Friday, May 19, 2006

Paramedics Save Lives (Despite ER Staffs' Efforts)

People say we practice "cowboy EMS."
I say "Damn straight!"

So Frezel is bringing a guy who got all beat to hell to Elmwood. Halfway there he codes, and Elmwood diverts the unit to E.J. (By the way, does the trauma center accept any trauma patients? WTF?!) So Frezel arrives at E.J. with the guy in asystole. (Hey Dave, what's up with no IV's on the guy?) So we start coding him; I'm charting everything and calling out reminders like 'time for another Epi.' After 4 Epi's and 3 atropines the guy goes into V-tach w/ a pulse, then after shocking him into pulseless V-tach, then into V-fib. After Amiodarone and several more shocks, the guy is still in V-fib. Nothing's working. Dr. Creel is standing there wondering what else to do. So I hollered out, "let's give him some mag sulfate." The doc looked at me quizzically and said "Well I guess if you want to, but I don't think it'll do any good." So I told the nurse pushing the drugs to give a couple grams of magnesium sulfate.
Right after she did, and circulating it for a few seconds, the v-fib converted into a beautiful sinus rhythm with pulse and a decent blood pressure! The doc's jaw hit the floor. He said "I haven't used magnesium in years; what made you think of that?"
"Doc, I've used it a million times, and I know the shit works. Always," I replied.
"I'll remember that."

Same night: Susan brings a lady with a decreased LOC to Tulane. The patient wasn't really protecting her airway so they decide to RSI her. After pushing the succinylcholine, the ICU resident tried three times to intubate the woman, three times he only pulled back a bloody ET tube. Then Ehlenberger tried. Again, no dice (big surprise).
So Mike Condatore, one of the RN's there, said "Hey, why don't you let Greg [Gavel] try. He was a paramedic with the city for years."
The docs step aside and let Greg give it a shot. One quick attempt by Greg, and the woman was tubed!
"Uh, nice technique," said Dr E.
"How'd you learn to do that?" the ICU doc asked.
Greg answered, "Experience, Doc; lots of practice!"

2 lives snatched by paramedics from the jowls of a doctory death! Tell us more!

14 comments:

Kim said...

All I can say is fantastic work! I just feel my skills here slipping more everyday. I can't wait to come back and start learning from some of the best again. Hopefully there will be a job for me. Only 5 months left in my 12 month prison sentence. I will never sell my soul again to a contract!

Sean said...

I wanted to tube the lady but on scene 6280 didn't want to. By the way, TMC waited about 2 hours to finally tube the lady- susan

Anonymous said...

oops!-Susan

girlmedic said...

Whats up with the newer 6280's ??? They're all idiots....or am i just expecting too much from them??? Keep up the good work ya'll ....least WE know what the pt needs!!

i'msofain said...

Why did med control divert the unit that was bringing Elmwood the ejected lady on the I-610 to EJGH?? That was today, I think it was Troy?

Sean said...

Who knows? Does Elmwood take any patients at all? Why are they there? All they do is divert trauma to other hospitals. And transfer out the few that do show up there. Give 'em a phone and a broom closet to sit in and they can do the same job.

i'msofain said...

Well, they took our MVA yesterday (yet another late call for Mel and I of course) but maybe because Mel gave him a GCS of 10? Maybe it's their "no mechanism-only" thing? All I know is that they are way uptight over there these days...almost like they are out of practice! It just seems like a much different atmosphere than the old Room 4 days.

What does everybody else think?

Melinda said...

Yeah, that's the only reason we were able to bring that guy there was because of trauma with a GCS less than 14. If he had a GCS14 or 15, they would have never accepted him, even though I think that Elmwood have been the most appropriate facility in that situation.

Melinda said...

Hey Ashley..... Nothing like a scream at the top of the lungs to make you feel better about getting off late every day!!!!!! THEY BETTER HEAR OUR SIGHS!!!!! hahahaha

i'msofain said...

Fitz, that fella that Frezel brought you at EJ is now a news story. Apparantly he is some sort of musician. They didn't say anything on the news about him coding but they did say he had near-fatal facial injuries. I can't believe Elmwood diverted that. Way to go for you for bringing him back, though.

i'msofain said...
This comment has been removed by a blog administrator.
i'msofain said...

This is an article about what I think is that EJ patient. NY Daily News

If this is indeed the pt, I didn't know he was internationally famous. Damn, Bourbon St is getting hard on the visitors.

Sean said...

Yep that's him! Last I heard he was still alive in the ICU! Damn, makes ya afraid to leave yer house!
Now with all these out-of-towners here, none of them know where crime is "supposed" to happen, so we're getting it everywhere!
Which reminds me, when are we going shooting again?

EQUENSUEHOCHA said...

ASAP