Just when I think Iâ€™ve got it all figured out and have finally reached the pinnacle of EMS greatness, Iâ€™m reminded how quickly things can change. One minute youâ€™re on top of the world; the next, the world is on top of you.
The latest meeting of the mutual admiration society was in full swing as we drove through the East Side. Adam and I talked about how fabulous we were, knowledgeable, dashing lifesavers with no equal, here or anywhere. Why we had to share the same earth with lesser beings escaped us as we cruised Thayer Street, searching for that elusive, perfect cup of joe worthy of such brilliant EMTs.
Our previous job went off without a hitch. A 59-year-old female was found slumped at her desk. She had been alert and conscious five minutes beforehand, according to her friend in the next cubicle. Every time Iâ€™m called to one of these mazes Iâ€™m reminded how fortunate I am to have the freedom of movement and the ability to interact with hundreds of different people every day.
A call was made to 9-1-1, and the closest fire company arrived promptly and did a primary assessment. Rescue 1 arrived from the opposite end of the city in eight minutes.
The patient reported for work, said hello to co-workers, poured herself a cup of coffee and walked to her little space in the vast office. Thankfully, a few minutes later her friends noticed her slumped over and recognized a problem. It was unusual for her to be anything but alert and conscious and, according to her supervisor, productive.
The firefighters from Engine 2, all trained EMTs, found the patient disoriented with a moderate left side facial droop. A preliminary neurological exam indicated left side weakness, leading them to suspect a CVA. She was hypertensive and agitated. A blood glucose test showed within normal range.
Rescue 1 arrived on scene, listened to the report from the officer of Engine 2 and got to work. With her coworkers and others looking on, a non-rebreather was attached to the patientâ€™s face and the flow set at 10. A 20-gauge IV was established in her left forearm and the flow set at a KVO (keep vein open) rate. She was gently moved from her comfortable office chair onto our stair chair, strapped in and made as comfortable as possible. Each member of our team had a role and did it expertly, with very few words exchanged between us. We gathered her things and moved her outside.
Five minutes after our arrival at the office building, the patient was sitting comfortably on our stretcher, IV established, 02 administered, history obtained, vital signs documented, closest stroke center notified and we were ready to roll. The crowd of anxious onlookers parted as Rescue 1 departed, taking their friend and co-worker away, confident she was under the care of trained professionals and receiving the best medical care available.
Every now and then a call goes perfectly, the patient is given prompt, efficient treatment with a hopefully positive outcome, and the onlookers and friends fall over each other trying to touch us as we leave, or even share the same space, hoping some of what we have might rub off on them. We casually bask in the glory, accept the accolades as our right and privilege, and wait for the next cry for help from the citizenry we are sworn to protect.
It never takes longâ€¦
A 60-year-old man has fallen and struck his head on a tile floor. He had been waxing a floor at a local elementary school and slipped on the shiny surface. We respond. An engine company arrived prior to our arrival and began treatment. The patient is a small man, lying supine with a large cervical collar around his neck. â€œItâ€™s the only one we had,â€ Iâ€™m told by one of the guys from the engine company.
Adam gets a backboard from the rear compartment and I assess the patient. Last nightâ€™s crew neglected to replace the straps on the backboard with matching sets. We fumble around for a while as the patient moans in agony and finally immobilize him, only after nearly suffocating him when the large collar slips from his chin and blocks his airway.
We recover nicely, get the proper-size c-collar in place, lift the board with the patient firmly attached and put our package onto the stretcher. Backwards. The patientâ€™s co-workers are now very concerned about the welfare of their friend, and begin questioning our heroes. The patient himself violently shakes his head, freeing himself from his restraints and joins the chorus, verbally attacking his rescuers. So much for c-spine immobilization.
With our capes firmly stuffed between our legs we attempt to right the situation, explaining that his feet are at the head of the stretcher and his head is at the foot. â€œIt happens,â€ we say, and spin him around.
Somehow we get him to the rescue without paralyzing him, lift him inside and then botch three IV attempts. Add mangled arm to his list of injuries. An air leak has rendered the truckâ€™s suspension useless; it feels as if weâ€™re riding a hay wagon down a rocky trail on our way to the hospital. What began as a fall with a minor head laceration and no loss of consciousness is now a Level 1 trauma.
Our patient survives transport and his co-workers and family wait for us at the ER, forming a gauntlet as we wheel their loved one past. I swear some are holding pitchforks and torches. Our heroes pass the patient over to the ER staff and slink out of the hospital, avoiding eye contact with the angry mob.
Fortunes change quickly here in the city streets. Another call for help comes in as we adjourn the latest, and hopefully last, meeting of the mutual admiration society.
Good thing there were only two members.