Cell Phone Samaritans

Since just about everyone carries a cell phone these days, it's not uncommon to get sent to a "car off the road, no further information available." People driving by see something and call it in. I guess that's really a good thing, cause there could be someone in real trouble and unable to summon help. Unfortunately, what often happens is several people make the call, and (especially if it's snowing hard) there are different descriptions of what they see. This results in the dispatch center thinking there is more than one incident and dispatching multiple ambulances and fire trucks to what in reality is a single event. I don't know if there's a solution to this. Just awhile ago, we were sent to a car off the road about 5 miles from quarters. The location was a dirt road, and with the weather in the past few days, the dirt roads are a mess. We got a little more than halfway there when a first responder on the scene called in to advise that it was just someone who had gotten stuck in a ditch...no real MVA and no injuries. That's good, but it is frustrating to have the ambulance and heavy rescue and fire responding to nothing. That's the nature of EMS though. You have to treat every call as if it is a serious situation. So, back in quarters just achillin.

Posted: 18h56, March 3, 2007

Saturday 24 at EAS

Haven't written in awhile. Haven't had any really decent calls in a while either. I should know better than to put that out there as I usually end up with a bad call after I complain about getting no decent E-calls. Speaking of a bad call... I got a phone call from a woman while I was working at EAS the other night. She called to let the service know that she wasn't blowing us off as far as her bill goes, its just that she has been unable to get things together enough to make a payment. I was confused as I don't do the billing end of things, and insurance covers this anyway. I let her know that she needn't worry, that we aren't gonna make a big deal out of things, as long as she makes an effort, etc. Besides, it takes a while for Medicaid to pay etc. After I got off the phone with her, I suddenly realized why her name was familiar. My worst call ever came last fall when we were dispatched to a MVA. Arriving on scene I found a patient laying in the road amidst the debris and the remains of a small sedan. Fire and heavy got there just ahead of us, PD was there and the officer on the scene said there was a DOA in the car. I approached the patient in the road, finding out it was a 15 y/o boy. He'd been ejected and had severe injuries to his head and upper body. Bottom line is we had a 25 min. transport time, with the kid coding on us when we were still about 10 mins out. I only had free hands enough to do one large bore IV and maintain the airway and do CPR. There were just 2 of us in the back, (my partner being certified at the BLS level) while a firefirghter drove. The patient had a brain injury that precluded his ultimate recovery, but we managed to get a heartbeat back in the ED (we meaning the doctors, RTs, nurses, and me as I continued the CPR). He was rushed into surgury, but died later in the day. He was an organ donor and there are people living longer and better lives today because of him. My partner and I recieved an accomodation from the hospital and the medical director for our efforts, which was I guess helped ease the hangover from the call. I still see that kid's face just about every day though.

Posted: 11h27, March 3, 2007

Transports and More Transports

We do alot of transports at AmCare, it's a big part of why our call volume is comparitively high, and frankly probably why I have the luxury of getting paid to do what I love to do. Transports help support the company. We have several nursing facilities in our area, and patients are always needing to either get to one of them or get to the hospital from one of them. Also, just about every major illness or injury eventually goes to FAHC in Burlington, and we usually take them. It's late so I have little time to write tonight. Just let it suffice to say that my partner Jen and I did our share of transports today. I also talked to Jen about some of my ideas for bringing some positive, progressive changes to our district. I believe that for starters what we really need is someone with passion, drive, and an ability to bring the issue(s) onto the public's radar. She was very supportive. More on that later, gotta go!

Posted: 01h10, February 24, 2007

Back To it Tomorrow (Maybe)

After a couple of days off, I am back at it tomorrow, that is if I can get to work. The power steering pump seized up on my truck today, and Sherry's van is in the shop as well. Man oh man. Kinda hard to write about EMS when I haven't done it for a couple days. I could have worked tonight's shift at Enosburgh (EAS). The director, Robert, called me today to see if I could. EAS runs just 1 ambulance during nights and weekends, and one and a half during weekdays. Well, its not really one and a half, I mean you can't have half an ambulance, now can you? They have 3 EMTs on duty during weekdays and on the odd chance that there are 2 calls at the same time during the day, they only need to find one other member to fill the spot for the call. Call volumes are comparitively low at EAS, so it's rarely a problem. There are about 20 members and someone usually hears the tone for an additional member to respond to quarters if we get a "Unit 2" call. Anyway, because of the vehicle problems my wife and I are having, I had to pass on the extra shift. In hindsight it's a good thing. I usually end up signing up for extra or open shifts without thinking about how it will impact my family and I if the shift is a busy one. It's a no-brainer sometimes to grab a day's pay simply for being available if needed, but if you end up running a couple of middle-of-the-night calls, your ass is draggin the next day. EAS calls are generally much more time consuming than AmCare calls, simply because AmCare is based about 2 miles from the hospital and EAS is about 20 miles out. A call at EAS usually lasts about 2 hours. Then if the next day is busy too, you can get pretty out of whack in a hurry. OK, gonna wrap this up for today.

Posted: 22h20, February 22, 2007

Home Again

Back home after my 24 at AmCare. It was a relatively quiet night, though I stayed up too late last night writing in my blog and we ended up getting called out at 0400. It was an easy-to-manage SOB (Shortness Of Breath) call with a 2-minute transport time. I am once again reminded that oxygen is a good thing. Another easy call at 0730 (CC: weakness, the all encompassing protocol) ended up the shift. I now have 48 hrs off, if you don't count monthy training tonight at 1600.

Posted: 11h00, February 21, 2007

Another Tuesday 24

Just read online of a line-of-duty death of a Pennsylvania EMT. He was responding to quarters at 3AM for a call to assist a pregnant woman. They talk of the brotherhood amongst firefighters or police officers, but I feel a strong connection to other EMTs and medics out there. Let's all pray that our brother's family, fellow EMTs, and the community find some peace in the days to come. A shitty way to start a blog I suppose. Maybe its cause I'm trying to do this as a stream of consciousness thing, lest I never get around to writing it. I currently have a dismally slow and unreliable freaking dial-up connection at home, therefore I don't foresee spending any time online while at home updating this thing. Luckily the two squads I run with both allow free access to the web (gotta wait in line when its quiet to use it though ), so hopefully I can update when I'm on duty. Shifts vary here at AmCare (www.Amcare.org), but generally start at 0800 and run till 1700 or from 1800 to 0800 the next day. 24s are always 0800-0800. Been slow today (sorry, I guess I just jinxed myself): My partner Kari and I ran 2 calls during the day shift that both ended up being cancelled, and just completed the return leg of a sick nursing home patient "sent to the ED and back to the nursing home with a prescription" pair of runs. Kari's sleeping now, or at least trying to, trying to get into REM before I start snoring. I'm hoping to make this a diary of sorts with EMS as the main topic, but also a way to flesh out ideas, feelings, gripes, and praises for the way the State of Vermont in general and our district (District 1) runs things. I'll likely toss in a pinch of bitch about the local hospital, though I suppose they deserve a pinch of praise regularly as well. A little background is in order I suppose, assuming that at some point someone other than myself will read at least some of this. You should know at least a little bit about who you're dealing with here. I am a relative newcomer to EMS. Though I'd been interested for years, I took no courses or training (not even basic first aid) until I started my EMT-B class in the spring of 2005. I began ride-alongs with Enosburg Ambulance (the 2nd service I run with) a couple months prior to my B class starting up, but never witnessesed anything but a few routine calls. Heck, I didn't even know if I could handle the stress and demands of the work. But the second I stepped into the back of the ambulance on my first ride-along, I could feel an intense sense of belonging. Maybe other EMTs feel the same way, but it was almost as if (to steal a line from the Blues Brothers movie) I was "on a mission from God." My B class was an intensive course that took place over seven weeks starting in June of 05. We did (if I remember correctly) Monday and Wednesday nites for 3-4 hours and every other weekend, Sat. and Sun. from 0800 to 1600. I was blessed with a fantastic teacher, Pat Malone of the University of Vermont. His dynamic and challenging teaching style really forced us to think, not just learn techniques. His best lesson was (and is to this day something I incorporate into nearly every call) that a good EMT "gets it done." Having a can-do attitude (not cockiness) on calls has resulted in some really great patient care (and that's what it's all about folks.) Once I realized that EMS could be a career and not just a very part time neighbor-helping-neighbor deal, I decided that I would make it my career. I was a consulting forester for nearly 10 years prior to becoming an EMT, and had found myself in a career and job that I couldn't freaking stand anymore. Going from that to something I absolutely love is just amazing. I was offered a full-time position with AmCare the very day I received word that I had passed the National Registry B exam. My boss (Walter Krul, also the owner and director of Amcare) told me during the interview that he really hoped to have as close to an all-ALS staff as possible, and wanted me to persue my Intermediate training when I felt ready. I think I ran with Amcare for a full 3 days before finding an I class and signing up. I earned my I in December of '05, just 7 months after I got my CPR card (which was my first instruction in 1st aid.) Having written that I suppose the argument could be made that I jumped in too soon. However I've always been a quick study, and have been blessed with a great group of EMTs here who teach through example on nearly every call. Amcare is located in St. Albans, VT, which is the largest city in our county (Franklin), and in our district. We cover 911 calls for St. Albans City and the towns of St. Albans, Georgia, and Fairfield, and also provide transport service throughout northern New England (though I'd say 90% of our transports are from our local hospital (Northwestern Medical Center, hereto referred to as NMC, web site at www.northwesternmedicalcenter.org ) to FAHC (Fletcher Allen Health Center, Vermont's largest hospital, www.fahc.org , in Burlington, nearly 30 miles south of St. Albans.) For anyone not familiar with Vermont, it will likely come as a surprize to learn that the total population (2000 census data) of Franklin County is just over 45,000. Our service area is rural by just about any standards, but decidedly urban when compared to the rest of the district. VT EMS District 1 is made up of 15 towns and one city which are served by 13 EMS services: Eight ambulance squads and five 1st Responder squads. While AmCare's territory is located essentially adjacent to NMC and thus our total time spent per E-call is relatively short, it is not uncommon, due to the rural nature of this area, for some squads to have transport times upwards of 45 minutes, and that's if the roads are not snowy, icy, or otherwise messed up. OK, its now past 0034 and while I have tomorrow off, I suppose I should try to grab some sleep in the likely event that we run some calls tonight.

Posted: 00h32, February 21, 2007