The MacMedic

So it turns out that my trepidation about another new partner was unfounded. We were politically in different places but that really didn’t effect us at all. He was a bit more conservative but I was careful to stay away from the “hot button” topics that would surely bring politics to the forefront.

It didn’t matter anyway, we ran most of the day doing about eight responses but only three transports. None of them much more than routine ALS. By the end of the day we had spent little time in the ED when we weren’t doing paperwork or restocking. It actually worked out nicely.

About fifteen minutes before we were to be released to head to quarters for the night we were sent to intercept for “pain control following a laceration”. A little on the strange side was that this particular service was a private service that is staffed with a paramedic, usually I guess. When we arrived it ended up being a BLS ambulance and the patient turned out to be a 9 year old girl. The story I got was that she had done something that every kid has done, push against the window to open the door. I know that I had done it probably hundreds of times when I was a kid and never had a problem other than my parents getting ticked off at me. This time her luck ran out and when she pushed against the door her hand broke through the glass and she went through up to her shoulder.

The patient was presenting with extreme pain from a very long and very deep laceration to her right bicep running from her elbow all the way to her axilla. I was impressed by the injury and also by her luck. When she flexed her arm and moved her fingers I could see the muscle and tendons move and none of them appeared to be damaged. No visible foreign bodies were seen and the bleeding, with some direct pressure was slowed to merely a trickle. But she was very, very uncomfortable.

I put an IV in and while securing it down started mentally working the drug calculations in my head for Fentanyl and Morphine, the two pain medications I had. After a couple of doses her pain was decreased significantly but still 5-6/10 and she was obviously uncomfortable. I would have loved to have given some Nitrous-Oxide at the same time but that was a treatment that was not available to me so I could only watch her vital signs and mental status and continue with the narcotic administration as needed.

She finally arrived at the ED complaining of 4 out of 10 pain and with good and stable vital signs. While I did the report the staff were starting to clean the wound and I could tell just from the tone of her voice that her pain was increasing quite a bit. This time Nitrous Oxide was available and the ED doc ordered it to be used with great effect. The patient liked the effect, as a matter of fact she liked the effect a little too much. By the end of her 74 stitch run she was huffing on the Nitrous and gushing that “this stuff is great”. Fortunately the ED nurse had already noticed her like of the nitrous and seemingly low pain level and had started the 100% oxygen flush to detoxify her system of the nitrous. In a few minutes the mask would offer no more greatness.

We were up and down a few more times during the night but none of them resulted in any transports leaving me with a grand total of two transports out of twelve dispatches. Although I seem to be getting some of my wish, the volume is increasing, the patient acuity and the number of patients I am actually working up are just not rising very much. I can only hope for the summer to pick that up.

It’s been a week since I have written anything. I’d love to say that it was because I was busy with interesting things but the reality is that the past week has been dreadfully routine and downright boring. Lots of work around the house in order to get in shape for the summer. Since we moved into this house during the winter we were able to do nothing in the yard to improve it from the initial “construction grass” that was thrown down before we bought it. The deck needed staining, windows cleaned, screens installed, snowblower put away and lawnmower brought out of storage. Just nothing of interest. By some quirk of the schedule at work I didn’t even have any shifts scheduled.

Another 24 hour shift today and I am feeling some trepidation regarding it. One of the problems being the new guy is that you don’t have a set schedule nor do you have a set partner. Yet another partner for today that I am not very familiar with. He’s working here full time in between his shifts at a fire department an hour away. That is about the extent of what I know. I always feel some anxiety when it comes to new partners, especially one that I will be with for 24 hours straight.