One of the more interesting nights I've had in a while (long)

So, after watching Drawn Together, I layed down on the couch at 10:30 and ended up falling asleep for about half an hour, so I decided to just go to bed, especially since I had to get up today a little earlier than usual. I fall asleep fairly quickly, being so tired, but was awakened at about 1:45 by my fire department pager going off. It seems there was an EMS call. I listend to it, and it was a priority two (ie, take your time getting to the station) Seeing as I was so tired and getting up early, I decided not to go unless it went to a third alarm (meaning that ten minutes after the initial call there was still no response, or the ambulance was awaiting more people.) Well, less then two minutes after they called that out, I heard them say “standby, second EMS call.” Well, two EMS calls late at night, I had better go. As I am getting up I hear the description:

“Respond to a priority one EMS call to [address] for a gun shot wound to the groin.”

:eek:

Man oh man did I ever get dressed fast. I flew down the stairs and ran out the door and to my car. After sitting down in the seat and failing to fish out my keys from my pocket I realized my heart was going a mile a minute. I just sat back for a few seconds to regain myself, then was able to start the car and drive through town, getting just one red light that I was able to turn right on. Amazingly, I was the first one at the station (there are a few people who live closer than me, one of whom is right up the street and almost always beats me there.) But I open the bay door, turn on the ambulance and tell dispatch I am awaiting manpower and EMTs for both calls. Luckily, less than a minute later, another member (still not an EMT though) arrives, but at least he is qualified to drive the truck. I hop in the passenger seat and we wait less than a minute and an EMT arrives. As he is getting in the truck, two more EMTs arrive. One of them gets in the truck, we take off, and the other follows us in his personal vehicle.

When we get on scene a few minutes later, the state police have already responded and one of our EMTs was already on scene (he lives on the same road.) We grab the truma bag and O2 bag and run inside as the driver backs up the driveway. I wait outside to grab the strecher and bring it in once the amubulance is backed in. I don’t know what to expect. I had never been to a gun shot wound before, and one had one major trauma before this (a snowmobile vs. car that resulted in an amputation of a leg and a coma and eventual death.)

As I get in, one trooper is talking to some woman, a rifle is on the kitchen table, another trooper is getting all our names, and I see the patient on the floor in the living room yelling. He is not so much screaming in pain as he is yelling curses at us and telling us help him, but not to touch his leg because it hurts. He had already lost a lot of blood by the time we got there. He was shot in the front of his right leg, near his groin, and the bullet exited out the back, tearing apart his leg. He had an arterial bleed. The EMTs put a few of thr largest trauma dressings on his leg, applied lots of pressure, and lifted him into the strecher. They couldn’t get any vitals because he was so combative. It seems he was drinking that night, and combined with the massive blood loss, resulted in quite the altered mental status.

We get him into the truck and radio dispatch to have the local commercial ambulance service meet us en route to the hospital for advanced life support. We have no paramedics, and they do, and the EMTs felt that we needed to get an IV going (which EMTs cannot do.) The whole time the patient is screaming, yelling obsceneties, and trying to flail about. During this time, my job was mostly to help hold down his arm so the paramedic could get the IV going.

We get to the hospital and go right into the trauma room. It’s a small, rural hospital and generally understaffed at night. Luckily, a minor trauma just got done about 30 minutes ago and the doctor on call was still there, but they had just him, two nurses, one PA, and one CNA in the ER, so we had to stay for a while while they got him stabalized to help out.

I spent about thirty minutes in the trauma room just holding pressure on his leg. We changed dressings once while en route, and twice more at the hospital. His blood pressure when we got there was about 80/40. They staff started another saline line, and added a new bag to the current one, and got some O neg from the blood bank. I distinctly remember his words when they inserted the catheter to check his urine for blood:

(as the nurse grabs his peins)
“Hey, who’s sucking me off?” (nurse inserts catheter) “WHAT THE HELL YOU DOING TO MY DICK! FUCKING WHORE!” (He seemed to liek calling all the women whores or sluts.)

By the time I left, his BP had gone up to 105/50. They barely had a pulse in his right foot, though. The whole time he was still extremely combative, and the staff had to tie his hands and left leg to the strecher.

Of course, just because we were leaving the hospital didn’t mean we were doen for the night, oh no. After a trauma like that, we had to scrub down that ambulance and the strecher. A good, strong bleach solution on the strecher and all surfaces of the ambulance, hose down the floor and mop it with bleach, put the “cocoon” (the wrap around blanket we use) in a bio hazard bag to get cleaned.

When I got back to my place, I took all my clothes and put them in a bag to wash seperately later and took a shower. It’s now 5 AM, and I kid you not my pager just went off again for another EMS call.

Well, it’s not almost 7 AM. The 5 AM call I was an old man having trouble breathing. Got him to the hospital and was sitting around the station when at about 6 AM another EMS call came through for another elderly man having trouble breathing. Just got back from the station after transporting him to the hospital as well.

When we went there for the most recent call, we were told the GSW victim took a turn for the worse after we left, and was transported to a large facility about two hours away, though they were all sure he would be diverted to the other larger, but not as large, facility an hour away. It turned out that was the case, and that was the last we heard of him, but it seems like he might no make it from the amount of blood he lost.

And now I have an hour to eat some breakfast and piddle around unti lI ahve to be at work. Fun, fun, fun.

Based on the responses to your thread, I figgured I’d let you know: I’m glad you’re out there.

I too, am thankful for people like you.

One of my friends is a paramedic and he has told me some horrific stories about stuff he has seen.

Best of luck to you and thanks for being there.

I’m glad you’re out there, and I bet that first guy is glad the nurse wasn’t feeling particularly vindictive, cause I know if I were in her shoes I’d be a little more rough than usual with that catheter.

bouv, I didn’t know this about you! I know generally whereabouts you live, and that is a rural area. If there wasn’t people like you…well, let’s not think about that. Good on you!

Next time I’m going to have a major medical emergency at 3 a.m., I know where to be.

Good work! Having seen my share of blood, guts and gore, back to back to back etc. I know how draining (and exciting) it can be. You did a great job.
It sounds like the only thing that a level one trauma center would have done differently would be chemical “restraint” and intubation.
I’ve worked in 3 level ones, and in all three, combativeness, and calling the staff bad names combined with bleeding, buys you a ticket on the “trauma train” >Morphine, Atavan, Norcuronium, ET tube, catheter, three 14 gauge IVs, Cat scan, Trauma series of xrays and a trauma panel of blood work. Then ICU.

Do you ever get the urge to punch the patient in the jaw and knock him out so you can help him without him flailing about?

Good job. Sorry you didn’t get much sleep. I don’t understand…were you on duty, or did you just respond to the call anyway? I can’t see where it’s a good idea to have sleep-deprived paramedics and EMTs speeding down the highway and trying to stick an IV in someone.

Hell of a way to spend the night before your last day at work!

Heh, yeah, sometimes you do get frustrated that you’re trying to help someone, and they are actively fighting you. Obviously, some of the time we just have them sign a waiver and don’t treat them, but if we determine that it’s severe enough, or they aren’t in the right state of mind, then we can treat them against their will, and 99% they thank us later.

It’s a volunteer service, so no one stays at the station. The way it works is that for a given month, one platoon is on duty*, and if a call goes off at night (between 10 PM and 5 AM) only members of that platoon are expected to respond. It wasn’t my platoon’s month, so that’s why I didn’t feel like responding to the first call.

And while it might not be a great idea to have EMTs and firemen doing things with not much sleep, it beats the alternative…which is no emergency service at all.

(*Although starting today we are going to duty nights, where each person has one night that they are assigned to with three others. In theory, it’s better, , because there’s no chance of being woken up and having to respond for several nights in a row. Although there’s moe accountability, because before, with ten poeple on a platoon, if someone was gone or sleeps through the call, it’s not a big deal, but with only four people a night, if two of them son’t show up, then it’s an issue (we always run with at least three on the ambulance.))