# The tale of an ambulance driver.



## SoCal911 (Mar 24, 2012)

Absent.

Being that this is my first post, please allow me preface it with a few things. First and foremost I'd like to thank you for taking the time out of your busy day to read the ramblings of a lone EMT. Second and more importantly, I caution you - the reader - that the content contained within this and the other posts to follow, is of a graphic nature and will be told from my perspective - an aspiring flight paramedic working as an EMT in LA County responding to both urgent (non-911) and emergency (911) requests for service. Now, you're probably asking yourself why I would even waste your precious time discussing urgent requests - 911 is where all the action is, right? Wrong - for there have been many lives saved and many lives affected by the day to day non-emergency requests for services that EMT's respond to daily - myself included.

I'd like to start off with some background about myself - of course I'm going to keep these posts semi-anonymous for both my patients privacy and protection as well as my own.  You see, I've been an Emergency Medical Technician since June of 2011; where bright eyed and bushy tailed I stepped foot in the back of that ambulance, never to look back - and let me assure you that I had not a single clue of what I was getting into. 

Now for the good stuff! (I'll drop a little more info about myself as we go on, but I don't want to bore you) 

It was a crisp saturday morning; the sun hadn't even begun to enter the skyline, the fog still hung low and the sky was an eerie grey. I was hardly awake, my eyes were droopy and I had just pulled into our hub in SanteFe Springs. I desperately needed some form of caffeine. Nervous as I was, I slowly climbed from my new car that I was so proud of. You see, I was a new hire... and I had never been to this station before. "Where the heck do I go?" I asked myself aloud. Ambulances were scattered all over the parking lot almost at random. As I walked around the Target sized industrial building searching hopelessly for an entrance. I saw another EMT walk around to the other side of the building - so I followed, trying shamelessly to look like I worked here. Eventually we made it to a huge opening in the wall - an ambulance sized opening!

I strutted right on through that opening - trying to muster up as much confidence as I could for 7:45 in the morning. Inside it looked like an empty Costco - concrete floors, buzzing green florescent lighting, and ambulances parked in a manner allowing them to leave at random without being blocked in by any of the other ambulances. I continued to stalk that poor Emt, hoping to find my way to the start area (where we pick up our keys, nextels, paperwork and any thing else we need to start our day). 

We walked around one of the previously mentioned ambulances and there it was... The start area. "Now I have to find my FTO" I muttered to myself - so I did what any new hire does when looking for an FTO... I stood there and looked stupid. Eventually he found me.

Like any good FTO not wanting his trainee to get lost,  he walked me to our unit. I did a quick check out and verified that we had all of the required supplies (oxygen, sheets, gloves, trauma dressings, a first in bag, ect.) and we were off. I proceeded to get comfortable in my vinyl chair in the back of the ambulance while my FTO and his partner chatted away happily upfront; seemingly like they've been best friends for years, despite only having met for the first time 10 minutes prior. 

Then, it happened... The call I will forever remember as both my first full arrest (a person who's clinically dead - no breathing and no heart beat) and my first real save. The radio crackled sharply - a male voice close to that of what Ive always imagined as an adult Charlie Brown quickly barked our call sign. "Twelve zero eight" My FTO quickly handed the radio's microphone back through the compartment door leading into the back of the ambulance. "It's all you buddy" Confidently I snatched the mic and in my 'sexy'  voice I barked back "1208 - Go ahead" "Man! Do you hear this guy?!" - My FTO chuckled. "1208, county fire. Xxxx More Lane, cross of Studebaker. It's going to be for a sick person".

The driver hit the switches and off we went, sirens blazing. 
I desperately tried to stay seated while upfront it seemed like any ordinary trip to the grocery store, a bunch of giggling and chatting about day to day things. You see, I could continue to rant about how the ride felt very similar to that of a shopping cart being pushed down an escalator... but for all of our benefit, I'll skip to the good stuff. We turned the corner and to my surprise, there was no fire truck; no big red engine, no tall chiseled men running around in yellow turnouts, just a house with a man standing out front waiting for us.  This was getting good. 

Now, let me tell you... When we get a call for a "sick person" its generally a very uneventful call.. I mean seriously, 99.999999% of the time it's someone with a fever, or a flu, or the most common - "weakness" - something the patient could very easily have taken a taxi for. This was not one of those times. 

You see, I had prior experience as an EMT... I had worked for about 8 months at other companies - both of which were 911 providers; the call volume was low, but it was enough for me to get me feet wet and become more than proficient at running a call on my own. Knowing I wasn't a green EMT,  my FTO sent me in on my own. "Alright patient boy, this ones all yours. Start your assessment and we'll grab the gear and be in there in a few." So out I hopped. 

A gentlemen (I say gentlemen out of respect and professionalism - he was a very disheveled looking fellow) had met me at the curb. "What going on today sir?" I asked confidently. He was an older male in his late forties, over grown and unkept facial hair and apparent bed head, the man looked like someone who spent their whole life partying and possibly doing drugs - but I wasn't about to judge. "I don't know maaaan... She's not feelling all that gooddd. I was gonna take her to the hospital but alls I got is a motorcycle, so I went and took her car out to the garage to take her. (by now we were walking into the residence) Then she wasn't really talking to me anymore so I called you guys." 

Here was my impression of the residence.

Small, 2 bedroom residence that appeared to be built in the 60's. As I walked through the door way I noted a musty odor, almost like smell you notice after it rains; but not nearly as pleasant. The carpet was an old grey color and was a very worn shag - notably covered in stains. As soon as you walked into the residence you walk straight into the living room/tv area; to the left was an extremely cluttered kitchen. The whole residence was very unkept and kind of gave you a general dirty feeling just being there... However, this is the norm and is something I'm generally used to. My room is probably just as bad 90% of the time, who am I to judge? 

It was then that I saw her, a woman mid to late 50's in age - probably  around 120 pounds sitting upright on the floor against an easy chair. The chair was facing the 80's era big screen television sitting in the north/west corner  playing some type of news. She was wearing a teal colored bath robe which was open in the front, exposing her fully nude body. Her head was extended all the way back in what appeared to be a very uncomfortable position, her mouth fully open and her eyes staring blankly at the ceiling. I approached her, very focused on my newly acquired patient. 

"MA-AM! Can you hear me?" I said in a powerful monotone voice - the voice I learned to use in this type of situation to demand control and order - no emotion is to be displayed. I placed my hand on her shoulder, squeezed, and tried unsuccessfully to rouse a response - nothing.  I placed my hand on the side of her head and the other on her neck to check for a pulse... Nothing. I checked again to be sure. (Had to be sure, can you imagine the flogging I would have gotten being a trainee and starting chest compressions when they're not needed? Much less how stupid I'd look) I placed my right arm under her left, bent my right arm at the elbow and used my hand to cradle her head as I grasped her right shoulder with my left and quickly yet smoothly lowered her to the floor. (You see, a hard surface is needed when performing CPR. You need to be able to press deep enough into the person's chest to place adequate pressure on the heart.)  I once again checked for a pulse then checked her pupil response - nothing... @$&* I thought, I have a full arrest on my hands. I placed one hand on top of the other in the center of her chest and without hesitation (okay, maybe a little..) I gave that first, deep compression... Just like I had trained to do over and over again... 

"Pop. Crack. Pop. - As I pressed forcefully into this woman's chest I broke the cartilage connections between the lower ribs and the sternum. (don't worry, its normal.)  I continued to press hard and fast, secretly hoping that my partners would come through that empty doorway to my assistance.

Now, this whole time in the background the gentlemen which I spoke of earlier had been asking incessant questions - you know, the ones you'd expect: "Is she going to be okay? Is she dead? Should I have called earlier?" The only answer I had managed to give was a quick and stern "No."  At this moment my driver walked in with the first in bag - no sound from him. All I saw was him dive onto the carpet in front of the woman and open the first in bag (a blue duffle bag in which we carry our critical supplies that we might need outside of the ambulance). He took out a red piece of plastic and placed it in her mouth - we call it an OPA, essentially its purpose is to keep the persons tongue out of the way, so that we can deliver adequate breaths. 

This is my favorite part... This whole time my FTO has been standing outside, under the impression that this was just a normal bs "sick person" call... It was at this moment he steps into the residence to see the driver and myself in the middle of full CPR. "F#CK!!" I turned to see the sweat bead on his forehead just before he ran out the door to grab a backboard (we place full arrests on a backboard because they're dead weight and if we try to carry them they just flop around).

Were about 4 minutes into our call now and the big red fire truck rolls up with paramedic squad in toe. They pretty much copied my FTO... Once they walked in the door you could clearly see that look on their faces of "Holy :censored::censored::censored::censored: - not what I expected". (This is where the real action starts) One of the fire fighters whips out the AED (automated external defibrillator) and slaps those pads to the patient.. Okay, I left out some stuff...like the fact they had to lift her right breast, shave her side, and then slap those suckers on there - but regardless they made there. 

"CLEAR!!! - I said CLEAR!!!" - barked the paramedic. *click* the patients lifeless body convulsed aggressively. "No luck" whined the medic - "Continue CPR" - So I did exactly that; pressing hard and fast into the center of her chest. All the while a world of chaos was unfolding around me. My FTO using the bag valve mask to force air into the patient's lifeless lungs. The two paramedic's starting IV's and subsequently administering pure adrenaline (aka epinephrine). 

Once again, it happened. "CLEAR!" barked the medic and everyone hastily placed their hands above their heads. *click* again - her body convulsed. "We got her" whimpered the paramedic. "I got a pulse!" I yelled. "Continue respirations." It was at this point that we rolled that patient onto her side, slid the board under the patient and then rolled her back onto the board. She was secured using all 4 of the blue nylon straps previously attached to the board. "Let's go" I said the my partner. Looking around, I noticed how much trash had accumulated - wrappers from tubes and iv's and drug syringes and who knows what else. We each grabbed ahold of one side of the neon orange backboard and lifted our patient from the now trash covered floor. We then placed the board on top of the awaiting gurney and quickly buckled the two available straps. "Let's go!" yelled the captain. 

We piled into the ambulance and off we went. I was tasked with continuing to breath for our patient using a neon blue colored rubber bag attached to the endotracheal tube now placed into our patients trachea - a direct connection to her lungs.

It was at this point I noticed something different about this call. Typically (despite how it might look from a bystander point of view) while driving lights and sirens, the ride is smooth and the driver maintains the posted speed limit, stopping for all red lights before proceeding through. NOT THIS TIME! I could feel that we were WELL above the speed limit, swerving around cars and generally hauling ***. Every time we approached a red light the following paramedic squad (also lights and sirens) would dash past us and into the intersection, possibly sacrificing itself so that we could run the light safely without being hit - I mean what driver really expects an ambulance to run the red light at 80+ mph...? 

After what seemed like hours we arrived at the hospital, unload our patient and literally run into the ER... Much like you'd see on TV (this NEVER happens). We dash into the open room and quickly slide our patient on the the bed. The ER nurse has an electronic vent ready and waiting to take over for our little rubber bag. We did it... Our job was done.. When we left, she had a steady heart rate, a decent blood pressure and was no longer dead. Now, I hate to say that I have no idea what happened after we left - except to to say she was still alive when I dropped another patient off at the same ER later that day. We did it, we "saved" her. Now unfortunately she may be a vegetable, or she may have passed away after we left... But as far as our pre-hospital job is concerned - it was a save.


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## SoCal911 (Mar 24, 2012)

Copied from my little blog, thought Id share a story from about 6 months back.


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## FourLoko (Mar 24, 2012)

too much filler, I got bored and quit reading

I want to work there though. Our ambulances are parked like sardines.


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## SoCal911 (Mar 24, 2012)

Lol I thought the samething, I'm taking a writing class and needed a topic. Yea, our rigs have this little setup - keeps it real nice.


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## SoCal911 (Mar 24, 2012)

For being banged out on my iPhone in between calls, it's decent-ish.


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## firetender (Mar 25, 2012)

*There's no such thing as writing...*

...there is only re-writing. 

Work at it until it says what you want it to say.


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