Thursday, November 19, 2009

BUSY WEEK ON THE BUS


MOOD: slightly tipsy, it’s true
MUSIC: Erykah Badu

She was pregnant and lying in a pool of blood. There were 2 others, deeper in the deli, but a quick glance letme know they weren’t nearly as bad. The project across the street was already emptying out, folks screaming and yelling, breaking towards us at a run as PD scrambled to control the scene. Bright lights bouncing across the brick buildings. Utter chaos.
While my partner and an EMT strapped the patient to the long board, I set up an IV and liter bag of saline fluid so everything would be ready when they loaded her in.
The thing about most shootings: they’re a) usually not THAT bad- a in and out tib/fib shot or a hand, and b) the patients are rarely surprised to have been shot. Always wanna act like they saw it coming, like it’s just some of run of the mill shit, bla dee bla. Or like the guy two months ago who wanted us to take a picture of him for the cover of his album (Sweartogod). But this lady was both very near death and very afraid. She had no blood pressure, because she barely had any blood- what she hadn’t left on the corner store floor was quickly soaking through the bandages, and she kept teetering in and out of consciousness.
My partner put one IV in and I yelled to the driver to go, but not go crazy – cuz mofo’s will drive like hotholy hell on jobs like these and make things much worse- and we speed off. There’s no trauma center in North Brooklyn. If we’re any further up than we were we usually haul ass over the Williamsburg Bridge to Belleview but were slightly closer to Kings County, so off we went, slipping along through the rainy night towards Atlantic Ave, then Eastern Parkway. She had a juicy vein along her forearm, so we dropped the second IV there, bouncing along with the Brooklyn potholes and stubborn, non-clearing stopngo early evening traffic.
She wakes up some with the fluids flowing through and wants to know if she’s going to die, if her baby will make it.  The truth is, it’s looking good for her but there’s no certainties with jobs like this. I tell her as much, but with a more positive spin, and give as clear and update as I can while I try to staunch the bleeding and not fly across the ambulance. We screech around a corner, the cop in the back with us looks like he might lose his lunch at any moment, and then we roll up the hill into the County ER bay.
The other two victims roll in soon after us, one in handcuffs from a previous warrant---dang imagine gettin’ shot and arrested in 5 minutes for separate shit… And the hospital staff jump into their frantic dance.  When we leave, I’m happy to say, our patient is stable and the baby is out of danger.


Later that night, we’re in the train station, looking at an elfish Puerto Rican pothead who’s pretending to have chest pain. When we get him away from the cops I raise an eyebrow at him: Really, dude?
He sighs. “No, I just smoked A LOT of herb.”
How much?
“No, bro, I can’t even. No. Too mothafuckn much.”
I won’t write it down on the paperwork, I swear.
“Well,” he laughs hysterically for a few minutes and we wait for him to collect himself. “Three grams. Plus I tripled up on my antipsych meds. Hehehe…”
Damn.
“Yeah, son.”
Hungry?
“You have no idea.”
Chest pain?
“Nah. I was just…you know.”
You just want somewhere to take a nap.
“Basically.”
No problem.

Then, two nights later, we’re chilling in Marcus Garvey Park, whiling away the night, when the cardiac arrest comes over. Everything happens fast and efficiently: we’re there in two minutes along w/ the BLS, the dude is 41 with no medical problems lying dead on his bedroom floor. Wife and 3 kids looking stunned, staring in at us from the doorway as we setup our shit. I pass my partner and the student the tube kit and they get to work putting an airway in him. The EMTs start chest compressions and pull out the oxygen. I throw the EKG pads on and take a look.
Quick cardiology lesson for those that don’t know: when you’re heart stops beating, it doesn’t necessarily mean all the electrical activity stopped. When that happens, you get the flatline. But sometimes there’s still a ridiculous little floppy line of current running through- it’s called ventricular fibrillation. It’s rare and usually fleeting but if you catch it you can sometimes shock it back into a nice normal working rhythm.

When they stop compressions so I can get a look, I see our guy’s in a rare form of v-fib called Torsades de Pointes. It’s pretty, a windy, spiraling squiggle. “Clear away from the patient,” I say, charging up the monitor. Everyone takes a few steps back, I hit the button and the patient flops up in the air, his inanimate limbs jolting around eerily. When he lands, we do another round of compressions and check again. A  few gimpy complexes float past on the monitor before it settles into a nice steady regular rhythm. We check a pulse and voila- miracle of miracles the man has a beating heart. The tube is in, we drop an IV and begin setting up for transport. We’re exchanging glances but trying not to get all excited cuz the shit could fall apart at any given second and usually does.  Even in the rare case that folks DO come back, they almost never come back to be anything beyond total vegetable.  But there’s always a chance.
Our guy stays quite stable throughout transport.
He coded and was revived twice more in the hospital (where a tox screen revealed large amounts of cocaine in his bloodstream) and at last check was still comatose but expected to pull through.


4 comments:

  1. Wowwwwww....major drama. If I ever get through schooling, I guess I might have to be very alert during my ER rotation? Saving lives is amazing.

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  2. Daniel your blog is intense and incredible. Thanks for hookin' me up, yo.

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  3. This shit here...it reads like a damn soap opera! You gotta have nerves to do this job! Jeez. Good blog!

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  4. @doctress- yeah, the ER's fun and a great place 2 learn. You'll love it...
    THanks Shaun, glad u enjoy!
    And BrothaCopper- appreciate u stoppin thru Baba...and yeah, soap opera is about right. Sometimes. Sometimes its boring as shiiiiit...lol

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