Tuesday, January 22, 2013

My First Call as an EMT

This is the tale of my very first call as a fully registered and licensed Emergency Medical  Technician.  I had literally received my certification in the mail the day before this call occurred. 

On the volunteer fire department we were discouraged from responding directly to the scene of the call. Usually the local PD would respond and arrive to assess the situation before the FD got there.  It didn't make sense in most instances for somebody to go to the scene without all of the equipment and supplies on the ambulance or fire trucks.  The only exception was if it was on the direct route between your home and the fire station or was one of your immediate neighbors.

It was around 4:30 in the afternoon and I had just gotten home from my boring office job.  I hadn't even changed out of my business casual attire of cheap Dockers and button down shirt when my FD pager went off announcing a possible heart problem in the apartment building right next door to mine.  I figured I could at least get a history and record the patient's vital signs so when the ambulance arrived they could just package them up and head to the hospital.  Besides, like 80% of these possible heart calls turned out to be bad bologna and not a real cardiac issue.

I grabbed my sphygmomanometer (fancy name for a blood pressure cuff I was forced to learn in my EMT training) stethoscope, badge and identification and headed next door on foot.  I arrived at exactly the same time as the police officer.  We were greeted by a 70+ year old woman who informed us that she thought her elderly aunt was suffering a heart attack.  I asked where the patient was and she directed me to the bathroom.

I discovered her 90+ year old aunt lying on the floor with her pants still around her knees. I introduced myself as being from the fire department and told her I was just going to check her pulse and blood pressure.  She was very disoriented and barely acknowledged my presence.  Her pulse was rapid (150) and very thready.  I slapped the BP cuff on her and started to inflate it and before I could even begin to deflate it she let out the most awful gasping breath that lasted about 10 seconds and then ceased respirations.  I jabbed two fingers onto her carotid artery and confirmed what I already feared.  Her heart was no longer beating.

I hooked my hands under her arms and dragged her frail 100 pound frame out into the living room and shouted at the cop, "Get on the radio and tell the ambulance to step it up because we are starting CPR!"  The cop did as he was told and then told me he would do respirations since he had his one way valve mask with him.  I started compressions and felt two or three ribs crack on the very first set of 5.  It was only about 2-3 minutes later when the ambulance crew arrived and packaged her up and headed for the hospital. 

I wish I could tell you that being there to initiate CPR right away saved her, but she didn't make it.  It doesn't haunt me or anything because at 90 something it was just her time.  In the course of my service as an EMT I saw multiple dead bodies and worked on people who were alive, but died soon after we treated them.  This was the one and only time in my life that I have witnessed somebody drawing their very last breath and I will never forget it.

Friday, January 18, 2013

Tales from the FD

Wow...I haven't written anything here in almost as long as Very Josie.  The other day I was chatting with some friends when a turn in the conversation led to my revelation that I used to be a volunteer firefighter and EMT (Emergency Medical Technician) back in the late 80's and early 90's.  I quit when my oldest son was born because it takes a lot of time and commitment to do it right and I didn't want to miss his childhood. 

As you can guess I have a treasure trove of stories from my time on the FD.  I'll tell a few of the better stories here and if you're interested I can always share more.

"What is the Grossest Thing You've Ever Seen?"

Without fail the first thing people ask when they find out you were an EMT is, "What is the grossest thing you've ever seen?" There are lots of stories that fit under the gross category, but I don't even have to think about this one.  One story stands out above all others. 

I was a very green rookie and had only had my EMT certification for maybe 6 months when the call came in.  The police department was asking for assistance.  They had discovered a body in a mobile home and needed us to come verify they were dead.  The police never declare somebody dead and even though this guy was very obviously dead they needed us to confirm it.  It wasn't a good sign when they told us we should probably bring along some of the fire air packs. 

Did I mention that it was the middle of July and the mobile home wasn't air-conditioned?  Did I also mention that the reason the cops were called was because the occupant hadn't been seen by his neighbors for several days and a foul odor was emanating from the residence?  Yeah...we already knew it wasn't going to be pretty, but hoped the air packs would at least spare our olfactory nerves.

There are only three times when an EMT can declare somebody dead in the field.

1.  If rigor mortis has set in. Rigor mortis can occur shortly after death, but will eventually subside.

2.  If the body is dismembered.  E.G. the head is missing or something.

3.  If lividity has occurred. Lividity is what happens when your body stops circulating the blood and gravity causes it to pool anywhere the body is touching the ground.  It looks like a big bruise and the blood will even ooze out of the pores in the skin if you press on it.

In this case we were checking for number 3.  We arrived on the ambulance and the experienced paramedic turned to me and said, "Suit up, rookie, you're going in with me."  We donned our air packs and made our way into the dimly lit mobile home.  The poor bastard was lying on his back just in front of his couch.  I felt a twinge of sadness that somebody could spend nearly a week without somebody missing them. 

We positioned ourselves on either side of the body and prepared to pull him forward at the waist so we could check his back for lividity.   He was a pretty big dude who looked even bigger because he was a tiny bit bloated.  The paramedic counted to 3 and we pulled on his upper arms to lift him.  He came about 2 inches off the floor when....well....

Have you ever had roast chicken?  You know how the skin on a roast bird just kind of slides off the meat?  Yeah...that happened.  With a sickening smacking sound his skin separated at each shoulder and started to slide down his arms.  We both immediately dropped him and the paramedic jumped up and said, "Yep he's dead. Lets get out of here until the coroner arrives."  I high-tailed it outside and ripped off my mask.  I was sweating not just because the mobile home was an oven, but because I was on the verge of purging the contents of my stomach.  Swear to God, but the coroner strolled in without any air pack eating a fucking sandwich when he got there.

The stories aren't all as gross as that one.  Some are sad.  Others are inspirational.  Still others are scary.  Want to hear more?  Ask me anything in the comments and I'll write up more stories if you're interested.