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It was a familiar name, but...[shrugs]. I was going to say The Who.
I had to suppress an eye squint at Nails. He's young and cocky, which by itself bothers me less, but he also talks off-topic and is a know-it-all. "How could you not know who John Bonham is?" he laughed at all of us, since he was the only person in four squads who knew. Well, damn, cause I didn't grow up listening to Zeppelin, that's why. Happens all the time.
Sarge called Nails "Ricky" today. Not to his face. Then later, Instructor Crash responded to something Nails was saying and it began, "You can be a Ricky Rescue and go lights and sirens, but..."
From Urban Dict:
A Ricky Rescue is similar to a "Wacker." It is a person who works in EMS (EMT, Firefighter, Paramedic) and gets way too excited for every single little call. On weak-ass calls (such as bullshit anxiety) they are in there with oxygen and trauma sheers in hand. These people usually have the stickers on their truck, carry scanners and listen to them on and off duty, always wear those annoying shirts, and cannot run an assessment to save their life.
I actually knew guys like this in security.
Something Serene said the other day has had a Billy Bragg song running through my head.
Will you say that we were heroes?
Or that fear of dying among strangers
tore our innocence and false shame away?
And from that moment on
deep in my heart I knew
that I would only give my life for love.
Brothers in arms, in each others arms,
was the only time that I was not afraid.
What will you do when the war is over, tender comrade?
...
I ran another mock call last night.
I don't know.
"Dispatch to Squad 4."
"Squad 4, go ahead."
"Squad 4 report to 2075 Allston Way for Unknown Medical."
"Copy. Squad 4 en route."
General impression: Patient was "tripodding" (hunched over with hands on knees such as after jogging and out of breath) and appearing in respiratory distress. Chief complaint was shortness of breath (SOB). Asthmatic female in her early 20's forgot her Albuterol and had an asthma attack walking home from BART.
My assessment of Level of Consciousness was good. A&O=4. She knew her name, where she was, the date, and what had happened that brought us there (those four questions are supposed to be better than "Who is President?" or "How many fingers am I holding up?" because they go to four parts of the brain...that are really important. (I don't know which four.... Are there "unimportant" parts of the brain? OK, long-term memory can go if it means I can breathe, I suppose.)
After that my call fell apart.
My ABCs were not really in the correct order, and we don't do rates for them, but just report generally, "Pulse is thready." The rates come later during the vitals signs. Confusing upper airway obstruction with an asthma attack is not really good. It would be better to remember to own my own lung sounds (we don't delegate those).
I did remember to stick in a couple of good questions. "Have you ever been intubated for this before?"
Crash broke down everything I missed. Advanced Life Support (ALS) have the Albuterol. Vitals--skin signs are key information. Mnemonics for respiratory distress. Provocation/Progression, Associated chest pain, Sputum--presence and color, Time Talking, Exercise Tolerance. PASTE. And slow. Way too slow. The whole call should not take more than a couple of minutes and then it's in the ambulance and go.
I was confused because they've indicated before that putting high-flow O2 on asthmatics probably isn't going to do much. But in this case, because she was tachypneoic (rapid breathing > 28 breaths/minute), she wasn't getting deep enough inspiration for O2/CO2 gas exchange anyway--so the high flow O2 with positive pressure ventilation would be the correct call until we get to drugs that I wouldn't have as an EMT, otherwise, her respiratory distress could progress to respiratory failure, respiratory arrest, and finally cardiac arrest. No, thank you.
Delegation is difficult--especially when you have 6 minions to direct. "OK, Nu Ma could we get high-flow O2 on her? Lil' Doc, would you assess tidal volume while I listen to lung sounds? Strong Girl will you hold the gurney while pt sits down?" I still had three people standing around (which might or might not be the case necessarily in real life). The squad was sweet about it, though. "You did almost everything.... It just took a little prompting," Lil' Doc said. He has a really kind face.
You might think they wouldn't let you run calls fresh out of EMT school, and it's true that most people would work on a transport rig (taking people to dialysis and home again--things of that nature) for 6-12 months before having to respond to a 911 call. OTOH, if we're on duty and walking down the hospital corridor and happen to walk by someone--not our patient--who is having a code right then and there, guess who gets to do some chest compressions.
So...what am I on here? Day 11? Well, the numbers will go up to 40+ so I guess I have some time to get. it. fucking. right. Grrrrrr. In the meantime, I have to get Lil' Doc and Soldier Girl to run a call. Nu Ma did one last night too. Drug OD in a car, "unwitnessed" arrest, with rapid extrication. I owned the AED and gurney for that one. It was ok, but the toe issue is definitely cramping my style (no pun intended).
At some point soon, I want to write about motivations, but right now, I need to do some more reading.
I gotta say though...it's not about the lights and sirens. I'm not even interested in working an ambulance crew. I want to be a nurse. I'd like my port of entry to be ER Tech. I've heard enough scanners that I never want to hear any again.
I have to learn these assessments.
I had to suppress an eye squint at Nails. He's young and cocky, which by itself bothers me less, but he also talks off-topic and is a know-it-all. "How could you not know who John Bonham is?" he laughed at all of us, since he was the only person in four squads who knew. Well, damn, cause I didn't grow up listening to Zeppelin, that's why. Happens all the time.
Sarge called Nails "Ricky" today. Not to his face. Then later, Instructor Crash responded to something Nails was saying and it began, "You can be a Ricky Rescue and go lights and sirens, but..."
From Urban Dict:
A Ricky Rescue is similar to a "Wacker." It is a person who works in EMS (EMT, Firefighter, Paramedic) and gets way too excited for every single little call. On weak-ass calls (such as bullshit anxiety) they are in there with oxygen and trauma sheers in hand. These people usually have the stickers on their truck, carry scanners and listen to them on and off duty, always wear those annoying shirts, and cannot run an assessment to save their life.
I actually knew guys like this in security.
Something Serene said the other day has had a Billy Bragg song running through my head.
Will you say that we were heroes?
Or that fear of dying among strangers
tore our innocence and false shame away?
And from that moment on
deep in my heart I knew
that I would only give my life for love.
Brothers in arms, in each others arms,
was the only time that I was not afraid.
What will you do when the war is over, tender comrade?
...
I ran another mock call last night.
I don't know.
"Dispatch to Squad 4."
"Squad 4, go ahead."
"Squad 4 report to 2075 Allston Way for Unknown Medical."
"Copy. Squad 4 en route."
General impression: Patient was "tripodding" (hunched over with hands on knees such as after jogging and out of breath) and appearing in respiratory distress. Chief complaint was shortness of breath (SOB). Asthmatic female in her early 20's forgot her Albuterol and had an asthma attack walking home from BART.
My assessment of Level of Consciousness was good. A&O=4. She knew her name, where she was, the date, and what had happened that brought us there (those four questions are supposed to be better than "Who is President?" or "How many fingers am I holding up?" because they go to four parts of the brain...that are really important. (I don't know which four.... Are there "unimportant" parts of the brain? OK, long-term memory can go if it means I can breathe, I suppose.)
After that my call fell apart.
My ABCs were not really in the correct order, and we don't do rates for them, but just report generally, "Pulse is thready." The rates come later during the vitals signs. Confusing upper airway obstruction with an asthma attack is not really good. It would be better to remember to own my own lung sounds (we don't delegate those).
I did remember to stick in a couple of good questions. "Have you ever been intubated for this before?"
Crash broke down everything I missed. Advanced Life Support (ALS) have the Albuterol. Vitals--skin signs are key information. Mnemonics for respiratory distress. Provocation/Progression, Associated chest pain, Sputum--presence and color, Time Talking, Exercise Tolerance. PASTE. And slow. Way too slow. The whole call should not take more than a couple of minutes and then it's in the ambulance and go.
I was confused because they've indicated before that putting high-flow O2 on asthmatics probably isn't going to do much. But in this case, because she was tachypneoic (rapid breathing > 28 breaths/minute), she wasn't getting deep enough inspiration for O2/CO2 gas exchange anyway--so the high flow O2 with positive pressure ventilation would be the correct call until we get to drugs that I wouldn't have as an EMT, otherwise, her respiratory distress could progress to respiratory failure, respiratory arrest, and finally cardiac arrest. No, thank you.
Delegation is difficult--especially when you have 6 minions to direct. "OK, Nu Ma could we get high-flow O2 on her? Lil' Doc, would you assess tidal volume while I listen to lung sounds? Strong Girl will you hold the gurney while pt sits down?" I still had three people standing around (which might or might not be the case necessarily in real life). The squad was sweet about it, though. "You did almost everything.... It just took a little prompting," Lil' Doc said. He has a really kind face.
You might think they wouldn't let you run calls fresh out of EMT school, and it's true that most people would work on a transport rig (taking people to dialysis and home again--things of that nature) for 6-12 months before having to respond to a 911 call. OTOH, if we're on duty and walking down the hospital corridor and happen to walk by someone--not our patient--who is having a code right then and there, guess who gets to do some chest compressions.
So...what am I on here? Day 11? Well, the numbers will go up to 40+ so I guess I have some time to get. it. fucking. right. Grrrrrr. In the meantime, I have to get Lil' Doc and Soldier Girl to run a call. Nu Ma did one last night too. Drug OD in a car, "unwitnessed" arrest, with rapid extrication. I owned the AED and gurney for that one. It was ok, but the toe issue is definitely cramping my style (no pun intended).
At some point soon, I want to write about motivations, but right now, I need to do some more reading.
I gotta say though...it's not about the lights and sirens. I'm not even interested in working an ambulance crew. I want to be a nurse. I'd like my port of entry to be ER Tech. I've heard enough scanners that I never want to hear any again.
I have to learn these assessments.
tired