Sunday, September 26, 2010

GhostBuster my first week as "Medic 12"

It was 3 am and as my eyes shut for what I hoped would be a blissful night of dreaming, the radio shattered the silence. "Medic 12 respond to fire" My eyes opened wide as I shot up and jumped into my boots. The call came across as a fire and thats the only information we received. My Basic partner and I hop into our fly car, hit the lights, and speed off into the night. I start going over the burn protocols in my head on the way to the fire. I know I will probably be the only Advanced Life Support unit at the scene, so I want to make sure I have a plan in my head when we arrive. I would soon find out the plan(s) I had where about to go out the window and there was no protocol for the situation I was about to encounter.
    We arrive to the scene, fire trucks are everywhere and the firemen are searching for patients inside. The Basic ambulance had the only patient waiting in the back of there ambulance. The patient was a male in his 30's appeared to be unconscious. I administered a sternal rub and he quickly "woke up" staring at me with confusion. Trying to find out whats wrong the patient in often a big challenge here because no one speaks English. My Basic partner is often the only one who can translate and his English is very limited. We get baseline vital signs, pulse ox-cemetery, a blood sugar, and check pupils. Everything is within normal limits. The patient appears to be very confused and is having trouble standing... Aparrently he is saying some very odd things in arabic. I start considering possible causes to his altered mental status and unstable gate. He wasn't near the smoke in the fire, and did not appear to have carbon monoxide poison, Hes pupils and vital signs where normal, his blood sugar was normal, he wasn't having a stroke, I did not smell alcohol, so why was he acting so strange? At this point I found someone who could speak pretty good English. He told me the patient had not slept in 2 days and saw a ghost.....
Apparently "the ghost" made him like this. I tried not to laugh but I could not hold it back, but as I looked around I was the only one laughing. I recommended we see if he had a past medical history, if he took any mind altering substances and he go to the hospital for a physiological evaluation by a physician but thats not what happened.
    At this point as a Paramedic I was no longer in charge, but it wasn't a doctor that took over care from me it was a holy elderly man with a large beard. With a Quran in one hand he stood over the patient and began to pray. He started to perform some kind of procedure which I soon found out was like an exorcism This is when I left. I waited near by and talked with a local who spoke English. When I told him what was happening he said, oh yes... He saw a ghost and the holy man is healing him from the powers of the ghost. I said "a ghost, you believe that?" He said "yes, dont people call you in america for ghost?" I said "no... they call the ghost busters."
    To make a long story short I wait for my first pre-hopspital exorcism to be completed and released the patient to the ambulance crew for transport to the hospital. I spoke with a local Medical Control doctor later that day and told him the story. He laughed and said yes a local EMT-B called him once for online medical control because of altered mental status. The conversation went something like this.

EMT: yes hello doctor I have a patient who is acting strangely and the patient says he was possesed by the spirit of a Genie. Please advise, over.

DR: Sounds like a Psychiatric patient, has the patient taken any drugs or does he have a past medical history?

EMT: Damnit doctor did you not hear me!? I said the patient is possessed by the spirit of a Genie!

DR: *Sigh*.... Yes, a Genie... Ok, monitor vital signs and treat any signs or symptoms as you usually would until you arrive the hospital so the Genie can be banished from the patient.

EMT: Copy that Doctor.

( for more on Genies check this link )

I saw a lot things my first week including 3 Myocardial Infarctions (heart attacks), Assaults, Motor Vehicle Accidents, Diabetic emergency's, and Respiratory emergency's. I was so busy and had not slept in 24 hours. My body and mind where running on auto pilot. I just wanted a break or a real easy call but the last call of the week was an unstable unconscious person who was extremely hypoxic, tachycardia, had a very low blood sugar, tachypnea, an extremely low oxygenation saturation, with an uncontrolled airway. If left untreated this patient would die soon, from hypoxia if nothing else. The patient had a gag reflex but we needed control of the airway so I inserted a Nasal Airway Adjunct into her nose, then we attached oxygen to a bag valve device and started assisted ventilations. Her o2 saturations started improving immediately and all her vital signs started to improve except of course for her blood glucose level because she needed sugar. Her veins where very difficult to feel and extremely fragile. We attempted 3 IV's with no success to give dextrose, so I gave her a medication I have to mix called Glucogaun which is administered as an injection into the muscle. After I gave her the shot she started to regain consciousness as we arrived at the hospital. we re checked her blood glucose and it was now within normal range. I was soooo tired and worn out but I felt really good about the call. We took an unstable patient, fixed her airway control, fixed her ventilation problem, fixed her hypoxia and 02 saturation, which in return fixed all her other unstable vital signs except the glucose. Then we gave her the shot and fixed that, stabilized her and delivered her safely to the hospital who can continue managing her for the longer term.

Friday, September 17, 2010

Getting paid to sit around

I have been here over 6 weeks now and have only worked the 1 observation shift I wrote about in my last entry.  The good news is I am salary and have been getting paid regardless. For some reason it takes people a long time to process in here, in addition to that I got here during Ramadan and Eid holidays. As cool as the concept is of getting paid to sit around, its pretty boring and I hope to hit the streets again soon. I hope to have more exciting news to update everyone on soon. until then......

Sunday, September 5, 2010

Life is fragile

Yesterday was my first shift, it was an orientation shift with another U.S. Paramedic. Our first call was for some one who "fainted." We jumped in the fly car(which is a souped up Toyota Camry modified like a police car) and sped towards our destination. A BLS ambulance was behind us when we left the station but it wasn't long before it was unable to keep up with our fly car and I soon lost sight of it. Our EMT-B driver was one of the more "experienced" ones and I still almost craped my pants as we reached speeds of 118MPH. I looked out the window and everyday objects where just a blur at these speeds. Cars did not pull over for us and sometimes it felt as if we where traveling faster than the sound of our siren before it could warn drivers ahead of us. If it is possible to travel forward in time or through a wormhole I might discover it soon. 
 A lot raced through my mind on the way to the call, and it wasn't so much about the patient. I was a little scared for my own safety. I knew if a car pulled out in front of us, opened a door, changed lanes, or anything happened in our path we where screwed. I thought about statistics, statistics like how Saudi Arabia is #1 in the world for motor vehicle accidents. I thought about how 16 people die everyday in the very city we are now driving 118 MPH hour in. I thought about how ironic it would be if the people sent to save the those people could just as easily become part of the daily statistic here and it wouldn't even make the news. 
I thought about how our driver wasn't wearing a seat belt and how to him and most of the other locals, everything that happens is "gods will." I am sure that comforted him, but let me assure you it did not comfort his atheist human cargo. 
Upon arriving to our destination we where lead into a small room with 2 beds. Our patient was laying on one of the beds and as we went to assess him we noticed something important, he was cold. After checking his skin tone/color, pupils, pulse, and respiratory rate we slapped the EKG patches on him to confirm the obvious... HE WAS DEAD. DOA, Dead on Arrival. In fact he had been dead for so long there was no reason to even attempt resuscitation efforts and we pronounced him dead for the police and gave them a copy of our report.
How funny that we came so close to death ourselves just to reach a corpse. I soon learned that we drove this way to every call, sometimes on the freeway going against traffic in the emergency lane. I saw a lot as the day went on. A man that was scalped with an exposed skull wondering around confused after an accident with a semi truck. We quickly shoved what was left of his scalp back over his skull and wrapped a large trauma dressing around it. As the day stretched on we had several other car accidents resulting in broken arms, shoulders, missing teeth, closed head injury's, open head injury's, burns, and almost anything else you could imagine. We even had a couple shortness of breathe and cardiac calls. This was all on 1 shift. 

I am going to be busy and get a lot of amazing experience but things are a lot different here and a lot more dangerous. Life is fragile here, and not just for the patients.