determined if it was a blockage or a bleed without further exam. There is a 3-hour window for the drugs to be effective. So some math had to happen: Patient arrived at hospital approximately 15 min after onset of symptoms...arrival recorded as 1232h. Our arrival to transport was approx 1245h. Add all the time of transferring patient care from the hospital to us, as well as leaving our other patient with them, restocking/cleaning the unit and then getting on the road and heading into Edmonton. We made it to U of A with approximately 45 min to spare.

My very uneducated understanding of why there is a 3 hr window for the drug's effectiveness is (at the most basic level)...because the clot is otherwise too well formed to be broken down. Again, our arrival at U of A was expedited. This time there were three other EMS calls in line: two from Edmonton I think, or maybe just one... one from Peace River. Nothing like feeling like an arse butting in as they have to sit and wait LOL.

The last I heard, this patient was given the drugs.

The daughter was visibly distraught with the whole situation and her main concern was that her mother be kept warm as she is always so cold. She told me this as the other two were prepping the patient for transport. That was the first instance that anyone looked at me as if I belonged there. She had to get herself to U of A and so we had already left the patient and were on route back to base before she arrived. Despite stupid traffic with no idea what to do with flashing lights and sirens behind them, we still had all right time into the city.

I also learned three other general things:

First - Come February St. Mary's hospital will no longer have to transport patient's for scans as they will be set up for it themselves. This is of course good news for the community.

Second - In the new year Camrose EMS is changing up its shift style a bit to eliminate the need for 24hr on call shifts. This is good news for the staff. Also good for anyone looking for work because they're hiring.

Third - And this is only applicable for the chicks (I hope). While riding in the back I highly recommend that any girl who might be considered to have a relatively 'decent' sized chest...wear a well supported sports bra! LOL. Not that this disclosure is entirely professional...the truth is... I feel like I ran a marathon without any bra at all!

I met some of the staff there after our last call...the back up crew that was in for their core hours, the night crew coming in for their shift. Everyone was super friendly with me...asking me about lots to get to know what was happening. I was wearing my uniform pants so they right away knew that I wasn't some idiot off the street hoping for an exciting day. None of them ever went to NAIT LOL... and they all had a variety of different backgrounds. Questions I was asked often included any preferences of where I want to work in the future (at this point, I don't) and how far into the EMT program I/we are (not very).

If anyone else is looking for rides I'd totally recommend Camrose. It was a good time...and not once did I feel like I was imposing on anyone. The attitude was very much about welcoming me, and giving me as much exposure/experience/knowledge as possible without making me ever feel stupid or as if I was over stepping. I even got to help the EMT I was with learn a thing or two about digital cameras LOL. Working in the department that I do at NAIT I tend to have a lot of technology knowledge and I forget that these EMS people tend not to! So they benefited from me too...and not just from the homemade cookies I brought them to say thanks.

I did get teased about my 'newer looking' boots LOL.

The other thing I realized yesterday...as I was talking with one patient and just listening and observing the boys as they worked...yeah I have lots to learn...but I am totally going to be able to do this.

Rock on!!!

EVEN better...after getting home after 11pm last night...this following only 4 hrs sleep the night before because I was too excited...and then online debriefing with my Medic bud up in till 3am...and waking up because the phone was ringing at some obscenely early hour of 10am!!! I found out I've been scheduled for another ride Saturday night in Lloydminster!

Lloyd is BLS so it will be a very different experience I'm sure...not to mention the fact that it's a night shift. Maybe it'll be quiet (I hope not)... but I'm sure it will be equally as informative.

You know...I really wish I could somehow make it so that any weekend we don't have school...I could be getting a ride somewhere. I'm not giving up yet...