Bee-dee-dee-deep! Bee-dee-dee-deep! I look at the clock: 4:30 AM. I jump into my car and drive to Vital EMS in Worcester for a fourteen-hour shift as an EMT. Upon entering the ambulance, my partner and I are quickly dispatched to the residence of a 50-year-old male for an unknown medical complaint. As we rush to the scene with lights and sirens, I know that it is imperative to remain calm and immediately begin to allocate tasks. Upon arrival, I rush out of the ambulance and seize the first in bag, an oxygen tank, and the defibrillator. We head into the residence and encounter the patient lying on the couch complaining of chest pain and presenting with an inadequate oxygen saturation and increased breathing rate. I immediately realize that …show more content…
As I walked into the room, I met George for the fist time. I noted that he seemed very tired and barely acknowledged my presence when I spoke to him. As I smiled at him and related that everyone will take great care of him, he simply nodded his head and refused to make eye contact with me. After we placed George onto our stretcher, loaded him into the ambulance, and made our way to the dialysis clinic, I had the opportunity to learn more about him. He confided in me that this was the first time that he had been outside in a couple of weeks and he felt estranged from his family because his children lived in another state. As a result, he said he did not interact with other people very often and mostly stayed in his room and watched television. As we spoke about local sports and in particular the Boston Celtics, I established a connection with him and had a wonderful experience talking with him. While waiting with him for his dialysis appointment, we continued to converse and I remember to this day that his face was lit up with a giant and beaming smile. He was ecstatic and had completely shifted his initial isolated and depressed attitude. I was truly astonished at how such a minor action, such as taking the time to listen to what he had to say, resulted in such an immense positive change in his emotional state. As I sat in the back of the ambulance with George after his
“Code Blue, ER. Code Blue, ER”. I can still hear that calm, unalarmed voice over the intercom. Seconds later, John Doe, a 50-year-old male, is rushed in through the double doors of the Emergency Room with an EMT pounding on his lifeless chest. Although the medical staff had been preparing for some time, it still appeared like a scramble to resuscitate this man’s life. It was my first shift as a medical scribe; I had no idea what to expect. While paramedics shouted the jargon-filled report, the surrounding chaos was quieted by the physician who maintained the room's composure. The instant the pulse was obtained, I was overcome with a foreign feeling that can only be described as pure exhilaration as if the epinephrine injected into the patient manifested its effects on me.
Pulling off the ramp, we turned onto Church Hill Road responding on a priority one for the cardiac arrest. I tried to review my field guide en-route to the call, but all I could see were flashing lights reflecting off the guide’s pages and crowds of cars moving over for our wailing sirens. Within three minutes we had arrived on-scene and it was clear that our patient was not in cardiac arrest; however, his 12-Lead EKG and oxygen saturation were marginally reassuring and pointed to an active heart attack. At this point in my EMS training I was a BLS provider, but had adequate knowledge to assist Kathy. Instinctively, I went right to work and loved every second of it. The concept of formulating a differential diagnosis in the field and testing that theory is one of the principle factors that kept drawing my back to EMS. In addition, I developed an unparalleled appetite for knowledge, stemming from my desire to get every differential diagnoses right. Coming to this realization early in my EMS career, we [healthcare providers] frequently forget that patients often lack the medical knowledge provided to us through years of training. Behind CT Scans and MRIs are patients with questions. Having the ability to provide compassion, sympathy and reassurance to a patient is a central part to their recovery and survival; therefore, we [healthcare providers] need to be able to care for our patients on a holistic level, focusing less on the disease and more on the
Clipboard and stethoscope in hand, I walked toward the double doors that flashed emergency in bright red letters above. It was my first clinical shift as an EMT student, and first day jitters flittered around in my stomach, I had no idea what to expect. However, I was not expecting to witness the fragility of life. About a half an hour into my shift the rapid response alarm blared through the emergency room. I turned to my preceptor and quizzically asked what this meant. “A rapid response is a patient who is in need of immediate medical care and intervention. As an EMT who is part of the rapid response team you will be expected to assist with vitals and chest compressions. Let’s head toward the recess room, and I’ll explain more there.” Eventually, we reached the recess room, and the rapid response team was already there preparing for the arrival of the patient. A nurse was on the phone with the firefighters that were bringing the patient in. Seconds later she announced “It’s a STEMI”. Then fright ran through my veins. A STEMI is medical jargon for a segment elevation on an EKG. In other words the patient’s coronary artery is completely occluded. The patient is suffering from a heart attack. Prior to this, I had never seen someone who was having a heart attack. However, the thing that terrified me the most was that I knew I would be expected to perform chest compressions. I had only ever performed chest compressions on a dummy.
After his lunch break, Tom didn’t have long to wait before the paramedics burst in through the swinging double-doors of the ambulance bay wheeling in a young man on a gurney. Edward, a veteran EMT, recited the vital signs to Tom and Dr. Greene as they helped push the gurney into the trauma room,
Charging to 200....Stand clear…Shocking! CPR....EMS providers experience the adrenaline and rush of a patient in cardiac arrest. Trying to bring dead back to life is not a simple task by far, especially with the limitations and resources of the field. But, what happens after the patient makes it to definitive care? Annually, around 300,000 adults in the United States experience out-of-hospital cardiac arrests (AHA), and EMS providers only see the results of the short term survival of the patient, but rarely the actual patient care and recovery after an arrest. Patients undergo intense, aggressive treatment and recovery measures in the hospital post-code. These patients have a variety of treatment regimens
In April 2012, Mr. Hammett’s death was ruled to be human errors that individually would have been unlikely to harm him but proved collectively to be fatal. Mr. Hammett surgery was at at private hospital that did not have any after hours medical cover. During the procedure his oxygen saturation levels were almost perfect, maintaining it at 99%. Somehow during or after being transferred to Post Anaesthetic Care Unit (PACU) his oxygen saturation levels fell to 64%. The anaesthetist assumed that it was caused by an obstructed airway and discharged the patient to the ward; he did not look for anything further to be wrong with the patient. Mr. Hammett complained continously to the RN of high levels of pain; the RN ignored him and referred to him as a “wimp” when switching shifts. Although Mr. Hammett was on a Gemstar pump, which recorded him pressing
There are errors and hazards in care that occurred in the Mr. B scenario. One error was the emergency room physician’s failure to recognize the signs and symptoms of deep vein thrombosis (DVT) that Mr. B was presenting. If not treated early, a DVT can become a pulmonary embolism, a fatal condition that Mr. B unfortunately developed. Another error in care that happened in the Mr. B scenario is the nurses’ failure to monitor Mr. B’s ECG and respirations. Early detection of critical ECG and respiratory changes could have initiated medical interventions that would have saved Mr. B’s life. One hazard is the emergency room nurses’ heavy patient load at the time of Mr. B’s sentinel event. Another hazard is having a licensed
You hear a distinct crashing sound in the near distance following a loud screeching noise while driving down a dimly lit road. As you are driving down the road you come upon a car wreck and you can see people that need your help. You jet out of your vehicle and immediately get your medical bag with all your instruments that you use to save lives. You have to react fast because the people that crashed have already lost a lot of blood and will not survive if they wait for the ambulance to arrive. You start the normal procedure by cutting off their clothes to find where the wounds are or anything that needs to be attended to. You try to cut off the blood flow and apply pressure to the wounds to slow down the amount of blood loss in the patient
Clipboard and stethoscope in hand, I walked toward the double doors that flashed emergency in bright red letters above. It was my first clinical shift as an EMT student, and first day jitters fluttered around in my stomach. I had no idea what lay ahead of me. However, I was not expecting to witness the fragility of life. About a half an hour into my shift the rapid response alarm blared through the emergency room. I turned to my preceptor and quizzically asked what this meant. “A rapid response is a patient who is in need of immediate medical care and intervention. As an EMT who is part of the rapid response team you will be expected to assist with vitals and chest compressions. Let’s head toward the recess room, and I’ll explain more there.”
As staff was quickly working to connect the patient to the monitor, obtain IV, EKG and labs the physician was assessing the patient. Shortly after we began our routine process of treatment for this patient he became unresponsive and pulse was lost. Since everyone was already in the room we were able to begin CPR immediately and obtain a pulse within 2 minutes. The gentleman was then rushed to the cath lab where they were able to perform interventions and open up the blocked arteries.
The chaos of a crowded room swirls before my eyes, as bodies blur and congeal with activity, while a new race against the clock is set into motion. The steady thumping of drums can be heard resonating in my ears as my heart beat tries to drown out the physician’s idiomatic recanting of the patient’s primary injury survey. The anxiety of the moment swells as I begin to lose focus and my thoughts start to wander, and I begin thinking about the patient’s wife, children, parents, and friends. At the edges of my concussions the physician asks for the patient to be intubated due to an airway compromise, and my wondering gaze snaps back into focus as my heart beat begins to slows. A forty-year-old male with a gunshot wound to the chest is fighting
| Lesson Outline: Allocated teacher-NExplaining legal requirements : Duty of care: A duty of care is implied when the person who is requiring your assistance is in your workplace. E.g. patient, co-worker or visitor. Consent of an unresponsive patient is assumed in an emergency situation. (Crouchman, 2009; Milne & Mellman-Jones, 2010).Cultural awareness/sensitivity: We need to mindful of varying cultures when assisting patients, as different cultures prefer to be unexposed which is necessary when defibrillation is required. Eg, Muslims (Hattersley & Keogh, 2009). Confidentiality: Following an emergency situation it is vital to refrain from speaking to others outside the workplace about the patient to ensure the patient’s privacy and dignity. Think about how you would feel if you where in the patient’s situation. (Maeder, Martin-Sanchez, Croll, & Ambrosoli, 2012)?Limitations: Remember that once you start you can’t stop until you’re physically unable to or help arrivesDebriefing: Participating in the debriefing process is vital due to the enormity of the situation, enabling the nurse to express
A failure to react promptly or appropriately escalate care in patients with sudden, critical abnormalities in vital signs constitutes a “failure to rescue” and may end in a serious adverse event. There are many causes for an abrupt critical event and for failure to rescue, and they help hospitals understand why these events are astoundingly frequent (Jones, DeVita, & Bellomo, 2011).
When I woke up, I was surprised to find a weird, padded board with red and green stripes on it, wrapped up onto my arm so it would stay. I was told that they could not get my elbow back in and I was transferred to a different hospital. I didn’t enjoy the presence of the people in the second ambulance with me nearly as much as I liked the first two people because, they weren 't nearly as good at comedy. Although, second ambulance made me feel a bit safer because I had already experienced what riding in an ambulance was like. I was familiar with the white interior and the medical equipment with bright red crosses on the cover hanging on the walls. I had already known the pain in my arm as the vehicle bumped into the
Mr. L was the gentleman I chose to assess, he was very friendly and talkative; has been a dialysis client for the past three years. He has dialysis treatments three times a week, and treatments are approximately 3 to 4 hours long depending on his level that day. I asked Mr.L how he felt about being on dialysis and his response was “In the early days of dialysis, I would not even drive myself home. I would just collapse on the couch in the living room and be there until morning. But all that has changed. I now drive myself to and from dialysis, and I feel just fine after. I even have a part time job now. I tend to be very hungry after dialysis so I try eating something as soon as I get home. Just one evening recently it was like old times. It was because the nurse took off more than I wanted and my body really reacted to it. I just went home and collapsed. I was not even able to work the next day. But that is very rare for me.” I enjoyed our conversation and my experience at the dialysis center.