Intravenous.
The back doors slam shut, rattling the tinted and screened window in back. In front of me, an altered, bruised, bleeding patient struggling to stay alive. Memories of better times trace the patient's brain and ominously fall into that stereotyped category of seeing one's "life flash before your eyes". I rip off my bloody, blue gloves and throw them into the garbage. I try to slide my new pair on, over my sweaty palms, and struggle greatly. I adjust the tips of the fingers, look down at the patient, and tell myself to get to work.
We are five miles away from the trauma center and averaging 60 mph. I do the algebra in my head and come to 5 minutes. I have 5 minutes to stabilize this patient, prepare my story, clean my mess, and package him neatly so when we arrive into the ED everyone silently "oohs" and "ahhs" over the efficiency displayed in front of them.
I reach blindly behind my back and search for the blood pressure cuff. In the well, between the glove boxes and tourniquets, I find it cowering in the corner. I rip the Velcro, wrap it around the only good arm available, squeeze the black bulb like a teen playing a video game, and watch the needle apex at 200 mm/hg. Slowly, and as quietly as possible, I ease the little silver knob on the cuff to gradually release pressure. The patient's arm is raised by mine, so it floats in the air and won't absorb any indirect road vibration. My eyes squint on the needle as it falls counter clockwise and begins to twitch. Those twitches, hopefully, correspond with the faint thump of the exerted heart within. 70/20, seventy over twenty, if I heard it correctly. Again, 70/?, seventy over something. The huge bumps, the vibrating ambulance, the loud air horn, the sirens, my partner yelling at me, the dispatcher on the radio, the patient moaning, and my cell phone ringing in my pocket, all prevent me from hearing that last number.
Must be my wife, I'll have to call her back.
Slapping me in the brim of the hat, with each knot in the road, is the tubing to the I.V. It screams at me with each sway from the hook on the handrail attached to the ceiling. "Time is ticking -fast, and you need me -now," it silently fills my head.
To my right, on the bench seat, is my next goal. I duck forward to look through the small opening dividing the patient compartment and driver's compartment, and quickly try to recognize some landmarks. The surroundings screaming by look quite familiar. I plug this new variable into my algebraic equation and deduce I have 3 minutes.
I tourniquet the left arm of the patient. Wrapping the plastic tubing as tightly as I can around the upper portion of the bicep, ending it with a fancy little knot that allows me to "pop" the tourniquet open once I'm done preventing deoxygenated blood from returning to the heart.
I slide forward on the bench, check my gloves for any blood, and grab the cell phone attached to the metal wall. I push a series of buttons, push the green button, wait uncomfortably as the sirens remind me we are advancing quickly, and finally get a MD on the other end. Here's what I got, what I'm doing, and when we'll be there. I punch the red button on the bottom and the sling the phone forward, hoping that it lands anywhere near it's designated area.
I slide back down on the bench seat to where I was previously. I rip open a small square encasing an alcohol swab, pull it out, and as concentrically as possible, attempt to somewhat sterilize the filthy arm where I plan on poking the patient with a needle.
I've marked my bull’s-eye. I grab the 3 inch wrapped needle and rip the packing off, attempting to toss it into the trash and, like a feather floating in the wind, it lands not but a foot away from me.
I straighten the elbow, pull back the skin, see the bulge in the crook of the elbow, and stab. I push the 14-gauge needle through the tough outer layer of skin and advance it until a little chamber in the needle fills with blood, telling me that I am in a vein. I stop advancing the needle, move my forefinger onto the catheter tip, and like E.T., push my finger forward advancing the catheter into the blood-swelled vein. I hook up a device that allows me to draw bloods for the ED. A tiger top, because the top looks like a tiger, a blue one, a red one, and a few more that I can't remember the colors of.
I pop my safety lock on the tourniquet and blood rushes back into the circulatory system. The arm pinkens as everything returns to normal.
Again, I lean forward and determine where we are. 1 minute away.
I repeat the previous process on the other arm. This time, it takes me half as long.
I cover the semi-clad patient with a sheet as the siren changes from a steady wail to a whoop-whoop. We're pulling in. I grab the green oxygen cylinder and slide it between the patient's legs, attaching the vital end of the oxygenating mask to the outlet spewing out 15 liters of oxygen per minute.
Next, I follow the I.V. wires to the bags hanging from the handrail and lay them on the patient's lap as well. The doors pop open and my partner, as well as anyone else killing time in the ED ambulance bay, quickly unlatch the bed from the locking mechanism and pull him out the back, catching the wheels as they drop to the pavement. My patient is now taken from me and quickly wheeled into the ED. I follow, reciting the poetry in my head that is about to be yelled in a large room with a lot of people.
I enter the ED behind my patient, watching all the white coats scurry into the room like bugs under a white light. I attempt to wipe off the beads of sweat on my forehead, but quickly realize that my arm is just as sweaty as my head. I want desperately to fix my hat, clean the sweat, and tuck in my shirt for this emergent rendezvous, but can't because spots of blood stain my gloves.
I turn the corner into the large room and say,
"Is everyone here that needs to be here?"
We are five miles away from the trauma center and averaging 60 mph. I do the algebra in my head and come to 5 minutes. I have 5 minutes to stabilize this patient, prepare my story, clean my mess, and package him neatly so when we arrive into the ED everyone silently "oohs" and "ahhs" over the efficiency displayed in front of them.
I reach blindly behind my back and search for the blood pressure cuff. In the well, between the glove boxes and tourniquets, I find it cowering in the corner. I rip the Velcro, wrap it around the only good arm available, squeeze the black bulb like a teen playing a video game, and watch the needle apex at 200 mm/hg. Slowly, and as quietly as possible, I ease the little silver knob on the cuff to gradually release pressure. The patient's arm is raised by mine, so it floats in the air and won't absorb any indirect road vibration. My eyes squint on the needle as it falls counter clockwise and begins to twitch. Those twitches, hopefully, correspond with the faint thump of the exerted heart within. 70/20, seventy over twenty, if I heard it correctly. Again, 70/?, seventy over something. The huge bumps, the vibrating ambulance, the loud air horn, the sirens, my partner yelling at me, the dispatcher on the radio, the patient moaning, and my cell phone ringing in my pocket, all prevent me from hearing that last number.
Must be my wife, I'll have to call her back.
Slapping me in the brim of the hat, with each knot in the road, is the tubing to the I.V. It screams at me with each sway from the hook on the handrail attached to the ceiling. "Time is ticking -fast, and you need me -now," it silently fills my head.
To my right, on the bench seat, is my next goal. I duck forward to look through the small opening dividing the patient compartment and driver's compartment, and quickly try to recognize some landmarks. The surroundings screaming by look quite familiar. I plug this new variable into my algebraic equation and deduce I have 3 minutes.
I tourniquet the left arm of the patient. Wrapping the plastic tubing as tightly as I can around the upper portion of the bicep, ending it with a fancy little knot that allows me to "pop" the tourniquet open once I'm done preventing deoxygenated blood from returning to the heart.
I slide forward on the bench, check my gloves for any blood, and grab the cell phone attached to the metal wall. I push a series of buttons, push the green button, wait uncomfortably as the sirens remind me we are advancing quickly, and finally get a MD on the other end. Here's what I got, what I'm doing, and when we'll be there. I punch the red button on the bottom and the sling the phone forward, hoping that it lands anywhere near it's designated area.
I slide back down on the bench seat to where I was previously. I rip open a small square encasing an alcohol swab, pull it out, and as concentrically as possible, attempt to somewhat sterilize the filthy arm where I plan on poking the patient with a needle.
I've marked my bull’s-eye. I grab the 3 inch wrapped needle and rip the packing off, attempting to toss it into the trash and, like a feather floating in the wind, it lands not but a foot away from me.
I straighten the elbow, pull back the skin, see the bulge in the crook of the elbow, and stab. I push the 14-gauge needle through the tough outer layer of skin and advance it until a little chamber in the needle fills with blood, telling me that I am in a vein. I stop advancing the needle, move my forefinger onto the catheter tip, and like E.T., push my finger forward advancing the catheter into the blood-swelled vein. I hook up a device that allows me to draw bloods for the ED. A tiger top, because the top looks like a tiger, a blue one, a red one, and a few more that I can't remember the colors of.
I pop my safety lock on the tourniquet and blood rushes back into the circulatory system. The arm pinkens as everything returns to normal.
Again, I lean forward and determine where we are. 1 minute away.
I repeat the previous process on the other arm. This time, it takes me half as long.
I cover the semi-clad patient with a sheet as the siren changes from a steady wail to a whoop-whoop. We're pulling in. I grab the green oxygen cylinder and slide it between the patient's legs, attaching the vital end of the oxygenating mask to the outlet spewing out 15 liters of oxygen per minute.
Next, I follow the I.V. wires to the bags hanging from the handrail and lay them on the patient's lap as well. The doors pop open and my partner, as well as anyone else killing time in the ED ambulance bay, quickly unlatch the bed from the locking mechanism and pull him out the back, catching the wheels as they drop to the pavement. My patient is now taken from me and quickly wheeled into the ED. I follow, reciting the poetry in my head that is about to be yelled in a large room with a lot of people.
I enter the ED behind my patient, watching all the white coats scurry into the room like bugs under a white light. I attempt to wipe off the beads of sweat on my forehead, but quickly realize that my arm is just as sweaty as my head. I want desperately to fix my hat, clean the sweat, and tuck in my shirt for this emergent rendezvous, but can't because spots of blood stain my gloves.
I turn the corner into the large room and say,
"Is everyone here that needs to be here?"
Comments
Kingmagic of Purpleplus UK Para