Parsley in the Butter, Watson

Thursday, March 17 2005

In order to take the tests in EMS “they” require one to ride along with people already doing the job. To test for EMT-B one must first ride with Basics; to test for Intermediate or Paramedic level one must ride with medics, and so on.

Not only that – after a bit of ride along, when the working crew gets to know you, they are expected to let you “lead” the team – pretend you are at their level – to see how you do. They are there, naturally, to catch and correct any mistakes you might make in patient care, but for the most part step back and see what you’ve got. As a matter of fact, they all put on their poker faces and do what they’re told – no clues at all to help you out, no raised eyebrows, no “Really? You really want to do that?”.

But sometimes, just sometimes, they need to step in.

My Best Stoopid Story begins with the career medics being toned out for a “difficulty breathing” call. I’d been riding with these particular medics for several days a week, the past four or five weeks. They decided to “give me” the call and let me act as lead. Oh boy!

We get to the residence – permanent trailer-type home with a zigzag wooden ramp leading to the front door.

Difficulty breathing, let’s see, what do we need? I ask that someone bring an aid bag (for the stethoscope, pulse oximeter, glucometer, bp cuff), O2 bag (for the oxygen, masks, cannulas) and Lifepak (cardiac monitoring, backup pulse ox, backup automated bp cuff).

“Okay”, says the medic.

The fire crew has arrived – they generally show up for these things. They immediately ask the medic what he wants them to do. The medic points to DTs.

“Ask him. He’s in charge.”

We enter to find an elderly female patient sitting in a laz-e-boy type chair, complaining of a tightness in her chest. She’s alert and oriented times 3, speaking in full sentences, non-cyanotic, good impression. Her SaO2 is 93%. Nervously, DTs asks one of the medics to put her on O2 at 4lpm nc.

“Okay”, says the medic.

Diffidently, DTs asks the other medic to apply a four-lead EKG and run me a strip, to see if she’s having any cardiac problems.

“Okay”, says the medic.

“My compliments to the fire officer, and can he please get me some vital signs?” – at least, it felt like that coming out. Big confidence.

“Okay”, says the officer.

I begin questioning the patient. When did this begin? Sudden or gradual onset? What makes it better, or worse? Ever happen before? Medical history?

In the meantime, DTs with supreme confidence asks the remaining fire guys to bring the cot to the front door.

“Okay”, say the fire guys.

I’m convinced we do not need to whisk her away but can proceed leisurely to the hospital for a checkup. Her cardiac function looks perfect – sinus rhythm, no PVCs, no tachy- or bradycardia, good P waves followed by good QRS, no T waves. Her SaO2 is up to 100%, her tightness is diminished or gone.

Damn, DTs is getting cocky.

I fish around for a line I’ve heard these medics use before, when all is seemingly well with the patient: “Ma’am, if we assist you, do you think you could take five steps to our cot over there?”

Dead silence from the medics. Dead silence from the fire guys. Oh shit, thinks DTs. I’ve done something wrong, but what…

“No,” says the patient.

“Why not?” asks DTs, confused. Muffled grunt from the fire guys, who flee the room en masse. DTs notices eyes widening on his medics.

“Because I only got one leg,” says the patient, pointing.

Well, fuck me, thinks DTs. Sure enough, she’s missing one leg from the knee down. I noticed her knee when first we arrived, but thought she was sitting with her foot tucked under her – I used to have a similar recliner and found that position comfortable myself. No, no, she only had one full leg. In a flash DTs recalled the ramp leading up to the house.

Gosh, it sure is getting hot in here all of a sudden, thinks Our Hero.

“Um, well, um. Uh, in that case…” DTs’ brain went to his Happy Place, where Care Bears played pattycake with unicorns. The medics, sensing Mental Breakdown, assisted the patient to the unit and smoothly allowed DTs to slide into a “third” role without so much as a word between them, God bless ’em.

What I really liked about this crew was their sense of humor. We returned to the station after transferring patient care to the ER. As we backed the unit into the station, there lined up were all the fire guys in a row – each standing on one leg, holding their left leg up behind them with their left hands and saluting DTs with their right.

Gawd.

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