I’ve been off the ambulance for most of this month participating in a vendor selection process for some neat new IT stuff. Well neat if you’re kind of a geek, which I guess I am. Since the bosses have interpreted the rules to mean that they can’t pay me overtime to go, they’ve put me on the day shift on days when we’re meeting to see demos. Which actually is harder work than doing ambulance calls because there is no downtime to relax on. I’m sitting in a room with about 30 other people watching real IT geeks and IT sales geeks show us their wares.

As a result I worked on the ambulance one whole shift this week. But, it was a quality shift.

The first call was actually ten minutes before the shift started, but I was in and let the guy who was waiting to go home, go home. The dispatcher breathlessly told us that it was a Difficulty Breathing call. We only get about 1,009 of those per week, most of which turn out to be minor illnesses, not serious emergencies. The kicker here was that the dispatcher also told us that there were no BLS ambulances available to assist us. We did get the fire department first responders though. How exciting is that? We arrived to find the officer on the piece waiting outside the apartment. Apparently this call was so minor that the first responders didn’t even bother to give the patient oxygen. “He’s been coughing and had a cold for four days, but he decided that he just had to go to the hospital in the middle of the night.” Which was a very unusual statement for the FD to make in our system. Usually, they have no comment and just give us the basic story. Which, when I think of it, is actually what he did. The patient told us that he wanted to go to the ED in the next city over. I told him that was not happening because we were so busy. He told us that the lady he talked to at dispatch told him that he could. The only problem was that the lady at dispatch wasn’t at OUR dispatch. He had called one of the private ambulance services that has units in the city. Only their ambulances were tied up doing, uh, something. Sleeping would be my guess, but I’m just cynical. For the record, this was not Walt Trachim’s outfit. They always take their own calls. It was another one that constantly turfs their calls to us. So, we put the patient in the ambulance and drove the two minutes to his alternate choice. Where the lazy ass triage snurses took their sweet time triaging him.

After we cleared I had enough time to get a coffee before we got our next well triaged gem. A shooting call, only it was a call for shooting in the area with a description of the suspect car, but no notion of a patient. The cops arrived and then canceled us as it was a police matter. At least we have good cup holders in the ambulances so I didn’t have to toss my coffee out for that one.

Then another chest pain call, the BLS crew arrived and determined that the chest pain was from the seat belt the patient had on when she was in an automobile accident 12 hours earlier. Apparently she was unhappy because the hospital only gave her one Motrin. They gave her a script for more, but she tore it up because, “It didn’t come from my doctor.” The patient wanted to go to the hospital that was literally across the street from her house! I’m not kidding, I could clearly see the “Emergency” sign from her front porch. There was a time when I would have walked across the street, got a wheelchair, rolled her across the street, and then cleared with a “Patient by own means”. Only we can’t do that anymore because it makes too much sense and our overseers want the revenue for the transports. So, she got into the back of the BLS unit and they drove her 150 feet to the hospital. At about $800.00 expense to the taxpayers because the patient had Medicaid.

Then it calmed down for an hour or so, until closing time. Bar closing time for those of you who don’t know what I’m talking about. Which I refer to as amateur hour. We were visiting at one of the EDs when a call came in for a roll over MVC about three blocks away. We rolled over (no pun intended) and were the first unit to arrive. Sure enough, the car was precariously balanced on it’s side, the air bags, deployed, and the driver standing next to the vehicle looking confused. No obvious injury so he was loaded into the handy dandy BLS ambulance for the 500 yard ride to the ED for evaluation. At least he had insurance and the semblance of an injury. His car was not so lucky and was last seen being loaded onto a flat bed truck.

Then another shooting call, but once again the aim was bad and no one was hurt.

Then it calmed down as the drunks either went home, to jail, or to the hospital.

We went back to the station for lunch (or is it dinner?), an email check, and some internet surfing. That got boring pretty quick, so I went outside to violate the rules by having a cigar and watching the street traffic. One of the BLS crews stopped by to chat and we were standing outside when a car came racing up the hill, crossed over onto the sidewalk, crashed into a chain link fence, bounced off a tree, and came to a stop about an inch from a much bigger tree.

“Whoa! That was impressive! We better go over and check that out.” It sure looked good and we thought that someone might be seriously hurt or even dead. So, we mounted our mighty iron steeds and drove the 150 feet over to where the car was. The driver was standing next to the car, looking a bit confused. His passenger was sitting in the car, wailing away, but not injured. Well, not seriously injured, the air bags having done their job. We extricated her, put her on a back board, examined her, and put her in the BLS truck. She went to the hospital, the car was loaded onto a flat bed, and her boyfriend wandered off after talking to the police. Apparently he wasn’t drunk, or at least not enough, to be arrested. I’m guessing that this is not the end to the night either of them planned, but oh well, what can you do?

A little while later we got a call for a seizing diabetic patient. We raced over along with the fire and a BLS crew. Climbed three flights of stairs and then up an 18 inch wide spiral stair case to an attic apartment. Only to find the seizing patient sitting up eating a sandwich and drinking orange juice. Which wasn’t bad on several levels. First, we wouldn’t have to start an IV, give Dextrose, and then maybe take her to the hospital. Second, she was very pretty. Very, very pretty in fact. And wearing a skimpy night gown. She was also very pleasant, as was her boyfriend. I did, however, have to refocus my young partner’s attention on the medical aspects of the call. The nice young lady passed all of our tests and so we had her sign the patient refusal form and left her and her boyfriend to go back to, uh, sleep. Yeah, that’s it.

We then had our only sick patient of the shift, who was the patient I wrote about a few days ago. In that one call, we earned our keep for the night.

Which is how it goes some times in sort of big city EMS. You run around all night chasing silliness and then get the one serious call that redeems the night. Usually at the end of the shift too.