What type call is the hardest on you (mentally or physically)

ErinCooley

Forum Lieutenant
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Is it children? Elderly? DOA? Or something else (I don't know all of the proper terms yet, just started my first class last week!)..

We've been talking, I really think the decomp/maggots are going to be the worst for me. I'm already dreading that first call!
 

Ridryder911

EMS Guru
5,923
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The most disturbing calls to me is the personal ones that involve emotionally distraught scenarios, such as multiple deaths of children. Especially senseless ones of homicides, or accidental ones caused by a parent.. The other ones is those involve death of an elderly spouse, that was married for a great length of time.... > 60 yrs. etc. In which you see you not only see one death but the beginning of the death of the other loved one.

The most memorable ones is not so much the patient's rather the victims or those left behind. Telling a mother that all of her children have died is something one does not forget, no matter how many times one has to perform such.

The maggot, decomp's, bloaters, etc.. does not bother me. I worked part for the M.E. as a field investigator for years, as well as we used maggot therapy for necrosed tissue.

R/r 911
 

BAMAMEDIC

Forum Probie
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Children by far. On Monday we responded to a child that fell out of the back of a truck, the driver said the 12 y/o kid was sitting on a cooler in the back, he said he was going approx 45 mph down a bumpy county road when he noticed the kid wasn't back there, he had gone about 1/4 mile. The kid was sitting up off of the side of the road, his scalp and face on the rt. side was peeled down to his rt. eye and below his ear to his lips. In other words the whole rt. side of his face was peeled down. All of his front teeth where missing, he had an obvious skull fx down the rt. side, multiple cuts and abrasions all over this torso, arms and legs, and a partial amputation to the distal tip of his rt. index finger. He was very combative when he was conscious, I think that he was the strongest 12 y/o I have ever seen. Our transport time to the nearest hospital was 25 min, as soon as I saw what we had I called for a chopper, the closest one was 45 min out so I called the hospital and told them to get Air Evac enroute to them. By the time we got to the hospital and had him intubated and x-rays done they where on the pad. He was flown to Childrens Hospital in Birmingham, the last I heard he was not doing to well. This was the 3rd critical pedi pt in the last month and a half, that is unheard of for our service so I have been labeled as the sh** magnet for the month.I was totally drained for the rest of the day, I just hope the kid pulls through.
 

RedZone

Forum Lieutenant
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Sure, all that stuff makes for a bad call... but nothing beats having to treat a critical patient when it happens to be someone you're close to.

Sure, ethics says you shouldn't do it, but what happens when you don't know until you get there!?!? What if you work in a system where you can't get another unit to you in a quick amount of time??? What if it's someone well known in the field... and you can't possibly find an EMS crew that hasn't established a personal relationship with them???
 

BAMAMEDIC

Forum Probie
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Sure, all that stuff makes for a bad call... but nothing beats having to treat a critical patient when it happens to be someone you're close to.

Sure, ethics says you shouldn't do it, but what happens when you don't know until you get there!?!? What if you work in a system where you can't get another unit to you in a quick amount of time??? What if it's someone well known in the field... and you can't possibly find an EMS crew that hasn't established a personal relationship with them???

One of the main reasons I quit working for the service in the town where I live is that I had to make the initial 911 call on my father in law (who I am really close to) when he had a stroke. I also had to transfer him 110 miles to UAB hospital in Birmingham AL. He went south on me about half way there, he is doing very well now thank god. I have heard many people say that if it was one of their family or friends they would want to be there, not me I would rather not have to see him or any of my family like that again.
 

Grady_emt

Forum Captain
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Pediatric burn patients, agency personell/FF/PD officers injured badly.
 

Asclepius

Forum Lieutenant
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One of the main reasons I quit working for the service in the town where I live is that I had to make the initial 911 call on my father in law (who I am really close to) when he had a stroke. I also had to transfer him 110 miles to UAB hospital in Birmingham AL. He went south on me about half way there, he is doing very well now thank god. I have heard many people say that if it was one of their family or friends they would want to be there, not me I would rather not have to see him or any of my family like that again.
My biggest fear is that I'll answer the call for someone I hold very dear. I couldn't imagine wanting to be anywhere else, but by my loved ones side, but I also couldn't imagine, and I actually have nightmares about, being by my loved ones side.

Also, in my tenure in EMS, I have never had a burn patient. <knock on wood>. I hope I never ever do, either. They just gross me out from all I've read and see about them. Of course, I said that about doing CPR for the first time too, but once you do it a few times, it just becomes second nature.
 

firecoins

IFT Puppet
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children who seize for the first time

seeing a patient with feces still coming out the wrong end

having a pt be my elementary school teacher who I hated.
 

RedZone

Forum Lieutenant
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having a pt be my elementary school teacher who I hated.

I'd love that one.

Actually.. one of the teachers I hated.... Well I didn't transport her... but... certain things came up in a conversation with a patient and he ended up asking me specifically about her

"Ahh... we had issues," I told him.


"Oh, I fired her," he told me. :D ;)


This had nothing to do with her job as my teacher. That's all I'll say even though this was before HIPPA, I still respect confidentiality of my pt
 

eggshen

Forum Lieutenant
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Ran plenty of of people that were both sick and well known to me. For me those calls are a drag but do not reach me all that bad. What bothers me? Murdered kids, those can be a real downer.

Egg
 

sksmedic

Forum Probie
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My hardest call occured 3 months ago when I was called for a man down, cpr in progress. On scene to find a 48 yo male in cardiac arrest. He was the former general manager of my ambulance company and friend. I was nervous for about 2 seconds but then it was all business. The hardest part was after calling it, telling his wife. We were 45 minutes from town and Mercy Flight was not available. I gave him 3 rounds of meds and had no changes. He was laser line asystole, it almost looked fake.
 

RedZone

Forum Lieutenant
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Ran plenty of of people that were both sick and well known to me. For me those calls are a drag but do not reach me all that bad. What bothers me? Murdered kids, those can be a real downer.

Egg

I didn't say sick. My words were chosen carefully.

Murdered kids... youngest I had was 14, but I didn't learn about her real age until a few days later, nor the fact that it was a murder either. I did have an 18 year old that got to me for a second.

I guess I've been lucky so far in that department... so I prolly shouldn't talk, but I'd trade you a murdered kid I don't know for a friend's mother with a ruptured AAA who was still alive when I got there. Sorry if my expression of emotion causes rage to some... I just can't better explain how I truly feel about it.

No, I'm not getting personal on ya eggshen.
 
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firetender

Community Leader Emeritus
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This is about my worst scenario, and, yeah, it happened a couple times.

Working small-town Florida I got to know lots of the locals, and, over time become a regular part of their lives through transporting them or dealing with them in the ERs where I also worked.

Amongst the suicidal were those who made repeated attempts, and kept getting close, but, due to a minor technical screw-up, don't quite get there. They so much wanted to die, and knowing some of their histories, I didn't blame them, (and, yes, part of me, after a few rounds of this, wanted to help, too!).

Still, even in their sickness, some of them were so alive and vital (and so many of them superb physical specimens, too!), and...well, funny! that you had to love them for the incredibly twisted human beings they were. Eventually, most of them succeeded.

And then, there were the critical calls where I had used up my bag of tricks and the patient entered into a few moments of a perfect combination of consciousness, lucidity and freedom from pain (i.e. spinal) to be able to communicate so I couldn't miss the message. All I was left with in those experiences was an excruciatingly brief interval of time with a human being who desperately wanted to live, and I knew they would not, and, before my time with them was over, they were dead.

When a "run" of the former crashed into a scene like the latter, I was the one that got splattered.
 

eggshen

Forum Lieutenant
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My youngest murdered kid was a 4 y/o F, double homicide, she and her mom. Nothing personal about it. BTDT, just happens to be different things that bother different folks.

Egg
 

RedZone

Forum Lieutenant
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My youngest murdered kid was a 4 y/o F, double homicide, she and her mom. Nothing personal about it. BTDT, just happens to be different things that bother different folks.

Egg

I hear ya on that one. I was kind of hoping you felt that way too. Maybe you wish you were in my shoes, but I've never been in yours... so I realize I should be careful too.

I don't personally know most of the people here.... and I'm sure some of those newer to the field are going to look at this the wrong way...... but take a word from the experienced here:

Day one of my EMT class:

The #1 person when I'm at work is myself.

The #2 person at work is my partner(s).

The #3 person at work is my patient.

That is one rule I have yet to break, and I've broken many.
I hope you had the same lecture your first day. Don't take that advice lightly. NEVER put a patient before you. I'll also add: #3 always stays at work. #2 has to have high standards, at all costs.
 

Ridryder911

EMS Guru
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Very good points. Not to get off track, but the old saying ... "A dead or injured rescuer, is a No good rescuer"..... is so true.

This can be viewed more than just from physical injuries, in can involve emotional injuries as well. It is a double edged sword problem. From those that hardly ever run a call to and forget to those run a large amount and become compliant and laxed. Both have potential problems, again both physically and possibility of emotional as well.

This is not selfishness, this is self preservation. I cannot give my next patient 100% of me, if I am thinking about or if I am in pain from a previous call. The next best thing, would be my partner. Again, if they are in the same predicament or involves them.. someone has to pick up the slack and the potential of something being missed goes up.

This is why I cringe of comments such as .. "...my patient's come first..I do it for the good, of the community, any comment of "saving someone"...etc.

As someone described.. majority of this job is the use of common sense. Unfortunately, it is not that common.

R/r 911
 

RedZone

Forum Lieutenant
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This is not selfishness, this is self preservation.
R/r 911

This is half correct. It is selfishness.

I like to think of the concept as being on a scale:

Unselfishness-----------------<My ideal target range>----------------------Selfishness

Both extremes are bad, and I can explain further but I'd be dragging out way off topic.
 

DOCMEDIC

Forum Probie
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Worst patient/scene....

ABUSED CHILD BY DADDY.... :excl:

I have fought back some really intense urges to give daddy some abuse...

And watching as mom had no clue and the police take dad away, still in denial... even when the child has 4-5 cracked ribs.. Torn Rectum, and battle signs.

That is my worst day!
 

RedZone

Forum Lieutenant
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Worst patient/scene....

ABUSED CHILD BY DADDY.... :excl:

I have fought back some really intense urges to give daddy some abuse...

And watching as mom had no clue and the police take dad away, still in denial... even when the child has 4-5 cracked ribs.. Torn Rectum, and battle signs.

That is my worst day!

I can relate to that.. this is similar to egg's scenario.
 

BossyCow

Forum Deputy Chief
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Hubby had a call to a double child homicide, Father killed both boys then did a suicide by cop. They had to stand by for hours while cops negotiated with the father.

Cops where first in, came out and told my husband and his partner, both of them fathers of boys aprox. the same age.. "No need for you to go in.. nothing for you to do".. both of them turned around to the rig, without saying a word. Some images you just don't want in your brain.

Mine was a 12 yo suicide at school.. shot himself in the head in full view of his classmates. ..... I knew the kid since he was in kindergarten, knew all the kids who watched him die, knew the teacher who was trying to figure out how she could have prevented it, knew the parents... Hardest part was standing by, waiting for law enforcement to release the automatic lock down of the school required by law after the discharge of a firearm on school property.
 
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