ratel

http://www.news24.com/News24/South_Africa/...2189073,00.html WTF!!!!

In SA EMT-B's can't transport IVed pt's

Friendly fire isn't friendly

First and only time I've had contact with that specific crew.

All the people on the bus were triaged green, and I did triage the dead girl as blue. I started bilateral I.V's on the red patient and even with them running full her BP continued to fall. Air ambulance was not available due to weather so when I heard that the nearest ALS was 30 min. out I decided to scoop and scoot. At hospital we found out that she had a ruptured diaphragm, and was bleeding into both her abdominal cavity and her chest cavity. When I returned to base I found out that the ALS unit had put a complaint in against me for not waiting on scene for them. As far as I'm concerned this patient would have died without immediate hospitalization, and ALS could not have done anything more then what I had already done.

This was an actual call I attended. You are dispatched to a MVC between a sedan and a 15 seater mini-bus. On arrival you find that the mini-bus has T-Boned the sedan on the passenger side. Inside the sedan you find a 16 year old female trapped with no pulse or respiration. Lying outside the sedan on the drivers side you find a 40 year old female, GCS 14/15 (pt confused and disorientated) Pulse 140 weak and thready, BP 80 systolic and falling rapidly, respirations 18 clear and equal. No signs of fractures, no bleeding, Abdomen soft, no guarding or tenderness. In side the mini-bus you find 8 people with minor bumps and bruises. There is extensive damage to the passenger side of the sedan and the front passenger door has been pushed in at least one foot. On scene you have 1 ambulance (no EMT-P, 1 EMT-I and 1 EMT-, 1 rescue tender (First responder and 1 EMT-B on board), and 2 police patrol vehicles. Other vehicles enroute ETA 20 minutes. nearest ALS unit 30 minutes away (in the opposite direction of the hospital). Nearest hospital 22 minutes away.

Signs That It’s Going To Be A Bad Shift 1. The ER stretchers are bloody and sticking out in the hallway. 2. The crash cart is covered in EKG paper and empty syringes, and all the drawers are open. 3. You meet a city or county cop in the elevator who asks for directions to your unit. 4. A nurse is filling out 3 incident reports and 5 med error sheets. 5. Bloody sheets and pillows are flowing out into the hallway from a patient’s room. 6. The Charge Nurse is yelling “Does anyone want overtime??!!” 7. The ambulances are double parked in front of the ED 8. On your way in, an agency nurse storms out and says “I’m never gonna work HERE again!!!!!!” 9. During report, the off going nurse reports that we are out of Pavulon and COFFEE!!!!!! 10. You walk into the trauma room, and the physician is actually doing something, like, with his hands and that could be taken as actual patient care.

Q. Why did you bring the patient here? A. I guess the sign out front that says “Emergency Department; Physician on duty” fooled me into thinking that this was a hospital that treated patients! Q. Do you think the patient can be triaged to the lobby? A. Since they demanded transport for a refill on their prescription I am sure that the lobby is more than an appropriate place for them to go. Unless you can triage them to the parking lot or the nearest bus stop. Q. How come the patient didn’t just call a cab or take the bus? A. Because the taxi services and the bus lines are smart enough not to take Medi-cal instead of cash payment. Q. What are the patients bowel sounds? (On a critical ‘auto vs. tree’ patient). A. Since we were on the side of the freeway and now are enroute to the hospital the bowel sounds pretty much resemble a diesel engine. Q. Did you look for ID? A. Sorry, no. I might find guns, knives razors and crack pipes during the physical exam but I am not going to reach into his pockets looking for ID and find a needle. Q. What’s the patient’s name? What’s the patient’s name?!! (on a cardiac arrest victim). A. I don’t know, I asked him four times after he coded and he wouldn’t answer me once! Q. What are the vitals? (Different Nurse, same code). A. If we’re doing CPR right he should have a pulse rate of 80-100/min, 24 respirations/min, and a blood pressure of maybe 40 systolic. Q. Can the patient sign the insurance and permission forms? A. Only if they use your pen. Q. (On the radio) Are you sure she’s in ventricular tachycardia? The complexes are rapid and wide not narrow, right? A. Uh, yeah I’m sure it’s V-tach, we covered this rhythm in some detail in Paramedic school. Is this a pop quiz? Q. Can we clear? We don’t do this medical stuff. (Fire Captain). A. Yes, you can clear. I am sure there is a La Z Boy recliner and a quart of ice cream waiting for you somewhere. Q. Is he dead? (Different Fire Captian, same department). A. What tipped you off? The dependant lividity, the rigor mortis, or maybe the ants crawling in and out of his nose? Q. Why can’t you hold over for a few hours this morning? (Managment). A. Why not? I’ve only been awake for 26 hours straight and been puked on twice, I think it is safe to say I would rather floss my teeth with barbed wire. Q. Can you guys hear the siren when it’s on while you are in the cab of your ambulance? A. What?! You will have to speak up I can’t hear you from all the years of listening to the siren inside this ambulance. Q. Do you need to go to school for this or can anyone do it? A. You have to go to school, it is long and hard and most of the people involved like to abuse the hell out of you while you are doing it. Q. Hey, Ambulance dudes, how do I get to the Dead concert at the Oakland Coliseum? (or any other request for directions) A.Hmm, well,uhhh. I’m sorry I don’t think you can get there from here. Q. I’m seeing things, will you take me to the hospital? A. Sure, if you are seeing rats and bugs we will take you to County Hospital, if you are seeing music and hearing colors we will take you to the Berkeley border and drop you off, you’ll fit right in. Q. Do you like you like your job? A. Yes, in spite of everything I do like my job. Q. Do you make a lot of money? A. Not enough by a long shot. At least not after my State, Local, and Federal Government gets through with my check. Q. How come the Police come to the call with you? A. Investigation, crowd control, and to keep me from getting my ass kicked by an irate bystander/family member/patient. Q. How come all the Firefighters come to the call too? What do they do? A. Beats the hell out of me, it’s not like the patient is on fire or anything! Q. Have you ever seen a dead body? A. Yes, in all the various states of decomposition and putrefaction. I’ve even seen maggots in ones that weren’t dead yet. Q. Do you have anyone (like maybe a patient) in the in the back of your ambulance right now ?(asked while we are sitting in the unit eating lunch in the parking lot of Doug’s Bar B Q) A. No patients. Only the Paramedic Student; don’t bug him, he’s a stress case and might crack. Q. What antacid is best for a stomach ache (asked in the parking lot of 7-11 at 03:30 a.m.)? A. Pink, white or green pay your money and take your chances. Q. Do you have any spare change? A. Take a hike, I don’t believe there is such a thing as spare change. Q. Can I have bus fare to get to the hospital? A. Yes, if it means you won’t take an emergency rescue vehicle out of service so you can get to a routine appointment for your toothache and if you promise to quit bugging me. Q. How long have you been doing this (asked by a recently hired rookie Paramedic)? A. Let me figure it out. Since you were in second grade, partner. Q. How come you are smoking that pipe , don’t you know that is bad for you? A. How can pipe tobacco be bad for you? If it was bad for you they couldn’t sell it at Walgreens Drug Store. Right? Q. Can me and my four kids ride in the back with my boyfriend to the hospital? A. No. Q. Can I ride up front on the way to hospital? A. Maybe, if I like you and think you wont bug my partner in the back. Q. How come is ambulance painted on your front grill? A.There is a device on motor vehicles that is known as a rear-view mirror, some people have even been known to use it to see what is behind them when they are driving. Q. How fast will your ambulance go? A. I don’t pay that close of attention, faster than my employer would be comfortable with, most likely. Q. Is he going to make it?!! Is he going to make it?!! (asked in reference to a patient who puked after too many 40 ounce bottles of Old English 800 Malt Liquor). A. Yes, I am sure that in spite of our best efforts , he will survive. Q. Can I have a band-aid? A. This is an ambulance, our band-aids are 8 inches x 6 inches. How many do you need? Q. What happened? (at an minor fender-bender auto accident). A. Plane crash! Q. What happened? (outide of a house where a person was having shortness of breath). A. Plane crash! Q. What happened? (at a plane crash) A. Shark attack! Q. What does EMT stand for? A. Every Menial Task, Eggcrate Mattress Technician Q. What does the EMS on the side of your rig stand for? A. Earn Money Sleeping, now please let me get back to earning some money, thanks. Q. Does this tie go with the rest of my suit? (asked by a guy on his way to church). A. Sure, a red, purple , pink, and black tie always goes with a gray pinstripe suit. Q. Do you have an extra one of them urinal bottles. I have to piss real bad. A. No. We don’t carry those any more but thank you for sharing. Q. What is the worst thing you have ever seen? A. A 12 gauge shotgun blast to the left side of a woman’s face that didn’t kill her, so she was writhing on the floor and trying to scream through the blood running out of her mouth with a good part of her face missing. Either that or it was the 6 month old baby who died because his drugged out parents left him on the floor heater grate until he was so cooked that the flesh of his fingers split away from the bones. Now aren’t you sorry you asked? Q. Are you always this much of a smartass? A. No, I am usually much worse, but the medication is helping.