Closest Most Appropriate 4/7

John, my partner, is a new medic in the county so Scheduling floated him to my unit today because my normal partner is out on light duty from an injury he received while lifting a 600 pound patient. John has to be with a more experienced medic until he gets signed off by a Field Training Officer. Scheduling doesn’t seem to care that I only got signed off last week. Although we’ve never worked together, and honestly just met a few hours ago, we had a good bonding on our last call. Stat calls can bond partners in a way few things can. I imagine it’s similar to people who go to war together but I’ve never experienced that so I can only guess.

Our first call of the day was for a teenage gang banger who got shot in the ass. The large city in our county is ripe with urban violence – gangs, drugs, and everything else that eventually ends with a trip to the hospital. Consistently ranked in the top five of the country’s most dangerous cities, it tends to be a great place for a new paramedic gain experience – fast! The baby gang banger was pretty much okay – single entry wound, no exit, small caliber bullet, able to move all of his extremities. Actually a pretty basic call for the city and John and I executed the necessary tasks and got him to the trauma receiving hospital in good time.

John and I are on the same page about Josh’s treatment and I trust he’ll make the case for the Base MD well enough to allow us to do the right thing. Meanwhile I make a quick call to the supervisor and tell him what’s going on. Company protocols dictate that I alert him if I need to transport out of county. I quickly lay out the scene for him and he agrees that it’s what needs to be done. His parting words gave me a shiver, “Good luck with that.”

I see John hang up his cell phone and I give him the raised eyebrows as I’m helping to wind up the EKG wires and put them back in the monitor. “Okay, I talked to Dr. Finch and he understands the situation. He would rather us take him to Kid’s but said if the mother is insistent then we have permission to go to University by ground or air.”

I turn to Mom, “Which hospital do you want him to go to, University or Kid’s?”

“Definitely University!”

“Okay, we’ll get him there.” Mom, who has had every mother’s worst nightmare in groundhog day repeats gives me a big smile and thanks me as she starts gathering up necessary paperwork and belongings for yet another ambulance ride with her very sick child. I’ll take her with me if I have to drive him, sitting up front of course. There is a very real possibility that Josh may decompensate en route and no mother needs to watch us run a code on her kid from a ringside seat on the bench  – where you can actually hear the ribs break from CPR.

As I’m getting ready to pick Josh up and carry him to the gurney the fire captain comes up shaking his head. “They just flew a guy off the freeway, ETA for the next closest helicopter is 30 minutes.” Crap, that’s too long!

“Okay, it looks like we’ll be driving him, I’m glad that accident was the other direction on the freeway.” The captain raises his eyebrows and gives me the tight chin look that says he understands what the next 40 minutes are going to be like. He’s a paramedic also – keeps his certs current, does the occasional IV or helps out with an intubation now and then. But he’s a captain now and the fire medic that works on his crew is supposed to do all of the advanced life support interventions. He’s put in his years and deserves his position even if he would rather be pushing the Dextrose into the vein of a gorked diabetic instead of writing down the same medications on every call and asking the same tired questions of family members. Yet I can see that this is one call where he’s happy to down his engine and go back to the station to wait for us to bring back his fire medic.


~ by KC on May 30, 2010.

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