A Long Night

Two days ago, I went to the station for my ride-along as scheduled with the Unit Chief.  When I got to the station, I saw a kind-looking man about to close the ambulance garage.  Smiling, I told him I was there for a ride-along with the unit chief (UC), little did I know he was the unit chief.  He didn’t introduce himself and just said “okay”, showed me in and told me to take a seat and wait.  There were six other paramedics in the station, they all seemed nice, but I felt a bit awkward and out of place.  One of the paramedics asked me why I’m there. 

Medic:  “Are you from RCH (Royal Columbian Hospital)”?

Me:  “Uhh…no.  I’m thinking of being a paramedic and the UC arranged a ride-along for me today.”

Medic:  (Looks at me funny)  “You know that was the UC just then right?”

Me:  “Really?”

I was told to be there at 17:30, crew change is at 18:30.  I had an hour to kill.  The UC came up to me later and asked, “So why are you here again?”  Now I’m just puzzled.  Didn’t I explain it to him earlier and we communicated via email beforehand?  Unsure, I said… “The UC told me to drop by today for a ride-along…wait you’re the UC right?”  He must think I’m weird talking to him in third person.  The other paramedics laugh and said, “Yah he’s the UC.”  

The night shift crews arrived and the UC introduced me to the crew I’ll be riding with.  Guess who I see?  Paramedic H and a red-head paramedic I’ve never met before.  They were checking and re-stocking the ambulance.  The UC told me some safety guidelines while riding, covering topics like shootings, ODs and to never stand near the door of the ambulance (incase some psych patient tries to escape and slams the door in your face), what to wear in an MVA, dark alleys in sketchy parts of town etc etc.  Then he left.

pulse-oximeter-jerry-ii2

Pulse-Oximeter

I was rather relieved that I’m riding with a medic I’ve already met before and that I’ll get along with.  Paramedic H showed me where all the equipment was stocked in the ambulance such as the various oxygen masks, nasal canuulas, glycometer, and the drugs they’re allowed to administer such as glucagon, ventolin, nitroglycerin, epinephrine, etc, how they administor it and the doses.  He then showed me the pulse-oximeter which is placed on your finger and shows your pulse and oxygen saturation in your blood.  He placed it on his finger and got me to take his pulse to see if the light was flashing in accordance to his pulse.  Next, he pulled out the run form which includes the patient’s information (age, address, etc), the general impression/chief complaint, primary/secondary assessments, history, etc., how to fill it out and the codes used.  Along the way, he told me a couple of stories:

You should have rode with us yesterday night.  It was busy.  We went to a run-down apartment in a bad part of town.  The patient’s friend called for the ambulance because he has been sick for several days.  The guy was lying on his side, facing the smoke-stained wall on a bed he had already wet.  It was difficult to do assessments due to the poor lighting and the cramped quarters.  The patient didn’t want to go to the hospital, but we managed to pursuade him to go.  The man said he needed to go pee first.  As he stood up and walked to the bathroom door he just collapsed like fallen log and went into cardiac arrest.  So we had to start CPR on him and called ALS where they did their algorithm of drugs and brought him into the hospital. 

I asked what he thought the patient had.  Paramedic H said it was a strange case because one minute he was fine and talking, and the next he’s in asystole.  He said maybe he had a rupture or something.  Goes to show you can never expect what’s coming.

Next we talked about the patient refusal part of the form.  Sometimes if the injury is serious, as a paramedic, you have to try your best to pursuade your patient to go to the hospital instead of just signing the form and releasing them.

There was a girl who was drunk and she was riding her bike in a park in the middle of the night.  She went over a hill and fell and smashed her head.  Her friend called an ambulance.  Since she was intoxicated, she didn’t feel much pain and was reluctant to go to the hospital (another reason was that she lived in far from the park).  We couldn’t persuade her to go to the hospital.

Girl:  “Is it really that bad?  Am I bleeding?”

Medic:  (What do you think?? There’s a soft-ball sized lump on your head!)  “Yes it’s bad.  You need to go to the hospital”

It was dark, and we don’t stock mirrors in the ambulance, so my partner took a picture of her head with his phone to show her the massive lump on her head.  She still refused to go.  In the end, we managed to get her to come along by offering to drive her to a hospital near her house (a good hour or more’s drive away).

Red-head paramedic (I’ll call him Red) I will later learn, is a bubbly, energetic guy who has a great sense of humor.  He really lightens the scene and is definately a paramedic you’d want on a call. 

We didn’t eat dinner yet, so we headed out to grab something to eat at a place called The Wrap.  Red and I both bought a turkey avacado wrap while Paramedic H waited for us in the ambulance.  We arrived back at the station to chow down.

Red:  “Finished before you!  Maybe that’s because I have a bigger mouth.”

(My mouth was full so I didn’t say anything)

Red:  “I guess you like to eat slowly and savour your food.  It really goes to show your personality.”

Me:  “How I eat shows my personality?”

Red:  “Yah, it shows that you’re a patient, detail-oriented person who is calm under pressure.”

Me:  (I give him a funny look and started laughing).  “Are you serious?  You need a better pick up line.”

Red gives me this I-can’t-believe-you-just-said-that-face and we both succumbed to laughter.

I got to experience a paramedic’s quiet night.  I was there at 17:30 and there wasn’t a call until about 21:15.  It was a Wellness Check call aka a check up for a homeless person who’s not feeling well from being outside in the cold.  We dragged ourselves away from the Canucks game, grabbed our jackets and went out into the windy night that had started pouring rain.  There wasn’t much to do, Red checked the patient’s ABCs, his glucose, BP, and that was it.  There’s not much we can do for him and he didn’t want to go to the hospital.  The van will take him to a shelter.  Exciting?  Not really.

It’s been a very dry night.  Just waiting, watching tv, chatting.  The UC and Paramedic H went to sleep in the bedroom.  It was just me and Red in the lounge along with another medic.  I asked if it was always this quiet on Sundays. 

“It’s usually quieter on Sunday nights, but it’s rare for it to be this quiet.  If it was always this quiet, I would have quit this job by now”

Red was getting antsy and figety from doing nothing.  He goes into the kitchen and grabs the salad he’d bought from The Wrap and started stabbing it with a fork.

Red:  “I used to eat pancakes like this as a kid…(pretends he had another fork and starts tearing away at it and shoving it into his mouth, chomping and puffed up his face as if he’s stuffed himself)

(I laughed at his strange face)

Me:  “I used to eat pancakes whole” (I pretended to stab the pancake with my fork and shove it into my mouth whole)

Red:  “You know what pancakes I love best?  Banana pancakes.  I make the best banana pancakes in the world.  I used to tell girls, I make the beeeest banana pancakes in the world.  I say to them:  I’ll make some for you…in the morning if you stay the night.”

(I give him a what?? look)

Red:  “Okay yah, maybe I need a better pick-up line.”

Me:  “All your pick-up lines are food related…what’s with that?”

Red:  (Laughs)  “Yes, what is with that?  Can’t go wrong with food, right?”

At least Red was amusing, but I was still bored with sitting around and a bit disappointed.  Not that I’m asking for people to get sick and die, but I did want to experience more calls.

23:05.

Me:  “I’m going to leave in 10min”

Red:  “I bet you there’s gonna be a call in 5 minutes.  Then what are you going to do?”

Before the words even finished leaving his mouth.  A call.  Code 3 to a nursing home for respiratory distress.  Red smirks at me, I shake my head as sleepy Paramedic H walks into the lounge, woken from his nap by the call.  I thought what the heck, might as well tag along, as I grabbed my jacket and scarf.

Paramedic H was driving.  We went blaring lights and sirens to a nursing home.  During the ride, dispatch updated us that there was a GI outbreak on the third floor of the building.  Red threw me a pair of gloves as we jump off the ambulance.  The gloves looked like elephant skin on me.  It was 2 sizes too big.

We took the stretcher, oxygen tank and jump kit with us, got to the door, but can’t figure out the code to get in.  Red remembered the numbers but can’t remember the order and tested it randomly without success, while Paramedic H radioed dispatch.  Finally a nurse came down and lead us to the 2nd floor.  We entered into the patient’s tiny room.  He has a history of various illnesses including COPD.  His breathing was bad, you can hear edema in his lungs and it sounded like crackers crunching together every-time he breathed.  Red asked the nurse questions regarding the patient’s history and the nurse fumbled through her charts for information.  She told us he’s on Lasix.  We gave him oxygen via mask while Red did a thorough patient assessment, noting the patient’s barrel chest and found edema in the patient’s ankle.  Looks like it could be CHF I thought.  I rolled the stretcher into the room since we had to transfer the patient to the ambulance.  We asked the nurse how to raise the bed.  They didn’t know (and I thought they worked there?).  All of us ended up kneeling on the floor and looking around the bed.  We looked silly.

Red:  “See, this is the toughest part of our job.”  (Cracks a wide smile)

We managed to find the control and transfer the patient.  I’m given the run form.  On the way to the hospital, Red told me to fill in the patient’s information from the nursing home’s documents.  Then he told me where to fill out the other primary assessment and reassessment stats such as BP, glucose level, SpO2, pulse, and times.  It was difficult filling out the forms with giganto gloves on and the ambulance swerving left and right.  He then told me what he thought the patient might have and the signs and symptoms, like the patient’s breathing, edema in the legs, then he looked for another sign:  distended veins in the neck.  He told the patient to turn his head and showed me the large vein popping out.  It was neat seeing these symptoms that I’ve only ever read in textbooks come to life.

Nothing exciting at the hospital.  Red checked in with triage while Paramedic H dealt with the patient’s oxygen and monitored the breathing level.  I tried not to get in the way of the hospital staff.  Later while Red was finishing up the paperwork, Paramedic H showed me how to sanitize, fold, and replace the cloths onto the stretcher.  Then we wheeled the stretcher outside, he showed me the hooks on the ambulance floor and allowed me to lift the stretcher and secure it onto the ambulance.  Cool.  Stretcher was lighter than I thought.

oo:15.  The medics knew I transited to the station.  They dropped by the station so I could pick up my stuff and drove me to the skytrain.  It was nice of them.  I thanked them, shook Paramedic H’s hand and Red hopped off to open the side-door for me.  I stepped out, only to find myself in the MIDDLE of the road (ambulance has right of way?).  Red gave me a goodbye hug.  Time to go home.

I’m tired, it has been a long night, adventure’s over, it should be a smooth sailing home.  Instead, I found myself stuck in New Westminster.  All the skytrain stations had shut down for the night.  Great.  I thought it was open till 01:00.  The night was cold and windy.  I ended up calling my bro and he was nice enough to drive 30min to pick me up.  I get home at 02:00.  Got to wake up for school in 5hrs.

What a night.

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Comments
2 Responses to “A Long Night”
  1. Queenie says:

    🙂 you write very well, you know that?

  2. Jun Li Kanashii says:

    I’ve been wanting to do a ride along for ages, but at 15 I’m kind of nervous to apply for one. I figure I’ll wait till 16 and cross my fingers it goes half as well as yours does.

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  • Courage is the discovery that you may not win, and trying when you know you can lose. -Tom Krause
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