An Introspective During Tribulation

[firetender]

Thanks folks for the kind well wishes

...and here's another wheelbarrow of them, along with thanks for the thread!

You have to look at this in perspective.

In the 1950's, in Brooklyn, N.Y. which was beginning to really feel the effects of a changing society and increasingly more crowded conditions, people were dying left and right for no damn reason!

Excuse me, there was a reason; nobody knew how to do anything to stop or delay the downhill slide into death. Death seemed to have come much more easily back then, a scant 50 years ago!

I lost a Grammar School classmate to a choking incident. In my world, car accidents were usually fatal!

Many of us were aware of this lack. Coming across the scene of an accident, injury or acute medical condition was a complete nightmare. Not only was there no one trained on the scene to intervene, but in most cases there wasn't even anyone to CALL!

So let's now go to the late 1960's and the advent of American National Red Cross offering basic medical intervention skills to the public. All of a sudden, a few of us could do something!

Now what this meant to MOST of us who had the privilege of being trained to intervene, it was completely unthinkable that we would NOT respond if in the vicinity of an emergency! We were trained to AID! How more simple could it be?

The value of having someone on the scene that could actually help, if you can imagine this, was APPRECIATED by the people surrounding the stricken one!

(Today, the way it boils down, someone who is stricken is expected to be WHISKED away from the scene of the disaster and removed quickly from the sight of the passerby.)

On one hand, it's wonderful that there are so many out there who CAN take action. So many, in fact, that a whole lot of us can duck out and not get involved at all!

Being able to intervene in an emergency was once a precious gift, well-respected, and a sacred trust. Today, it's taken for granted, and people on both sides of the fence suffer for it.

[uglyEMT]

Hey Folks, me again.

Another update. Well as you can see some time has past since I last posted here. Well it was for a good reason. Dad had complications. A few days after my last post in the thread Dad was released and came home. I stopped by the next day just to check on him and was astonished what I saw.

He looked like crap, I went to my truck and grabbed my bag. Checked BP 50/40, pulse 75, resp 16. Skin dyaphoretic. Dialled 911 and got things moving. Being they do not live in NYC he went their local ED. Took 4 units and rushed for tests. CT, MRI, Echo. Well it was the echo that astonished us all. A load of blood in the pericardial sac. 750cc to be exact!! Docs sucked it out and prepared for a pericardial window. Mt Sinai was advised and said send him there.

He was transfered to Mt Sinai and they ran their tests. The bleed was stoped so they decided to monitor instead of surgery. After 24hrs they felt he was in the clear. He spent several days in CCU. During this time it was decided he would need acute care after recovery so plans were made. Monday he was transfered to KCC which is Mt Sinai's acute care center.

Well Tuesday he crashed again. Unresponsive BP 63/48 but breathing. Took 2 more units this time saline and BP came back up. Wednesday docs were scrambling to figure out what the hell was going on.

Well last night we finally got the answer.... too many meds!!! Seemed like every doc added something to the chart and what not. Had so many vaso dialators in his system his volume couldnt keep up!!

Hes back in KCC now and doing well again (keeping my fingers crossed). This time with his meds closely monitored through blood work and inroom checkups.

It has been a roller coaster of a ride here. I went back on duty tuesday and wednesday and it felt good. Since Dad has been in I have been on a LOA so felt good to put the uniform on. Was actually funny, Tuesday was a core 12 drill so it was like the EMS stars aligned and wanted me back. Got some CEUs and a nice refresher to clear the cob webs.

I am feeling good here, less unconfident. I was second guessing myself there for a while. I guess we do that when its a loved one. Thankfully my squad, my wife and you folks have been helping me get through this tough time. It makes me feel good to know I have a good support system that I can rely on when needed. We really are one big family.

I will keep you all updated when I can.

[Richard B the EMT]

Well last night we finally got the answer.... too many meds!!! Seemed like every doc added something to the chart and what not. Had so many vaso dialators in his system his volume couldnt keep up!!

If I get pharmaceuticals at the neighborhood drug store, they have a computer to keep track of what I am taking, as to not have drugs that interact against me. I am truly shocked to find that mighty Mount Sinai Hospital doesn't have one, and that the doctors didn't read the charts to determine what, and how much, he was getting of those vasodilators.

If only by reputation, try Saint Frances Hospital in Roslyn, Nassau County, NY. Per what I have heard, they have the best cardiac care in the NY/NJ/CT "tri-state" area.

[uglyEMT]

I was too Richard. What we are coming to the conclusion of is the nursing orders were unclear as to when to give the meds. Most of the charts, from what I caught a glimpse of, showed XXX med 2 times daily. So without definitive orders such as only if BP is above XX then the nurses gave the meds at one time.

Spellings might be off so bear with me

Coreg

Imdor

Plavix

Crestor

Asprin

Heprin

Dilaoton

Morphine

Percicet

Basically what was supposed to happen according to the docs. Imdor and Plavix post op 48 hrs morphine for pain 2 times daily if needed. Coreg and Crestor 2 times daily after 24 hrs with just asprin to clean out system of previous meds then maintain those two until necessary. Percicet back to pre op dose after 1 week. Morphine while in post op only. Dont know where the Dilaton came from. Also what the hell were they giving him Heprin for??? When he crashed Tuesday again blood work showed all above mentioned meds in his system at daily levels. The charts seem to show the meds never being removed from the previous days chart just added to. So right now we dont know why but we know how it happened as far as the bottoming out.

We are just glad the problem was caught and rectified Wednesday after a thourough review of his charts by multiple dept heads. The head of cardiology that did Dad's original procedure actually called them all in because and I quote, " I have too much invested in this patient to quit now."

As far as other hospitals. Mom and Dad have decided they will come back close to home in NJ at a local sub-acute care facility he was at once before. Then home. He has been through too much right now and we just want him strong again and back in his home.

So thats the skinny on whats been going on.

Edited August 19, 2010 by UGLyEMT