Saturday, October 22, 2011

Peds ER: Ambulance ride-along

Even tho my rotation is technically over, I am required to do 1 ambulance ride-along. Its a 12 hour shift and I got to go hang out at the firehouse. Apparently, the firefighters and the paramedics are the same people! I totally didn't know that. The different alarm sounds tell them what truck to drive and what gear to put on.

I had a really good time. They go to the grocery store to buy meals, they have a nice kitchen, a huge TV, a study table, and bunk beds.  Its actually a pretty sweet setup.  I was sad in a way that I hadn't considered being a paramedic instead of medical school.  You get all of the fun but less of the responsibility.  The paramedics laughed when i told them this.  I guess I deserved it since about 80% of the calls are not emergencies (free ride to the hospital).

After this whole experience, I think the paramedics opinions about patients are under appreciated simply because they get to take in the patient's home and surroundings. It really can tell you more about the problem than anything else.

Overall, it was a 'slow day' they called it. Only 4 calls and several calls that were cancelled on-route. The rest of the day I spent getting to know the paramedics around me, why they had chosen what they had and trying to glean any helpful information I could.

I did learn that usually on a 911 call here, there are first responders who appear on scene first. Then if further assistance is required or if the original 911 caller explains the situation well enough, then the paramedics are paged. I don't know who or where the first responders come from, but they were at all our scenes.

The paramedics I worked with were eager to teach me and more than happy to have me ride along. Things I learned were more about myself than medicine I have to say. The paramedics treated me like a doctor. They asked my opinions on things, forced me to do IVs and a few random other procedures.  Many of the more serious calls have more than one paramedic team present. There is a call for a known diabetic in hypoglycemia (he is very agitated). So when we run in there is no time for introductions, everyone is running about. He is being held down on his bed, his has no pants or underwear, and he doesn't know where he is. The oldest paramedic in the room, maybe 40 comes up to me and hands me an EKG. He explains what he sees and asks if I agree. Then another paramedic who cannot get the IV in his hardened veins (on 8th try), says let the doctor do it.  Then they hand me a bunch of needles (i have never done an IV before, much less a hard stick) and I try and try until I say, "its not happening." And they agree and hand me a needle and some glucagon. I try to explain I've never done it, but they keep insisting and saying things like "move for the doctor" and I try to stab the guy with the needle but I don't push hard enough. The needle bounces off and I have to do it again. Now this might not sound that exciting to some of you, but this is the first time people who have more experience than me are looking at me for answers. It was my first terrifying experience into the world of authority I suppose.  I wasn't able to clarify I was just a student until later. And I can't help but have some doubts about my capabilities. Granted I'm only a third year, but it still makes me a bit nervous.

Other calls we got to go on were about a choking child, chest pain at a doctor's office, and a car crash that the helicopter had already arrived at and took the one critical patient. The picture is below of the helicopter as it took off...



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Overall, a fun, educational experience. I hope to go on more ride alongs.

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