Smells like......

I got my ass whooped last night. We had an incredible team... the same team that was on last Friday when we had 15 traumas in just under 4 hours. It was painful! So last night started with a couple of teenagers that rolled their cars. Nice patients, nice families. Not sure I even know what to do with those anymore. No huge injuries... couple of broken bones but nothing big.

We got a trauma from the area that my helicopter used to be in. Female had her door briken down and was shit several times in each leg in front of her 7 year old. She was hypotensive and combative on arrival and not a small girl. We gave her 4 units of blood which she bled out just as fast as they went in. When she went to the OR she had multiple vascular injuries that tied up the trauma team for HOURS. The next couple of traumas were run by the intern who, fortunately had a good head on her shoulders and did a damn good job. Too bad she's going into ortho and not trauma.

Everyone has the things that make them cringe a little. Some hate poop, some vomit some hate trachs..... when it comes to trauma I don't really like the open fracture dislocations of the tib/fib at the ankle. They flop around in ways a foot should never do and they just look painful as shit. We had a drunk lady get out of a reckless driving ticket tonight because the state trooper watched us attempt to reduce her ankle and decided that she had been punished enough. That bled everywhere too. These patients are usually screamers... (not that I blame them) and they can scream until your ears ring.

After 10 traumas it was 645 and I was ready to go home. My charge nurse looked a little upset when she had to come to me and say.. "PD found a guy shot in the head and arms, he's still breathing right now." Ugh... never good. This guy had 8 holes in his head, a through and through to the temples, one under his chin and a couple to the back of the head that I didn't get a good look at. He was bleeding from the mouth, head and the through and through to the arm. The crazy part was that he was still awake and talking. I didn't get to see his head CT, but I know that he was lucky as shit.

My relief walked into the trauma room at 7am and said "wow.... it smells like blood in here"

Ya think?!?!?

Merry Christmas Charlie Brown!

Merry Christmas friends. I was off the 23 and 24 and (naturally) my back started to ache yesterday morning. I'm not one to take more than motrin and tylenol, but this was bad. I had to break into the percocet and skelexin. Even THAT didn't do it. I'm not one to show up at the ED for "back pain" but the thought definitely crossed my mind. I would have let them shoot me in the ass just so I could get through Christmas Eve with the family at my house.

My sisters and their boyfriends and my mom came over for food, wine etc. It was wonderful. Its interesting hearing my mom's take on Christmas these days. She has said that she is so happy to now have adult children. I think she is finally able to relax and enjoy the holiday. Even my in-laws came by this year while they were out looking at lights. We only give 1 present Christmas Eve... which is new pajamas so we all look good in the Christmas pictures the next morning. The cop and I exchange presents after the family all leaves.

I must say that he exceeded my expectations this year. I was genuinely surprised... and blown away with some of the things he chose. I hope his Christmas is just as good. We are slowly waking up to go to my sister's for breakfast, then mom's for presents. Last year my sister "forgot" breakfast and had to get breakfast shit at 5am at the all night convenience store. Nothing like WaWa bacon and old doughnuts!

I hope my friends with children are enjoying their morning and didn't have to get up to early!

December 7

Growing up my next door neighbor was an old widower who used to let us extend our kickball field into his perfectly manicured backyard. His children were grown and gone and he was lonely. We spent Thanksgiving and Christmas with our family, but in the evenings we went to his house to visit. I suspect that Santa hid our presents at his house too. He was a friend to my mom, a grandfather to the kids and a saint during the divorce when we needed all the help we could get. Before he died I visited him in the hospital and we talked for hours. I was finally old enough to know him as a man, not just a grandfather. He was there 67 years ago in Pearl Harbor. He was not on a ship, but I don't remember what his role was. He didn't get into the details, I was probably too young to hear them. He said he was there to "clean up" afterwards. I can hardly imagine what that was like.

So today I remember Mr O, grandpa number 3. I wish I could have known you better. Love you!

Curtain Call

This morning at work, sitting in the trauma room I emailed my supervisors with the helicopter company and turned in my resignation effective immediately. I knew it was coming, just had to do it when I was good and ready. The cop said something this weekend that really cut to the core. He said.."if they are treating you like crap now, what are they going to do if something happens to you at work? How will they handle me if you were to crash?" I think that is what did it. My gut kept saying "get out" and its about time I listened.

So I'm going to watch a pirated version of "The Dark Knight" have a beer and unwind. Thank you all for your love and support through this. I appreciate you all!

Happy Granny Dump Days!

A couple of months ago one of the flight nurses from our competition approached me with an idea. He is the coordinator for a critical care transport course for paramedics. (CCEMT-P). Its a class that I wanted to take a couple of years ago when I was trying to get my shit straight to get a flight job. Its a pretty long course with all kinds of critical care concepts covered. He asked if I wanted to teach the neuro lecture! That was a pretty big deal to me. So I got my lecture straight and went in to teach yesterday. I think it went well.... I was REALLY nervous but I hope it didn't show. I originally thought I had 2 hours to cover neuro assessment and Intracranial Pressure... but turns out I had 4. (I can't imagine talking for 4 hours about anything but Jimmy Buffett and maybe Key West!) I get my evaluations in a couple of days so we will see how I did. He already asked me to come back and teach next year so I take that as a good thing!!!

I also was approached by the professional practice council from the ER about teaching a critical care class down there as well! Its weird how stuff works out. I don't mind teaching, but I'm always nervous that someone is going to ask a question that I don't know the answer to.

The ER leading up to Turkey Day was absolute insanity. The Monday-Wednesday are officially referred to as "Granny Dump Day." Thats when families come up with a good story about why grandma needs to be admitted to the hospital over the holiday. Usually they drop off Monday or Tuesday and are "unable" to pick her up on Wednesday or Thursday morning. Its sad, but predictable.

Had a transfer head bleed (from coumadin and htn) that has an INR of over 7, no ffp of Vit K given. She had no exam on arrival and we were in the process of prepping her for brain death testing. When the neurosurgeon went to tell the family (all 40 some of them) they started screaming, yelling, throwing up, throwing themselves on the floor... someone went AFTER the doc and got arrested. It was quite the scene. The poor chaplain said its the worst reaction she has seen in 15 years. At least they were OUTSIDE of the ER and couldn't get back to where I was.

I also had a lady who weighed 450lbs and was short of breath (surprise, surprise). She was too big for the bedside commode and would have crushed the bedpan. I tried to take her to the handicap bathroom and help her to the toilet. Let me refresh.... I am 5'0 and not a big person.... she was about 5'3 and 450lbs. This was not an even match up. Had she gone down I would have had to just get outta the way! When we finally got back and the MD ordered Lasix that was my limit. I recruited some (very good) friends to put in a foley. It took three of us and I was in the bed with the patient. I can tell that there is still some ICU left in me.... I had to clean her up down there before I would put the foley in. It was just the right thing to do.... even if the right thing smells like it hasn't seen warm water and soap in several weeks.

My (former) base manager left for Afghanistan yesterday. He is going to be a medic embedded with the Afghan army. Please keep him in your prayers... I am so worried about him.