Tuesday, November 25, 2008

Link Love

How about a pre-Thanksgiving post for some of the blogs I enjoy:

  1. Congrats to EE on a new kid! I hope he's as stubborn, hard headed, and smart as you are!
  2. Sam moved her blog to wordpress, if you haven't read her writings before they're well worth it.
  3. Receiving is one of my favorite blogs, they're Quizzes give me some hope for the future (I'm soooo much better at them than Ochem- but hey, an A in Ochem means you'll be a good doctor right?)
  4. Does anyone know what happened to PJ country?
  5. OMG doesn't seem to be looking forward to trauma surg... I hope it goes well. My experiences with the trauma surgeons has been a total dicotomy. They're either going for motorcycle rides with me and super nice, or complete pricks who need a cranial-anal disimpaction.

Friday, November 14, 2008

A Probie's First Callout- Part 3

"Hi, my name is Jason, I'm an EMT with ________ county search and rescue, what hurts?"

"My leg.... where's the helicopter?"

"Dude (yes, I called a patient dude...oops), there's no helicopter tonight, we're carrying you out."

"Oh shit"


I've certainly done better assessments in the past than I did that night. With my right foot and ass hanging off a 15 foot drop, the wind kicking up, and the excitement of my first night on the mountain I was scattered during my initial assessment.
'Shit, do I check his leg out first or give him a head to toe, what about vitals, god damnit- stop moving your head, how am I going to do all of this without exposing him to the elements?'

Kenny damn near smacked me up the head and I got my shit together in about 20 seconds. Talking= ABCs, a quick head to toe revealed no abnormalities except his ankle, and Kenny started on some vitals.

The kid's ankle was bad. Not quite bone sticking out of the skin bad, but bad enough that I lost a pedal pulse in his foot as it swelled to the size of a nalgene bottle. We splinted it and hoped for the best. I know EE hates them, but I love SAM splints, especially in situations like this. One posterior and plantar on the foot, the other medial and lateral under the heel and both shaped as best as possible around the foot/crus made for a fine splint with the requisite duct tape. I put my spare socks on the patient (they are XXL just to fit over a splint) and we wrapped him back up in the survival sack.

At this point, we had a dilema. Everything was in place for a potential spine injury that couldn't be cleared via the NEXUS criteria- MOI, intoxication, and a distracting injury. But, we had no C-collars, no KED, and no Bean Bag. We packed the patient's head into the litter with his boots, our first aid kits and a jacket, put a helmet on him, and I taped it all in. Was it perfect? No... but it worked. I've already placed both an adult and peds C-Collar in my pack...

Skip forward 10 hours and 25 assisted belays later. The eight of us were black and blue from tripping down scree and being torn off the litter team by scrub. Backs were strained, eyes were scratched, hands were bleeding, and everyone was hungry. I have no doubt that this is what 90% of resuces are all about- and I loved it.

I had taken to 5min catnaps while the next belay was being set up. I have a wonderfull talent (wonderfull for EMS at least) in which I can fall asleep anywhere, anytime. The patient was quiet, cooperative, and docile even as we were cussing at the trail and struggling to lift him over downed trees and stumps.

We loaded him into the ambulance at 7:30am the next morning as the sun was coming over the peaks behind us. I gave the bullet to the medic (who looked far to warm, comforatable, and well rested having slept in our command post all night) and we all hid from the TV cameras.

After the debriefing I ate $16.32 worth of food at a breakfast diner and collapsed onto my girlfriend's couch (which may still stink because of it). It was, without a doubt, everything I had expected a mountain rescue to be, and I loved it.

I don't want anyone to get hurt in the hills... but I like knowing that if they do we'll be there, again, to get them out.

Thursday, November 13, 2008

A Probie's First Callout- Part 2

"Jason, you have your pack ready?"
"Yes maam"
"Good, follow Kenny, you're chief medical, don't fuck up"

You
Have
Got
to be
Kidding
Me

That was, word for word, what went through my head. I shoved the trauma kit and an extra pig rig into my pack as it was thrown at me (memo to self, bring a bigger pack next time), an extra liter of water, and resisted the urge to piss and vomit.

We started up the "trail" in two teams that quickly caught each other. Trail is really a loose term for a deer path up some quasi scree. After a wrong turn, Kenny and I found ourselves at the front of the group and were able to stretch our legs out a little.

I would like to digress for a second into one of the reasons I really liked this rescue (and hopefully rescues in the future). I've always had an aptitude for endurance sports. I was an elite cyclist, I ran in high school, I've always been able to hump the heavy pack really fast for a long time. This was, however, the first time that it actually meant something. Whatever genetics I was born with or hard work I've put into my heart, legs, and lungs finally was able to do something other than just cross a white line in the middle of nowhere....

Because there was no helicopter in the air it was hard for us to know exactly where our patient (victim?) was. We had a general idea from the team members in the helicopter who had dropped a survival bag to him but the perspective from the air and from the ground are vastly different. The survival bag contained glow sticks but they were all but worthless in the deep scrub oak we were fighting.

Kenny and I found ourselves in deeper vegetation and on a steep side hill fighting the branches that obstructed our way, and periodically yelling but never getting a response. In the 45min it took us to hike the 1800 vertical feet in there were a lot of thoughts in my head. Was our patient still conscious? Still alive? Are we in the right draw? Did we pass him? I had no frame of reference with which to base anything on and we kept pushing.

Bright yellow green is not a color that belongs in the woods, but visualizing the glow sticks from the survival bag made my bag feel lighter and upped our pace. Kenny had not been able to find them but trusted me and we plowed oh so ungracefully through the woods towards it, cliffing ourselves out twice, and finally descending to the patient.

I approached from the uphill side and the patient's head- usually not a good idea (I don't want to startle him nor make him crane his neck) but dictated by the terrain. He looked good, in the survival bag and yelling at us. I could see about 25feet of scree that had been disrupted when he fell- the MOI for a spinal compromise was certainly there.
"Hi, my name is Jason, I'm an EMT with ________ county search and rescue, what hurts?"

"My leg.... where's the helicopter?"

"Dude (yes, I called a patient dude...oops), there's no helicopter tonight, we're carrying you out."

"Oh shit"



Oh shit is right....

Ahhhh, I'm an idiot

There will be a few posts popping up in a second. I had been saving them as drafts and not posting them. Please, no one tell the admissions committees that I'm an idiot.

Saturday, November 8, 2008

A Probie's First Callout- Part 1

We had just finished a ropes rescue training session, it was 9 O'clock, dark, and slightly drizzling. There had been the usual SAR team bullshit arguing about our team standards, whether or not we should have attendance requirements, what our medical certification level should be, etc. Not surprisingly that all disappeared as everyone unconciously reached for their hip as the multitude of beeper tones and vibrations began.

The five probationary officers of my incoming class looked at each other. I'm sure it was a look akin to a combination of a deer in the headlights and a kid caught with his hand in the cookie jar. We'd been on the team for two weeks, had three training sessions of training under our belt and were very, very green. Hell, we barely knew how to call in 10-8 (on duty) to the dispatcher, all of just listened to radio traffic for a few minutes once we were in our cars.

The trailhead was only 15minutes away, it probably should have been twenty but most of us drove a little to fast. Of course, it didn't matter. In typical SAR fashion we stood around in the parking lot for 30min just waiting. One of the more experiences members of the team knowingly stopped and grabbed a burrito on the way over- I envied him for most of the next 10 hours.

Not much longer we had a National Parks Service helo on scene and the old, ex vietnam era military era, pilot to go with it (I say this with all due respect, it was the only helicopter we could get at night, in a slight rain). We also had the patient on a dieing cell phone but he didn't know where he was. The bird went up, the Haste team went up the trail and the search began in earest. All while the newbies sat on the bumpers of their cars.

I packed, repacked, and packed again my backpack. Then I drank a liter of gatorade, a liter of water, pissed a lot, and waited. All the while I wished I had packed more food than the package of oreos I scavenged from the floor of my car (the proverbial shit show that it is) and a cliff bar from a cycling jersey on said shit show. It didn't matter, I reasoned, there was no way I was going to be put "on the hill".

Word came back that they found the hiker and he was much farther south of where we were at. The whole shebang of private SAR cars, our mobile incident command center (a large motorhome), fire trucks, ambulances, and the rest picked up shop and moved to a closer location. I hesitate to call it a trailhead because, well, there was no trail. Again, everyone who knew how to do something did it and the probies waited. I made sure I had my pack on and clothes ready to go so I wouldn't have to strip off any layers if I got to go up...

"What about Jason, he teaches Wilderness EMT classes, let him go up" I have good ears and a curious mind and I couldn't help but overhear one of the training officers talking to a COG (crusty old guy- again, a term of incredible indeerment).
"Nah" A simple anwer accompanied by a head shake that seemed final. My hopes, what little were there, were killed.
Yet, another training officer began speaking to the COG and after 5min he nodded, very subtley, and walked away. I wouldn't let myself believe it, I had to be making things up.
"Jason, you have your pack ready?"
"Yes maam"
"Good, follow Kenny, you're chief medical, don't fuck up"

To be continued.....