SO. I know this blog is supposed to be all about Remus, which it is, mostly, but I think I’m going to expand topics. A.) Because as cute and goofy as Remus is, I’d much rather be playing with him than writing about him and B.) Because other aspects of my life make more interesting and varied reflections, i.e., the fact that I run around on an ambulance all night. Also, on the more traumatic calls, writing about them helps me “deal”.
Very tentatively then, I would like to include some Paramedic-ish-ness stuff on here. I will, of course, not use any names or locations or even dates on any call stories I reiterate, and I’ll also try very hard to leave out any pt descriptors. Why do I feel compelled to write all this down? Well, because it’s what I do and it seems shockingly misunderstood at times.
To begin. I live in a rural county. The EMS system is on a 24 hour shift basis, the Paramedics ride around in “Quick Response Vehicles” (QRVs) which are SUV’s with lights and sirens, and meet the first responder EMT Basics on the ambulance on scene. In the rare case that the person actually needs a medic, the paramedic rides in the ambulance and one of the basics drive the QRV to the hospital. I rode clinicals out here and several times in a 12 hour shift I had no calls, or 1 call. A “busy day” in the county I live in, is 4 calls.
I WORK in one of the busiest systems in the nation. The city we serve is very densely populated and so are the surrounding areas still in the county. We work on 12 hour shifts, because it’s too busy to work on 24. A light night shift is 4 calls, though I have had a night with only one call. It was bizarre. A busy night is 8-12 calls. A light day I don’t think ever happens, and a busy day can hit 11-14 calls depending on whether we’re working interfacility transfers. Oh yeah, transfers. There is a seperate EMS system that is supposed to handle all interfacility transfers. If we had to handle all the emergency calls AND all the transfers, the entire system would bog down and we’d have Alpha calls waiting for hours for a response.
I work nights. Why? Because the call volume is lower on BS (though we do get plenty of drunks), there are more psych calls (my favorites!) and most of the Gunshot wounds/stabbings/drunk driving accidents happen at night- at least in my limited experience. In the summer it’s also cooler, which is a plus, though it sucks in the winter.
I suppose I should explain some abbreviations and “technical terms” that I’ll use frequently.
Code Purple: When the hospital has literally run out of beds. Meaning, it’s not just the ER that’s full, the upstairs floors are all full as well which means people who are admitted through the ER are stuck in the ER until an upstairs bed is opened, which bogs down the ER. It is not uncommon for wait time in the ER to be over 6 hours and us to leave pt’s on hospital beds in the hallway in front of the charge nurse with a paramedic crew doing holding.
Holding: When Code Purple goes into crisis and in order to free up medic units (i.e. Not have us stuck in the hospital for hours waiting to move our pt to a bed and transfer care to a nurse) we move our pt’s to any available beds in the hallway and transfer care to a medic unit who then monitors vitals, etc., until a room and a nurse free up…. sometimes this seems highly ironic to me. If the hospital is full to bursting, why is it so important that we get “units back in the field!” as quickly as possible just to bring in more pts for whom we have no room?
SOB: not a very nasty person. It stands for Shortness of Breath.
MVC: Motor vehicle collision. (There is no such thing as an accident!…according to EMS charts that is…)
CAO x3: Conscious, alert, and oriented to person, place, and time. (I actually never use this abbreviation in my charts for legal issues, but this isn’t charts)
Cold call: No lights and sirens
Hot call: Lights and sirens.
EKG: A type of monitoring of the elctrical activity in the heart. You know, like on all the medical shows. It indicats heart beats in spikey lines and has a really annoying beep. Technically it should be ECG but apparently that’s harder to pronounce that way so people say K instead of C. Either that or it was originally designed by Germans. I’m not sure, someone else look it up.
12 lead: a much more indepth picture of the electrical activity in your heart. The standard EKG monitors in 3 leads, the 12 lead shows, well, 12- and views the inferior, septal, anterior, and lateral portions of the heart. This is where we can diagnose…anything that needs diagnosing. The EKG is pretty worthless on leads II, III, and aVF (take my word for it if you have no idea what I’m talking about) for any diagnostics except rhythm changes.
15 lead: move 3 electrodes around to view the R ventricle and posterior portions of the heart.
STEMI: ST segment elevation myocardial infarction….i.e. heart attack. I think I’ll explain any other cardiac terms in context with the story.
Pads: refer to the cardiac pads, large sticky gel pads wired to the monitor. Used for defibrillation (I’m clear, you’re clear, we’re all clear? Shock!), pacing (like a pacemaker, just on the outside), and cardioversion (heart is in hysterics, we’ve got to “slap” aka “shock” it across the face. BUT it can’t just be at any ol’ time-otherwise we’d just defibrillate-because if it happens at a certain time in the heart’s electrical conduction we could kill the pt. So the monitor “syncs” with the heart first, and THEN slaps it out of the hysterics,)
“Working a Code”: means doing CPR and pushing appropriate drugs in a cardiac arrest. We don’t always work codes. Yes, I have called time of death on scene.
I think that’s enough for tonight. I’ve got plenty of stories back logged and I’m headed to work again tomorrow night so I should never run out of inspiration, (though I’ve got to figure out a way not to give out any pt indicators.) Plus, I will continue to include Remus stories. He’s a part of what keeps me not just sane, but happy. Hopefully this way I won’t bore people in every day conversations by constantly bringing up Remus OR EMS. If you get bored reading, you can always stop and I won’t ever know 🙂