Jamie Davis's Blog, page 19

Paramedic Graduation

The Elk City EMS academy paramedic graduation class stood at the front of the room looking out at their families and friends who watched as each of them was recognized in turn for their achievements over the last two years. The program was an Associates Degree program that culminated in the students testing for the National Registry Paramedic (NRP) certification. That certification, coupled with the passing of the Maryland State EMS protocols test, made them a licensed paramedic.

Proud New Paramedic

Dean Flynn had worked hard alongside his classmates with that one goal in mind. He stood a little apart from the others in the group. He had always wanted to be the best, not just good, but the best paramedic in the academy. That drive had put some distance between himself and his classmates as he expected the same drive to be the best from them, too. Most of them considered him aloof at best.

Dean had always wanted to be a paramedic. Ever since his own tumultuous ride in the back of an ambulance following a car accident at sixteen, he’d known this was what he wanted to do. He’d watched from the ambulance’s front passenger seat as his girlfriend’s life was saved by a quick thinking, fast acting paramedic, working his magic in the back of an ambulance speeding to the trauma center. Now all the hard work, the long hours studying, the working alongside real paramedics with street smarts was about to pay off.

Dean had heard that the top of each class got to pick their first assignment in the city. He’d thought long and hard about where he wanted to be. There was Station 1, located in the center of downtown. He’d get his share of high energy calls, with shootings, stabbings and other exciting trauma calls to keep him busy between the boring medical runs for the diabetics and asthma patients. He’d given some thought some about picking one of the two stations near I-95 where it went through town. They got some pretty terrific car accidents there which would test his skills and problem solving abilities as he tried to extricate the victims from the twisted wreckage.

He was sure of one thing. He didn’t want one of the outlying stations in suburban areas, where they were working on implementing some community paramedic and integrated health programs. These paramedics made house calls and didn’t even get to transport most of their patients to the hospital. He’d done his rotations there and learned the importance of helping patients with chronic disease and minor problems stay out of the hospital. He knew that these stations were part of the new healthcare reform that was shifting high health care costs to the savings of prevention, but where was the fun in that? There was no glory in helping a diabetic patient keep his blood sugar even from day to day, was there?

Waiting for the Paramedic Assignment

Dean wandered around, making small talk with the few people who would talk with him. He filled up his cup with some more punch from the refreshment table as he watched his primary instructor, Mike Farver move around the room with a collection of big manilla envelopes, talking to each of the students in turn and handing them one. Dean knew that in each was their final scores, the badge they had earned to pin to their uniforms. The one that said paramedic on it. The envelope also contained their new uniform patches and, most importantly, their new assignments and the name of their preceptor at the new stations. It was a formality in his case since everyone knew he’d picked Station 1 by now and the top of the class always got their pick of assignment.

Mike was taking his time getting to Dean, though. He’d passed by and said hi when he first started handing out the envelopes but since then, the older paramedic instructor had not come over in Jerry’s direction. People and their families were starting to leave as the assignments were handed out, shaking hands or hugging each other before they left, wishing each other luck on their first days on the job next week.

At this point, Dean had pretty much figured he was going to the be the last one who found out where he got assigned and he was ok with that. Everyone else had people here to congratulate them and most were going out with family to congratulatory dinners and such. While he considered himself friendly with his classmates, he’d never gotten close with any of them and he didn’t have anyone here to celebrate with anyway. The reception had pretty much wound down by the time Mike came over to Dean with the final manilla envelope. The deputy chief had left long ago, along with all of the other invited dignitaries. The catering crew was starting to clean up the tables and mess.

“Took you long enough.” Dean said with a smile as Mike made his way over to him with his assignment. “I would have thought that I would get to go first.”

Mike stepped over and shook his hand. “‘The last shall be first and the first shall be last,’ my friend,” he said smiling. “I wanted to have a few words with you in relative privacy before you got your assignment. You’ve been the brightest of my students in a long time, Dean. You’ve studied the hardest. You have a good handle on skills and you’re one of the best intuitive problem solvers I’ve ever seen. I want you to know that it’s been a pleasure teaching and watching you grow into a fine paramedic these past few years.”

He handed Dean the envelope. Dean could feel the extra bulk as he took it. The badge and patch were pushing the envelope out in places. Mike continued, “I just wanted you to know that as you head off to this first assignment, you got picked for it because you’re one of the best to come through the academy in a while.” Mike put his hand on Jerry’s shoulder. “This is not what you expected, Dean, but it suits your unique skills and talents. Remember to keep an open mind and stay safe out there. You’ve definitely got the skills to do this job the way it needs to be done.” And then he shook Jerry’s hand again and walked away, grabbing his uniform coat and heading out the door to the parking lot.

Well that was weird, Dean thought as he flipped the metal tabs on the manilla envelope and lifted up the flap to look inside. He reached in and slid out  a stack of papers along with his patch and badge balanced on top. He sat down at one of the round tables as the caterers continued to cleanup around him, looking briefly at the silver badge that said paramedic on it. The patch looked a little different than expected which was weird. He thought all the Elk City paramedic patches were the same. It said EMS-U at the top, had a star of life in the middle and Paramedic at the bottom. There was a certificate of completion. His diploma for an associates degree in applied science as a paramedic was in there along with another white sealed envelope with the Elk City letterhead on it. He quickly opened this one, tearing open the sealed flap with his finger, careful to avoid a paper cut, and pulled out the paper inside. He unfolded it and read the letter.

“Dean Flynn, congratulations on your achievement and graduation from the city college paramedic program. This is your letter of acceptance to employment as a paramedic for Elk City and pending the receipt of your state paramedic license, will act as your proof of licensure. Please report on Monday morning June 2 to Station U …”

“Station U?” Dean muttered under his breath, his shoulders sagging a bit with disappointment. “Where the hell is station U?”

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Paramedic’s Crazy First Night

Dean literally couldn’t believe what was happening. He was in a darkened bedroom lit by a single overhead light and the flashlights of his two-person EMS crew. There was a struggle was taking place, accompanied by grunting, growls and shouts of the two paramedics and their patient. The smaller of the two EMS providers, a diminutive dark-haired female was wrestling with a large, snarling, furred creature on the bed.

“Get me the glucagon,” said paramedic crew chief Brynne Garvey through gritted teeth. “RIGHT NOW!” Brynne was apparently a lot stronger than she looked, Dean thought as he struggled to figure out how to reconstitute the powdered drug in the preloaded syringe. She was only about five foot two inches tall with her long, straight brown hair pulled back in a pony tail.

“Probie. I. Need. That. Syringe.” She said through gritted teeth.

“I’m coming, I’m coming!. I’ve never used one of these prefab syringes before.” Probationary paramedic Dean Flynn finally got the syringe assembled and handed it to his preceptor. “Here.”

“I can’t do it. I’m a little busy here,” she says as she grabbed one of the creatures flailing arm and pinned it to its body with one leg, avoiding the claws that had spontaneously grown out of the fingertips. “You do it, probie! It’s time you stepped up your game and showed me why you got this gig to begin with.” The struggle on the bed intensified. “DO IT! GLUCAGON! NOW!” The last was almost a whisper.

Dean stepped forward hesitantly and then injected the syringe into the hairy thigh of the creature struggling with his partner on the bed.

As the beast continued to struggle, Brynne muttered under her breath. “Humans are easy to save.”

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All That Glitters Isn’t a Vampire, Usually

As the ambulance pulled in to the Jiffy Mart parking lot on Bridge Street, Dean scanned the area. Scene safety was the first responsibility and while it was moderately busy with people coming in to get their morning coffee on the way to work, there was nothing out of the ordinary. He pointed to a gold tone minivan parked along the side of the building. The windows were tinted dark and in the early dawn light and the headlights of the ambulance, there was no way he could see if anyone was inside.

Brynne drove the ambulance up beside the minivan as Dean keyed the mic and said, “U-191 on location.”

Brynne put the unit in park and climbed out. Dean did the same on the passenger side and as he did so, a short, plump, middle-aged and shirtless white guy jumped out of the driver’s door of the minivan, shrieked “Thank God you’re here” He dashed to the side of the ambulance, opened the side door of the ambulance box and jumped in, shutting it behind him. Brynne came around the back of the unit while Dean just stood there.

“Well, get the gear out probie!” she said. “Don’t just stand there with your mouth open.”

“Don’t tell me, Boss,” he said, gesturing to the ambulance door. “I think our patient just jumped from his car to the back of the unit shouting ‘Thank God you’re here.’”

“What?” she said crossing over to the ambulance’s side door. She stood on tip toe and looked in the window before letting out an exasperated sigh. “I didn’t recognize the car but I should’ve guessed.” She looked at Dean. “Well climb on in. Let me introduce you to Gibbie.” Dean grasped the door handle, quirked an eyebrow at Brynne, opened it and climbed in with his preceptor close behind. As Dean sat down in the captain’s chair at the head of the cot, Brynne climbed in and sat in the side chair facing the patient.

The patient was stripping off his clothes and appeared to be covered in some kind of glitter make up or something, which he was getting everywhere. There were also noticeable hives popping up all over his torso. Gibbie, as Brynne had called him, ripped open a ten pack of four by four gauze and began to frantically wipe at his skin. He looked up at Brynne and Dean. “Thank, God! Thank, God! Thank, God! Brynne, you’ve got to get this stuff off me. It’s itching like crazy. I swear I’m having some kind of reaction to it.”

“I’ll say,” said Brynne looking him over. “Gibbie, calm down. Getting yourself all worked up is only going to make the reaction worse.” She looked at Dean. “Get a bottle of sterile water out of the cabinet behind you. I’ll get some more gauze. There should also be a few folded white towels in with the sheets and pillow-cases for the cot. Get them, too.” She turned back to their frantic patient. “Good Lord, Gibbie what is this stuff?” Brynne said as she, too began to wipe the glittery cream off him as best she could.

“It’s sunscreen, ok. I was trying to impress my new girlfriend. She’s all in to those old Twilight books and I thought I could impress her by showing that I can sparkle in the sunshine, too.” He started blubbering, as he looked around. “Oh my God! We have to get out of here. She works night shift here at the Jiffy Mart and gets off at 6. I was going to surprise her by standing by her car as the sun came up. Sparkling the way she wants me to. Now it’s all ruined!” He started sobbing and whimpering as he continued to swab at the glitter cream all over his chest. Gibbie was actually the esteemed Gibson Proctor and while he looked middle aged, Dean would later find out he was over 600 years old, more that a bit flighty, and a vampire.

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Paramedic In Trouble With A Lady

As the two paramedics approached the front door a man in his twenties met them on the front porch. “She’s in here, she can’t breathe!” He told them as they approached. He pulled the screen door open and held it for them as they walked through into the house. On entering the living room at the front of the home, they saw an attractive young woman in her twenties with red hair, seated on the edge of the sofa, her hands on her knees, slightly leaning forward as she struggled to lift her torso up to allow complete filling of her lower airways. This was called the tripod position and it was not a good sign. She was clearly struggling to breath and was pale with a slightly blue tinge to her lips. The could hear the wheezing noises from her labored respirations from across the room. On the coffee table in front of her were several medication inhalers and a portable home nebulizer with tubing that led to a mask, now laying on the floor.

Dean put the bags down on the floor next to her and started to pull out a non-rebreather mask and tubing from the oxygen bag. “Hi, my name is Dean,” he said as he worked. “We’re going to do what we can to help out, ok?”

“She’s Lydia,” the man said. “Her asthma is acting up. This is the worst I’ve ever seen it.”

Lydia gasped out some words, one word at a time. “I. Tried. My. Nebu. Lyzer. Treatment. But. It. Did. Not. Work.” There was a gasping breath between each word she said.

“Here,” Dean said, holding the non-rebreather mask up to her face with oxygen set to fifteen liters per minute. He stretched the elastic band around her head to hold it in place. “That should help a little bit while we get some other things set up.”

Brynne set the heart monitor down on the coffee table in front of Lydia and turned it on. She connected the blood pressure cuff tubing to the machine, wrapped it around Lydia’s arm and pressed the button to start inflating the cuff for a reading. She placed the earpieces of her stethoscope in her ears and held up the bell end in one hand. “I’m going to listen to your lungs, ok?”

Lydia nodded and Brynne reached around the woman’s back, lifting her shirt up and sliding her hand under. She started at the top listening on the left and right side and then moving down and repeating twice left and right for a total of six lung fields. “Wheezes at the top, diminished breath sounds in the middle and nothing at the bottom.” Brynne looked up at Dean. “So, Dean, what’s next?”

“Nebulized combination meds,” Dean said confidently. “Albuterol and Ipratropium, two point five milligrams of Albuterol and five hundred micrograms of Ipratropium via nebulizer mask.” He turned to the oxygen bag pulling out the neb mask and tubing. Taking the non-rebreather mask off Lydia, he replaced it with the nebulizer mask and attached that tubing to the oxygen cylinder, setting the flow to ten liters per minute. The chamber began bubbling, sending a cool mist of medication up into the mask for the woman to breath in.

“I need you to try to calm your breathing down,” Brynne said. “I know it is hard but try. We need to get that medication in as deep as we can into your lungs. Listen to my voice and try to breathe in as I count to five, hold it for a second, then breathe out.” Her calm voice started counting slowly holding Lydia’s eyes as she worked with the struggling woman to slow her breathing down. Dean watched as the technique actually started to work. While she was still having trouble breathing, the combination of Brynne’s tone and the medicine seemed to start having the desired effect.

“Lydia,” Brynne said, anticipating Jerry’s thoughts about treatment. “You are looking better but I think you still need to go to the hospital” She looked at Dean, “Let’s switch her to a nasal canula for now and discontinue the neb treatments.”

Dean nodded and took the spent nebulizer mask off Lydia, and reached in to pull out a nasal canula. He was in the process of removing the cannula from the plastic bag wrapper when Lydia spoke in a non-distressed voice for the first time. Her tone was captivating, literally and he just sat staring at his hands as she spoke.

“You all are so helpful,” Lydia said, her breathing easier. “I want to thank you but I’m not sure I need to go in to the hospital. You could just stay here and help me out. Right, Dean?”

Dean looked up from his hands at Lydia. Jeeze! She was beautiful. Why hadn’t he noticed that before. Her voice was so convincing and melodious, how could he even consider telling her no. “I would be happy to stay here and attend to you, Lydia.” Dean said, his eyes glazing over. “You only have to say the word.”

Lydia’s husband was staring at her aghast, “Lydia, I can’t believe you’re doing this again.” He held up a hand. “I want nothing to do with it.” He turned and stormed out. Brynne looked at the man’s back as he left the room and then looked at Jerry’s face.

“Aw, hell no!” She shouted and started digging around in the med bag on the floor, “Crap, crap, crap!” The senior paramedic obviously didn’t find what she was looking for because she stood up and bolted out the front door for the ambulance. Dean couldn’t understand why she was being so rude to their hostess. After all, Lydia was generously offering an opportunity to stay here with her which was obviously a better idea than taking her to hospital. And anyway, if he stayed here he could keep listening to her lovely voice. She was humming a tune now, nothing he recognized but a lovely melody with a steady up and down cadence that —.

Suddenly a loud clanging broke through the melodious humming and Lydia shrieked, covering her ears. Dean looked up at Brynne startled as she stood in the center of the room. How had she gotten there? She was just sitting on the couch a second ago. And what was that she was banging on with a drumstick? She stopped for a second and then held out her hand.

“Dean, twist these up and put them in your ears,” Brynne ordered. He reached out for what she was handing him, confused but obeying. He stopped though as soon as Lydia started talking again.

“You come in my home and make that infernal noise when I’m talking?” Lydia said. She shut up and covered her ears again when Brynne started beating on the metal box again. Dean shook his head to clear his thoughts. It wasn’t a metal box. It was a cowbell, like from a drum kit. Where had she gotten that?

“Dean,” Brynne shouted over the din of her banging. “Come over here. Pick up the two pieces of beeswax, twist them up and stick them in your ears.” Dean stood up, took a few steps and picked the two orange lumps off the floor. They were sticky and soft and he rolled them, one in each hand between his thumb and forefinger and then inserted the column of wax in his ear canals. The din of the cowbell taps were not as sharp as soon as the two earplugs were in place and as soon as Brynne saw that he had done as she asked she stopped the banging.

She looked at Lydia, “Lady, you’ve got a lot of nerve trying to charm my partner! We came here to help you!”

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