Ever had one of those days?

[Dark Angel]

So, I get into the firehouse today to start my 24, and the first thing out of the outgoing medic's mouth is "The truck needs fuel." I couldn't help it, the first thing out of my mouth was, "Again, really?" You see, this was the fourth shift out of the last 6 that the truck was left needing fueled. I listened to the rest of his report and then went about checking the rest of the truck. After stewing over it for a few minutes, I went up to him and asked what the deal was. After he gave me some lame excuse about how sometimes they just aren't able to get fuel, I told him that it was becoming a habit, it was getting really old, and it needed to stop so he had better figure out what needed to be done to change things. The only time we truly can't get fuel is between 2359-0400 on Sunday nights/Monday mornings. So, that accounts for today's incident, but doesn't explain the other 3 out of 5 shifts.

Then we started running. In the first 7 hours of our shift, we had 5 runs. The first couple were run-of-the-mill, no big deal, types of runs. On the third run, we had a very grumpy old man that had flu-like symptoms, refused to put a mask on, and was insistent on going to one of our heart hospitals rather than the "regular" ER.

Run 4 was an unresponsive person at this huge retirement compound and all the nurse could tell dispatch was we needed to go to "door 10." Each wing/building has a name and we know the facility by building names, not door numbers. It took us a few extra minutes to finally figure out where we needed to be, and that was after asking a few different employees who called/where door 10 was and no one could tell us. We finally get to the patient and she takes one last aginal breath and then stops breathing. She is also pulseless. She has a valid DNR, so I hook the monitor up to get my strip of asystole to include with the report & DNR, and she is in PEA. Yes, she is pulseless, but technically, her heart hasn't stopped beating yet, so now what the heck do I do? Since she has the DNR do I just stand there and do nothing until she is finally in asystole? Well, since I wasn't sure, and there wasn't another medic on scene with me, I opted to get the patient moved and to transport. Just as we were getting ready to move her, she converted to asystole. We double checked all of the leads to make sure none of them were pulled off (they weren't). I printed my strip, took the paperwork that I needed from the ECF, and we went on our way.

Run 5 was an unresponsive person at the Jr. high school. While we are enroute to the school, dispatch advises us that our patient is a 13yo special needs child who has stopped breathing, and CPR is now in progress. The engine arrives first, and takes over CPR until the pt has ROSC. When we get there, he is not letting them bag him any longer, and while he is pale, he is no longer cyanotic, like he was when the engine first got there. He is fighting having a NRB on his face, but needs the oxygen, so we use kerlex to restrain his hands at the side of the cot. He is breathing well on his own and is interacting with us at this point. We head downtown to the children's hospital, about 15 minutes away. About half-way there, he begins breathing inadequately again and we begin to bag him again. He eventually stops breathing again, and goes from sinus brady to PEA. I only had one other person in the back with me, so we start CPR and take him in with only an OP, BVM & chest compressions. He was ventilating well with the OP, so I didn't attempt to intubate. I also was unable to get a line or push drugs since CPR was taking precidence. The ER was able to get him back, but I am not sure what sort of quality of life he will have if he even survives.

So, that was the first 7 hours of my 24 hour shift. We haven't done anything else (yet), but we still have until 0800. (I swear if I get a third arrest this shift I am going home and will be done for the shift.)

[strwblue]

Remember that eventually everyone dies. We just happen to be there when it happens to some. We are just speed bumps on the highway to even or hell depending on the patient.

[safdrookie]

can i work with you??

[wvditchdoc]

Hang in there, it'll get better or worse before its over. I've had a hell of a week as well over here. Just remember it comes in waves.

As for the crappy truck hand over, hopefully since you addressed it with the off going crew that will remedy itself. If not don't hesitate to take it higher in the Chain of Command.

[PSYCtest040]

Yes, every single day. Granted I haven't been on back to back codes yet but I'm sure that will come.

[screaming pizza]

Ya gonna fuel the truck up?

[PSYCtest040]

Ya gonna fuel the truck up?

Not this morning.... Dispatch held us on post until five minutes past off going.

[FF/EMTP1317]

Been there, done that, bought the shirt...oh wait that was county issued.

The medic I relieved for about year would leave the unit a mess for me. I can understand if it was one of those nights where you have back to back calls until shift change but when your last call was at 2030 there is no excuse. I said something to him and when that didn't work instead of relieving him at 615 I didn't show up until 650 which resulted in him getting held over a few shifts. That got the point across real well.

[fishy]

Been there, done that, bought the shirt...oh wait that was county issued.

The medic I relieved for about year would leave the unit a mess for me. I can understand if it was one of those nights where you have back to back calls until shift change but when your last call was at 2030 there is no excuse. I said something to him and when that didn't work instead of relieving him at 615 I didn't show up until 650 which resulted in him getting held over a few shifts. That got the point across real well.

Ahh, don't you just love it when the night shift brags about how they were able to sleep all night and the rig, or station (what's up with piling up dishes in the sink anyway?) for that matter, looks like shit.
Granted if you run back to back calls or if it was an honest mistake, we all forget stuff from time to time, no biggy I'll take care of it.
I have done something similar in the past. If they didn't get their shit in order when I came to work I would refuse to change into my uniform and relieve them. I'd tell them "listen guys I'm gonna go to the backery down the street and get some breakfast and when I get back in a half an hour things had better be in order or I'll go for a walk around the block for another half an hour". That usually does the trick :)

[Dark Angel]

So, what is it with crappy peds runs? We ended up having about 4 more runs for the shift, and of course all of them were overnight. One of them came out as a seizure. We get there, and there is an 18 month old laying on the kitchen counter and dad is giving him rescue breaths. All I could think was, "You are fuckin' kidding me!" Turns out the kid was breathing (although not very well), and he was still seizing. Got hiim on O2 and gave him 2.5 mg of Versed and the seizure stopped.

Then I got to deal with the respiratory issue. He had a rate of around 30, with retractions and that awful looking see-saw motion between his belly and chest. He had tons of congestion in his chest, and wheezes. I started 2.5 mg of albuterol, and as all of the crap in his chest started to loosen up, I began to suction him. So much stuff came out of that little nose and mouth, it was amazing. We got him to the ER and along with continuing to suction him, and getting a line on him, they also tested him for the flu, meningitis, and did a blood gas on the poor little guy. However, he was breathing tons better when I left.

I can't tell you how glad I was to get off shift this morning. I really hope I don't have a repeat shift like that any time soon.