Happy 2013!

Here we are, a week into the new year and I haven't even had a chance to recount my New Year's Eve adventures. For whatever crazy reason, I voluntarily signed up to work New Year's Eve. For the last several years, I have worked it as a dispatcher but this year was the first time that I worked it on the ambulance.
My partner that night was a baby-faced rookie EMT. He impressed me early on by completing all the truck checks while I ate dinner with my family. When my family had left, Baby Face confided in me that he didn't feel 100% comfortable with the layout of our district and asked if we could go drive around for a while so he could familiarize himself with the some of the major areas.
Before we could vacate the station, a veteran firefighter called to cajole me about working that night. He told me he had worked the last 3 years. Two of those nothing happened and on the other they had a stabbing. "You probably won't have much going on tonight," he told me. Although I secretly hoped he was wrong, my rookie partner & I wandered into our district unabated by any calls.

We meandered up and down dirt roads and highways and side-streets for a few hours, mostly making small talk. In spite of his tender age of 19, Baby Face was not a typical rookie. He had a hunger like few others I have seen. He asked me all kinds of questions about district operations, my work history, interesting calls and lessons learned. Amongst the many questions, the one that struck me the most was when he asked why I became a paramedic and my thoughts on other individuals, such as himself, following the same career path.
"Quite honestly," I told him, "there are a lot of calls that can be handled with just basic skills. However, there are those rare and critical calls when your patient needs more. Like, if someone can't breathe, a simple nebulizer can make all the world of difference. As a basic, I couldn't do that. I wanted to do more, so I became a paramedic. It's not easy. And I certainly didn't do it for the money. But it was worth it. I would recommend it for sure."
My answer appeased him & he quietly pondered it for a few blocks. A short while later, he decided he was feeling comfortable with navigating our district roads so we made our way toward the station. The night was still young but it mattered not to me. I made my way to my quarters with the intention of sleeping into the new year. My plans were foiled when, just as I was dozing off, a group of party-goers began shooting off artillery shell fireworks just across the street from our station. I tried in vain to shut out the noise by pulling my pillow over my head but it permeated my dark room & shook the walls. After several minutes of incessant explosions, I gave up on the idea of sleep and decided to go watch the show. Baby Face was still awake watching TV and briefly joined me to watch the spectacle in front of our station. When the party-goers were out of ammo, they staggered back into the bar from where they'd come.
"Well, I'm going to try again to get some sleep," I told me partner. But no more had the words passed my lips that our pagers buzzed to life. It was for a motor vehicle accident on a highway in the eastern part of our district. I don't recall the rapid donning of gear and sprint to the truck but I do remember the twinkle that shone in Baby Face's eyes. We blasted down the road, lights and sirens blaring.
As I have said before, we are a fire-based EMS service with transport capabilities if our contract agency has no units available. This night, however, there was an ambulance available and they called onscene long before us. By the time we arrived, the patient was in the ambulance and ready to head to the hospital. We bade them farewell and made our way to the vehicle to make sure that it was secure. The driver had over-corrected and careened off the highway down a 30-or-so foot embankment. During such, the vehicle had completely rolled over and when it reached the snow-covered field below, it had miraculously rolled back up onto all four wheels. The unrestrained driver had thankfully not been ejected. The car's engine was still running when we reached it. It calmly idled as if nothing had happened. Not a single window in the vehicle was intact and the passenger compartment on the driver's half of the car was smashed to a 45-degree angle. As we often do, we pondered how badly it could have went and said a silent prayer of thanks that it hadn't. The tow truck radioed that it was nearly onscene and so we decided our work was complete. We stowed our gear away in the truck and made our way back toward the station.
We had no more than backed the truck in and switched off the engine when our pagers summoned us to another call. This one was for an intoxicated male whose friend was trying to give him a ride home when he got angry and decided it was o.k. to start breaking out the car windows with his fists...and head. New Year's Eve mayhem had officially begun...
We arrived onscene a short while later to find officers in custody of a not-so-pleasant man screaming obscenities. He had obvious lacerations to his hands, arms, face & scalp. I quickly baled out of the ambulance as the officers rushed toward us with their arrestee. He resisted their efforts and, as he screamed and fought, I pulled the cot out of the ambulance. The officers took their chance, looked at each other & before their arrestee had a chance to plan for what came next, he was face down on the cot with both officers trying to hold him while we grabbed for seat belts and restraint straps. The man in custody did not agree well to this scenario and the barrage of cursing increased in intensity and he began to try to spit at anyone in range. We all stepped back and let the officers work their magic. It is EMS policy with combative patients that we don't intervene until we know the situation is safe. This, at times, does mean that life-saving care is delayed for the sake of the rescuers safety. However, if it is a difference of a responder going home safely to their family, the price is worth it every time. My paramedic preceptor once told me that, although it is a difficult choice, it is better to sometimes stand back than run in and make yourself a victim too.
So, on this chilly New Year's Eve, we stood back and waited. At some point in the mix, our contract transporting agency freed up a rig and they arrived onscene. They felt it wiser to transfer the patient to their cot and haul him into the hospital so that we could remain available in our district. Their arrival apparently disoriented our combative patient just long enough for us to lift him from our cot to theirs without incident. As quickly as they had come, they whisked him into their ambulance and were gone. New Year's Eve call #2 complete.
Once again, we wandered back to the station and I actually made it all the way back to bed. Not for long though. Call #3 came in a brief while later...a 26-year-old male with breathing difficulty. We made our way to a quiet neighborhood where Baby Face and I had driven around just a few  hours before. Two young men waved us down in front of a house in the middle of a block. In spite of obvious extended New Year's partying, they were distraught.
"He's inside but you may need to come in through the garage to get to him easier," they said.
The front door was open, however, and, from the wheezing sound alone, I needed no further direction as to the location of my patient. His panic-stricken wife met me just inside the door and hurriedly explained that her husband was an asthmatic and that he didn't have his rescue inhaler. I made my way to the rear of the house where the source of the wheezing emanated to find a relatively healthy looking young man lying on the floor on his stomach and holding himself up on his forearms.
Auto-pilot switched on for me. "I need an oxygen mask at 15 liters now," I told Baby Face. His eyes met mine and something of terror and excitement flashed across his face. He obediently followed my command and, while I rattled off  questions to whoever would answer, he shoved an oxygen mask into my hands. The problem had started about 10 minutes ago and I knew we didn't have much more time. He needed breathing medications...and he needed them now. However, I was running on a basic rig and our advanced rig was somewhere behind me...delayed by a train. I tried to pull other treatment possibilities from my sleep deprived brain but nothing surfaced. Talk to him, try to keep him calm and hope the oxygen helps was all I had. It was probably only seconds but it felt like an eternity before our advanced life support officer raced through the door.
"He needs a neb," was all I told him. A few more eternal seconds raced away while the life-saving drugs were poured into a nebulizing cup and thrust at my patient's face.
"Take a deep breath. Look at me! Breath deep! This is gonna help you."
Almost as if a magic wand had been waved over him, our patient's breathing slowed and from somewhere he found the energy to open his eyes. Everyone in the room breathed a sigh of relief. As usual, our transporting agency arrived, moved him onto their cot, and rushed him away to the hospital. His friends and family stood around us, and, despite their level of intoxication, stared at us in silence.
Finally one of them spoke. "You guys are awesome. Thanks for what you do." Their gratitude was genuine and we all took a moment to soak it up. Then, as quickly as we had descended, we gathered our things and made our way out.
Baby Face silently strode beside me across the deck and down to the street where our ambulance waited.
"And that's why you become a paramedic..." I told him.
A broad smile beamed across his face. His adrenalin rush was tangible even on that dark curb. "It's exactly what you said earlier," he gushed.
The awe and wonder he had in that moment was enough to keep me going forever. For him, nothing in his life had surpassed those intense minutes that had just unfolded before him. En route back to the station, Baby Face launched several questions again at me about the what and why of our young asthmatic patient. When he was done, he drove on quietly, then said "I'm sorry I ask so many questions. I hope I'm not bugging you."
"Never be afraid to ask me questions. It's how you learn. I'd rather have you ask than not," I assured him.
We managed, once again to park our ambulance back in its bay but the engine was still warm when the pager sent us to our next call. A middle-aged female with abdominal pain...in the same neighborhood where we had just been.
"Man, your district orientation was spot on," laughed Baby Face as we raced off again.
We arrived onscene of the next call and rushed in without much fanfare. A middle-aged, heavy-set female sat on her couch in her dimly-lit living room. She seemed to be guarding her side but didn't appear overly distressed. I ran through my series of assessment questions but didn't hone in on any life-threatening problems. However, when the transporting agency arrived, she revealed to us that her 5-year-old son was upstairs sleeping and she didn't know what to do with him.
"He can ride with you in the ambulance," someone offered.
That idea seemed to satisfy her. "Who wants to go get him?"
We all stopped and glanced at each other with much hesitation. Finally, I looked around the room and it suddenly occurred to me that, other than my patient, I was the only female in the room.
"I'll go." I pushed past the other responders standing around and  crept up the darkened stairs searching for a light switch. The house was that of classic design and generally the same floor plan as every other one in this subdivision so it didn't take me long to figure out which room belonged to her son. I called his name and then flipped on his light. He was sprawled on the lower level on a bunk bed and he didn't even flinch when the lights came on. I shouted his name as I quickly made my way across the small room. No response. I ripped off his blankets much more briskly than I normally would under other circumstances. He turned and looked at me puzzled for a brief second before rolling over and going back to sleep.
"Your mommy is sick and needs to go to the hospital. You need to go with her," I said, shaking him gently.
He finally sat up and whined. Knowing that this wasn't going to go like I had hoped, I grabbed him from the bed and raced from the room, grabbing a jacket and shoes for him along the way.
At the bottom of the steps, the driver of the ambulance glared at me as he told me he needed the kid in the front seat. Obediently, I strode out of the house and made my way to the ambulance in record time considering I was lugging a hefty, struggling 5-year-old. I plopped him in the front seat and quickly seatbelted him in as he tried to scramble into the driver's seat. I told him to be brave and that his mommy was in back. The attendant who was driving crawled in a few moments later and glared at me and the kid again.
"Have fun," I smiled at the attendant and the kid and slammed the door. The ambulance drove away into the night...and the pager buzzed again.
This time it was for a simple lift assist just a short distance down the road from our current location. We were onscene only a few moments. The sweet woman who had called insisted only her pride was hurt and she needed nothing else from us. We wished her a good night/morning and headed toward the station...just as the sun was coming up.
And that, my friends, is how I rang in the new year. I did finally get a few hours of sleep before I got up to face New Year's Day. Since then, I have a gotten a email from Baby Face thanking me for being willing to teach him and be patient with him. I returned his email, thanking him for being there to help out, his positive attitude and calm demeanor. Kids like him are so rare these days. I hope that next New Year's Eve I have someone of his caliber to work with also.
As far as the veteran firefighter who called me at the start of our shift and said we wouldn't have much going on, I got an email from him too. It simply said "Boy, I was full of bull."
It may sound crazy to you, but I had a great New Year's Eve.I had a chance to work with great people and help out those in our community. I can't think of a better way to start 2013.