December 31, 2006 Patience Grasshopper!

My first 14-hour night shift, 2 hours away on the day before new years! Geez LOL. I got only a couple 20 min naps the whole night and then got back to Edmonton just in time to head to church. By the time I got home, I had just a couple hours to recoup before heading out for the evening events!

Ok the Lloydminster ride along...I think I learned stuff that is more general then anything. It would seem as though me riding along equates to good shift activity. Lloyd Ambulance averages about 200 calls per month (roughly 6 calls a day). I was scheduled to ride with two very nice EMTs...one who's been with Lloyd for about 15 years and the other (we'll call her Neesie). She's been with Lloyd 2 or 3 years...in EMS for about 4 years. To add to the 'small world' thing, I've actually seen her online at another Paramedic discussion website EMTCity

Those of you in EMS in AB will already know most of this stuff...but for those outside or new here's what makes Lloydminster unique to itself and a really interesting place to go is that they are in a border city between Alberta and Saskatchewan...technically the base is on the Sask side. Sask EMTs are given special restricted license to work in Alberta for Lloydminster only. Scope between Saskatchewan and Alberta is of course different, and is further influenced by the service's protocols and medical direction.

A few examples of Sask scope differences:
EMTs in Sask cannot do IVs, but EMTs in Sask can administer Nitro. Oh and no Entonox (not sure if this was a Sask thing or just a service thing).

I imagine that Lloyd staff generally are much more aware of the politics in EMS both locally (ACoP and SCOP) as well as nationally then most other services we will likely encounter on our practicums. How could they not?

This base is in a residential neighbourhood, privately owned. The owners own the property and buildings...the service staff have access to the garage and basement of the house. No one really knows what's in the upper level LOL. It's a quick jaunt to the hospital. In contrast Camrose EMS is city owned and in a matching structure right next to the hospital (and heli-pad).

So I was there for the shift for 1745h. I had assumed that this night shift would be like those of other services that I know...14 hours. And for the first 2 hrs we were able to just sit back and watch a little TV and shoot the poop. I was definitely more at ease this time then in Camrose. I came with cookies here too! If they don't get compensated for having me tag along it's the least I can do.

It was Neesie's shift to attend, leaving her partner to drive.

Call #1
Toned out at 1950h to 14 y/o female chief complaint 'chest tightness, SOB'. The call was to one of the furthest points of the service area so it took about 20 min to arrive. Mom met us at the door and was very distraught and panicked. Patient was in a sitting room lying on the couch looking nervous and pale. Patient had complained of abdominal pain (RLQ) and mom had given extra strength Tylenol x2. Within 15 min patient began to feel SOB, chest tightness, became very panicky, difficulty speaking, dry mouth. Resps were good although a little rapid. Pulse was rapid but good. BGL good. Since mom had called us in, patient condition had improved noticeably although signs of panic were still prevalent. It took a few minutes for the parents and patient to decide if they wanted to transport themselves or have us take her . Dad was more concerned about the bill. Patient and Mom decided to let us take her and so we did. Transport was uneventful, although patient remained tachy at 120.

Neesie (after completing her assessment) offered me a chance to get involved including questioning the patient. Of course I had nothing, and I felt she'd done a thorough job already. One question that I hadn't heard yet, and was curious about...was regarding the patient's last period. 14 y/o abdo pain...first thing that comes to my mind is just bad cramps LOL. I figured the absence of the question on scene was probably because of the parental presence. On car...mom was in the front with the driver so it would have been a better opportunity.

From my perspective the most important detail... this patient gets the honour of being the first patient that I was able to get a BP for on car! Small victories (146/90).

After we'd transferred the patient to the hospital, were back in service and hanging out at base Neesie gave me a chance to debrief asking what I'd thought about the call. She confirmed my thoughts about the parental presence and questioning the patient about her period. Then admitted that it didn't seem like an appropriate question under the circumstances after talking more with the girl on transport.

Call #2
Toned out at 2155h to rendezvous with parents driving back to Lloyd on the highway with their 20 month old male 'postictal'. We took mom and patient while dad followed. patient had a cold x4 days with slight fever. Transport was uneventful. Later on we had a chance to follow up with the Dr and the diagnosis was a febrile seizure. We were back at base and in service at 2230h.

Finally after an hour or so watching the tube, and further chit chat with the crew we shut things down in hopes of getting some sleep. Everyone was out like the dickens except for me the night owl LOL. And like the good little student I had my textbook with me in hopes of reading. Sure enough that's what it took to get me to sleep...

Call #3
Toned out at 0145 just 20 min after I'd finally dozed off. 87 y/o male chief complaint 'lower GI bleed' (lucky us, no odour!). patient lives at an 'assisted living residence' in town so it was a quick jaunt. On arrival we learned that the patient had blood in stool x2 times and he was extremely pale (as Cory K likes to say, "this pt is sick sick sick"). SpO2 @ room 75...on NRB @ 10 lpm 97. We quickly prepared patient for transport. The staff member at the residence was helpful. patient was a very sweet man whose primary concern was inconveniencing us. The nurse let the other EMT do an IV at the hospital which he did very easily. It was during this we learned the patient was stationed in France during the war = Cool stories. We were back at base an in service again by 0245h.

We didn't have any other calls for the rest of shift. Sat around again, TV...talking...studying...dozed a couple times while everyone slept. And then eventually it was time to head back home.

This was equally a positive experience. It was cool to compare to Camrose and I felt less intimidated with other EMTs. I also feel more aware about the process of calls. By no means ready to do it...but the process doesn't seem so foreign. I am going to aim for more on any available weekend or day off from work that I can swing.

Oh...and of course I forgot the most important thing. I DID go with a sports bra this time and it was tons better.