April 8th, 2012 Comments


As soon as I walked in the room, I knew we had a problem.  My first thought was, “this man is going to die – unless we figure this out.

Weighing well over 400 pounds, this poor man was sitting on the edge of his bed struggling to catch his breath.  The fire district paramedics were working hard to help him.  They had already started to administer nebulized medication for his lungs and given him steroids to reduce lung edema.  They were frantically seeking for a place to establish IV access.  They finally got an IV in his shoulder.

But now the hard part loomed before us.  Not only was this man about ready to stop breathing because of his exhaustion, but we weren’t sure how we were going to get him to the ambulance.  It was going to take at least eight people to carry him, but eight people carrying a large man are just not going to fit through an older house – especially one stacked with boxes of clutter and stuff.  In the meantime, we had a bariatric ambulance responding Code 3 to our scene and another fire crew to assist with lifting.

We were also preparing to intubate this man if he were to stop breathing – this alone was going to be a challenge.

We did not have to carry him, nor did we have to intubate him. Everything turned out well – in fact, it was a relatively rewarding call. But I don’t like those type of calls. There was too much that could have gone wrong, and while the patient was in grave danger, I was very concerned about being disciplined by my employer. It shouldn’t be that way.

Three hours later, instead of being home in bed, I was attending a mandatory training session. The topic was stress, PTSD, and coping. Ironically, the speaker talked about sleep deprivation, good diet, and exercise to combat the stressors of EMS. These are three things that are difficult in my profession. And sitting there, after having worked all night, was just frustrating. I had now been awake for close to 20 hours, and I wouldn’t be home and in bed for another three hours. My peers, working for the other agencies, were attending during their regular shift, and they had just reported to work.

Sometimes, even though the information is valid, the irony of the situation its just hilarious.

I don’t do this job to get pats on the back, but a little respect and acknowledgment would be nice. I’d like to discuss how others would have dealt with the obese man who was on the verge of respiratory collapse, but it isn’t safe to ask questions. I’d like to get enough sleep, but I’m not.

We saved a life the other morning, but it wasn’t acknowledged by my bosses, they were busy issuing corrective action to other employees for being errant humans.

I’d like to care, I really would, but it’s just not safe.

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