This has been an insane week. It is finishing out with body aches and a low grade fever which broke during the middle of the night. Unfortunately I still have to work, and that's all I have been doing this past week; the only day I had to use for down time was Tuesday, and I still had to go in at night.
As I write this I am sitting up in bed working on my second cup of coffee and thinking about all of the things I have to do today before I go into work tonight. Next week I think my schedule will be more manageable, and I'm working on organizing myself better. I have to; right now I am employed by three different EMS agencies, and when the harness racing season starts I will also be working at Rockingham Park in Salem on the track there. Of all of the places I work, that one is the most fun - I'll be starting my fifth season there during May, I am the crew chief of the EMS personnel that work there, the person I work for is an absolute angel, and they pay me pretty well. All good reasons to go to work. Not to mention the fact that watching horses run counter-clockwise on a mile-long hard track is actually rather entertaining. Because I am working I can't bet - not that I would, but it would be a conflict of interest if I did - but that doesn't matter because the entertainment factor alone is worth going to work.
Going back to the beginning of the post: it was a crazy week. Monday there was a murder-suicide on the West Side. We got a call to respond to a stabbing at 9:30AM. Actually, it was not just us, but a second ALS unit, fire, and lots of police were on scene. Turns out that this man murdered his wife, stabbed and critically wounded their son, then turned the knife on himself. The survivor is a 25 year-old male who has Down's Syndrome. His older brother had stopped by the apartment that morning and found the scene in front of him. It was a bloody mess, and I only saw the victim who became my patient. I didn't go anywhere near the parents, as I didn't need to; I had my hands full with my patient. He had 5 stab wounds in the chest and two in the back. I believe he lost quite a bit of his blood volume just from what was on the furniture and the carpet. From the time we were dispatched to when we rolled into the Emergency Room with him was just short of 25 minutes; considering where we were when we were dispatched and what we had to do once we got on scene, I have to say that was a pretty quick turn-around.
The wounds were closed with a big occlusion dressing (in this case, a 12X12 sheet of plastic wrap taped down on 3 sides) and he got 2 large-bore IV's, one KVO, the other titrated to his hemodynamic status, which wasn't great as he presented to me with an initial blood pressure of 88/50 and a heart rate of 130 with a thready pulse. He was conscious, but with the Down's I can't say what his alert status was. As we got closer to the hospital, though, his mental status started to waver. Between myself, the police officer who rode in with me, and the patient's brother who also rode in, we had our hands full keeping him from losing consciousness. I thought it would happen as soon as we got through the doors, but it didn't. We had the trauma team waiting for us. Within 15 minutes of us walking through the doors he had two chest tubes and was on his way to the OR.
Since then, I've dealt with a combative alcoholic in withdrawal, a patient who was status-post CABGx3 and an aortic valve replacement who wouldn't let me put her on my cardiac monitor much less start lines, and a frequent flyer who was out in the cold for approximately 12 hours and managed to develop frostbite in both of his hands - a homeless alcoholic that I know rather well, in fact. He's actually harmless to others, but I'm afraid he'll ultimately do a job on himself. Last time I transported him he'd gotten into a fight with another person and they were smashing each other over the head with beer bottles, and he was a bloody mess. Not this time, though.
Those were a sample of some of the people I treated this week.....
I actually feel pretty good, other than a sore back. My suspicion is that this part of my body is where anything opportunistic like a bug is going to make me feel discomfort both at the beginning and the end. Considering the area where my back hurts is where I had injury (right at the SI joint), it really doesn't surprise me. I'm hopeful a shower will loosen up that spot so it doesn't feel like I have a bowling ball wedged next to my spinal column.