Tuesday, January 20, 2009

You're Very Welcome.

It's a rule in EMS... It's a self preservation kind of rule.

Eat when you get the opportunity. You don't know when you'll get your next chance.

So it was with that in mind that I was quickly consuming some very cold Chinese food. Chinese that I had stupidly ordered three hours prior thinking that it might be a slow night.

Hey, I was new.

Two bites into my meal the phone rang. I shoved the styrofoam takeout container aside and picked up the phone sitting a few feet away, "26's," I answered, looking longingly towards my shrimp lo mein.

I really need to look into a cooler and cold meals.

The bright and intelligent although occasionally directionally challenged dispatcher answered, "Code three run for the county at the Local Marina."

The local marina. 12 miles and four stations separated us.

"Okay we're heading out." I shoved my dinner into the dorm fridge and we made our way to the truck.

A quick phone call to a Medic who worked in the station that should have been responding to this run revealed that there was a major regatta going on at the marina. Hundreds of people were out on the water drinking and partying.

I got the distinct feeling one or both of us were going to get puked on.


The ride over was uneventful... Well, as uneventful as a Code three response through 12 miles of city traffic could be. PD was driving, I was the look out. He would roll up to an intersection, and we would both scan the roads to make sure that it was clear before proceeding. I didn't know what the nature of the call was that we were speeding across town for, in Toledo they don't give us that information. It could be a popped pimple, it could be a femur fx. As a BLS truck, dispatch was typically pretty good at not sending us to ALS runs, but the truth is, you never know.

We pulled into the park that lead to the marina. Assorted revelers were stumbling along the narrow road we were driving on. The sun was setting fast, we were losing light, and there was scant street lighting provided along the road we were on. We continued creeping along the path until we saw the flashing red lights of the BRT (Big Red Truck, typically the engine TFD sends to the scene). I jumped out of the truck and met my partner at the back doors. Our patient was nowhere to be found. TFD was there, FF's sat on the bumper of the truck. The Medics were presumably with the patient. No one knew where anyone was. It was like the hand wasn't communicating with the brain. Nothing new there, sadly.

We radio'd the County in an attempt to locate someone, anyone, who could tell us why we just put our lives and the lives of the people on the roads we drove on for 20 minutes for a patient and Medics who couldn't be found.

Before the County could give us an answer, we found them. Two TPD officers, two TFD Medics, and our patient. It was a brawl, folks. Four vs. one very unhappy (and vocal about it) boater. It's never good when it's four versus one and you can't tell who's winning.

And of course he would be my patient.

PD began to sprint over to help the LEO's and the Medics. The patient was a pretty imposing guy, towering over most of the guys trying to take him down. PD was as equally imposing. I followed him for a few feet before he yelled at me, "Epi, stay back. Stay back!"

I stopped where I was. PD had been around the block more than a few times, and I trusted him. He hadn't let me down yet, and until he did... well, I wasn't going to argue with him. I watched from twenty feet away while the now five men wrestled him into submission.

Good God.

The patient was screaming to anyone who would listen that he did not "want to go to jail or to the hospital". He was just fine, thank you very much. The fact that he was bleeding from the head and nose didn't mean much to him. Nor did the fact that according to bystanders, he had fallen face first on to a dock after tripping over some anchor line on his boat.

Now that they had him under control, I approached the group. He was my patient, after all. I thought that maybe a female might be a calming influence after having just fought with several men. Drunks can be weird like that.

"Hey there, I'm Epi with Itty Bitty Private Service EMS. Let's take care of your bloody nose there. Okay?"

Our Patient, who I'll call James, was looking tired from all the commotion. He nodded his head.

PD glared at me. "I'll take him, Epi." His voice was pretty firm, something I wasn't used to. I backed off for a moment.

But only for a moment. One of the LEO's was a bit of an instigator. "Dude, I remember the first time I had a beer. I think I handled it better than you...." It wasn't the worst thing I've ever heard someone say to a patient, especially someone behaving like an idiot. It frustrated me because it wasn't helping the situation.

I stepped back up to James and put it all out there for him. "James. You can chill the hell out and let me take care of you.... or you can continue to fight with these guys, get handcuffed to my stretcher, and still go to the ER. Your options are kind of limited at this point. Dude, you're bleeding. Let me take care of you."

For a moment we locked eyes and I thought he got what I was saying. He climbed into the back of the truck with a little bit of effort and sat down on the stretcher. It was about the time that Pseudo Dad ordered me to stand down yet again and tried to force him into a collar and board situation that he flipped out. Fantastic. Here we go again. More fighting. More yelling. I stood on the step at the back of the truck while five grown men fought with James. This time it was seconds before he found himself handcuffed to the stretcher.

Hey, I warned him...

He was restrained. Finally. I have very little tolerance for stupidity, and getting hammered and then fighting with MY PARTNER AND THE POLICE definitely qualifies as stupid. That being said... Antagonizing him isn't going to help. Particularly when he's my patient. Our patient.


"You realize that now you have to ride with us." I'm staring down the baby faced Officer who was picking a fight with our patient.

"I know." He kicked an imaginary rock, or piece of lint, or EMT. He wasn't happy about it, but rules are rules, he was going.

I climbed in back and started to talk to the patient. I'm a mother, a wife, and a woman. Sometimes having these things in your favor can help calm folks down. Sometimes it doesn't. In this case it worked miracles. James was reduced from the insane fighting drunk he was to a crying depressed drunk. At least he wasn’t throwing punches anymore. It's amazing what a stern word from a maternal figure can do.

Pseudo Dad seemed to have a problem with me handling patient care because he was worried about me. While I appreciated his concern I told him that we (myself and my patient) were both fine. I knew where he was coming from, he saw his daughters in me.

The transport to the hospital was truly uneventful. My patient had a broken heart, which is unfortunately not something I could fix. He was refusing a collar and board, which caused some problems with the receiving ER Doc. He would have problems bigger than his broken heart once he sobered up. TPD ended up arresting him a few hours later.

It took a few hours to get our patient off of the stretcher thanks to the handcuff situation; apparently the ER weren't allowed to use restraints.

We donated our leathers. The ER Nurses had no problem with that.


The following afternoon:

Mr. Epi, myself and the kids were at a local festival. Mr. Epi tugged on my sleeve.

"Hey... That dude is staring you down. He looks pretty ticked off. Do you know him?" He motioned towards a gentleman in a flannel shirt and jeans that I didn't recognize.

I couldn't tell who he was pointing at, but it didn't matter. The gentleman emerged from the crowd and introduced himself. He definitely had a surly look on his face. I stepped forward, instinctively putting my kids between us. Mr. Epi pushed the stroller holding SWR and took FC by the hand. He took them out of the equasion.

My heart raced.

"You're a Paramedic, right?" The guy's speech was slurred. He was holding a Busch Light can in his hand.

Did I mention the fact that I was a little nervous?

"I'm an EMT, yes." Over his shoulder I could see who I could only assume was his wife or girlfriend approaching. She looked significantly less upset.

Who the hell was this guy?

I surveyed the area for my escape route.

"You're the one who took care of my Buddy last night. I was with him at the Marina. I just wanted to shake your hand."

I exhaled.

"Thank you," he started, putting his palm out there for me to grasp. "He was acting like a complete moron. I'm glad you were there to take care of him."

I shook his hand, instantly relieved.

"You're very welcome." I replied.


Bernice said...

I hate that moment of panick when someone else recognizes you and you have no recollection of ever being aware of their existance.

As always Epi, you rock! Great story & great job.

JS said...

Great story EPI. It seems like the cops always want to get our patients worked up...... JS

Ambulance Mommy said...

Isn't it nice to get a thank you when you least expect it though?

(but I'm sure it would have felt better if you hadn't had to go into alert mode)

My place for that is the supermarket. People recognize me, and I don't remember them...it's a small town, and sometimes its just better to not run into people you treated.

Great story Epi!

Jeff said...

Could someone explain BLS and ALS truck to a guy who sits behind a desk all day? :)

Ambulance Mommy said...

BLS= Basic Life support. Typically an ambulance staffed by two Emergency medical technicians who are certified at the basic level.

ALS=Advanced life support. Staff involves at least one Paramedic, whose training is more intensive.

What I like to explain to people when they ask why we intercept (which is when a BLS ambulance meets up with an ALS provider) is that EMT-B's have a lot of skills, but the Paramedic has some more advanced training. However, to make them feel like they aren't getting jipped by my service because they only got an EMT instead of a Paramedic, I explain that not every call requries the high level of training the medic has undergone.

An EMT-B can totally handle basic things such as a broken arm, etc. If someone is in cardiac distress, a Paramedic can dispense different drugs, take different actions, than the EMT-B can alone.

Each state is different in what an EMT-B or Paramedic can or can't do.

Basic Life support is the foundation for Advanced Life support, so you often will see the expression BLS before ALS.

That is a SERIOUSLY over-simplified explaination of the defintion of EMT's and Paramedics, in the interest of time and space.

I feel like I should put up a disclaimer that I did not intend to insult anyone, or hurt any feelings if I didn't describe it the way you would have. :)

Sandi McBride said...

Words to live by when you're a cop, too! Loved this post...hugs

Evil Transport Lady said...

I've had people look at me oddly at the supermarket. I can sorta remember them, but most times not. I just keep walking....it kind of makes me nervous.

Gertrude said...

I live in the same city I work. It's not huge. I run into people all the time I have picked up. It is weird. I mean what do you say? Hey how are you hemmroids? I mean jeez. great post btw

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