Tincanfireman
Airfield Operations
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Kids abused by parents... I'll write more later, need to organize my thoughts a bit
What type call is the hardest on you (mentally or physically)
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Tincanfireman
Airfield Operations
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Went to the classic, vague, "child injured" call about 10:30 one weeknight on an FD response to back up EMS. UOA, PD is on scene with us, mom has 18 m/o screaming kid cradled in her arms. Father is backed into the corner of the kitchen, glaring at mom over crossed arms with clenched fists. (No weapons visible or nearby). Kid has bilateral circumfrential burns at ankle level with skin sloughing already in progress and blisters forming. Mom cautiously glances at the father and tells us she was running water for the child's bath and got distracted by a phone call (remember, 10:30 P.M....). I noticed that kid and Mom had several visible old bruises; mom continues that apparently child had crawled over edge of tub and water had been "a little too hot". We were a three man truck that night, and now I had two problems, a seriously burned kid and two partners (both younger and less experienced) who had definite plans of leaving me with the child and taking the father out back and imparting some parenting skills on him. I had about a 1/2 second to prevent a riot, so I told the cop to go and get the information from the father in the living room. I quickly told the other guys (under my breath) that we had to focus on the child no matter what. He was the injured one and we needed to be 100% on our game for this kids feet and his future. We dressed the burns, luckily, EMS was close and arrived right then. We transferred care and I got a word with the second cop about our suspicions before I hustled my guys back to the truck and we got out of there. As we left the scene, I knew my guys were seething with anger and you could cut the tension and the silence with a knife. After we got back to the station we sat up and talked for over three hours. I'm not knocking my partners, I wanted nothing more than to join them out in the backyard while they "talked" to the father. However, I told them that vengence, punishment, and violence were not our role. We had been called to assist a (possibly) abused child and we needed to leave our feelings at the door and do our job. While I could want to do a lot of things (I had three little boys at home at the time), I told my guys that you have to check your feelings and keep your eye on the ball sometimes. We never did find out what happened to the child, the mom or the father. It happened many years and hundreds of calls ago, but it is one of the few I'll never forget (no matter how hard I try).
I'm seeing trends here. This turned out to be a great topic!
The calls that cause the most psychological distress to the EMS providers seem to fall into categories:
- Those that involve a crisis where the provider is personally involved in such crisis.
- Those that involve a crisis where the patient was victimized by a perpetrator who violated the PROVIDER's highest moral values:
------ The provider thus feels as if his or her own morals were violated beyond their control.... they too were victimized.
- Those that involve a crisis which the provider perceives as a breach of their own sense of security. (BossyCow's statement "both of them fathers of boys aprox. the same age")
The calls that cause the most psychological distress to the EMS providers seem to fall into categories:
- Those that involve a crisis where the provider is personally involved in such crisis.
- Those that involve a crisis where the patient was victimized by a perpetrator who violated the PROVIDER's highest moral values:
------ The provider thus feels as if his or her own morals were violated beyond their control.... they too were victimized.
- Those that involve a crisis which the provider perceives as a breach of their own sense of security. (BossyCow's statement "both of them fathers of boys aprox. the same age")
The call that I lost the most sleep over was a 6 month old little girl that was left alone in a pool. She was also my first code save. For three nights everytime i closed my eyes i could see her face.
Anytime I code someone my dad's age, being that he has cardic problems, it bothers me.
Kids that are needlessly hurt are hard. Thats the hardest!
One of our firefighters lil boys just drowned. I think it hit hard for everyone knowing that this lil boy was one of ours and they couldnt save him.
Anytime I code someone my dad's age, being that he has cardic problems, it bothers me.
Kids that are needlessly hurt are hard. Thats the hardest!
One of our firefighters lil boys just drowned. I think it hit hard for everyone knowing that this lil boy was one of ours and they couldnt save him.
Airwaygoddess
Forum Deputy Chief
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Pedi calls are the hardest for me, second is the woman beaten so badly that her kids could not recognize their mom....... Dam it gets hard.
Summit
Critical Crazy
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Badly hurt/dead children...
Badly hurt/dead people I know...
People who were alive when I got there but cease to be while in my care...
Badly hurt/dead people I know...
People who were alive when I got there but cease to be while in my care...
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BossyCow
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We teach our EMT's that often allowing our anger to be seen by the abusing parent or spouse merely gives them another reason to be abusive again later. Also, knowing that EMS is going to judge them may stop them from calling in the future when its needed.
I think that's why those calls are so difficult. When the damage done to a patient was intentional and done by the person charged with protecting them, it's difficult and durn near impossible at times to put that aside and do our jobs, which is treat the patient.
For me, the worst is that feeling of helplessness. Knowing I can't fix it, it will probably happen again. Hmmm isn't there some literature about control and EMS workers being a bit on the freakish side of the control meter?????
Interesting though.... the dying don't bother me if its from natural causes. Trauma can piss me off if its due to blatant stupidity and the stupid one caused pain to someone other than themselves.
I think that's why those calls are so difficult. When the damage done to a patient was intentional and done by the person charged with protecting them, it's difficult and durn near impossible at times to put that aside and do our jobs, which is treat the patient.
For me, the worst is that feeling of helplessness. Knowing I can't fix it, it will probably happen again. Hmmm isn't there some literature about control and EMS workers being a bit on the freakish side of the control meter?????
Interesting though.... the dying don't bother me if its from natural causes. Trauma can piss me off if its due to blatant stupidity and the stupid one caused pain to someone other than themselves.
bstone
Forum Deputy Chief
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Working the NICU/PICU ambulance at Children's Memorial Hospital in Chicago for about 2 years. One early morning (4am or so) we get a call to go to a local ER to get a 10 year old boy who had a severe asthma attack. The RN who is coming along says, "it would be better that he coded and they pronounced him now as we are giving the family false hope". Seems he was without air for too long and was brain dead.
We get to the ER and the boy is intubated. His chest is rising in the most unnatural way possible and his mother is sitting by him, eyes red from crying. Father is sitting in a chair on the other side of the ER, eyes also red. You could tell he was scared. The ER was in a stand-still. The docs, RNs, techs...all just looking so helpless.
We loaded him into our ambulance and the RN said "light it up, but not so fast". We brought him up to the PICU where the floor staff had the same resigned feeling and look as the ER. Went back downstairs to do paperwork and watched as his family slowly filled into the PICU at 5am, all with tears in their eyes, all looking completely disheavled and miserable. He died a few hours later.
Worst call of my EMS career. Still brings tears to my eyes. Sigh...
We get to the ER and the boy is intubated. His chest is rising in the most unnatural way possible and his mother is sitting by him, eyes red from crying. Father is sitting in a chair on the other side of the ER, eyes also red. You could tell he was scared. The ER was in a stand-still. The docs, RNs, techs...all just looking so helpless.
We loaded him into our ambulance and the RN said "light it up, but not so fast". We brought him up to the PICU where the floor staff had the same resigned feeling and look as the ER. Went back downstairs to do paperwork and watched as his family slowly filled into the PICU at 5am, all with tears in their eyes, all looking completely disheavled and miserable. He died a few hours later.
Worst call of my EMS career. Still brings tears to my eyes. Sigh...
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firetender
Community Leader Emeritus
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Just want to put in a word that these are the calls that make us who we are. It's not inappropriate to take a silent moment to thank each and every one of our teachers, especially the dead!
I will flat out guarantee that in the course of our careers these calls have been living inside of us, and the lessons learned, the territory covered, the tears shed, the sleepless nights that (hopefully) have faded away, and, yes, every moment of agonizing have contributed to the saving of countless lives and alleviating untold amounts of suffering.
One of the things that may really distinguish us from others is that we put ourselves in the position to experience sheer terror and loss way out of proportion to what Joe and Jane citizen are called upon to deal with. In fact, that's why we're there, so they don't have to be!
But the incredible part is, and maybe not now but ten years from now, you'll see that something in those calls helped you add some incredibly effective tools to your bags of tricks! ...and not only for use Code 3, but in your lives as well.
Thank you all for sharing moments that remind us of the sacredness of what we do.
I will flat out guarantee that in the course of our careers these calls have been living inside of us, and the lessons learned, the territory covered, the tears shed, the sleepless nights that (hopefully) have faded away, and, yes, every moment of agonizing have contributed to the saving of countless lives and alleviating untold amounts of suffering.
One of the things that may really distinguish us from others is that we put ourselves in the position to experience sheer terror and loss way out of proportion to what Joe and Jane citizen are called upon to deal with. In fact, that's why we're there, so they don't have to be!
But the incredible part is, and maybe not now but ten years from now, you'll see that something in those calls helped you add some incredibly effective tools to your bags of tricks! ...and not only for use Code 3, but in your lives as well.
Thank you all for sharing moments that remind us of the sacredness of what we do.
Airwaygoddess
Forum Deputy Chief
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Learning from our patients
As I sit here and have read all of the posts so far, I am reminded of all of the patients I have cared for though the years. The living and the dead have taught me so much. Bless their hearts.......-_-
As I sit here and have read all of the posts so far, I am reminded of all of the patients I have cared for though the years. The living and the dead have taught me so much. Bless their hearts.......-_-
I had a call where a patient died during the time she was in my care. I don't want to get into details, just in case there are any liability issues that haven't been settled yet.
Basically, ther may have been some serious errors made during the management of this patient. And by that, I don't mean while the patient was in my care.
There was a medical control review, although there was some bias in the process due to the infrastructure at the time (since corrected).
I was found to not be at fault and from what I understand (second/third hand) the majority of gross errors were found to be made by another institution. Now the medical director, rightfully, notified my supervisor about the situation and discussed it with him... as well as some thoughts as to how he felt the call could have been handled differently by myself.
Now, my supervisor decided to call me up and basically say, "I just wanted to let you know that such and such died, and Dr. XXX says you should have done YYY." It was made clear to me that Dr. XXX felt the real negligence lied out of my hands, but I had some damn good arguments as to why things went the way they did. As well as huge concerns of my own about the way the call was handled.
The way I was approached really messed me up for a minute. I wasn't even comfortable working for at least week, and I still feel uncomfortable around certain professionals I run into who were involved in this case. Of course, I feel this may have been handled better by both medical control and my supervisor (allowing us to meet & discuss the case & learn from other potential ways to approach a situation... plus a full investigation should have included the med contol doc interviewing me directly.) But, as a team, we do need to evaluate everyone's actions when :censored::censored::censored::censored: hits the fan.
Eventually I became a little more open about discussing what was on my mind with some trusted and experienced professionals. A doctor familiar with the case realized I was bothered and offered me the best advice:
"What do you do when you go home from work? Do you have kids / a family / loved ones? Just go home and give whoever a big hug and know that they'll still love you no matter what."
Related note: I'm interested if someone had stats on the precedence of gross errors by MDs vs EMS personnel.
It's so important to have a network of support both inside & outside of work.
Basically, ther may have been some serious errors made during the management of this patient. And by that, I don't mean while the patient was in my care.
There was a medical control review, although there was some bias in the process due to the infrastructure at the time (since corrected).
I was found to not be at fault and from what I understand (second/third hand) the majority of gross errors were found to be made by another institution. Now the medical director, rightfully, notified my supervisor about the situation and discussed it with him... as well as some thoughts as to how he felt the call could have been handled differently by myself.
Now, my supervisor decided to call me up and basically say, "I just wanted to let you know that such and such died, and Dr. XXX says you should have done YYY." It was made clear to me that Dr. XXX felt the real negligence lied out of my hands, but I had some damn good arguments as to why things went the way they did. As well as huge concerns of my own about the way the call was handled.
The way I was approached really messed me up for a minute. I wasn't even comfortable working for at least week, and I still feel uncomfortable around certain professionals I run into who were involved in this case. Of course, I feel this may have been handled better by both medical control and my supervisor (allowing us to meet & discuss the case & learn from other potential ways to approach a situation... plus a full investigation should have included the med contol doc interviewing me directly.) But, as a team, we do need to evaluate everyone's actions when :censored::censored::censored::censored: hits the fan.
Eventually I became a little more open about discussing what was on my mind with some trusted and experienced professionals. A doctor familiar with the case realized I was bothered and offered me the best advice:
"What do you do when you go home from work? Do you have kids / a family / loved ones? Just go home and give whoever a big hug and know that they'll still love you no matter what."
Related note: I'm interested if someone had stats on the precedence of gross errors by MDs vs EMS personnel.
It's so important to have a network of support both inside & outside of work.
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I've kinda gone back and forth bout posting this....but i kinda feel like with this thread everyone can relate. In EMT school, a whole year and a half ago, my professor talked about Night Walkers. I dont think any of us really understood. But after I worked a pedi code I soon realized what he meant. It was three long nights before I found out she was going to make it. I could see her face everytime I closed my eyes and hear her mothers screams. I dont think any call has bothered me like that one did. But anyways.
Night Walkers
It’s three o’clock in the morning,
You find yourself pacing the house.
Your spouse of loved one is either undisturbed or doesn’t understand what is haunting you.
It comes on suddenly, no warning, no chance to attempt to keep it at bay.
It’s a call.
Maybe one you haven’t dealt with yet,
One you though you dealt with just fine.
Maybe its one that has haunted your nights before.
Maybe last night, maybe a month ago, maybe fifteen years ago when you started this career.
Maybe it’s a call you though you already put to rest, but something has triggered it,
Something has made it real again.
Maybe a smell, a color, a texture, a particular wound.
Maybe nothing at all, but all of the sudden you there again reliving it,
And its real.
Your senses are sharp!
Your walking the halls of your house in search of something you can’t find.
Maybe mad that you can’t sleep,
Embarrassed this is happening to you.
Your not a wimp, you think!
You’re a strong person…you can control your emotions!
What’s wrong are you normal? What’s the deal?
I call them night walkers.
Welcome to EMS!
Night Walkers
It’s three o’clock in the morning,
You find yourself pacing the house.
Your spouse of loved one is either undisturbed or doesn’t understand what is haunting you.
It comes on suddenly, no warning, no chance to attempt to keep it at bay.
It’s a call.
Maybe one you haven’t dealt with yet,
One you though you dealt with just fine.
Maybe its one that has haunted your nights before.
Maybe last night, maybe a month ago, maybe fifteen years ago when you started this career.
Maybe it’s a call you though you already put to rest, but something has triggered it,
Something has made it real again.
Maybe a smell, a color, a texture, a particular wound.
Maybe nothing at all, but all of the sudden you there again reliving it,
And its real.
Your senses are sharp!
Your walking the halls of your house in search of something you can’t find.
Maybe mad that you can’t sleep,
Embarrassed this is happening to you.
Your not a wimp, you think!
You’re a strong person…you can control your emotions!
What’s wrong are you normal? What’s the deal?
I call them night walkers.
Welcome to EMS!
Epi-do
I see dead people
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At different times throughout my career different types of runs have gotten to me. I am sure alot of that has to do with where I am in life and what is going on with me.
When I first started doing this job, just over 8 years ago, the toughest runs for me were suspected CVAs. My mom was 39 when she had a massive stroke and collapsed in a parking lot, where she laid for over 2 hours before getting help. The entire time, my brother, who was 3-4 at the time, was with her, trying to wake her up. In time, these runs have gotten easier for me, and I have gotten to the point where I like to be able to give these people the help my mother desperately needed, but was unable to get. Would that help arriving sooner have helped "save" my mom? I can't really say. I do know that had she survived, there would have been alot of deficets for her, and am not sure she would have ever recovered enough to have a true quality of life.
To this day, I dread the miscarriage runs. I personally have experienced two of them. Knowing first hand that there is nothing anyone can say to you to ease the pain of knowing you are loosing your baby makes me feel so helpless with these patients.
I find it interesting that sometimes the runs that hit you the hardest, or stick with you the longest, are the ones that seem the most benign at the time. The run that sticks with me to this day was dispatched as a shooting.
We show up onscene, PD is already there, and we see a small car that has driven through a fence. The driver is a guy that is about the same age I am at the time, so mid-20's. He has been shot in the head and you could still smell the gun powder in the air. I had been on other shootings before, but for some reason, I froze for a brief moment. (Think that deer in the headlights type reaction.)
We pull the kid out of the car, get him on a board and into the back of the truck. About that time, the medic showed up and jumped on board for the trip to the hospital. We worked the kid all the way there, and even had pulses back for a brief period of time. Eventually, the ER called him.
It really wasn't a remarkable run - just "another shooting", but it kept nagging at me. I wasn't able to go back to sleep after getting back to the firehouse, and wasn't ready to talk about it yet either. I get home, wait for my husband to wake up, and tell him small bits about it. As the day went on, I eventually told him the whole story. Come to find out, I had met this guy once, but didn't know him at all. I honestly wouldn't even have called him an acquaintance. I did have a couple friends that knew him, so had heard his name in conversation though. I can't help but wonder if that feeling of familiarity is what made it hit me so hard.
I wasn't supposed to be back at the firehouse for about a week, but found an open spot on the volunteer schedule for the next night and went back in. I just felt that I really needed any run at all so that particular run wasn't my last run for a week. If it had been, I wonder if it may have just been my last run ever. To this day, I honest can't say what exactly it was about that night that made that particular run hit me that hard and stick with me like it has. It has been years since I lost sleep over it, but to this day, I can't help but think of it from time to time.
When I first started doing this job, just over 8 years ago, the toughest runs for me were suspected CVAs. My mom was 39 when she had a massive stroke and collapsed in a parking lot, where she laid for over 2 hours before getting help. The entire time, my brother, who was 3-4 at the time, was with her, trying to wake her up. In time, these runs have gotten easier for me, and I have gotten to the point where I like to be able to give these people the help my mother desperately needed, but was unable to get. Would that help arriving sooner have helped "save" my mom? I can't really say. I do know that had she survived, there would have been alot of deficets for her, and am not sure she would have ever recovered enough to have a true quality of life.
To this day, I dread the miscarriage runs. I personally have experienced two of them. Knowing first hand that there is nothing anyone can say to you to ease the pain of knowing you are loosing your baby makes me feel so helpless with these patients.
I find it interesting that sometimes the runs that hit you the hardest, or stick with you the longest, are the ones that seem the most benign at the time. The run that sticks with me to this day was dispatched as a shooting.
We show up onscene, PD is already there, and we see a small car that has driven through a fence. The driver is a guy that is about the same age I am at the time, so mid-20's. He has been shot in the head and you could still smell the gun powder in the air. I had been on other shootings before, but for some reason, I froze for a brief moment. (Think that deer in the headlights type reaction.)
We pull the kid out of the car, get him on a board and into the back of the truck. About that time, the medic showed up and jumped on board for the trip to the hospital. We worked the kid all the way there, and even had pulses back for a brief period of time. Eventually, the ER called him.
It really wasn't a remarkable run - just "another shooting", but it kept nagging at me. I wasn't able to go back to sleep after getting back to the firehouse, and wasn't ready to talk about it yet either. I get home, wait for my husband to wake up, and tell him small bits about it. As the day went on, I eventually told him the whole story. Come to find out, I had met this guy once, but didn't know him at all. I honestly wouldn't even have called him an acquaintance. I did have a couple friends that knew him, so had heard his name in conversation though. I can't help but wonder if that feeling of familiarity is what made it hit me so hard.
I wasn't supposed to be back at the firehouse for about a week, but found an open spot on the volunteer schedule for the next night and went back in. I just felt that I really needed any run at all so that particular run wasn't my last run for a week. If it had been, I wonder if it may have just been my last run ever. To this day, I honest can't say what exactly it was about that night that made that particular run hit me that hard and stick with me like it has. It has been years since I lost sleep over it, but to this day, I can't help but think of it from time to time.
Family Runs are the Hardest
As the only paramedic in a very rural area with 32 miles of water separating my service area and any mainland hospital, the most difficult runs for me are the ones that involve my family. All of the runs in the rural area involve friends or neighbors, but when you have no choice but to take care of a family member, that is the most difficult. I have had my daughter, my wife, and my father-in-law to assess and treat and transport. When you are the only paramedic in a rural setting, you have to be responsible for anything and everything.
The second hardest in the rural area is any run where it is close to impossible to transport the patient due to fog or blizzard conditions. Our longest wait to transport a patient was many years ago, but it is still the record. No planes, no boat, and 32 miles of water separating the patient from the hospital for 48 hours.
If you would like to read a little about these cases, you can go to my website and read them for free. http://ruralemsisdifferent.com
I would like to hear about any other rural EMS calls that required a modification of written protocols. Email me at medic5740@yahoo.com
I have retired from volunteering as an EMT and paramedic for 20 years in this rural environment and am compiling some of the more interesting stories.
As the only paramedic in a very rural area with 32 miles of water separating my service area and any mainland hospital, the most difficult runs for me are the ones that involve my family. All of the runs in the rural area involve friends or neighbors, but when you have no choice but to take care of a family member, that is the most difficult. I have had my daughter, my wife, and my father-in-law to assess and treat and transport. When you are the only paramedic in a rural setting, you have to be responsible for anything and everything.
The second hardest in the rural area is any run where it is close to impossible to transport the patient due to fog or blizzard conditions. Our longest wait to transport a patient was many years ago, but it is still the record. No planes, no boat, and 32 miles of water separating the patient from the hospital for 48 hours.
If you would like to read a little about these cases, you can go to my website and read them for free. http://ruralemsisdifferent.com
I would like to hear about any other rural EMS calls that required a modification of written protocols. Email me at medic5740@yahoo.com
I have retired from volunteering as an EMT and paramedic for 20 years in this rural environment and am compiling some of the more interesting stories.
firetender
Community Leader Emeritus
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Here's the part where I just chime in to share my thanks for this forum and the very real and human people in it.
I also have to give some kudos to the technology.
I really appreciate knowing that you, my (mostly) younger Brothers and Sisters can have a miserable, maybe even devastating day or week or month or moment in the field and be able to tap into here 24/7 to see that you're not alone...no matter how twisted the scenario!
Having come up (in the 70's and 80's) in a medical culture where there was no such resource to turn to, I know me and a lot of my peers ended up piling on the armor. I really don't think that's as necessary today.
It's wonderful that, along with so much of the important nuts and bolts and politics that go along with the job, there's little pockets like this where we can share the hard stuff, too.
Water is finding its natural level, so what we see here is probably a fairly accurate reflection of the proportion that most of us have to deal with heavy stuff like is being discussed here.
It's the one-percent of our experiences that produces 99% of the changes in our world views.
Thank you all for helping me better see how the person I am today was shaped by my experiences in the back of an ambulance.
I also have to give some kudos to the technology.
I really appreciate knowing that you, my (mostly) younger Brothers and Sisters can have a miserable, maybe even devastating day or week or month or moment in the field and be able to tap into here 24/7 to see that you're not alone...no matter how twisted the scenario!
Having come up (in the 70's and 80's) in a medical culture where there was no such resource to turn to, I know me and a lot of my peers ended up piling on the armor. I really don't think that's as necessary today.
It's wonderful that, along with so much of the important nuts and bolts and politics that go along with the job, there's little pockets like this where we can share the hard stuff, too.
Water is finding its natural level, so what we see here is probably a fairly accurate reflection of the proportion that most of us have to deal with heavy stuff like is being discussed here.
It's the one-percent of our experiences that produces 99% of the changes in our world views.
Thank you all for helping me better see how the person I am today was shaped by my experiences in the back of an ambulance.
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