A lot of people join transport EMS because they don't want to deal with the serious life-threatening shit 911 folks see on the streets. Transport is safe; you come in, pick up a more or less stable patient, take them to a hospital/nursing home/residence. It's simple and easy and you rarely have to see people die.
Rarely. Well, 'rarely' refers to the freak stuff; there are those one-in-a-million BLS calls where something nasty happens - a psychiatric patient who should have been restrained decides to go apeshit, or the dude with COPD decides to stop breathing because you gave him high-flow O2 during an hour-long drive (see also: Hypoxic Drive). Scary stuff, but stuff you can reasonably expect and be prepared for as the need arises. Stuff you trained for, and stuff you have the ability to foresee and deal with.
Not like any of that crazy out-of-left-field 911 shit, right?
And then that crazy 911 shit decides to happen while you are working your safe transport job.
I gave this post the 'Transport' header because it happened while I was working transport. In fact, this happened last night - less than ten hours ago as of the writing of this post.
We were at an ER in Camden for a pretty standard trip - a fat lady (320lbs) was waiting for a ride to her family's house in the city. Fun times; my partner (let's call her Jane) and I were discussing how we'll need to call for a lift assist because the patient's house has six steps leading up to the porch, and how we'll probably get shot at since it's in the bad part of Camden (lol, it's funny because all of Camden is the bad part).
I'm standing at the nurses' station, chatting up one of the techs while getting started on my paperwork. Jane is getting the stretcher ready and rearranging the patient's room so we can slide the woman over.
Someone calls our attention to one of the security camera monitors. There is a lady out in the ambulance bay yelling and waving her arms around; she is obviously distressed. The doors leading to the ambulance bay open up, and we hear her shouting, "he got shot, he got shot!" Jane and I look at each other; I drop my clipboard (face down, of course - gogo HIPAA!) and help her run the stretcher outside as security tells us what's going on.
The lady and her husband had parked their car right by our ambulance, which is just at the ER entrance. Stretched across the back seat, with his upper body and head mostly wedged between the back and passenger seats, was a gentleman soaked in blood. Two GSWs (gunshot wounds) to his chest. We wheel the stretcher up against the back of the car and scramble inside to assess him.
No pulse, no breathing. Jane and I grab him by the arms and haul him out; security is there, helping, and Camden PD is just pulling in (they later comment that this was 'only the second murder of the night; not even midnight yet'). We get him onto the stretcher and haul ass back inside, a nurse and a tech running in with us.
ER staff already has a room ready for us, and they're wheeling a crash cart in. We pull the stretcher alongside a hospital bed and slide the man over, and Jane starts doing chest compressions while I drill one of the clueless nurses for a BVM (bag-valve mask). She manages to find me a bag... with no mask. I get it hooked up to the wall O2 'outlet' and start blasting 25 LPM (liters per minute) and filling the reservoir while someone manages to find a mask. A nurse starts bagging the patient while I take over chest compressions (you wouldn't think CPR is difficult until you actually try it; they never show folks with sweat pouring off their faces while they're cracking a dude's breastbone and ribs on those hospital shows).
The room is filled with pretty much the entire ER staff roster when I start to understand why this is the least popular of the ERs in the city; these guys are horrifically inept and entirely unprepared for a serious trauma of this nature. By the time it dawns on me that this guy was a DOA (dead on arrival) and had pretty much no chance of getting, it's been several minutes, and in this time:
- Nobody has gotten the paddles out. Not that they could do anything with them, since - Nobody has connected him to a monitor. No 12-leads, not even a 4-lead. Not even a finger pulse-ox meter. - Nobody has even bothered getting a BP cuff on him, not that it really mattered. - One of the nurses has finally managed to start a line in his arm, because apparently she wasn't very practiced in finding a vein when a patient's arm is bouncing around to the rhythm of the EMT pounding on his chest, and - The doctor has finally managed to intubate the guy, because bagging is apparently not doing any good.
Why wasn't bagging doing any good? Blood loss is blood loss, but you'd think that full-fledged CPR (chest compressions and a bag with high-flow oxygen) would help save a guy, even if the ER staff are retarded and haven't thought to actually unpack the crash cart yet, right?
The man had been shot twice in the chest. Not in the heart - apparently, very deliberately not in the heart. Both bullets had, based on the entry wounds and two visible lumps inside his lower back, been shot from a high angle just above his collar bones. He had been shot through the lungs. Without treatment specific to this type of wound, we were basically blowing air through the holes in his chest while he was drowning in his own blood (think Angels and Demons when the protagonist tried to do CPR on the dude who had been stabbed in the chest).
The man had, for all intents and purposes, died when his family decided to bring him to this hospital. Distance is whatever; of the three hospitals in Camden, this particular one was the worst they could have picked. My impression after the fact, confirmed anecdotally by most of the coworkers I told the story to afterward, was that this hospital is woefully unprepared for life-threatening trauma. They only exist because the law states that major cities must have a minimum of three ERs open at all times. There had been only one nurse who seemed to know what she was doing while we were in that room; I'm not even sure what the fuck the doctor had been doing before he decided to try to tube the guy. Whatever, he finally pronounced him dead. Time of death was 2230 or something like that.
Going back to my original note about the 'safety' of transport EMS: this was my first serious trauma resulting in a death. This was my partner's first serious trauma, period (and she has been in the field a few years longer than me). My reaction, after the adrenaline high subsided, was giddiness and over-analysis of what had happened; hers, after we washed up and took the fat lady home and cleared that call, was that she needed to go home and and process what had just happened.
This was some serious shit. Most people's reactions to the story were that she's a trained EMT, and if she can't handle it, she's in the wrong field; I'm wondering if I'm gonna be riding an ambulance with a stupid grin on my face for the next twenty years or if I'm for-realsies going to hell.
TL;DR: some guy got shot and his family brought him to the shitty city hospital we were in. We helped the ER staff try to save him, but he was dead before he got there. There was a lot of blood. I had a blast and wouldn't mind doing it again. Discuss.
(If there are any typos or otherwise shitty writing, fuck it; I'm tired, and I'm working again tonight, so I'm going to bed. Enjoy, bitches <3)
Last Edit: Jul 15, 2012 8:05:19 GMT -5 by Mury 6.0
Post by Peter Potts on Jul 15, 2012 8:47:34 GMT -5
Damn, that hospital ER sounds like it sucks some serious balls. :/ You'd think they'd put the most competent people on call in that section if murders happen so often.
That sounds like a pretty good reaction to have, Mury. Your partner's probably just shocked since she's never been witness to this type of thing before.
As for you, maybe you ought to switch to the more exciting work?
Fuck, which hospital? Lady of Lourdes? Also it's been a while since there was a new episode of Grey's Anatomy but I'm pretty sure that giant holes in your lungs are not conducive to life, even at the best hospital.
I already knew you were going to hell. Discuss.
Last night I dreamt that I was chasing a pack of wolves, trying to belong.
Camden is, year after year, ranked the most dangerous city in the country. I have lived more than half my life within half an hour of there, in towns that are very safe and expensive to live in. Camden is merely the dirty black rapist little brother we occasionally make jokes about.
Six homicides in less than a week? Doesn't mention the countless shootings and stabbings that failed to kill
Took a critical care patient the other day. Big black dude, boarded and collared, reeking of alcohol - apparently he had gotten shwasted and fell or something. X-rays confirmed c-spine fractures, so we were taking him to a trauma hospital for better care.
Dude wakes up a few minutes into the ride and starts freaking out. My nurse says,
"It's alright, you're in good hands. We're taking you to xyz hospital, etc, etc."
Patient says, "Aww fuck."
Some time into the transport, he starts sobering up. He asks us,
Love you to death, Teagan, but I effing hate nursing homes. The staff there tend to be monumentally stupid (as I may or may not have pointed out in a previous post).
I don't think I can tell this story in lengthy prose without smashing my shiny new laptop to pieces, so I'll just give you the trailer:
Lady's SPO2 (O2 sat, pulse ox; basically, the level of oxygen in your blood) is horrendous. We come in and find it at 65%. She's sitting on a nasal cannula at 4 liters of oxygen (4 LPM). We stick her on a mask at 15 LPM. O2 sat climbs back up to a tolerable 95%.
Nurse comes in.
"Durr hurr, about two hours ago, her pulse ox started dropping, so we put her on a mask like that. It came back up, so we put her back on the cannula. But then it dropped, so we called you guys."
We got the call about ten minutes before that. The patient told us the nursing staff had taken her off the mask about an hour and a half before. So she had been sitting there, having trouble breathing, with crackles you could hear from across the room (good old congestive heart failure - fluid in the lungs and edema in the legs, arms, and belly), for an hour and a half.
Teagan Offline: This board is full of nostalgia.
Aug 22, 2020 8:39:09 GMT -5
Missing the old MH: gotta say missing when MH and all that was around.
Nov 6, 2019 0:02:30 GMT -5
Willow_lazy: why tf are there 400 posts about adidas
Sept 6, 2018 17:35:57 GMT -5
Azrael: I'm not hard to find, since I'm the only one there who goes by "Azzy", I'm pretty sure. XD
Feb 10, 2018 16:44:41 GMT -5
Azrael: Dunno if anyone still pops by here from time to time, but if any of you mofos do and still feel like gettin' yo nerd on, I've been hanging around this here place a bunch recently: www.roleplayerguild.com/
Feb 10, 2018 16:44:10 GMT -5
Azrael: hold onto your pantaloons
Jul 25, 2016 5:16:43 GMT -5