Above: Ripon Ambulance EMTs with Theda Star Helicopter
Above: Jamie (green sweatshirt) below the spinning rotors of the Flight for Life Helicopter
Above: Me and a couple of my coworkers. Connie (middle) baked me a giant "Good Luck, Reed" cookie and ordered us all pizza because last night was our last shift together!
Aunt Nancy is right, it is time for a new post! The last couple weeks have been a exhausting and confusing combination of excitement and stagnation in terms of work. The ER has been quite slow (when I've been working there on weekends) and the daily numbers have been in a bit of a "slump" lately. I've been told that patient surges and slumps come in cycles, and we're just in the middle of a slump right now. Just when things were looking predictable...
After working the weekend shift, I stayed up until the early morning hours of Oct. 27 to write a paper. After two hours of sleep I woke up to my pager going off. It was for an "unknown", one of those calls where the dispatchers just can't get a lot of information about what is going on. We were told that a husband had called for his wife, that she was "moaning" in the background and needed to be seen at the hospital. When we have very little information like that, we usually assume the worst and respond with lights and sirens. We arrived at their home to find his wife laying in bed, complaining of flu-like symptoms and not feeling quite right. She was very weak, but perfectly coherent and talking to us. We helped her to the cot and got her out to the ambulance and I hopped into the driver's seat for a quick 5 minute drive to the hospital. One of the EMTs called in a report to the hospital from the back, and the patient was laughing and joking. Suddenly she stiffened up, gasped for air, and went unconscious. The EMTs in back tried to get her to respond, but she was completely out. We were less than a mile from the hospital when I flipped on the lights and sirens and called the hospital to inform them of the change in our patient and "upgraded" response. By the time we reached the hospital, she had stopped breathing and as I pulled into the ambulance garage her heart had stopped. I jumped out of the ambulance and ran to the ER doors, yelling "PNB!" inside (PNB means pulseless and not breathing). We got her into the trauma room immediatly and started CPR. A "code" like this is one of the few times that the little Ripon ER is like the TV show. It is a blur of activity, but there is calm and control in every action. The ER doctor intubated her and their was a surgeon there to start a central line. I looked for a peripheral IV and rotated in and out of doing chest compressions. We worked for a half hour, trying different rounds of medications and all the while doing CPR, shocking her three times with the defibrillator. I was doing compressions when the doc told me to stop so he could see if she had regained a pulse. Amazingly, she had! Her heart was beating again on it's own and she had a good blood pressure for the first time after being dead for thirty minutes. She ended up being transferred to another hospital later in the morning but, sadly, died on November 4th. I never heard if she had regained consciousness (I suspect she didn't, but who knows) but at least her family got a chance to say goodbye.
After we had finished out paperwork that Monday we just kept getting calls until I was done at 6pm. The next day was even more busy, with a total of 6 calls. I started at 7am and didn't get done until 7pm. I had time in between calls to get home and let the dog out or take a quick shower. I went to my favorite place in town for lung, and just after I had ordered, paid, and sat down the pager went off again. Thankfully I'm a "regular" at this spot and they put my meal in the fridge for me until I was able to come back (I finally had my first meal of the day at 3pm during a 15 minute lull). At 7 I finally got home and took the dog out for a walk, not having to worry about getting paged out again. I was about halfway through the walk when I got a phone call from a "restricted" number... never a good sign. It was the hospital asking me if I could be on call overnight just in case they needed somebody to come in and help out. I didn't have any pressing plans besides homework, and I need the money, so I agreed, hoping that they wouldn't be as busy as they had been earlier in the day. Five minutes after I hung up the phone they called me in to work... ug. I finished the walk, took another quick shower, grabbed some food, and hopped on my bike (I always bike to work, rain or shine). I ended up working from 8 until 2:30 in the morning and stayed busy the whole time, including a patient that came in after being burned when their furnace exploded when they tried to light it. I don't think I've ever slept so well after those two days!
The rest of the week was pretty uneventful, as was the weekend. I wasn't on call at all this past week, and tried to get some homework done. On Wednesday I headed down to West Bend to visit Jamie and help out with her Grandma, who is living at home after a series of falls. Jamie stays with her during the week, making sure she gets her medications and making meals, etc, and I'm trying to help a bit too before we leave. So I was there for two days and then had to head back on Friday to work the ER again. On my drive back to Ripon, there was a gross combination of snow and rain coming down. It is an hour long drive and I have to take a major highway called Highway 41. I was only 15 minutes into the drive when I saw cars slowing down in front of me. There is construction, but it isn't usually backed up that far. Then I saw about four cars pulled over and a car in the ditch that had rolled over. I pulled onto the shoulder, and hopped out of the car and into the sleet wishing that I had brought my raincoat. I opened the trunk and grabbed the jump-kit of EMT stuff that I always have in the car. It was a single vehicle rollover with one patient, and I had gotten there only a minute after it happened. Luckily, there was a first responder there who had pulled over too and we started assessing the 18 year old driver. She was wearing her seatbelt and was able to get out of the car and was walking around when I got there. Then she started getting cold and dizzy and had to sit down. I ran back to the car and grabbed a blanket that I had in my trunk and covered her up a bit. She said that she didn't really remember the accident, and the other first responder held her head in place while I put a cervical collar on to immobilize her head and neck. She was bleeding from her ear, and then started to complain of pain around her ribs/liver on her right side and said she was getting sleepy (not a good sign). Luckily the fire trucks, police, and ambulance were all starting to show up on scene. By the time the ambulance got there, we had her fully assessed, on oxygen, a collar on her neck, and all of her info gathered so they were able to put her on a backboard and have her on the way to the hospital within 5 minutes. So, I was able to use my jump kit (thanks for the patches, Carol) on somebody besides a drunk college student finally!
I think that will do for now... I'm working on getting final arrangements made for the move to Colorado, and I'll hopefully be able to post again soon.
