Saturday, March 01, 2008

And Away We Go

A few months ago I had the privilege of manning the back of Medic 1 on a transfer to a higher level facility. We were 2 Paramedics short and they needed someone to provide care on the transfer. The patient was a stable GI bleed who needed the services of a surgeon. Ours was out of town on a hunting retreat in Africa.

I received report from one of my coworkers. 58 y/o female, bright red blood from rectum, vitals stable, mild abdominal pain. Alert and responsive. She threw me a cooler with 2 units of PRBC's (packed red blood cells) in it "just in case".

EMT Bob helps me pop her up into the back of the ambulance and away we go. I get her hooked up to the monitor, check her IV site, take vitals, do a quick assessment. Nothing has changed from previous report.

We get 60 miles out of town and her IV site blows. Not a big deal, right? An IV start is an everyday activity for me. Multiple starts per day.

But never in the back of an ambulance going over a highway that has multiple potholes from the nasty ass winter we had where the snow and gravel tore up the road.

I have two words................. NEW RESPECT.

It takes a certain finesse to start an IV in the back of the short bus. It was one hell of a bumpy ride. Trying to maintain your balance with a needle in your hand aimed at a vein while the rig is swaying back and forth and jumping over potholes is no easy feat. To think our Paramedics do this without thinking twice.

I did get it on the first try. I left a large amount of the patients blood all over the EMS stretcher and on their floor, but damn it - I got it. Yeehaw! EMT Bob even congratulated me. "You're the first nurse I've seen who got it on the first try back there."

The patient looked at me and smiled. She then promptly rolled her eyes in the back of her head and went out on me. What the hell?

Airway intact, breathing OK, B/P in the toilet, pulses weak, tachycardic. Shit.


Yeah - he can't help. He's driving.

Fluid bolus. Start second IV (amazing how a little stress made me completely forget about the bounciness of the ambulance. Bounciness? Is that even a word?). Initiate blood transfusion.

Pt condition improves.

Nurse breathes.

OK seriously - this condition in the ER would not have made me blink twice. But I also know I have backup at the drop of a hat. Being in the back of Medic 1 in the middle of nowhere halfway to the next hospital (120 miles of desert to cross with no towns in between) adds a new perspective to the problem. No one there to help. Closest help an hour away.

I loved every minute of it.

Must do it again.


Orthette said...

The ER nurses at my old hospital were supposed to do a day of ride time during their ER orientations. Most of them blew it off becuase they figured there was _nothing_ they could learn while doing it.(Sighs)
Awesome job of staying calm and saving your patient, by the way.

The T-Dude said...

You go girlfriend! Nice job!

Kal said...

Howdy - Welcome to our world! :)

Mad kudos to you for publishing mad kudos for others, nobody ever considers that as well as being "the boys that drive the van" we're also "The boys who have to stand in the back of the moving van at high speed and still deliver medical care."

But dach, details.

Are we buying you a reflective jacket....?

Julie said...

I should, eh?

I love our EMS crew. We couldn't survive without them. They are amazing.

Ambulance Driver said...

Addictive, ain't it? *grin*

RevMedic said...

It's not a good stick if there's no blood on the floor...

Good job, BTW. It's nice to know we're appreciated.

Have you done the CCEMTP class? Check out the link on my blog - they hold them at Emanuel on occasion.

Anonymous said...

Blood on the floor is a good sign of the line's patency...



Anonymous said...

Love that you now understand our world!