My first day on the job.

[mrsbull]

Well today went well. I was being trained on a few things (besides ems) Went to lunch. Went to clock in and I get grabbed my mgr and dragged out to the train tracks. Reported pt fell on the mtn/train tracks.

That was when it started!! 86 y/o f, fell approx 6-20 feet off the mtn. Not onto train tracks but below. I nearly rolled my ancle and sup and other ems got hurt getting to pt. (we are ALL good at mtn rescue and well trained. Terrain was rough.) I think it was 10-15 ft. (poss 20 feet ONTO rocks). If it is calculated by where her shoe was it was 6-7 feet. But by the MOI was it was 15 ish feet on Rocks.

Here is my ?? Pt was AAOx2 bp 170/90 resp 70 sats in the 80s. Keep in mind that anything above 70 at my (new) job is good. My sats are at 80-85 up there. Uncomfortable yes but adaptable. We are not to give O2 above 70% depending on pts MS and a few other factors. Pt was reported to have loc and fell reason unknown her family was not there. She knew time person place (mostly) but has poss dimentia as she was asking what hppned (dementia via daughter) Hx of glaucoma, family hx of heart problems. (pt states she has none) Pt broke her arm obvious break/avulsion 1 in lac on eye (Seen bone and "fat pad") on both injuries.

I completed my Trauma assessment mostly clear but wounds I have spoken of. PMS appropriate pre and post spinal precautions and splinting of arm/body. Pupils Right was 2mm non reactive and left was pinpoint. Abd was rigid and felt like marbles (WTH MARBLES??.) At first it was normal on the ruq and rlq. LUQ and LLQ rigid and non tender to palp. Re assessment 5-8 min later (by me) was what felt like a tight pouch of marbles... I have never heard/seen/known of this.

We made the decision to have ALS intercept on the mtn. I TOLD my sup to get flight going and to get an LZ established. (keep in mind this is my first call and first time ANYONE on the EMS staff has met me). So we get her rolling via back of truck by Rangers. (I did not go) pt started to crash bp 130/70 o2 80%-85% and dropping(last vitals I heard about) pt was on 15 lpm nrb sats stayed about 85 pulse is unk but def below what I got. She has a hx of syncopal (sp) episodes via 1 yr @ last episode. Pt came from Texas and went to 14,110 feet within 2 days (not wise).

Question is what could have caused the abd full of marbles (feeling)? I have never felt it before never told of it. ALS was intercepted 2 miles from flight so they got a set of vitals and a line established (we cant do lines via med control we will be working on that tho). Unkonown if pt is ok as we are not allowed to FU. However friends of friends can help!!

So this was my first pt and first call at this job. I have been told now that I am mgmt material because I am just that awesome!!

Thanks for reading I am just wondering about the "marbles" Mostly. I think it was just the altitude. This gal was AWESOME!! She only complained once in the hour I had her of "my arm is sore". Family was great and it was so smooth. There was me and another guy who just started today and it was/flowed like we had been working together for years.