Week One

I will just start by saying, this is a completely different world compared to Idaho EMS. No offense to the many great medics and EMS personnel back in Idaho, but the volume of calls and the EMS response here is totally different! Let me explain, I was lucky to get 2 or 3 calls in Idaho on a 24 hour shift, where as here in OKC (Oklahoma City) we will surely have at least 4 calls in a 12 hour shift. Here in OKC we respond to every single call, let me repeat that, EVERY SINGLE CALL FULL CODE (this means we respond to every single call lights and sirens and they drive very, very fast here)!  I told Kim the other night that it will be a miracle if I survive the internship because of the way we fly through traffic here. Each time we respond to a call, I buckle up, and just sit back in my seat and brace myself as we fly through the city streets.
     And let me tell you, just how comfortable the ride is in the back of an ambulance! Have you ever been in an old farm truck or better yet a tractor and driven over corrugated field? Well, try to imagine how you felt and now imagine those corrugates randomly popping up and some times they feel like your jumping a small drainage ditch as the ambulance is being driven anywhere from 60 to 85 mph! It is nice when the driver shouts a moments notice warning to me as we jump a curb or cross over the median into oncoming traffic. I think that's my favorite part, when I know I am heading into oncoming traffic and can't see anything because one; I am facing backwards in the back of the ambulance, and two I don't dare sit up in my seat and turn to see through a small 1 sq ft. hole that opens up into the passenger compartment where the driver and medic sit. I try to have faith that all will go well, but I think in those instances I am relying mostly upon grace, that somehow Heavenly Father will guide us through and protect us as we weave in and out of traffic and speed through red lights at intersections.
      Kim asked me just last night, "I thought you loved driving with the lights and sirens?" I replied, "That was in Idaho when it was few and far in between, and we didn't respond with lights and sirens to every single call! Here we drive with lights and sirens and put ourselves and every other driver and passenger on the streets in danger for somebody that's been sick for the past 3 days and finally decides that because they still feel crappy they need to be driven to the ER by ambulance!" What part of their illness is emergent? The best part is when we have to wait on them because they have to gather their ipod, their eye glasses, and a favorite book to keep entertained in the ER because they will be sitting there for a while until the doctor can get a second to see a person with such a life threatening emergency. Don't get me wrong, I enjoy helping and taking care of people with life threatening emergencies and that are too sick to move or help themselves, but for others that abuse the system, well I just pray that people are not killed or hurt in responding their urgent need!
     I am learning so much here! My preceptor is great! She is very smart and knowledgeable and demands the most from me. She has had me jump right in and run the calls, which is very nerve racking at times. Honestly, sometimes I feel like I don't have a clue and have forgotten everything I knew or learned and she doesn't just feed information to me and give me answers, she just looks at me and asks me what I think we should do. The moment I make a decision she is right there to support it and do whatever is needed to help, but she demands that I make the decision and judgement on patient care. The past week I had 3 chest pain calls, and of the 3 people, I believe only one of them really needed  pain meds and was really having chest pain. The two that I ended up giving pain meds (morphine) to, ended up being the two that I believe were only seeking to get a fix, because they were out of pain meds at home. One of them actually said that they were out of their pain meds early because they had ACCIDENTALLY dropped some down the toilet. Haha! I try not to judge in the moment. If they complain of pain and get so dramatic as to cry about it or pretend to be confused about where they are and where we are taking them, I give in and give them what they seek. I would hate to withhold pain meds from someone that really needs them so I give them to those complaining of pain. Did I mention that both of these patient would rest peacefully on the cot until I asked them how they were doing and how their pain is. Haha!
      My very first call of my internship was a great welcome to OKC. It was a patient complaining of difficulty breathing and he ended up being out of his pain meds and needing more and had been in the ER the day before because his oxygen tubing (a nasal cannula) caught fire as he was smoking a cigarette while it was attached and flowing a highly flammable gas through it. I can only imagine what that would have looked like. He told me that someone handed him the cigarette and he was simply passing to a women to his side and it suddenly caught fire. Haha! Rrriiiight! AS HE TOOK A PUFF AND THEN CAUGHT FIRE!
       So, the call begins as we roll up to this very rundown house in a very rundown neighborhood. As we arrive the Firefighters are already on scene. DID I MENTION THAT IT WAS 5 AM? So, we walk in and the house is filled with that lovely cigarette smoke saturated smell, the place has probably never been cleaned and I can feel stuff crunching under my feet every step I take. There is a women sleeping on a bed right in the living room (she is still asleep or passed out, since 5 firefighters are in the house plus 3 EMS personnel and no one was whispering), I walk into a very small crowded kitchen where two fireman are standing and turn to my left and peer in a small room with my patient sitting up on the side of his bed. He is a very malnutritioned man with longer white hair and a white beard. He is wearing red socks, red sweat pants, and a red T-shirt. My first thought was it is Gandolf the Red! He had a stunning similarity to Gandolf the White or Gray from Lord of the Rings. So, my preceptor enters the room and I decide to watch from the door and place my gloved hand on the wall to relax in my stance. The Firefighter next to me says, "I would watch where I place my hands in this place unless you want a bunch of creepy crawlys on you!" I look at the wall and see hundreds of cockroaches scurrying around. I thanked the Fireman, for the heads up. He said, "I wouldn't stand in one place too long either." I could already feel them crawling on me.
      My poor preceptor squats down to the floor to search for the mans medication bag and she grabs a little white trash can and I see hundreds more of all different sizes most of them being little tiny baby roaches. I could not wait to get out of the house and into the well-lit ambulance, where I would be able to flick or smash anything I spotted crawling on me. Don't worry, I found one. I believe it was a flea that had jumped onto my arm from my patient, I smashed the thing and threw it on the floor. Sick, Dude!