Looks like I missed some days.
So I'm on my first string of night shifts, and I'm on shift 3 of 4 for 1800 - 0600. I'm actually adjusting to it a lot better than I expected, I just don't seem to have the time I anticipated afterwards to write. So I'll try to make up for it now.
Friday was a fairly slow day, I only had three patients but they were in situations that were fairly new to me.
The first patient was a child who was involved in a rear end accident, the child's parent wanted to have the child assessed because they were worried. Nothing serious found, the child, the child was a fairly healthy shade of rosy pink, they were moving around a lot and didn't want to stay still and was understandably cranky for a kid that was just woken up from their nap by being rear-ended. The person who hit the the car was a fairly young person who just wasn't paying attention, no alcohol involved or anything. But they did surprise me a little when they came up to us and basically said "I don't give a shit about the car, or my mother freaking out at me over there, please just let me know that kid's OK". She was OK, and the persons mother did come by and start freaking out, which we thought was going to end up turning into a domestic.
Much later in the night, closer to 0000 we got another call for Code 3 knee and hip pain. Our patient was a late middle aged person who suffers from arthritic knee pain, and tonight it was far worse than they ever said they've had, so we brought them to the hospital. Not much to say about this one, the patient was a bit on the large side, but because of narrow stairs at the front of their house we had to assist them in walking to our stretcher.
Now this call ... this call was something else. Some time around 0500 we got a call that came in as Code 4 Overdose. Once we got details we were told that the patient was hallucinating that 30 clowns and 30 officers were harassing them ... but no officers were on scene (which we then requested to have meet us there). Once we finally found the patient in the bark yard, we realized that they were pretty damn well pickled. You could smell whatever the patient had been drinking, as well as the fact that they were at least a week overdue for a shower, from the path to the backyard. The patient tried to insist that they were fine, and began running around in the backyard in circles, jumping around and doing some sort of combination soccer kick/round house kick in the air. The patient then ran and sat on the fence and started saying to the officers "you'll never take me alive", at this point we just lost patience with the pt, pulled them off the fence and sort of coerced the patient towards our stretcher before they fell off the fence or tripped on something in the backyard and hurt themselves. We were asking what else they had taken and the patient starts going on about taking "20 clonazepam", so we start to really worry, as that would be a significant over dose. Then we get this little exchange with the patient.
"Don't worry, I only took 2, I'm just screwing with you guys. How did you even know to come here anyways?"
"Sir, you called 911"
"No i didn't, I called 411. I was trying to report my oriental neighbors, they're a bunch of clowns, always getting up at 0500 and gardening and making noise in the backyard, they never let me sleep when I work late shifts."
So the whole thing was pretty much just a mis-communication. Though there weren't any people in the backyard working, and the patient was pretty far out of it, they were still pretty much alert and oriented to their situation fairly well. We just brought the patient to the hospital and they let him sober up in one of the psych units before he was presumably sent home.
The next shift started out pretty quiet, but got very interesting towards the end on Sunday morning. Though I did get to go mountain biking for a few hours before my shift started with my sister, that was fun but may have lead to me being way the hell too tired by the end of the shift.
First patient that day was fir first roadside MVC, so I had to take out my vest and helmet for the first time. The patient was older, there was a bit of a language barrier, they were in the lane to make a left turn when they had gotten plowed into by a drunk driver from behind. Over all, the patient was fine. There was minimal damage to the car, whatever crumple zones were supposed to crumple did their job, there was no airbag deployment, it was just a straight up rear end collision. We transported the patient, but there was no reason to believe that they had any serious injuries that would have warranted spinal immobilization. Later on in the day however, we did end up seeing the drunk driver that hit our patient in the hall at the hospital having a blood alcohol test done. With the instrument they were using to measure his BAC 80 was the legal point of intoxication, this patient was sitting at 350, so a BAC of 0.35% ... and still conscious.
The next patient we had came in as Code 4 shortness of breath. When we had gotten there, it was a patient at a fairly nice nursing home who was complaining about sciatica pain that was far worse than what they'd ever experienced. Despite saying it was 10/10 pain the patient was fairly calm and only moaning complaining about needing to be re-positioned on the stretcher. We ended up waiting in hospital for about 3 hours to be offloaded because of a nurse shortage. We also relieved another crew so they could go back to the station and clock out. We took on their dementia patient who had essentially been sent to the hospital because the nursing home they were staying at couldn't deal with his violent outbursts and just wanted some time to deal with a mess the patient caused. My preceptor kept the patient engaged by talking to them about random things until they were ready to take the patient.
The next patient we dealt with was a young patient who actually did overdose. This patient was found on the street unconscious, and remained so for the entire time we had the patient. We moved them into the ambulance and my preceptor instructed me to get an NPA into the patient. The first one I tried to put in was too big and simply wouldn't fit, so we went to the smaller size and the patient accepted it without and trouble, we tried to get a second one in just to try, but that one wasn't going anywhere. From there I got to ventilate the patient to assist their own respirations and did that the whole way to hospital. We had found track marks on the patients arms, but we couldn't determine if those were from this instance right now, or if they were older. The patient was a known user to the shelter they were found on the street outside of, afterwards the nurses were able to tell us that they figured out that the patient had overdosed on benzo's and had been drinking a lot.
The last patient of the shift was this adorable 4 year old with croup. The child wasn't too bad off, they were still awake and able to talk to their parents, I didn't think they child necessitated the use of epinephrine but my preceptor decided he wanted to try it. The child met all the conditions for it as well, even though they had seemed to make noticeable in the time since we had gotten there. We drew up the dose and gave the epi through a nebulizer and the child seemed to perk up quite a bit. The stridor, which sounded like snarling dogs when I auscultated the patients throat, had cleared up considerably and the patient was able to talk much easier to their parents. In the end, it was a pretty awesome feel good call.
And after that we got posted to another station for an hour or so until we were almost at the end of our shift and they sent us back to our station where we finished our shift and went home. The end. Now I need to shower and shave and get to the station for the start of another shift.
Friday was a fairly slow day, I only had three patients but they were in situations that were fairly new to me.
The first patient was a child who was involved in a rear end accident, the child's parent wanted to have the child assessed because they were worried. Nothing serious found, the child, the child was a fairly healthy shade of rosy pink, they were moving around a lot and didn't want to stay still and was understandably cranky for a kid that was just woken up from their nap by being rear-ended. The person who hit the the car was a fairly young person who just wasn't paying attention, no alcohol involved or anything. But they did surprise me a little when they came up to us and basically said "I don't give a shit about the car, or my mother freaking out at me over there, please just let me know that kid's OK". She was OK, and the persons mother did come by and start freaking out, which we thought was going to end up turning into a domestic.
Much later in the night, closer to 0000 we got another call for Code 3 knee and hip pain. Our patient was a late middle aged person who suffers from arthritic knee pain, and tonight it was far worse than they ever said they've had, so we brought them to the hospital. Not much to say about this one, the patient was a bit on the large side, but because of narrow stairs at the front of their house we had to assist them in walking to our stretcher.
Now this call ... this call was something else. Some time around 0500 we got a call that came in as Code 4 Overdose. Once we got details we were told that the patient was hallucinating that 30 clowns and 30 officers were harassing them ... but no officers were on scene (which we then requested to have meet us there). Once we finally found the patient in the bark yard, we realized that they were pretty damn well pickled. You could smell whatever the patient had been drinking, as well as the fact that they were at least a week overdue for a shower, from the path to the backyard. The patient tried to insist that they were fine, and began running around in the backyard in circles, jumping around and doing some sort of combination soccer kick/round house kick in the air. The patient then ran and sat on the fence and started saying to the officers "you'll never take me alive", at this point we just lost patience with the pt, pulled them off the fence and sort of coerced the patient towards our stretcher before they fell off the fence or tripped on something in the backyard and hurt themselves. We were asking what else they had taken and the patient starts going on about taking "20 clonazepam", so we start to really worry, as that would be a significant over dose. Then we get this little exchange with the patient.
"Don't worry, I only took 2, I'm just screwing with you guys. How did you even know to come here anyways?"
"Sir, you called 911"
"No i didn't, I called 411. I was trying to report my oriental neighbors, they're a bunch of clowns, always getting up at 0500 and gardening and making noise in the backyard, they never let me sleep when I work late shifts."
So the whole thing was pretty much just a mis-communication. Though there weren't any people in the backyard working, and the patient was pretty far out of it, they were still pretty much alert and oriented to their situation fairly well. We just brought the patient to the hospital and they let him sober up in one of the psych units before he was presumably sent home.
The next shift started out pretty quiet, but got very interesting towards the end on Sunday morning. Though I did get to go mountain biking for a few hours before my shift started with my sister, that was fun but may have lead to me being way the hell too tired by the end of the shift.
First patient that day was fir first roadside MVC, so I had to take out my vest and helmet for the first time. The patient was older, there was a bit of a language barrier, they were in the lane to make a left turn when they had gotten plowed into by a drunk driver from behind. Over all, the patient was fine. There was minimal damage to the car, whatever crumple zones were supposed to crumple did their job, there was no airbag deployment, it was just a straight up rear end collision. We transported the patient, but there was no reason to believe that they had any serious injuries that would have warranted spinal immobilization. Later on in the day however, we did end up seeing the drunk driver that hit our patient in the hall at the hospital having a blood alcohol test done. With the instrument they were using to measure his BAC 80 was the legal point of intoxication, this patient was sitting at 350, so a BAC of 0.35% ... and still conscious.
The next patient we had came in as Code 4 shortness of breath. When we had gotten there, it was a patient at a fairly nice nursing home who was complaining about sciatica pain that was far worse than what they'd ever experienced. Despite saying it was 10/10 pain the patient was fairly calm and only moaning complaining about needing to be re-positioned on the stretcher. We ended up waiting in hospital for about 3 hours to be offloaded because of a nurse shortage. We also relieved another crew so they could go back to the station and clock out. We took on their dementia patient who had essentially been sent to the hospital because the nursing home they were staying at couldn't deal with his violent outbursts and just wanted some time to deal with a mess the patient caused. My preceptor kept the patient engaged by talking to them about random things until they were ready to take the patient.
The next patient we dealt with was a young patient who actually did overdose. This patient was found on the street unconscious, and remained so for the entire time we had the patient. We moved them into the ambulance and my preceptor instructed me to get an NPA into the patient. The first one I tried to put in was too big and simply wouldn't fit, so we went to the smaller size and the patient accepted it without and trouble, we tried to get a second one in just to try, but that one wasn't going anywhere. From there I got to ventilate the patient to assist their own respirations and did that the whole way to hospital. We had found track marks on the patients arms, but we couldn't determine if those were from this instance right now, or if they were older. The patient was a known user to the shelter they were found on the street outside of, afterwards the nurses were able to tell us that they figured out that the patient had overdosed on benzo's and had been drinking a lot.
The last patient of the shift was this adorable 4 year old with croup. The child wasn't too bad off, they were still awake and able to talk to their parents, I didn't think they child necessitated the use of epinephrine but my preceptor decided he wanted to try it. The child met all the conditions for it as well, even though they had seemed to make noticeable in the time since we had gotten there. We drew up the dose and gave the epi through a nebulizer and the child seemed to perk up quite a bit. The stridor, which sounded like snarling dogs when I auscultated the patients throat, had cleared up considerably and the patient was able to talk much easier to their parents. In the end, it was a pretty awesome feel good call.
And after that we got posted to another station for an hour or so until we were almost at the end of our shift and they sent us back to our station where we finished our shift and went home. The end. Now I need to shower and shave and get to the station for the start of another shift.