I did CPR for the first time when I was 16. CPR was something new at that time. There was no 911, or paramedics, most ambulances ran out of funeral homes. I remember the ambulance attendants hooked up an automatic CPR machine ran from the oxygen tank, they loaded him up and took off.
That wasn't the last time I did CPR, working on an ALS ambulance in Spokane, we did CPR on a regular basis. Emergency medicine is a love hate relationship. You love to save people, and hate to lose a patient.
It's hours and hours of boredom, interrupted only by moments of sheer panic. Then your training kicks in and you get to help people on the worst day of their life, and hopefully make it better.
Being an EMT or paramedic isn't just a job, you hold people's lives in your hand everyday. So you need to love what you do, or go home you're no good to me. I was trained as a Mobile Intensive Care Unit Paramedic at Daniel Freeman Hospital in Inglewood California during the 1984 Olympics.
I learned to deliver babies at Martin Luther King Hospital in Watts, cardiac and respiratory at USC Medical Center in Los Angels, and trauma at Cedar Sinai Hospital in West Hollywood.
It was a serious paramedic school. We took major tests three times a week, if you got under 70% on any three tests, you were out, come back when you're serious. They were, every day there were students missing for the first couple weeks.
PARAMEDICS MAKE MISTAKES
After paramedic school in LA, I did my ride along training with the Spokane Fire Department. I worked out of Station 10 on North Division, assigned to Squad 10 a paramedic rescue truck.
About 30 minutes into my first day we got a call. The dispatch tones rang out, Engine 10, Squad 10, man down North Bowl, 125 West Sinto.
As we signed in route dispatch advised the man down had a history of asthma. We were only about 4 minutes away, it was a straight shot down Division, hang a right and we were there.
I carried in more equipment as the other medic's did a patient assessment. The patients 14 year old son was standing there not understanding what was going on. The patient lungs were really tight, and he went into respiratory arrest, as one of the fire medic's started an IV for medications, the other tried to intubated the patient placing an ET tube to secure an airway.
He placed the ET tube then checked for chest rise and auscultated the stomach then the lungs for bilateral breath sounds, saying he heard them. As soon as the monitor was hooked up, he went into cardiac arrest.
I started CPR as the ambulance arrived and we got him packaged for transport. We loaded him in the ambulance and I continued to do CPR as we took off running code to Sacred Heart Hospital with one of the fire paramedics on board.
I did CPR on the way to the hospital, as the other paramedics monitored vital signs, and pushed medications. When we got to the ER he was still in cardiac arrest, so he was moved to the code room.
The first things they do in the ER is draw arterial blood for blood gases, and take an x-ray to check placement of the ET tube. That's when they called the code. There was no point in going on, his blood gases were way off because when he was intubated the ET tube was placed in the esophagus rather than the trachea.
We had pumped oxygen into his stomach all the way to the hospital, rather than into his lungs. It was something I swore I would never do.
During my training at USC Medical Center I trained with physician's and PA's learning medicine and putting hands on patients for the first time too.
The most important lesson I learned was that emergency medicine is learning from your mistakes, and never doing them again, because that lesson may have cost a life.
Another paramedic made a serious mistake when I was working as an EMT for Mercy Ambulance. We got a call that a retired fire captain had injured his back mowing the lawn. The worst thing you can do as a paramedic, is assume anything on a call.
In Spokane back then when you called for EMS you got the closest engine company, a paramedic squad, and private ambulance to transport. When we arrived in the ambulance the engine company was getting ready to leave, and the fire paramedic's told us he pulled a muscle mowing the lawn. They told us he was all ours, and followed the engine company down the road.
The paramedic I was working with, Mark Romero was a sharp paramedic. The fire captain told us he was mowing the lawn when he got a tearing pain in his low and mid back. This didn't sound right, so Mark took his blood pressure in both arms.
It wasn't good, there was quite a difference between the BP in his arms. Mark said we needed to get MAST pants on him, and get two large bore IV's going ASAP. He said we needed to get him to the ER now, I think he has a dissecting aortic aneurysm.
The fire medic's were shocked when they heard us advise dispatch we were code 3 to Sacred Heart Hospital with MAST pants in place, and two large bore IV's. That we wanted surgeons standing by to rule out a dissecting aortic aneurysm. He was in surgery within 15 minutes of hitting the ER doors, he lived.
EMT's and paramedics are not doctors, far from it, so after every call paramedics need to review, discuss, argue about, and then adapt to make the next call better.
This is important to me because:
As a firefighter, police officer and paramedic I saw the limitations of government in day to day problems, and especially when major events happen. We cannot depend on outside resources if we have a major event like an earthquake, flash flood or the 6000 acre fire burning in Mohave Valley.
Where would we be, how fast could a small fire get away with our limited resources.
I've seen good EMS systems and bad EMS systems. I know we can have a good EMS system in the Dolan Springs, Meadview, and surrounding area. But we need to think out of the box.
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