Ever had one of those days where you just don't get it?

So I was thinking the other day about some of my really "head scratching" calls. You know, the ones where you just never really understand what happened and decide that you probably never will?

It was maybe a year ago--I know it was freezing outside but I don't really remember when it was--that my partner and I were dispatched to a MVC with a "minor headache". It was also O'dark thirty outside and we had been asleep for a few hours.

So ok, we check en route and Mike (my partner) drives us the short distance to the scene. When we got there, I think that I dang near soiled my britches!

This was no minor accident--This was a full blown tractor trailer--18 wheeler--semi truck, half flipped over, and teetering off the side of the road. Regardless of the status of the patient, we needed more help to safely access this patient.

I radioed dispatch and told them what we had, requested FD for rescue and extrication assistance, and asked to have Air Medical put on standby. We could see skid marks at least a half mile up the road. As I surveyed the scene, I also saw a sign that read "WARNING--GAS PIPELINE UNDERNEATH. CALL BEFORE DIGGING" Oh crap.

Well, step one was to get everyone out of the danger zone, including the cops who were crawling all over the cab of the truck. I inquired about the status of the patient and was told that she was semi responsive and "talking out of her head". Hmmmm. Thankfully the FD was only a few blocks away and they arrived on scene in record time. As soon as they had the semi initially shored up, Mike climbed inside and started an initial assessment of the patient. Once he relayed his findings to me, we launched the helicopter. We were also waiting on a large flat bed wrecker that had the capabilities to rig up safety wires to keep the semi from fully rolling over.

I started hanging lines and getting the patient compartment ready. I turned the heat on, attached electrodes to the cardiac monitor. I had already taken Mike the portable O2 and a non rebreather mask as well as a ccollar, so we had the basics covered until we could fully extricate the patient.

We wound up having to remove her from the truck through the side window. The doors were jammed and we decided that trying to have the FD use the jaws of life to pop the doors and gain access that way was just too risky. We were afraid that the wiggling and moving might cause the semi to become unsteady. I just wanted all my guys away from any potential danger as quickly as possibly.

So out she comes onto a LSB and we secured her quickly and got her in the back of the truck. We did a full trauma assessment and began treatment. Continued o2, monitor, warmed her up, IVs, etc. Her BGL was in the 40s. So she also got an amp of d50 which helped to perk her up some as well, although she was still lethargic and not responding appropriately.

We were driven to the LZ and in short order had the pt packaged for the helicopter and report was given the the flight crew and they flew her to the closest level one trauma center.

We went back to the scene and stayed with the FD and the wrecker crews for several hours while they attempted to remove the semi truck from the ditch that it was half in.

I guess the moral of the story is if you hear hoofprints, look for the zebra.

Uhhh, you'd better send some more help here...

It had already been a long and busy shift and I had grabbed a few minutes between calls to take a quick shower before going (hopefully) to lay down for a bit.

*tones drop*

Of course while I have shampoo in my hair and I am soaking wet.

"Medic X, need you to respond to 123 ABC Street. Female patient is unresponsive."

Crap!!!! I should have suspected it though, because the shift had already been long.

I heard my Captain check in route and knew that I had a few extra seconds to dry off before throwing my uniform back on. I grabbed a elastic band to pull my hair back and was grateful that I had a hat to out on my head since I didn't have time to drag a comb through my wet hair.

As I'm climbing in the truck, I hear several First Responders check en route to the scene, and my Captain checks out on scene. We check en route and a few seconds later I hear the weary voice of Captain D, "Uh dispatch, you'd better call the Anytown Fire Department. We're going to need some man power here."

Huh? Ok let's see...We've got my partner, myself, Captain D, and 4 firefighters. That's 7 people. What in the world is so bad that we need MORE help?

It became very apparent when we got there. We walked in the door and saw a mattress laying on the floor and a very very large woman was laying on it, unresponsive and with snoring respirations. We start to provide emergency care and the firefighters try to figure out how in the hell we are going to extricate the patient from her house. There wasn't enough space to bring the cot in to her, and frankly her estimated weight exceeded the weight limits of the cot (650 pounds).

We ended up using a spine board as a ramp from the bed to the cot and essentially pulled the pt from the bed, over the spine board, and onto the cot. She was so wide that she had to be placed on her side in order to secure her safely to the cot. That really was the best position for her anyway as the weight of her massive chest significantly impaired her respiratory effort.

We left the cot in the lowest position to roll it over to the truck, then the 11 of us raised the cot up and secured it in the patient compartment for transport. There was 4 of us in the back and Captain D drove us to the ER. We alerted them to get a bariatric bed. Once we left the patient at the er and transfered care, we returned to the station.

I punched Captain D in the arm..."Man Power? Geesh, man you could have come up with something better to ask for."

"But it's so near my brain..."

A young adult called 911 for a pimple on his face.

Why?

Because it was "so close to my brain".

He got transferred to triage when we got him to the hospital. The doctor was dumbfounded that he had called 911 for a zit.

Sometimes things just aren't what they seem to be...

I pride myself on being a fairly educated provider. I'm not the smartest and I don't know everything. I can always learn more. It's not often that I am rendered totally speechless while on a call.

I distinctly remember my first time....

My partner and I were dispatched to a "sick child". As we drove to the scene, my mind was racing about what the possibilities could be. It could be anything, I decided. An asthma attack, mental eval, traumatic injury, etc.

I was not prepared for what we found when we got there, however.

My partner and I walked into the house with our pedi bag and cardiac monitor. Mom was there and didn't speak any english. Dispatch had advised us that a third party was en route to the scene to translate for us.

I asked Mom where the child was and she pointed to the floor where there was a wadded up bedspread lying there. I leaned down and gingerly (with 2 fingers) pulled back the cover slightly.

A baby. Covered in blood.

My mind wasn't computing what I was seeing. I pulled back the cover a bit more and was dumbfounded to see an umbilical cord still attached to the infant. The baby had the most beautiful liquid brown eyes and just started up at me. It wasn't crying or fussing or anything.

Dread filled the pit of my stomach as I fully exposed the infant. I followed the umbilical cord all the way to the end....it was still attached to the placenta.

OH MY LORD! My partner and I looked at each other. He picked up the radio and asked for help. Dispatch wanted an update. "We have a-uhm-live birth here". My partner ran out to the truck to get the OB kit and we got mom seated on the cot. I picked up the infant and dried it off. I clamped and cut the cord and tried to stimulate the baby to cry. It seemed pretty content to just hang out, no crying or anything. We got the baby bundled up and handed it to Mom.

Turns out that Mom was young and she was afraid to tell anyone that she was pregnant. She didn't receive any prenatal care. She went into labor and managed to wait until her older sister left that morning before delivering the baby.

I still scratch my head when I think about that call.

The next shift I followed up on the baby and was told that it was doing well, despite some issues regulating the body temp.

It was my first "delivery" and the first birth certificate that I signed. And the first time that I was speechless throughout most of the call.