Multiple MI's... (Originally posted 5-26-06)

My first shift with Pseudo Dad.

*RIIIIIIING*

EpiJunky: “The Closet”

Dispatch: “I have a run for you out of St. Holy Hospital of the North End to Very Large Hospital in Cleveland.”

EpiJunky: Copy that. Enroute.

Pseudo Dad and I get out to the rig… He asks me if I want to drive.

I turn a shade of red. It’s raining and I still am not proficient at parking at St. Holy Hospital.

Pseudo Dad: “We’re going to work on that. I’ll drive for now.”

We meet my Patient, a very pleasant but somewhat anxious woman, very close to my age. I take a few minutes to talk to the patient, gather her belongings, and make sure the correct paperwork is completed. It’s going to be a long drive, the weather is awful, and we want to get on the road. Here’s where I made a mistake. More on that in a bit.

As we’re leaving St. Holy Hospital I get a starting set of vitals, and start to go through the extensive amount of medical records being sent with the patient. At this point I start to ask the patient some questions that I really should have asked before we left the hospital.

EpiJunky: “You’re having surgery?”
Patient: “Yes, I’m actually having a heart transplant”
EpiJunky: “You’re so young… A heart transplant?” I start to read into her medical records a little deeper.
EpiJunky: “You’ve had SIX heart attacks in the past six months?”
Patient nods.
EpiJunky: “You’re going to the best place to have your surgery done…”
I could sense she was very anxious, and I didn’t want her picking up on the fact that I was close to panic.

According to the paperwork she’s had two MI’s in the last ten days. She needs to be on a monitor, and we’re a basic car. We’re driving through a monsoon, two hours to a large hospital, with a cardiac patient, BLS.

What the HELL?

Was it dispatch’s fault for not sending ALS, the hospital’s fault for not relaying to dispatch that this patient needed ALS, or my fault for not picking up on the fact that this patient needed ALS BEFORE we left the hospital. I definitely find myself at fault for not reading her paperwork thoroughly before leaving with her. How could I be so stupid? How could I assume that I had the whole story and just assume that if they called for a BLS truck, it was because the call only warranted BLS? How could I not ask more questions before we left the hospital?

What happens if she starts having chest pain? We’re out in the middle of nowhere. Sometimes 20 miles between towns.

I stifled my panic and kept a close eye on the patient. We talked, joked, discussed jobs, families, etc. I took her vitals every 20 minutes and told the patient that if she had any discomfort whatsoever she was to tell me immediately.

We arrived at the huge hospital without incident and the patient thanked me for making the drive go by so quickly.

You have no idea… I thought… Two hours had felt like two days.

I later questioned my supervisor about it… Maybe I had blown the situation out of proportion. My supervisor, a Paramedic in a management position, blew me off.

“I don’t think it was an ALS run.”

That was all she said.

I came to a realization last night. I want to further my EMS education. I don't know that this will be my career... I'm far too new for that. And I almost feel like it's wrong to move on to EMT-I or Paramedic without getting more Basic experience... But I feel like I would be more of an asset to my patients and my employer with some more education.

I guess the positive spin on it would be at least I wont have any long term bad habits to break... Shoot, I haven't been around long enough to have developed ANY habits. This patient last night sealed the deal for me... If something, GOD FORBID had happened during our transport, with my education, I would not have been able to do anything for this patient other than give them aspirin. Cardiac Arrest? Get out the AED and start pushing, no ACLS drugs coming from me.

This isn't going to cut it for me, I have a feeling.

Maybe my intermediate this fall, Medic next year or the year after, and RN after that.

I’ll never be done learning.