Wednesday, June 20, 2007

No Time for Blog....

It's been a busy and particularly nasty week since I wrote last. I haven't had a lot of time and, truthfully, I haven't had the inclination because I've had a lot to think about. Some of that I'll share, and some I would rather not. But the things I'll talk about are enough, I think.

Last Thursday night I covered part of another medic's shift for him so that he could go see his son graduate from school up in the Lakes Region. Part of me wishes I hadn't, as we got one call in particular that has kept me angry ever since. We got called to the area of one of Manchester's fine drinking establishments for an unconscious person. On the way there, all I could think of was a passed out patron. When we arrived on scene, it was in the back parking lot, there were people milling around as well as a number of police on scene. We found this 2o year-old male on the ground, unconscious, bleeding from the mouth, nose, and ears. I was told by one of the officers that this young man who had become my patient was involved in a fight and was struck in the back of the head with a 2x4, which happened to be lying on the ground about 20 feet away from where we were.

When we got to the patient, he was not breathing effectively on his own, and he was clenching his jaw. We had an immediate problem with his airway because of what he was doing - it all of a sudden became both critical and difficult to manage his airway. We couldn't get an oral airway into him, and intubation, either oral or nasal, was going to be out of the question just due to the blood volume and the clenching. Plus, he had a gag reflex. The best we could do was a nasal airway (a "trumpet") and ventilation with a bag-valve mask. We put him on a long board, secured his cervical spine, and got him out of the area and onto the ambulance so that we could work on him. As soon as he was loaded I called for an activation of the trauma team at the Elliot so that they could stabilize him once we arrived.

He ended up being sent to the Massachusetts General Hospital in Boston where he died the following day.

The extent of his injuries included a sub-arachnoid bleed that covered approximately 60 percent of his brain as well as a near-total whiteout of his left lung from the blood and secretions he aspirated prior to our arrival on scene. We suctioned him almost constantly once we got to him, but it didn't seem to matter.

Anyway, the reason I'm still angry about this is that it should have never happened. This kid was only 20 - apparently he went to go see his sister graduate from Central High School; all of the trouble started at the commencement ceremony, from what I'm told. What happened afterward was simply senseless. When whomever committed this crime is caught, I have no doubt murder charges will be filed. I suspect it is only a matter of time, and on that I hope I'm right.

I'm having a hard time remembering what else I did, in terms of calls and work - it has all been a blur as I've had no time off. Last night I know we dealt with two different car vs. bicycle accidents, one a no transport, the other rather seriously injured. Today I worked at the track, and we got our "call for the season" of a near-syncopal episode on a 66 year-old male seen yesterday for chest pain in the hospital ED with negative findings on his heart, but out-of-whack hepatic enzyme levels. Since we don't transport at the track - Salem Fire does - we got the work-up started. When they arrived, they knew a Paramedic was there, but did they ask me for any information? No! They didn't! And I have a problem with that, as it is not the first time they've ignored me. But who am I, anyway? As far as they're concerned, apparently not an important enough link in the chain of care.....

On a humorous note.... My kids gave me a gift card to Best Buy for my birthday and Father's Day combined. I used it to buy new speakers for my stereo system, which I also planned to somehow interconnect with the audio port on my laptop. Well, I succeeded: I got a set of Altec-Lansing computer speakers with an active sub-woofer and satellite speakers. Total output power of somewhere in the neighborhood of 140 Watts. Very nice. Anyway, in the process of connecting them to my system, I had to go through my receiver/amplifier to get to the sub-woofer. Once it was connected, when I fired it up the next experience I had was to see the receiver shut down, followed by this horribly unmistakable odor of electronic components on fire. I blew the amplifier in the receiver to pieces.

It was actually pretty funny, in hindsight; the receiver was nearly a museum piece as I bought it almost 25 years ago on Okinawa, so it was really functioning on borrowed time. And I found a work-around that is perfectly acceptable: in a previous post I noted that my wife had given me a Grundig/Eton multi-band radio for Christmas. The radio has stereo outputs for FM, so I am able to by-pass what would have been my receiver and go through the equalizer, and I have auxiliary inputs on the sub-woofer for an MP3 player and for headphones. So I can connect any number of devices to the auxiliary port, including my laptop or the radio or my MP3 player. The sound is just as good with any of these devices. Right now I'm listening to classical music on the radio, and if I decide to get a second satellite receiver, I'm good to go!

It's nice when a plan comes together.....


Anonymous said...

Wow...that's a lot to handle with that 20 year old. It's such a heartwrenching job. Jay

manchmedic said...

I guess my biggest issue with this one, as I said, is that it easily could have been prevented. It's not the injuries as much as the cause that send me over.

It's calls like this that are among the hardest to deal with. And I know you know that, my bro.