Hi.  I think the reason I haven’t really updated is because I don’t really consider myself a new EMT anymore.  I’ve had a pretty good deal of experience.  Granted, it’s only been a year, but I have done a lot working for two agencies and volunteering at one.  I’m slowly working my way out of the commercial agency, namely because it’s soulless and generally a horrible place to work.  The municipal agency is great, aside from a shitty night last night.  Cardiac arrests are never easy, but even less so when the patient goes from fine to unresponsive in 2 minutes.  Even less than that when they go from a shockable rhythym known as ventricular tachycardia to an unshockable rythym known as asystole in 4 seconds.  It was debilitating to not be able to do anything.  CPR was done, BVM was used… but it was to no avail.  It was not a good day.

1- Do not invite drama into your personal life. Ever.

2- Never chase. Courtships are mutual. Chasing is one-sided.

3- You cannot force relationships to work. You can NOT force relationships to work.

4- No second chances. Decisions to end relationships should be final.

5- Loving someone doesn’t guarantee or mean you must be with them.

6- Money and babies do not save (or start) relationships.

7- Friend zone is a black hole from which is it is nearly impossible to escape.

8- Don’t be afraid to try; don’t be afraid to move on.

9- People don’t typically change, even if they claim they have.

10- You cannot argue your way to happiness.

11- Keep it out of the family. The family being work, friends’ sisters, etc.

12- Twelve dates and it’s gone nowhere? END IT.

Anyways, that was a fun little side note. Essentially, I’m breaking rules 1 and 11. You can make an exception for one rule, but not to the #1 rule. Also, if you violate 2 or more rules, run away. Realistically, this is probably an awful idea, but meh. Moving on!

Let’s go through a “normal” call.  ”Ambulance 0 on the air for an emergency” goes over the PA.  You have a grand total of 2 minutes to get from wherever you were to your ambulance, and be ready for the call information.  You get in, put on  your jacket and sunglasses, tell dispatch you’re ready for info and hold your breath.  You get your response code.  Priority 1 is lights and siren, that’s when you “go hot.”    You get called priority 1 to a chest pain call.  Off you go then, zooming through traffic and cursing at the bad drivers.  You get on scene.  Your patient is on the second floor, laying in a bed in a back bedroom.  You have to note EVERYTHING.  Situational awareness is key.  How wide are the doorways, what’s in your way, what’s the best route to get the patient out?  Can’t answer that?  Get a new job.  Great, your patient is in terrible shape and you need to go – 5 minutes ago.  You have to get them from wherever they are to where you want them to be.  Sounds easy, right?  Wrong.  How do you do it?  Backboard?  Stair chair?  Yeah, think of these things.  Ok now you’re in the ambulance and it’s deemed a priority 1 transport.  Off you go again, wee-woo wee-woo.  Now, as the driver, you have a shitfuckton of responsiblity.  You are not only responsible for the safety of your ambulance, but the crew working in the back, and your patient.  Who would EVER want to drive?!  Ok you’re at the ER.  Did you call ahead with a radio report to them?  You better hope so, or you’re gonna have a pissed off MD’s loafer so far up your ass.  Great, you’re in the ER!  All done!  Wait, no, not yet.  Give a full report.  Go through all of your acronyms (SAMPLE, OPQRRRSTI) and then tell them everything you saw or did.  Seriously.  Now, put it all into a paper report for your supervisors to scrutinize and look down their noses at.  

Ok, so that was one call.  Yay!  You’re like the best EMT ever now!  But, say it was a bad call.  Going back to the original thought, a bad day is one that you walk out of feeling crushed.  Today, for example.  You and your 3 coworkers charge up the stairs.  Your faces are masks of courage, you have ice in your veins, and you are ready to go to work.  You work quickly, efficiently, coldly.  Still… she ends up being number 4.  There is nothing to say.  You sweated like you were stoking the furnaces of hell, you might have felt bad breaking ribs doing CPR, but she did not feel it.  She won’t feel anything, ever again.

I was going to write a massive post about how I hate commercial, for-profit ambulance services.  I really want to fume, and scream, and get angry over it.  The more I think about it, the more futile it seems.  They are a business.  They are a big, big, big business.  And, unfortunately, they are a necessary evil.  Sure, some might have a wheelchair service, or a stretcher van, but 99% of the time, they use a good old BLS ambulance.  It sucks, but it’s a fact of working as an entry-level commercial EMT.  Just typing that made me cringe.  I have nothing against businesses making money, but I hate having to be the one making it for them.  Now for the good:  Being a slave to commercial EMS, while soul-sucking and faith-in-humanity destroying isn’t hopeless.  It gives a new EMT a chance to acclimatize to the world of emergency services.  It gives the new EMT a chance to practice what they learned in class.  Essentially, it’s one big learning experience.  I believe that learning never stops, but I consider myself a good EMT.  For better or worse, I owe that to the place that I hate.  Huh.

After donning and doffing for an hour, we took a water break.  After a water break, we did some obstacles.  Putting on 60 lbs of gear then crawling through an 18″ wide tube is certainly an experience.

I have a friend, who has been like a big brother to me.  When I first got involved with emergency medicine, as an Explorer, he was a major influence.  In fact, although he is 4 hours away, he still is.  He’s the kind of friend who I can call any second of any day.  We’ll either talk for an hour or a second, and can gauge what’s going on with each other by that second.  ”Len, can’t talk” generally means he’s in the middle of a full arrest in his ER.  We both have dropped off of the face of the earth for weeks at a time, only to call the other and catch up for an hour.  People thought we were related, when he was in this area.  We look and act alike.  When we were conversing the other night, he was talking about his business.  I offered to help.  Being a nerd, I tend to be good at this whole internet thing.  (Lol, yeah, right Len…)  I offered to help him with the website and Facebook of his company.   So, here are the links.  Be a darling and click that big thumbs-up, won’t you?  I’ll even throw in a laugh or two.

http://www.facebook.com/pages/Tac-Med-LLC/287131411297863

I’m sure there’s a way to make that pretty, but um… yeah.  Not happening.  Also, the page owner you see there is not me.  I’m entirely too clever to let that slip happen.

That’s about it for now.  I’m relaxing with a Blue Moon Harvest Pumpkin ale and Tron: Legacy.  This is a pretty great time.

“<Len’s ambulance number> on the air for an Echo”

Oops.  Welp, off we go.  Wait a sec, where is the new girl?  Page her… nothing.  Call her… no answer.  Nextel my Supervisor and say if she isn’t in the rig in 30 seconds, I’m leaving.  Oh!  Here she comes, sauntering out like it’s a lovely time for a walk.  Granted it was a lovely day, but we have an arrest.  Blah blah blah, lights and siren, andddd we’re on scene.  Fire dept. is there doing their thing, namely CPR and shocks.  Ok let’s load ‘em up.   My partner and my trainee just sorta stand there.  Yes, that person is in full arrest.   Yes, we need to get them into the ambulance.  Yes, that’s actually what you’re paid to do.  Blah blah blah again, patient is loaded and we’re en route.  Useless partner drove, and possibly hit every single bump in the city.  12-lead was nigh impossible to maintain, but of course it was some lovely PEA.  Fuckin’ A.  Drugs, drugs, drugs, compressions, shocks, breathing for patient, answering your phone in the back of the rig…  wait.  Myself and the medic kinda had a moment.  Look up, look at trainee, look at each other, back to trainee, simultaneous, “HANG UP THE FUCKING PHONE.”

Anddd we’re at the ED.   Into Trauma 1 or 2 or A or B or wherever it was!  Not looking good.  Sigh.  Paperwork time.  <30 minutes of paperwork and fighting with my laptop later> “Oh hey newgirl, I didn’t mean to yell but really… you were late getting to the rig and answered your phone in the back.  Don’t ever do that again.”  She apologized up and down, and I didn’t let it get any farther than myself.  My useless partner was too oblivious to realize.   Dear Lord was that really only our first 4 hours?