Another Attempt
I'm rotating through my time out of Station One, the station that houses our other ambulance and nothing else. At Station One, the two firefighters are on the ambulance, no cross manning an engine so when you go there, you know you're pretty much on the bus for your whole shift.
I'm on a thirty six hour shift which will then become a forty eight when we can't find coverage. The tones come through for a "Signal 21" which is dispatch's code for an attempted suicide. Had it been a sucessfull suicide, it would have been a "Signal 22". JT and I respond and take a student with us, the student is a 50 something year old woman who'd worked as an RN for a while and now was going to work as an EMT, supposedly.
The chief and several volunteers are already on scene including one of my favorite vollies of all time. We'll call her Sal but shes a cesspool truck driver who has been volunteering at the fire department for years. She was there when it was two seperate fire departments, two different districts. But Sal is one of those women who just exudes competence, she's calm no matter what and pretty much everything is met with the same attitude "Okay, yeah we can get this taken care of."
Sal is with the patient, a 60ish year old female who had taken 20 sleeping pills and some booze. While M, another volunteer who I like, is taking vitals and the chief is trying to figgure out how to get the patient out of the house, Sal gives me a quick run down in that no nonense, no bullshit this-reallydoesn't-impress-me tone of hers. The patient is pretty much fine, she's in and out of conciousness and this is one of many many suicide attempts.
My student is fumbling around with the O2 and puts a non rebreather on the bottle, cranking it all the way up.
"Woah, woah, she don't need that. Use a cannula." Just to be an ass I pronounce it "canoola" and the nurse turned EMT fumbles the cannula out. We end up carrying the patient down the front steps in a stairchair and I slip on a patch of wet cement, its raining like a bastard, the chief grabs my shoulders and forces me back to my feet before any damage is done.
In the truck I have the student take all the vitals and I try unsucessfully for an IV more times than I care to mention here. The woman's pressure is in the toilet so she goes into Trendelenberg with her feet raised and her head lowered to try and boost her pressure. Because I really have no idea whether she took more than just the sleeping pills I hit her with .4 of Narcan to see if it'll improve her at all. It doesn't and we end up BLSing her to Concord. She's sinus brady at 50 or so on the monitor and I really wish I had a line so I start looking at her neck for an EJ.
Even in Trendelenberg her jugular's refuse to dialate enough for me to see them and I'm not really in the mood to do it by palp (nor do I feel confident enough to get the stick if I try it) so we just screw to the hospital.
Once there we dump her in one of the rooms and the nurses do their thing. I still haven't found out about the outcome.
I'm on a thirty six hour shift which will then become a forty eight when we can't find coverage. The tones come through for a "Signal 21" which is dispatch's code for an attempted suicide. Had it been a sucessfull suicide, it would have been a "Signal 22". JT and I respond and take a student with us, the student is a 50 something year old woman who'd worked as an RN for a while and now was going to work as an EMT, supposedly.
The chief and several volunteers are already on scene including one of my favorite vollies of all time. We'll call her Sal but shes a cesspool truck driver who has been volunteering at the fire department for years. She was there when it was two seperate fire departments, two different districts. But Sal is one of those women who just exudes competence, she's calm no matter what and pretty much everything is met with the same attitude "Okay, yeah we can get this taken care of."
Sal is with the patient, a 60ish year old female who had taken 20 sleeping pills and some booze. While M, another volunteer who I like, is taking vitals and the chief is trying to figgure out how to get the patient out of the house, Sal gives me a quick run down in that no nonense, no bullshit this-reallydoesn't-impress-me tone of hers. The patient is pretty much fine, she's in and out of conciousness and this is one of many many suicide attempts.
My student is fumbling around with the O2 and puts a non rebreather on the bottle, cranking it all the way up.
"Woah, woah, she don't need that. Use a cannula." Just to be an ass I pronounce it "canoola" and the nurse turned EMT fumbles the cannula out. We end up carrying the patient down the front steps in a stairchair and I slip on a patch of wet cement, its raining like a bastard, the chief grabs my shoulders and forces me back to my feet before any damage is done.
In the truck I have the student take all the vitals and I try unsucessfully for an IV more times than I care to mention here. The woman's pressure is in the toilet so she goes into Trendelenberg with her feet raised and her head lowered to try and boost her pressure. Because I really have no idea whether she took more than just the sleeping pills I hit her with .4 of Narcan to see if it'll improve her at all. It doesn't and we end up BLSing her to Concord. She's sinus brady at 50 or so on the monitor and I really wish I had a line so I start looking at her neck for an EJ.
Even in Trendelenberg her jugular's refuse to dialate enough for me to see them and I'm not really in the mood to do it by palp (nor do I feel confident enough to get the stick if I try it) so we just screw to the hospital.
Once there we dump her in one of the rooms and the nurses do their thing. I still haven't found out about the outcome.
posted by Nick Stabile at 11:18 AM
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