Ignorance

Especially when it is related to kids, annoys the crap out of me. I don't understand how parents can be so wrapped up in themselves that they just forget to pay attention to those other little humans that they created.

Tonight we went to a "sick call" for a toddler. On scene, family and neighbors were outside literally screaming and yelling while mom was just screaming and pushing a little girl into my partner's arms. The little one was very hot to the touch, pale, mottled, and cyanotic around her lips.

Does anybody know what happened? No.

Has anybody been drinking? Yup, all of the adults (and it seemed like some of the teenagers).

How long has she been this color? About 5 minutes. They actually waited over 5 minutes before calling 911... Long enough for the kid to stop having a grand mal seizure and just start staring upwards (per the kid's grandmother who was the only semi-calm one on scene).

Okay... so a febrile seizure. No biggie, kiddos have them all the time.

Get her in the truck, little oxygen, quite a bit of stimulation since she wasn't breathing as fast as she should have been, and get her undressed. I would just like to say this: if you have cats or dogs in your house, clean up their shit! Don't let your kids play in it or walk in it. That's just disgusting and shows me that you are a lousy parent who doesn't take the time to wipe your child's feet off before you put their shoes on them. (The shoes would have had to be put on by an adult, the kiddo couldn't have tied them or slid them on with how tight they were.)

Dirty clothes I can understand. Wet/dirty diapers I understand. Dried and crusty animal shit on your kid's feet? No I don't understand.

We got a line in her and took her to the nearby pedi facility. She did do better enroute but still wasn't really acting appropriate for age.

Turns out that she was unsteady and "shaky" all day earlier and hadn't been as active as normal. This apparently didn't seem like a big deal until I started asking the grandmother about her activities during the day, after we'd gotten to the hospital. Apparently no adults had "really messed with her" since lunch. It's now 10pm. How can you just "not mess with" a 2 year old for probably 10 hours? That would explain why her diaper was completely soaked with urine to the point where it was only being held up by the pants that she'd been wearing.

I don't understand how some people can just procreate like it is nobody's business but yet there are so many couples that are trying so hard for a baby and can't conceive.

Oh, after we cleared from the hospital. RAD (from quite a few posts back) tells me "they're putting money on that she has croup."

DP: On what basis?

RAD: Well the sudden spike in fever and she was coughing in there.

DP: Yeah, she started coughing when she was crying (this was in the ER) and was sniffling. Her lungs were completely clear and she didn't have any stridor. (One of the first things I checked when I saw how cyanotic she was initially.) She has a really strong cry and doesn't even have the typical barking cough.

RAD: Well the nurses are putting money on it. So's the doc even! I'd put my money on croup.

Note: The doc doesn't impress me. It's the same doc from the status seizure pt I took there a while back.
DP: The nurses didn't say anything about that. All three of them were in the room the whole time with me, the patient, and the grandmother. (Those were the only nurses around that had even seen the patient.) If I had to put money on something, I'd say it was an ear infection.

RAD: Well, she has a high fever though! (It was 104.1F at the ER after we'd already been cooling her and she'd been given APAP enroute.)

DP: Yes, but that isn't really indicative of croup. Croup is normally lower grade fevers and doesn't normally hit suddenly or present with no respiratory symptoms.

RAD rattled on some other ignorant bullshit and I just tuned him out. It was a long ride back to the station.

Buzzzzzzzzz

You know those times when you can't help but laugh? When you're standing there, trying SO very hard to hold it in that you start snorting? This is one of those times.....
We got called out to an elderly female having chest pain. Okay, no big deal.... the firefighters on scene tell us that the pt has a history of anxiety and has been treated for it earlier today at her doctor's office.
When we get on scene (picture a very well-to-do neighborhood), this nice little old lady (LOL) is sitting in her living room, very calm and complaining of generalized chest pain, arm pain, neck pain, leg pain, and head pain x3 months. Okey dokey.
After we've loaded her up in the box and are transporting her to the hospital (it's about a 25-30 minute trip from there depending on the traffic), I start asking her some more questions about her pain.

DP: Have any medications helped your pain?

LOL: No

DP: Has anything else relieved your pain?

LOL: Well, yes. Actually my vibrator helps it feel a lot better.

DP: o-O ummmm really?

LOL: Oh yes, it's just wonderful and it vibrates so good! It helps work out a lot of my tension.

*thinking to myself* Surely she must have mispoken. I'm all for being in touch with your sexuality but this was just plain awkward now.

Of course... since it's awkward, I start to get the giggles.

DP: So could you describe it to me?

LOL: Describe what?

DP: The thing that you said helps you. (I was trying to not embaress her at this point.)

LOL: Oh my vibrator! Well it's about this long (holds hands up about 10" apart) and about this big around (about the size of a 1L bottle of soda). It vibrates really good and you can adjust the speed. Oh! There's heat from it too. That works the best.

DP: Heat? You have a heated vibrator? (at this point, I'm sure she's pulling my leg)

LOL: Oh yes, it's wonderful. My daughter gave it to me for Christmas.

I finally got an idea of what she was trying to say.

DP: Is it also called a back massager?

LOL: Oh yes! That's it... a vibrator or massager thing.

I was trying so hard to not laugh, I started snorting and just couldn't help myself. I swear I would have pissed my pants if I hadn't started laughing. I felt so bad for this poor lady. Here I am, laughing my ass off and she has no clue why. Her transport was uneventful and she did just fine.

Of course, the best part..... telling the receiving RN at the facility what makes her pain better.

Merry Christmas

Merry Christmas to everybody.... Yes, I said it... MERRY CHRISTMAS!!! It irks the hell out of me when people say shit like "happy holidays" or "season's greetings." This did actually cause me to yell "Merry Christmas" at a crazy lady in a store today.

End of the year updates: I'm still working in this hellhole. The powers-that-be have decided since a change of hands that occured this fall that they are going to majorly limit overtime. So, I'm going to focus on getting my RN since I'm pretty much being forced to have time off from work. I'm also in an absolutely wonderful relationship with a great guy.

Brief overview

I realize it's been a long time since I actually posted anything on here. Life happens. I don't think anybody reads this either, so it is more just something for me to do in my spare time (which I don't have much of lately).

Let's see, this will be a brief synopsis of all my jacked up calls since last time I posted.

Really nasty fatality wreck that will definitely be going to court. Yeah, that's not fun. No, I'm not posting more on it.

Then a really bad wreck thanks to a drunk driver. The driver and the passenger (both adults) were both drunk as shit and went the wrong way on a one-way street, smashing into another car. Once we really got to look at the vehicles (after all the patients had been transported) it was amazing that we had anybody survive at all. Apparently the driver that caused the wreck is still alive (this was about a month ago), even though he's paralyzed from the chest down, had massive internal injuries, had both legs amputated, and is essentially a vegetable now because of his multiple head injuries.

Then I had a patient that apparently walked out of the bathroom, told her family she had a horrible headache and went unconscious. When we got there, she was having a stroke. We treated her and flew her out to a stroke center. On follow up, they said that she had a such a massive bleed that there really isn't anything they can do about it at this point accept make her comfortable.

Well, that's about all I want to post for now.

Well, I've had a lot of interesting trauma calls lately. I also had one really bad make-you-reconsider-your-job call. I'll post about those probably in the next couple days. Right now, I'm headed to the bar to drink with a few friends.

Pedi Tube

Well, I got my first pedi intubation the other day. I was actually supposed to have already been leaving work but we caught a late call and I was stuck with the paperwork. I had just finished the report when calls started dropping. A call drops for a seizing toddler and no trucks available. Calls to the 2 nearest towns for mutual aid get nothing because they are already all on calls in their own cities.

I get on scene and she is STILL seizing. According to the mom, the kid has a history of seizures and the mom already gave her some Dialstat (it's a rectal form of medication to make her stop seizing).

When I actually looked at her, she's mottled and her hands and lips are blue. Ask the mom some more questions and come to find out that she found the little one in bed seizing after putting her down about 30-45 minutes prior, gave her the Dialstat and waited 10 minutes to see if it would work before calling 911. Also, apparently since the kiddo hadn't taken a nap that afternoon and the mom puts her normal seizure medications in her nighttime bottle, the kid fell asleep after only drinking a few ounces. So, since the mom didn't want to wake her up and make sure she got all the medicine, she just put her to bed.

We ended up having to intubate the kid and transported her to the closest hospital that would take her.

When we get to the ER, the doc in the room (who none of us had ever seen before) starts bitching about her having a 4.0 tube. Doc says "Well, since you put too small of a tube in, I'm just going to retube her with either a 4.5 or 5.0." I told the doc, there's no air leakage and she's being ventilated fine, the 4.0 was a perfect fit for the chords and I think that the others would be too big. Kiddo chooses this time to start seizing again. Doc looks at her and goes "Well, I'm not going to tube her now. I'll wait till she's no longer seizing." I know, she's SO smart!

So, the doc orders Ativan. First dose doesn't stop the seizure. Doc orders more. Second dose doesn't stop it. Doc orders Dilantin. Dilantin doesn't top the seizure. Doc orders a THIRD dose of Ativan. The kid is still seizing. I tell the doc "The other med that we used stopped her seizure the first time. Maybe that will work better than the Ativan now." Doc gets all snarky and says "We don't use that medicine here on pedi patients. We use Ativan."

The kiddo is STILL seizing and you can tell the doc is starting to sweat about it. The doc from the PICU comes down and tells the other doc that they should go ahead and hang a maintenance drip of Phenobarb after they give Ativan and to call for them to come down and take her up to the PICU. (He didn't know that the kid had already had 3 doses of Ativan and one of Dilantin.) So dumbass doc says "Okay, will do" and the PICU doc leaves.

Yup, STILL seizing. We've now been there for about 40 minutes and she's been seizing for at least 35 of it. So then the doc says "Well, it looks like the Ativan is starting to work and break the seizure." and gives me this smug ass look. I looked at the kid and look at my supervisor and told my supervisor "I think she's posturing. She's still seizing AND posturing." Supervisor looks at the kid and says "Yeah, she is." The kid is now DECEREBATE posturing while still seizing.
Me to the doc: "I think she's posturing."
Dumbass: "No, we're breaking the seizure."
Me: "She's still seizing, but now she's posturing."
Dumbass"She's getting better. " Turns to the mom: "Don't worry, she's doing good. She'll be fine."
Supervisor tells me "DP, let's go. They've obviously got this handled."

I hate dumbasses! The mom is just standing there, not upset or anything. Just standing there like everything is fine. After all, the DOCTOR told her everything is fine.

More coming soon

I apologize for the lack of recent postings. I will be posting soon, have had some interesting calls recently.