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Firefighter Intern: Day 55 and 56
Jan. 19th, 2019 12:54 pm“If it's both terrifying and amazing then you should definitely pursue it.” ― Erada
Almost before the morning safety meeting started, we were toned out on an elderly gentleman who fell on the steps of his home, and his spine issues required special handling and packaging to get him loaded for transport. I held his head and maintained his c-spine collar and helped with the transfer to the gurney. We still have the Paramedic Intern, so I was chasing in U482 - but Medic 481 was glad we showed up.
Once we got back to the station, we were almost immediately double-tapped out top two calls, so I rode third in our second out Medic Unit, Medic 483. We responded to an older lady who worked at the local mill, who had a complaint of chest pain. She ended up having supraventricular tachycardia, a fairly rare condition where the heart is beating very fast. The "supra" in supraventricular means above the ventricles. After we stabilized her with some adenosine, and chemically reset her heart, we transported her - but we stopped at a good place and swapped me for the Paramedic Intern, to also give him some good experience with this cardiac condition.
I spent the night at the Quincy substation by myself, as we had no room at the station with a full crew and the Paramedic Intern. I took U482 and my turnouts and monitored the radio all night for our response group - not very restful sleep, though. Back at the station by 8 am for the morning meeting, but the Chief and all the Assistant Chiefs had an out-of-town meeting elsewhere, so we got an early start on rig checks and house chores. I am taking on the weekly responsibility of washing and folding the towels. *smile* We spent the day working on a lot of little projects, and restocking expired medications and replacing expired kits at the Delena substation. Not much studying happened this week!
About mid-afternoon, we got double-tapped again, so the regular paramedics went on the first call, and the Chief, the Duty Officer, and I went out in the second-out Medic unit for an older lady who had fallen and was 'incoherent.' I brought in the jump kit and the monitor, and the Chief and I brought in the gurney after we did a lot of assessment. I got to help with vitals and the pulse oximeter, and some of the stroke assessment (the arm drift test), and handed different items to both of them on request. Once we packaged and loaded the patient, the Chief drove so I could stay in the back and learn and observe. I helped spike the bag, got the patient on a nasal cannula and administering 4 liters of oxygen per minute, and helped with the IV preparation and ongoing vitals. I also got her a hot-pack for her cold hands (poor circulation) and we treated her for shock. We transported her and I got to be a bit more hands-on than usual. Also, the Duty Chief and the Chief both got to see me working and doing a good job. (!)
We got back to the station, restocked and went to bed - and slept uninterrupted all night. *smile*
A standard rapid trauma assessment will check for each of the following life threats, and provide some forms of basic treatment. Treatment that would not be life-saving is not conducted until after the rapid trauma assessment.
For each area of the body assessed, it is helpful to review them while addressing the different parts of the mnemonic "DCAP-BTLS." This stands for: Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, and Swelling.
- goes from head to toe to find these life threats:
Cervical spinal injury
Level of consciousness
Skull fractures, crepitus, and signs of brain injury
Airway problems (although these were checked during the initial assessment, they are rechecked during the rapid trauma assessment) such as tracheal deviation
Penetrating trauma to the neck, distention of the jugular veins, or a break in the tracheal-bronchial tree
Signs of serious chest injuries, including penetrating trauma to the chest, which can cause a sucking chest wound; flail chest; tension pneumothorax; and cardiac tamponade
Breathing problems (like airway problems, these are also rechecked during the rapid trauma assessment by listening to breath sounds with a stethoscope)
Signs of serious abdominal injuries, including evisceration; penetrating or blunt force trauma; or peritonitis from bleeding into the abdomen
A fractured pelvis (a person can exsanguinate from a fractured pelvis)
Bilateral femur fractures (a person can also exsanguinate from bilateral femur fractures)
Lower spinal injury or any other trauma to the back
Almost before the morning safety meeting started, we were toned out on an elderly gentleman who fell on the steps of his home, and his spine issues required special handling and packaging to get him loaded for transport. I held his head and maintained his c-spine collar and helped with the transfer to the gurney. We still have the Paramedic Intern, so I was chasing in U482 - but Medic 481 was glad we showed up.
Once we got back to the station, we were almost immediately double-tapped out top two calls, so I rode third in our second out Medic Unit, Medic 483. We responded to an older lady who worked at the local mill, who had a complaint of chest pain. She ended up having supraventricular tachycardia, a fairly rare condition where the heart is beating very fast. The "supra" in supraventricular means above the ventricles. After we stabilized her with some adenosine, and chemically reset her heart, we transported her - but we stopped at a good place and swapped me for the Paramedic Intern, to also give him some good experience with this cardiac condition.
I spent the night at the Quincy substation by myself, as we had no room at the station with a full crew and the Paramedic Intern. I took U482 and my turnouts and monitored the radio all night for our response group - not very restful sleep, though. Back at the station by 8 am for the morning meeting, but the Chief and all the Assistant Chiefs had an out-of-town meeting elsewhere, so we got an early start on rig checks and house chores. I am taking on the weekly responsibility of washing and folding the towels. *smile* We spent the day working on a lot of little projects, and restocking expired medications and replacing expired kits at the Delena substation. Not much studying happened this week!
About mid-afternoon, we got double-tapped again, so the regular paramedics went on the first call, and the Chief, the Duty Officer, and I went out in the second-out Medic unit for an older lady who had fallen and was 'incoherent.' I brought in the jump kit and the monitor, and the Chief and I brought in the gurney after we did a lot of assessment. I got to help with vitals and the pulse oximeter, and some of the stroke assessment (the arm drift test), and handed different items to both of them on request. Once we packaged and loaded the patient, the Chief drove so I could stay in the back and learn and observe. I helped spike the bag, got the patient on a nasal cannula and administering 4 liters of oxygen per minute, and helped with the IV preparation and ongoing vitals. I also got her a hot-pack for her cold hands (poor circulation) and we treated her for shock. We transported her and I got to be a bit more hands-on than usual. Also, the Duty Chief and the Chief both got to see me working and doing a good job. (!)
We got back to the station, restocked and went to bed - and slept uninterrupted all night. *smile*
A standard rapid trauma assessment will check for each of the following life threats, and provide some forms of basic treatment. Treatment that would not be life-saving is not conducted until after the rapid trauma assessment.
For each area of the body assessed, it is helpful to review them while addressing the different parts of the mnemonic "DCAP-BTLS." This stands for: Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, and Swelling.
- goes from head to toe to find these life threats:
Cervical spinal injury
Level of consciousness
Skull fractures, crepitus, and signs of brain injury
Airway problems (although these were checked during the initial assessment, they are rechecked during the rapid trauma assessment) such as tracheal deviation
Penetrating trauma to the neck, distention of the jugular veins, or a break in the tracheal-bronchial tree
Signs of serious chest injuries, including penetrating trauma to the chest, which can cause a sucking chest wound; flail chest; tension pneumothorax; and cardiac tamponade
Breathing problems (like airway problems, these are also rechecked during the rapid trauma assessment by listening to breath sounds with a stethoscope)
Signs of serious abdominal injuries, including evisceration; penetrating or blunt force trauma; or peritonitis from bleeding into the abdomen
A fractured pelvis (a person can exsanguinate from a fractured pelvis)
Bilateral femur fractures (a person can also exsanguinate from bilateral femur fractures)
Lower spinal injury or any other trauma to the back
