This has been a rather busy 7 days since I last posted.... I had no time off to write, and as it is I am working tonight, tomorrow, Thursday, and Friday. Saturday I will be off after 7AM, and my wife and I are going to see James Taylor - a birthday present she got for me. I am so looking forward to going; I have been a huge JT fan for years, as some of my previous posts can attest to. I'll make sure I talk about the concert when I post afterward.
Mike, my Paramedic student, finished his internship this past weekend. Overall, he did extremely well and I was very pleased with his progression from day one to Sunday. It was really fun to watch him evolve from someone who had a whole set of skills at his disposal but no practical experience in using them to someone I would be willing to have treat me if I needed it. And I am glad I got to be an influence on him; I just hope I was a good one....
Monday morning started off with a bang; as soon as the student is out of the picture, what was our first call out of the chute? A cardiac arrest. A 63 year-old male, only history we were given was of diabetes, found by his wife on the floor of their living room. Unknown down time, but she and some other people at their house told us that it hadn't been more than 30 minutes since she/they had actually talked with him. I'm not so sure I believe that; he was still warm, but he was really cyanotic, especially in the beds of his nails. The engine company got there at the same time we did and started working him before we got in the door, mainly because the patient's wife asked them to. It was a hard code to work; he had no access, a Grade 4 airway, and he was large. I couldn't successfully intubate him because of his airway, so I went with a combi-tube. That was just as difficult to place because of his size. In addition, I had to put an IV in his external jugular vein; his arms and legs had nothing. I was able to get a round of medication into him before we got to the hospital and CPR was ongoing, so when we got him into the hospital we at least had gotten as much done as we could. I was upset at the ED crew, though; they gave me a hard time because we hadn't intubated him, but they changed their tune when they tried; the doc immediately backed off barking at me after two attempts of his own. Plus, they inadvertently pulled the IV we worked so hard to get. I was rather displeased. But by that point, however, the patient was in their care, not mine.
In addition, we had a diabetic with a blood glucose of 5mg/dl - just a little bit low, don't you think? We got him to 175 after 25 grams of D50 (50% Dextrose solution). His levels were like a roller-coaster after that, from what the nurse who took him from me told me later. We also had a cardiac patient who walked nearly 3 miles from his apartment to the clinic he went to while he was having an active heart attack , a 34 year-old male with a history of Leukemia who was weak and dehydrated, and a two-car accident with 5 refusals of care. A note about the Leukemia patient that is interesting: he was extremely jaundiced. While he told us he is not receiving chemotherapy or radiation therapy, he is taking medication to keep his WBC under control. My suspicion is that the medication is slowly destroying his liver.
All this talk about work.... I just finished reading "The Zombie Survival Guide" by Max Brooks. It is a tongue-in-cheek book that bills itself as "Complete Protection From The Living Dead", and it is basically an A-to-Z primer about the history of Zombies, how they are created, and most importantly, how to protect yourself from them. As I said, it is tongue-in-cheek, very funny, and worth the time it took me to read it. My wife looked at me askance, as did people I work with, but a few of them had read it before and understand my twisted sense of humor. I'm looking forward to his next book, "World War Z", which is "An oral history of the Zombie wars." Knowing how much I enjoyed this one, I should expect to get as much of a kick out of the next one.
Now I have to and prepare my defenses. You never know when an infection will occur.... Till next time.
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