Velcro Jumpsuits, Ball Gags, and other random thoughts.

I'm guessing maybe the title of this raised a few eyebrows? Maybe, maybe not. This post will most likely be quite random. My brain feels like a beehive in fight mode right now... 2 million things buzzing around, stumbling over each other, frenzied, confused, aggravated, frustrated, etc.

As for the velcro jumpsuits and ball gags, I think those items should be standard issue to any kid who rides a school bus. Tell em when they get on: "You can ride as you are right now, but if you get out of hand you're getting stuck to the seat and getting silenced." I covered the same route for several days last week. These kids were pretty cool, but they got way outta hand friday afternoon. Especially the elementary kids. The High school/middle school kids were pretty well behaved, but after the elementary run friday, I swear I just about had to clean footprints off of the ceiling of the bus. The whole week was kind of crazy in the kid department on all the runs I was on. The whole week was crazy, period.

I started my ride time last friday. I rode from 0800 to 2130 and I caught one call, an MVC rollover at 1915ish that wound up being a sign-off. It got me out of Phase One anyway...

Sunday, I went and started my ER time. The day started out pretty slow, then a few walk-in's started coming in. One lady came in and was a perfect example of why you should listen to your doctor when he gives you instructions for medication.
She was on Digoxin and her doc told her no stimulants at all. So what does she do? She starts her Sunday morning with 2 cups of coffee and some chocolate chip cookies. Reeealllly smuckin fart.
She was pretty sick. I was later told that she was admitted and put on Dig. withdrawl protocol or somethin like that... We had a few other run-of-the-mill pts come in, several frequent fliers... I got to watch one guy with bad kidney stones get 50 mg of Demerol with 30mg of Toradol. yeah. sleep tight, sunshine. I followed one of the nurses in when he went to check on the guy and he was out cold. The nurse walked up to try to wake him up to check on him and the guy snapped "awake". He was in a royal med funk. You could see how thick the haze was as he was lookin around with that "WTF is going on and where am I" glazed over look.

Then we were sitting there being bored when a guy walks up and asks us to help his wife. He tells us that she cut her finger off. We asked how and he rolled his eyes and said "She was picking her nose and I punched her in the mouth". We laughed and went over to check her out. It turns out that she had started to fall, reached for a solid object to catch her balance with, and just happened to grab a heavy steel door, which just happened to be open, which just happened to slam shut and lop off about 1/4" of the tip of her left middle finger.
The doc asked if they recovered the fingertip and the husband says "Yup, got it and brought it with us". I'm thinking maybe they have it in the car still, but the husband reaches into his back pocket and pulls out a ziplock bag with her finger in it! I found that kind of amusing. The doc was able to stitch it back on and everything.

There were 2 docs on that day. The one who did the stitching was the one I wanted to work with, because he's a real cool guy, a great doc, used to be the Medical Director for the region, etc.
He didn't really seem in a big teaching mood. I asked him some questions and he answered them and everything, but he wouldn't voluntarily explain stuff, so i just followed him and watched for a while. When the second doc came in at 1100, he got himself settled in, asked me who I was and what I was doing, and once I told him I was a paramedic student he told me to stick with him. He went into deep detail on everything. He was asking me questions about patients we saw, quizzing me on stuff, explaining stuff in great detail... It was great. He seemed genuinely interested in helping me out with stuff. When we had our lunch he was asking me all sorts of questions about class, my plans after class, my background, etc.

I got to try for one IV, which I missed. The lady had crap for veins. The nurse wound up having to use a 22 ga. to get the IV, so I didn't feel so bad about not getting the stick with a 20 ga.

Then of course my white cloud status struck again. 2 hours after I left, a 37 year old came in with chest pains and wound up coding in the ER. Go figure. It was a save, too.

After I left the ER, I went to visit a friend. We went out to dinner at Applebee's. It was a pretty good time. We just hung out, talkin and stuff... I was soooo tired. I only slept like 3 hours saturday night/sunday morning then I had to be at the ER at 7. After sitting around all day at the ER I was drained. Anyway, we had just about finished eating when I heard clapping coming from the kitchen area. My first thought was "Somebody must have a birthday today". Followed by "Hey wait a minute, my birthday's tuesday... Nah, must be someone else." Then I saw the entourage of employees coming out of the kitchen toward our table. I was like "Oh hell no." Then they started to gather around our table and I said "You have GOT to be kidding me." I'm not big on the whole restaurant birthday recognition thing, so I sat there beet red with my head in my hands for half of the song. I think I stayed beet red for about 10 minutes. The song was pretty funny, I got a chuckle out of it. I think my friend thought i was pissed because of my reaction. I assured her that I wasn't pissed and I said thanks. I was in a weird mood that night on top of being exhausted anyway, so I'm not surprised that I might have come off as a bit irritated.

Then on tuesday, I had a bus route that came equipped with a Monitor, Aide, whatever you want to call them. Halfway through the elementary route she said "Hey, isn't your birthday today?" I said yes. No use denying it, it was on the transportation bulletin... So as we pulled in to the elementary school to drop the kids off, the bus monitor said "Ok kids!" and 60-something elementary kids sang happy birthday. That wasn't as bad as the restaurant. I guess you could say it was kind of cute. Most of the kids I drive for like me. I've been on at least 3 bus routes where the kids have asked me if I could be their permanent driver. I tell them that i'm just a sub and their regular driver will be back and then the kids tell me I should take the route, make the regular driver switch routes, get them fired, make them quit or retire, etc. I keep telling them that it doesnt work like that and they get all disappointed. A very common complaint that I hear from the kids is that their regular driver is mean, screams at them all the time, etc. I've seen a few of the drivers in action and it seems like they think they're driving a prison bus. "Get in, sit down, shut up, and don't move" is the mentality that alot of the drivers have. I guess i'm still young enough that I remember what it's like to be a kid. Sit down, shut up, and don't move are not words commonly found in kids vocabularies. I do try to maintain relative order while I'm driving, but the way I look at it, driving safely is more important than babysitting. Friday afternoon, the kids were running up and down the aisles, jumping around like rubber balls, and generally going bananas. It got to the point where I quit trying to tell them to calm down and stay in their seats because I was losing my voice trying to make myself heard over them.

The other thing they like is the radio. Alot of the drivers will put the radio on country and leave it there. Now, I like country, but i understand how you can only take so much of it. Usually when I get in the bus, especially in the afternoon, I'll turn on one of the rock stations. Alot of the kids like rap/hip-hop and similar noise. I'll occasionally put that on for them, but that usually requires me to be in a good mood. even then, as soon as the bus is empty I turn on the country. Country is the antidote for that rap crap. So on a rap day, i'll be listening to alot of country for a while after work.

Just as an insert, i've cooled off quite a bit. My little brother and I were just chillin for a while and talkin and stuff, plus i put a whuppin on the punching bag he's got out in his lounge (for lack of a better word), so i feel alot better. I've got the skinned knuckles to prove it. :-P

Anyway. I did more ride time earlier. I'm riding at 2 ambulances. My preceptor works for 3 area ambulances and I can ride at 2 of them with him. One ambulance is based in a village and covers an area that's a mix of village and boondocks (the one I rode at last week) then the one I rode at earlier today (Saturday, actually) is based in a small city and they cover a huge area with a little bit of everything.

We had some good calls. The first one we had came in as "unresponsive, pt is breathing". We got there and city rescue told us that the guy was bradycardic, but awake. We got him on the monitor and at first glance it looked like he was in 3rd degree AV block. Once we looked at it though, it was more like an irregular sinus brady. His rate was in the mid 30's to mid 40's, he was weak, somewhat diaphoretic, and that was all he was complaining of. 0.5 mg of Atropine didn't do anything, so we got him loaded and headed for the hospital. We found out later that his Potassium level was 7.9. Normal is like 5.5 or something like that. The nurse told us later that she was shocked that he didn't code on us because 5.8 is usually the pucker factor threshhold.

Then we brought in an elderly woman with a nasty case of cellulitis on her lower leg.

After that we got called for a possible cardiac. It was most likely anxiety related. His rythm looked clean, he had been experiencing burning and pressure in his chest earlier in the day and had told us that he's gone in for it before and they just tell him it's stress. So most likely it was a repeat. As my preceptor said; "If you hear hoofbeats, assume it's a horse, not a zebra."That goes alone the same lines of; "If it looks like a duck, flies like a duck, and sound like a duck, it's probably a duck."

Our last call of the day came in as injuries from a fall. Elderly woman fell outside and sat ther for about 2 hours because she couldn't get up and none of her neighbors heard her calling for help. I think she had some alzheimers or something going on, because she wasnt quite with it, but it didn't seem like an abnormal "not with it." She was a simple ALS because for one, she was outside in mid 50's temps for 2 hours with a stiff breeze, plus she thinks she might have passed out, but wasn't sure.
My preceptor started the IV and stuff on the last lady and then just plopped himself in the captains chair at the front of the box and started writing. He hadn't really asked her any questions, so it was obvious to me that he was handing the reins over to me, at least for the interviewing side of things. I'd already done the assessment on scene, so I guess he just decided to see how I could do for the rest of the call.

By the end of the day, he decided that I was ready for phase 3. The only problem is
that I can't start phase 3 until I successfully test out of cardiology on the 12th of this month.
On the evaluation form for the call, he wrote "Adam is ready for phase III". That's all he wrote on it. Good enough for me. Hopefully I can keep up the pace when we get into phase 3 and 4.
I'm loving this so far. I just have to be cautious because it's easy to get confident in yourself on cake calls. Throw me in charge of a call that is circling the drain and it could be a different story. We'll see. I will do my best, whatever the situation. I'll probably do another shift or 2 in phase 2 just to make sure i'm brushed up and everything.

Things got kind of weird during the last hour or 2 of my shift there. I got this really bad feelling. I mean REALLY bad. Bad like I was kind of concerned about the drive home, bad. It was just this knot in my stomach that said "something REAAALLLLLLY bad is gonna happen." I was seriously worried about the ride home. I called home before I left and made sure everything was ok there. I get feelings like that from time to time. Sometimes I find there is a reason, most of the time I don't. But I have learned to listen to those feelings. Those feelings have saved our (my family's) butts in the past. And mine individually, as well. I started for home and the farther away from there I got, the better I felt. I didn't feel totally better, but it eased up a bit. That feeling threw my whole evening into a funk though. Alot of other stuff that has been bothering me kicked into overdrive and I was in a really dark mood for a while. Then I started talking with Matt (my oldest little brother) and the darkness started to lift. Then I started using his punching bag while we talked and that helped relieve the stress even more. So now I am in a good mood with skinned knuckles on my right hand and and mild headache from laughing so hard during the conversation Matt and I had.

I'm going fishing this afternoon (sunday). It should be interesting. My friend called the other day and said he has a new spot, some place that i've never seen before. "The only thing is," he told me, "that we have to watch out for the bears." "Excuse me, did you say bears?" "yup, bears." "Ok, i'll make sure I wear my bells." Sheesh. I don't think it is a coincidence that the opening day of Trout season and April Fools Day just happen to both fall on April 1st every year.

It's 0130 now. I'm gonna head to bed because I have to get up at 8. I've gotta get some sleep so I can outrun the bears while trying to catch fish.