Tae 10 - "Bar code"
Tae writes:
I don't know why I did it. Perhaps I felt an obligation to serve the community. Perhaps it was the fact that I hadn't worked a shift at this company for quite some time. Maybe it was the fact that a supervisor was on the other end of the phone, offering to suck my dick if I worked. Well, in the end, I think my negative cash flow was the big reason I worked a ...
DAY SHIFT!
Anywhere you go, whatever work you do, if you have a choice of what shift to work, never, NEVER work a day shift. Sigh.
Anyway, I showed up in the morning, already on my third cigarette, glugging a large cup of coffee that I'd hoped would replace several hours of sleep I _didn't_ get the previous night. I was raring to go.
Nervously, I eyed the garage. Good. No management-types in sight. I walked briskly towards the crew quarters, hoping the dispatcher wouldn't see me, and try to force me onto a truck before my shift. I was halfway across the garage floor, when the general manager emerged from behind a row of metal lockers. Most of the ambulances were out; I was trapped - with nothing to slink behind. His eyes fixed, then narrowed on me. I started to sweat.
"Tae, how GOOD of you to show up today. It's been ENTIRELY too long since the last time I saw you."
"Why, Mr. Mansfield, good morning." I smiled weakly, "How's the family?"
"Lousy. The wife just smashed up a rental car. My daughter moved in with a hippie." he growled. Damn. Then he noticed my uniform shirt. "That doesn't look like the shirts we issued to you."
"Well, you see - I was called in on short notice, and I didn't have any clean company shirts. Besides, this shirt is much more comfortable, it's a blend of cotton and polyester - see?"
"No, that won't do," shaking his head, "we have a strict uniform code here, you know that, Tae. Normally I'd have to send you home, but you're in luck. I happen to have some spare company shirts right here." Pats the lockers.
He then pulls out a stiff, all-polyester shirt, and hands it to me.
"Here you go - oh, and don't forget to put on your tie ..."
Damn. Damn. Damn.
An hour later, I was in the ambulance, fighting morning traffic to get to my 'satellite' location - a parking lot next to a donut shop. The other paramedic unit had received a call, and we were going to 'sit on the line' between the two cities - so that we could 'cover' both areas. Dispatchers call this 'dynamic system status management.' I call it 'sitting in a parking lot, for hours on end, on one of the hottest days of the summer, with no AC, and no bathroom in sight.' Damn.
My partner, Mellisa, had just passed her medic exam, and was chomping at the bit, waiting to do a call. Myself, I was looking forward to walking to the donut shop, where I would buy the biggest cup of iced coffee I could, drink the entire contents, then urinate into the empty cup. 'Sides, Mel was beginning to get on my nerves. She was one of those 'morning' people, and chattered on about how bright and sunny it was, and how she hoped to do a call, and how she was getting married soon ...
I got out of the truck, and started to walk to the shop. It was either that, or I'd find the nearest large rock, and SMASH, SMASH, SMASH!
ObAside: My former roommate (also a paramedic), and I used to plot ways to kidnap her. We'd convert the spare room in our apartment into a 'dungeon,' walls painted flat black, that 'egg-crate' foam sound-proofing covering the walls - so as not to disturb the neighbors. We'd nail the window shut, and after placing her in the room, seal her off from the rest of the world. The only thing we'd feed her was raw red meat laced with LSD. Occassionally, we'd use a slide projector to show images of violent deaths and eyeballs on the one white square of paint on the opposite wall. Ministry and Skinny Puppy would blare from speakers mounted on the walls, behind metal grates. Eventually, she'd go insane, and we'd be able to put her on a leash and walk her around the neighborhood, while she drooled and made guttural noises. Every so often, we'd have to pull hard on the leash, as not to let her get too close to the neighborhood children.
Er - where was I? Oh yes.
I was about to place my coffee order, when I heard my unit number being called over the portable radio I carried. I heard Mellisa answer - we were being dispatched to a 'man having a seizure.' Didn't get my coffee. Damn.
As we pulled up to the address, we could see the police and fire departments, huddled over a man, who was laying on the sidewalk, IFO (in front of) a neighborhood bar. They seemed to be doing CPR on the man. Since the man was not trying to push the burly firefighter off his chest, we had a pretty good idea that he was indeed in cardiac arrest.
Since Mellisa was newly certified, and needed some experience, I told her that she could intubate, while I would set-up the cardiac monitor, and start the IV.
A crowd had gathered, some of the people in the crowd were friends of the man. Apparently, they had all gone drinking in that very same bar, and when they emerged, the man complained of feeling dizzy, then collapsed. After a few minutes of "Hey Fred, are you okay?" passed with no response, they called the police.
While we worked over him, several of his friends were shouting drunken words of encouragement:
"C'mon *hic* Fred! I know you can make it!"
"Hey Fred, can you hear me? Wake up!"
I attached the monitor to his chest, while Mellisa positioned herself at the patient's head. I did not envy her; several minutes of 'firefighter' CPR had produced a stomach that was obviously distended with air. I turned on the monitor. V-fib. Ventricular fibrillation. Shockable rhythm.
I charged the paddles, and when the whine of the monitor leveled out and I heard a *beep* I yelled "Clear," then shocked the man. His arms jerked upwards, then fell back. I stared at the monitor, waiting for it the EKG tracing to re-center. Asystole. Flatline. One of the man's friends took the electrically-induced arm spasm as a sign of returning life:
"Atta boy, Fred. He's coming back!" Murmur in the crowd ...
Once I had the IV established, I quickly 'pushed' several milligrams of epinephrine (Adrenalin) and atropine into his vein in rapid succession. I told the firefighter to continue compressions, to try and circulate the drugs.
Meanwhile, Mellisa was having a hard time placing the tube. Several times she said she could see the vocal cords, through which she'd try to pass the tube. But every time she visualized the cords, then grabbed the tube to place it, the vocal cords would disappear, frustrating her efforts.
After a few tries, she finally placed the tube.
"There - I think it's in." she said.
She spoke too soon, as vomitus and gastric contents started to pour out of the tube - a sure sign that it'd been placed in the esophagus. The end of the tube had been aiming straight up. A stream of vomitus, propelled by the man's inflated stomach, shot into the air - only to land on his face, chest, and Mellisa. She quickly turned the tube down towards the pavement, and a small stream of pink, cloudy liquid began to creep slowly towards me. I moved aside. Too late. My pants leg cuff darkened with the vomitus it had absorbed.
The sun was directly above us. As I kneeled on the sidewalk, looking at the monitor, I could see the heat waves distorting the air several inches above the street. The smell of vomitus, which I believe had an odor of grain alcohol, in addition to the acrid smell of bile and pizza, began to make me gag a little. Just then the monitor indicated that the patient had a shockable rhythm. I charged the padlles again - this time at a higher energy setting, and shocked him again. His arms flew up again. The monitor stayed flat. Again.
"'Scuse me - do you think he's gonna be awright?" asked a boozy voice just inches from my ear. It was one of his friends.
I don't know. Maybe it was because he startled me, or perhaps it was that fact that I was wearing the equivalent of Saran Wrap, in terms of breath-ability and heat retention, for a shirt, and I was getting heevy from kneeling in some guys regurg, but my response was less than polite:
"Get the fuck away from me."
A cop motioned for him to move away. Mellisa was able to place the tube. I had just finished giving him another round of drugs. The monitor showed a change in rhythm. I checked for a pulse. Surprisingly, there was one. The patient's face began to change color, from a dark mottled blue, to a nice shade of pink - almost red in fact. I wondered about this for moment, then realised his color was partially due to his consumption of alcohol.
His pulse rate began to climb; so did his blood pressure. After rolling him onto a long board, we loaded him into the ambulance. Off we went to the hospital. He's in the ICU at this moment. Physiologically - he's doing pretty good. Neurologically - it's anyone's guess whether Fred's still in there.
Oh well, at least we still get to bill his insurance.
- Tae
The moral of the story: NEVER work a day shift.
(Originally posted on Mon, 25 Jul 1994) _________________________________________________David Cockburn asks: "Tae, I'm curious: why not? My MedicalMissus(tm) reckons the nights on duty are far worse, usually due to alcohol/drugs etc. All the worst accidents seem to be then, too."
Tae replies:
Well, David, I agree with your missus: night shift garners much more of the drug-related trauma than day. But that is not the thing that bothers me about working nights. I'd rather work the evening or night shift. You're dealing with a 'trauma junkie' of the highest dependancy. I can't describe how much better I feel about my life when I'm standing over some poor fuck who's noisily puking out his lower intestines.
ObAside: I've been known to say to myself:"Better him than me." A line shamelessly stolen from "Full Metal Jacket," while standing over said fuck.
The reason I warned y'all not to work the day shift is that that's when the highest ratio of managers-to-employees arises. That's when they notice that your boots are scuffed or
Bitter? Me? Noooo.
- Tae
(Originally posted on Fri, 29 Jul 1994)
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