Today was my first day on a truck (ambulance)! For the first 40 hours, I am still in training and will be paired with 2 EMTs, one of them will be a trained preceptor (field training officer or FTO). My partners today were great–so helpful, patient, and eager to teach and answer all my questions. I learned that it is much harder to get vitals in a moving vehicle (especially a speeding truck over pot-holed Boston roads) than it is in a quiet, calm classroom setting! They also should have taught us how to get a pulse with gloves on. I am slightly intimidated by the stretcher. Odd, I know, but it’s different from both models I’ve used before, and I just couldn’t get the hang of it today. EMTs have to sum up the patient’s condition and care at three times during a call: on the radio calling ahead to the hospital (30 seconds max), to the hospital staff (triage nurse, and staff assigned to patient after triage), and in the “run report,” the written document that covers everything that happened on the call. “If you didn’t write it, it didn’t happen.” This document is IT when it comes to health insurance, legal proceedings, and company reviews. I know it will take me a while to feel comfortable with all of these. But I learned a lot today, and I’m excited for what’s to come!
* Medical stuff ahead *
Every health care provider can remember their first patient. My very first call was a memorable one, even for my experienced FTO. We were called to the scene of an “unresponsive older male.” The police and ALS (paramedics) were 2 minutes ahead of us, max. I was nervous in the truck, but it seemed like the next second I was throwing on gloves, taking a deep breath, and jumping out the back doors. I followed my preceptor into the house where I saw a blur of activity. the medics were hurriedly escorting an elderly woman bent double out of a back bedroom. I was confused, since dispatch had said the patient was male, but then I saw the grave faces of the police officers, and my trainer was walking back out of the bedroom, shaking his head. He asked me, “do you want to touch a dead body?” My eyes got round and I managed to say, “um..?” The elderly man had passed away in his sleep early that morning and when his wife checked on him, she called 911. As EMTs, we’re not allowed to declare anyone dead, but we are taught to recognize the signs, and we are allowed to stop care at a certain point, if certain indicators are present. In this case, the most recognizable one was rigor mortis, the stiffening of the body’s muscles that usually sets in several hours after death. I was slightly hesitant to make contact, but my trainer wanted me to understand and recognize what rigor mortis feels like, so I tried to move his arm, and it didn’t move. I stared at him, thinking that at least he went in his sleep after a long life, which is how most people would choose to go. I looked around his house, and I saw a post-it with a love note he had written to his wife, memorabilia from their life together, and pictures of their family. This centered me, and I went off to see what we had to do next.
The house was eerily quiet except for his wife, who was quickly becoming our new patient. She was understandably beside herself, and we were worried about hyperventilation. Apparently, sometimes it becomes necessary to take a mourner to the hospital as a psych patient, if they become so distraught. Luckily, we were able to contact family and calm her down enough to where we felt comfortable leaving the police in charge, to wait for the medical examiner, who could officially pronounce Mr. X dead. As we left, we were silent, and my mind went to how difficult the next few days and months would be for his wife, and how glad I was that her family would be there for her. In my previous job, I helped the family through the funeral and sometimes saw them over the course of the following years, so I had a very clear picture in my mind.
It may be selfish, but I am relieved that I’ve past the milestone of seeing my first deceased patient. There are certainly more milestones to come, though: my first code (cardiac arrest), pediatric patient, bloody trauma, death of a patient that I work on, and more that I haven’t even considered. I learned so much today, and I went on other interesting calls, but this one will always stick with me. It’s odd to say that I’m looking forward to going on more calls, when that means more people will be in pain or distress, but I keep reminding myself that I am there to help. And that’s what I’m really anticipating: being able to do something to help.