Spring Break! (Yeah, right.)

Busy busy busy.
This is what I love about going to school or a really long training course. no time to be bored. Strangely, though, I still find time occasionally to be bored. Mainly because my study habits suck. I bought Ace Combat 5 for my PS2 a few weeks ago. You want to talk about wasting study time? That game is awesome, which also means it is a huge distraction.

Class is going good so far. I'm way behind in my clinical time though. The whole class is. So far I've done my time at the 911 Center, 2 ER rotations, and Part one of my mandatory rotation with our medical director. That was actually pretty cool. The Med. Dir. wants 2 rotations per student; one near the beginning of our clinical time, one at the end. Evaluation of our skills progression, they say. Anyway, the first thing I got to see when I got to the hosp. was the Doc setting some woman's elbow, whcih she had seriously dislocated while moving hay. That was pretty cool. Never seen a joint (or bone, for that matter) get set before.
After that, Doc and I were talking and I was asking questions and after a few minutes, he looked at his computer screen and said, "Go check out Mrs. So-and-so in Rm. 4, then come back and tell me what's wrong with her." So i did. I talked to the lady and her daughter for a while, got the HPI (history of present illness), PMH (past medical history), etc. I went back to the doc and told him she had A-Fib (atrial fibrillation. basically, the top part of your heart, the atrium, is quivering instead of rhythmically contracting.), I told him that i thought she had pneumonia, given her symptoms and lung sounds and all. He then said, "Alright, lets go find out." He hadn't even seen her yet. I was told before hand that that was his teaching style. It was pretty cool actually. I don't particularly like doing hospital time because usually you just follow the doc or a nurse around. Plus I just don't like hospitals.
Anyway, He agreed about my pneumonia diagnosis, which was cool.

After a while, he sent me in to another pt. This one had SOB (shortness of breath), also stomach pain. The stomach pain was from the liver cancer she was just diagnosed with 2 days earlier. She also had some CHF going on. I felt bad for her. She was really nice and she knew her days were numbered... I told the Doc when i came back that she probably had some CHF, plus there is always the possibility of lung cancer. Cancer usually doesnt start in the liver, i've been told. Usually it metastasizes from the original cancer and then sets up shop in the liver. This lady said she had been coughing for several months and it hadn't been getting better, soooo...

I got to bring my medications knowledge into play, too. I was looking at the monitor (you know, the ones that are in the ER that show all the rhythms of the patients who are hooked up?) and I saw bradycardia, multiple A-Fibs, and a Rapid A-Fib, which was chugging along at about 154. I pointed it out to him, his eyebrows went up and he said, "Well, we can't very well let her keep that up for too long, can we? What are we gonna give her?"
She was too slow for Adenosine, which probably wouldn't have worked anyway, so I said "Cardizem." "Good choice!", he said, and wrote the order.

I then went to see a guy who had passed out earlier due to a Sinus Bradycardia in the mid-upper 30's. He had been given Atropine, which brought him up to low 40's. The guy was relatively asymptomatic, except for weakness and dizziness. His pressure was around 80/50 when we got him... I'm wondering why he wasn't on Dopamine. Maybe because he wasn't having any major symptoms? Still, he'd had Atropine and a couple fluid bolus' and still his pressure sucked. They did slowly start to get the pressure up, i think it was in the low 90's when I left. I did get to do an IV on him though! Hospital policy dictates the removal of field IV's and then reestablishing access in the hospital if the pt. is going to be admitted. Something about sterility and infection issues. Anyway, the nurse was going to have one of the nursing students (it's a teaching hospital/Level 2 trauma center) do the IV, but he disappeared, so they gave me the honors. The guy had good veins, which was nice. I told them (the pt and his wife) that I was a paramedic student and i asked if i could do the IV... the guy looked at me and said, "It ain't your first one, is it?" I laughed and said no, that i'd done one or two before, so he let me. Got it on the first try, too!

So that was the fun for that rotation.

I've done a couple of rotations at the ER we go to alot with QVA, and i've seen some pretty interesting stuff there, even though it's kind of slow. I've seen some nice stitch jobs. It's strange though. I can deal with all kinds of madness, mayhem, blood, guts, and gore in the field, but make me sit through someone getting stitches and I turn green. The girl came in with a nasty lac on her thigh... about 2" long, 1" wide, and 0,5-1" deep. They called me in to help when they were cleaning it and numbing it. She started crying when the doc started cleaning around and in the wound, then really started howling when the doc started numbing the site. I wouldn't have been too happy myself... Jab a needle 20 times into the middle of a lac like that will get anyone a little steamed. Anyway, she was only crying for a minute and then calmed right down as the pain went away. She then said, "Mom, you can let go of my arm now." Mom was more freaked than her daughter, i think, because when she let go, you could see the red mark and indentation from how hard she was squeezing.

So anyway, we don't have class again til May 8th. I'm gonna use some of that time to get some rotations out of the way. I'm gonna do respiratory time tomorrow afternoon. I'm gonna try to get Resp. and ICU out of the way this week if i can.

Last week sucked. It was spring break from school, so I had the week off... buuuuuttt, i had to take the 30 hour bus driver safety course all week. And what a week it was. Not a cloud in the sky all week, mid 60's to mid 70's, and there I was, sitting through this class at BOCES. It was, most of the time, an interesting class, but i would soooooo rather have been fishing.

Today and tonite should be fun. My F.D. Installation Banquet is tonite. I am soooo behaving this year. last year was fugly. I almost got myself in trouble last year. Anyway, I'm moving up in the world... As of tonite, I'll be 3rd Lieutenant/Medical Officer. I was 4th Lt. but we had a shuffle this year so everyone moved up a spot.
Our Car 3 turned down his chiefs spot this year, he wants to go back to yellow hat. So one of the LTs (the one who works nights and is usually around during the day) got promoted to Car 3. One of our captains had to leave the Dept. to to an insurance issue... He hurt his back (for the 82nd time) and had to have major surgery and he got the surgery paid for and got a settlement, then the insurance said, "You're too much of a liability now. Goodbye." So he's joining a neighboring FD now, from what I heard. They aren't filling his Captain's position, so we're down to one captain (who also happens to be the county fire coordinator). They move all the LT's up a spot and The Chief's daughter is getting my old spot as 4th LT. i'm happy for her. she's calmed down alot since last year. She and I both went to the same college in the same fire protection program, had alot of the same classes, etc. She know's her stuff, i'll definatly say that. This is not a case of "My daughter is gonna be a LT this year because I said so." My dept. is good about staying away from brown nosing your way into a position. If you get an officer's spot, you earned it.

Anyway, the banquet is tonite. After the official stuff is over, i'm either gonna hang out there for a while or go to a bar for a bit with the friend I'm taking to the banquet. Then I'm gonna split around 11 and head back north of here for a concert/friend's birthday. It should be a fun night. I don't have a DD though, so I won't be drinking much, if anything.

Well, I gotta get running. Gotta go get some car parts and stuff.