Second verse, same as the first!

Trip Start Sep 14, 2008
Trip End Nov 01, 2008

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Flag of United States  , Texas
Tuesday, September 23, 2008

Second shift yesterday. Wow!

Our first patient was in really bad shape... the home she was staying in found her this morning not responding to anything. We get on scene and she's laying in bed. The nurse said her blood pressure was around 135/78 and her oxygen levels at 97%. We hook her up to our monitor and lo and behold, her blood pressure is 62/42 and her oxygen levels at 77%.  Even on a non-rebreather her O2 levels didn't climb at all. My preceptor told me that this one was mine, so we got her transferred to the gurney and in the back of the ambulance. I had the attendant start an IV as I started bagging her and getting the intubation kit ready. Bagging her brought her oxygen up to 81, but no further. I decided that if I couldn't get her oxygen levels up I would intubate and so I did after some suctioning - dropped that sucker on the first try! Her lungs had a lot of fluid in them, but I had to give her a fluid bolus to try and get her BP up. The positive pressure ventilations we were giving her would take care of any pulmonary edema... and if she didn't have a blood pressure her pulmonary edema wouldn't matter. I can fix PE. We were damn near ready to start CPR, but she had a very weak pulse.

Was pretty touch and go, but once we got her intubated her oxygen climbed to 88% - we couldn't get it up any farther. She had ST depression in every lead (that's bad, for those who don't know. It means her heart was starved for oxygen) likely due to the breathing difficulty. We got her to the ED with a blood pressure of 108/47. I checked back later and they still hadn't got her oxygenation up above 92%. It sucks.

coole ran a few other patients that day, but nothing near as exciting. We did have a diabetic wake-up that was pretty e. She was unconscious and completely unresponsive when we got there, but an amp of d50 and some glucagon later... she was up and talking by the time we pulled up to the hospital.

I've got to get used to the changes in this EMS system... they put oxygen and do glucose checks on *everyone*. No matter if they're satting normally, or don't have a diabetic history. I'm having a lot of fun here, even though it's only my second shift with my preceptor.

So I'm leaving my hotel today. I'm gonna head over to Robert's pretty soon, but I need to find a place to buy some new uniform boots. Mine are kind of worn.
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