Friday, July 3, 2009

more virginal moments

I am in the middle of a 10 day stretch of working my multiple jobs without a day off. Im not complaining....I have been getting to sharpen my skills and even had a couple virgin shattering moments this week.

Yesterday, from a medic point of view, was a satisfying day. I started my morning off out in triage ( which was uneventful) and shortly after that I went on a chest discomfort call.
A dialysis pt was waiting for his ride and began feeling his chest pounding and called 911. Pt was found in BLS care and to be in SVT at 160-180 bpm. Yes folks, the still-somewhat-new-paramedic had never had an SVT call on her own. His vitals were stable so I started a line and headed to the hospital on an easy class 2 (here thats lights and sirens as needed) and I got to give Adenosine for the first time. I gave 6 and then 12. Both doses worked, but the pt rebounded right back up to a rate in the 160s-170s. The underlying rythym was a sinus rythym. I still am not quite sure what could have been the underlying cause, but Im sure it had something to do with dialysis....I will be researching it.

Later, I was chatting with the other medics working and my partner was up in the rotation when a SOB call came in, he still needed to write a report from a cardiac arrest earlier in the morning so I took the call for him. It was dispatched as an 80 yof c/o SOB, called in by Life-alert. The BLS ambulance and I arrived on scene within 6 min of dispatch and found the pt in arrest....PEA, started CPR, got a line, pushed meds, got in the ambulance, got my 2nd field intubation ever, and worked her, gave 4 epi and 3 atropine, she remained in a PEA at 30-40 bpm. At the ER she went into V-tach (kinda looked like torsades) 2 times and they shocked her, but ended up calling it within 15 min.

And then I had one of the easiest ALS calls I have ever had but was an interesting educationally challenging call. A lady had an iron deficiency and had been at an out patient clinic for IV iron replacement. They sent her home after the treatment with no problems. 2 hours later she began feeling very ill and returned to the clinic, unable to get out of the car due to weakness. She was VERY pale. Turns out her BP was 60/30 and puls in low 50s. Apparently this is a side effect or adverse reaction to the Iron replacement. So I established my very first 16G IV (I know, so simple yet still another virginal moment for me!) and gave her approx 450cc by time we reached the hospital about 5 min later on a class 2.

So while none of these are BIG moments, the fact that had one on every call I was on made for a "big girl paramedic" day for me. I will admit I was a little down after my arrest. I know I followed my protocol, but could help feeling a bit in the dumps. I did get a compliment from a co-worker, especially after he found out it was my first "real" code on my own, my other was just sad.

As I have stated before, the more viriginal shattering calls I have the more and more I feel like a "real" paramedic.

1 comment:

Hometown Goddess said...

good for you ever growth counts!