lies and sirens^

I did some tour 2/day tour overtime today, mostly because I have $0.83 to my name for the next 7 days and I’d like to not have that happen again. So after I got over the initial urge to hiss at the giant ball of fire in the sky, and the smoke stopped rolling off my skin as the sunlight touched it, it wound up being an agreeable tour with an agreeable partner.

But we did have a patient who’s address alone made her go “oh not him again,” not because this gentleman was disagreeable but because he was huge. And not huge-for-a-90-something-year-old, just plain goddamn huge. There aren’t too many 200+ lb people over the age of 80 for a reason, but damn this dude apparently ate his way around natural selection.

So we walk in, the family goes: “They sent two girls?”

To which I reply: “They sent two girls to do the thinking, we have six boys coming to do the hauling.”

The way some engine companies get all fucking twisted over lift assists makes you wonder if theyve forgotten they get paid a stipend to assist on our jobs now. Tell you what, put 6 bls girls on a bus and pay us time and a half to go help cpr and lift pts and you won’t hear a peep out of us — I guarentee it.

So you getting on with your bad self and prepping for your housewarming party when suddenly your (insert hubby, fwb, roommate, pet fish here) comes up to you and says, “I can’t drink my beer; something’s wrong with my face.”

OK, you think. I know what to look for here, and you say: “Gimme a big ole smile!”

Which they do, and which looks kind of like :-\

Stroke! Or is it? Fun fact: the cranial nerves usually involved in stroke-induced facial droop don’t usually involve anything above the eyeline. Most stroke pts can blink, move their eyes, waggle their brows.

Also, strokes usually involve the entire side of a body (which most people know).

So, when my pet fish found he was unable to drink his beer because he couldn’t control the right side of his mouth, but could hold his solo cup in his right hand, he started to try to blink, and found he couldnt close his eyelid all the way. Now, since my pet fish is also a paramedic and a horrible patient, he explained Bell’s Palsey to me briefly mostly so I wouldn’t call him a bus and so he could still get his party on, but I would still recommend always calling 9-11 for facial droops of any kind.

Bell’s Palsey can still be a permanent change in facial muscle function, and it may be for him, it’s too soon to say. Other symptoms include changes in hearing or ear pain on the affected side.

1. Segment 7: Bipolar acting out on street, 3rd party caller:
   
   ME: Totally, totally GOA. 96.
   PARTNER: Eh, you’re probably right, but for the sake of argument, I say it’s a 91 dispute. 

REALITY: Bipolar indvidual who didn’t call for himself as per the text, was probably acting out on street but didn’t stay in once place — and isn’t at the specified cross-streets when we pull-up — because he’s not, actually, a tree. 10-96.

What do you mean, get ready to fucking write?? Hold on central, I’ll be 63 in a second, I just need to make sure my 1.5 man stretcher didn’t just downgrade to a 2 man in the timewarp. Oh wait, that’s right, this bus never had a 1.5 man stretcher in the first place! Silly me. What was the cross on this job again? Skenectady? The hell is Skenectady? Spell that for me, central?

First few months on the job, you learn that when the job text reads chest pain, it isn’t usually chest pain — just like stomach pain usually involves some other ouchie part of the abdomen and has jack-all to do with the stomach.

And then sometimes you walk into someone’s home on a Monday night and there’s a sweaty 6 year old sprawled out who has non-radiating, severe midline mid-axillary chest pain with no epigastric symptoms who tells you — without coaching — when you ask:

EMT: What’s up little man?

6 YO Kid: My heart inside feels really weird.

EMT: Hmmmmmm

You’ll be pleased to know the kids 3-lead was clean. I have no idea what the kid’s 12-lead was because the medics didn’t bother to do one before triaging the kid back to us. Because he had a tummy ache this morning (that resolved much earlier).

Again, hmmmmmm.

Granted its been a few days since I last popped on here to write something. I caught a good alt-ment job I wanted to write about because it, plus the prognosis from the hospital we took him to, I think might be helpful to those attempting to distinguish between drug ODs, diabetic AMS, cardiac, and stroke symptoms. Of course, each one of those four items has their own distinguishing signs, but occassionally you get pts where the earmarking signs are absent.

TL;DR, this is now a placeholder for me to write about Bob the Born-Again. Way too long a post to type up on my cell sitting 89.

First job out the gate was a 400 pounder cardiac the hose homos had to quite litterally axe-chop out his bed just to get him on the floor to do effective CPR. It was one of those box rooms that we tried to stuff four land pirates, two medics, and two emts into, with no AC, no openable windows, and seasonal radiator heating. At some point during the engine company’s destruction of the bed (and subsequently, the room), they wound up upending an entire stock-room’s worth of Lady Speedstick carribian cool deoderant sticks all over the floor. ALL over the floor — under the patient, on the rubble heap, one even made its way into our oxygen bag. Half of them, uncapped. The entire room turned into a microcosm of a woman’s armpit.

And oh, look at that — our second job’s an arrest too. Sweet!

I had this text conversation while I was trying to figure out how to write up this job I had yesterday for this blog. I made some minor changes, but the conversation actually serves to tell the story.

Me: so I keep a blog to help destress from work 1:50 AM

Me: and I have no idea how to handle a job I had last night with (this paramedic unit) 1:51 AM

Me: because the job was an “oh jesus” job, and of course you throw in a little Sleepy the Narc* and everything just goes to hell 1:52 AM

Pinky: OMG. What happened? 1:53 AM

Me: job was simple enough, ped statep ** 1:56 AM

Pinky: Yes 1:56 AM

Me: but the mom was mentally retarded and physically handicapped. and the kid was mentally retarded and a paraplegic. 1:56 AM

Pinky: Oh Jesus 1:57 AM

Me: and between Sleepy being built like the Hulk and carrying the child out of the apt giddily exclaiming “I stole a child!” and his fielding the mom in the back of the bus while on the way there who was going on about how she hoped her kid would grow out of being “retarded” faster than she herself had managed to 1:57 AM

Me: Idk, all I know is that I cranked up the hair metal and closed the partition sometime around Sleepy explaining to the mom that she had to tell the doctor to stop giving her daughter the retarded-child dosage of dilantin and tell the doc she needed the normal-child dosage or her seizures were never going to end. 1:58 AM

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If you own a car, OK, and a family member you live with feels ill and wants to go to the hospital, it’s appropriate to call an ambulance if:

1) They are currently unconcious. 2) They are currently not breathing. 3) They have chest pain, AND they’re dripping wet from sweat, feel kinda cool, are pale or greenish in color.

For anything and everything else, put them in your goddamn car and drive them to the hospital.

No, your mom/sister/dad/auntie will NOT be seen faster if they come via ambulance.

This post brought to you by the nitwit son of my last patient who had the sense to drive around the block to find us, to follow us to the hospital in his car, but not to skip the $400 taxi ride his moms took to BI for a headache of two weeks.