Tuesday, May 19, 2009


EMS is a different world, as I found out yesterday during my ridealong.

The reason I enjoy the ER is because even when we've got a hot mess coming in, we have somewhat of an idea of what sort of hot mess this will be. I know that's not true all the time and sometimes we do get completely surprised by something, but usually we have the most basic of info about someone before they roll through the doors.

Not so with EMS. I went on 3 calls during my ridealong, and each one was vastly different than the others.

Call 1: Assist for older man falling in a parking lot.

I got to ride the ladder truck for this one. Not going to lie, I was so excited; I felt just like an 8 year old who tells everyone, "I'm going to be a fireman when I grow up!"

The ambulance was right in front of us, and we roll up at the same time. The fallen guy had a pillow under his head, little nasal cannula on, and his feet propped up against the door frame. He also weighed probably 500 pounds. And oh yeah, he was blue as a primary color. The nasal cannula might have helped if he was actually breathing. The paramedics snapped into ALS mode and we started CPR in the parking lot. He was intubated (barely; he was apparently the hardest one they've had in a long while) on the way, and I got to be on the giving end of a call to the hospital to warn of a coming priority 1.

Call 2: Headache

We get to the trailer park, and the young teenage girl on the couch tells us of how she vomits every time she stands and can't speak at all because of how short of breath she is. While she walks herself down the stairs to the stretcher. And oh yeah, her headache is so bad that she can't take her headache pain or nausea pills that she was prescribed during her hospital visit the night before. She even still had her wrist band on. Gah.

Call 3: Fast heart rate

The call from the local sleep center came at 1145 pm, for a guy who was experiencing some heart problems. When we get there, the nurse goes, "oh, his heart rate went from 80 to 140." And that was the extent of the report. Mkay. We go in and talk to the patient, who was confused after just being shaken awake for no apparent reason. He doesn't want to go to the hospital, but then gives us a little history of how he occasionally feels tired and SOB, and oh yeah, feels like his heart is racing. We ask to look at the EKG he was hooked to, and the paramedic and I both point to the A flutter at the same time. He went to the hospital after we explained to him the dangers of an unstable heart rhythm.

In short, it was a great experience. I have so much respect for those first responders. I can't imagine going to every call without knowing what it will be. They deserve some mad props for that.

It's also interesting to see these three scenarios in one shift. We went to the first call expecting to scoop a guy off the ground and set him back on his feet, but we found someone in cardiac arrest. The second one was from a system-abuser who is hurting because she won't help herself - and we still have to transport her on the big expensive ambulance. The third guy was something seemingly unnecessary on first glance, but whom we may actually have saved a life on - he could very well have thrown a clot 2 months from now and stroked out. Instead, he got to voluntarily walk to the stretcher and go to the hospital preemptively.

I jokingly mentioned to the EMTs last night that I was scared to come into their room in the ER, because it's a big scary boys club and I felt like I didn't know anything about their job. I'm glad that I now have an idea, a greater respect for them, and some dirt on which to poke fun at them with.


The loco days of locolorenzo said...

I thought I was the only person who used hot mess when referring to a bad situation or crazy patient....mad props to you!

Kim said...

I have never done a ride-along, but I sure appreciate our medics. I work in a controlled (somewhat)environment, but they work in some crazy situations!