Friday, January 18, 2008

Overtime

It seems like lately I've been getting a lot of it that's been unintentional. Over the past 3 weeks (maybe longer, I can't say for sure) I've been getting out at least an hour - sometimes more - late every shift I've worked. Part of the reason is that the city has just plain gotten busier. As of yesterday (1/17) we're already up to over 1000 calls. That's pretty impressive as far as the numbers go. I have to say that the acuity levels have been higher, too; people are sicker. For example, yesterday we got called for a diabetic emergency. My partner and I both were thinking hypoglycemia, an immediate life threat if it isn't treated quickly. On the other side of it, once it is treated, the patient will respond quickly and be back to the world of the living. However, this was for a 34 year-old grandmother with a blood glucose level that measured "high" on her meter, the engine company's meter, and our meter. Now "high" is a level that is over either 500 or 600 mg/dl, I can never remember which. In any case, it's a dangerous level to be at, and hyperglycemia can lead to a condition known as Diabetic Keto Acidosis, or DKA. That is really bad news and is as much of a life threat as hypoglycemia is.

So we got her out of her third floor apartment (and she was a big girl at that - probably over 300 pounds) and we managed to get her safely downstairs on a stair chair, loaded her on the ambulance, and tried quite unsuccessfully to get IV access so we could get fluids into her. Between us and the ED staff I think there was at least 12 attempts to get a line into her. At the end they did get access, but I'm not sure where.

On other fronts: two fires yesterday in Manchester. The first one (first alarm at 3:15AM, total of 5 alarms) put a stretch of Lake Ave. out of reach for most of the day. The second was a stove fire that burned a woman severely across her back and legs. She went to Boston last night to be treated.

Both were bad situations. I know that during this time of year we tend to get busier because of the cold temperatures. Plus, people tend to get sicker at this time of year because of diminished immunity, less in the way of nutrition (especially the elderly) because they have to decide between food and heat, and just a general slowdown of metabolism because of the cold. That all relates to both of these incidents at least indirectly. I hope that the incidence of fires up this way slows way down as there have been a number of them so far this season.

More to come - working tonight and I have to start getting ready soon....


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