If I could do one more thing as a paramedic, I would be an advanced care paramedic (ACP) preceptor for my friend Jill. I just love her – and I know we would have so much fun being partners. I’m not sure how much my post traumatic stress would like it – but man it would be amazing if I could!
I miss being a preceptor. I miss feeling pride in my student after a call well done. I miss feeling the, “I get it now!” energy that radiates off of them when a concept clicks, usually after having a chance to use said concept on a call. Thinking about this reminds me of a call I will never forget. How a ‘concept’ was used much earlier than anticipated in an ACP student’s career, and how I know we saved a life that day.
It was my ACP student’s first shift. Like normal we arrived early to check the truck and the bags. I LOVED this day! Being able to zip open the ACP bag and unveil all of its amazing medications, and tools, and potential! Like a kid in a candy store, ACP students almost drool when they can actually touch the contents in that bag, and know that it would only be a matter of time until they get to use it. Getting to that unveiling point is HARD WORK! The drool is totally expected, understandable, and well deserved!
As I showed my student how to draw up a cardiac medication in a special way, (a trick of the trade that rightfully welcomed him to ‘the club’), we were shocked to hear the tones go off so soon (with the bag’s contents masquerading as a yard-sale on the bench seat). He didn’t have much drool-time as we were on our way to what would be a ‘career call’ for both of us.
Dispatch information was that we were going to a car accident literally around the corner from our station. It was a residential area, so we were anticipating a quick fender-bender call, allowing us to get back to the ‘candy shop’ in no time. But when we pulled onto the street, we immediately saw tire marks over the boulevard, barely missing a light pole, leading to a car which had crashed into a home’s garage leaving it half way through the bricks on the other side. I looked at my student, as he said, “Oh shit!” (Side note: paramedics hardly ever say oh shit – it has to be bad to say oh shit out loud).
As we pull up, I can see that the mangled car is most likely holding up the garage. In hindsight we shouldn’t have even went into the garage without it being stabilized – I actually take the safety of scenes very seriously, but for some reason on that day it looked ‘safe enough’, so I put my helmet on and headed to the car. My student was already there and could see the single passenger slumped over and blue. “I think he’s VSA (vital signs absent)!” He yelled. “Oh Jesus, here we go.” I thought.
My partner got to work wiggling into the passenger seat with the airway bag and started breathing for the patient who was a young male, maybe about 25 years old. His colour improved, and he had a pulse…but a weird pulse. My student and I grabbed the rest of the equipment, including the ACP bag we had just thrown back together in about 60 seconds, and began assessing the patient. Without getting into the medical details of the call, my student ended up having to draw up the exact medication with the trick I had just shown him how to do minutes before. There was a work bench in the garage – perfect! It became our drug table. I printed out the patient’s ECG as the fire department started to secure the garage roof. We would still have a bit of time on the scene because of the extrication that needed to happen safely. As pieces of the roof fell down around us (not big pieces, don’t worry 😉 ), our patient began to have a seizure. I yelled back to my student, “Oh you also need to draw up some midazlolam now”…an ACP student’s dream. After a base hospital patch fail or two for ECG guidance, we made some critical decisions together and got shit done…yet another ACP student’s dream.
With the help of the fire department we were on the way to the hospital with our patient in good time. He was in a very odd cardiac rhythm, so we were guessing he had taken some sort of drug to cause an apparent healthy young man to be this sick. My student and I loved to read ECG’s and both of us were stumped on what this patient’s heart was doing.
We transferred care at the hospital with our patient alive but still unconscious. As my student and I walked out to the ambulance bay, we stopped and starred at each other with wide eyes! If this was a sign of what calls were to come with him – we were in for a fun preceptorship ride!
Two days later we were able to check in with the hospital to see if our patient was still admitted. That was all we could be told though due to patient confidentiality. If it was a yes, he would most likely be alive, but with an unknown level of brain function. If it was a no, he could be dead and at the funeral home, or could have made a miraculous recovery and had gone home. He was still admitted and in the intensive care unit – not a great sign.
We took a walk to find his room. When we stepped inside there was what appeared to be his mom sitting beside the hospital bed, and what could have been a sister or a girl friend in a chair a little further away. Our patient was ‘not awake’, and hooked up to the monitor. It was his mom, and when we said that we were the paramedics who picked him up, she immediately started to cry. She stood up and hugged us both. The girl in the chair was crying too, but appeared to be frozen in time. After we answered a few questions about the call, we had a moment to ask how he was – at that time he was still ‘not awake’. Then just like he had heard us (and maybe he did) he rolled over and opened his eyes. His mom turned to him and said, “these are the paramedics who saved you”. He looked a bit confused at first, but without saying a word, he tossed his blankets off, sat up, disconnected the ECG leads on his chest, and walked over to us. He hugged both of us, still without saying a word. My student and I couldn’t help but join in the tears that were being sharing in the room.
He was so tall! It’s funny because one thing I remember when I was on the road was that when I’m focused on doing my job, and especially when that job is literally saving someone’s life, I never notice what my patient’s really look like, or how tall they are. Well this patient was young and tall, and lucky to be alive after a night of partying with cocaine.
I drove past that house many times after that call. The garage door now repaired and the boards that covered the hole in the side of the wall now back to bricks. Like nothing had ever happened there before – but I would always remember what had.
My student and I did have a preceptorship filled with many dynamic calls where life and death walked a tightrope before our very eyes, sadly often with a very different outcome than the call above. But that’s just the way in goes, actually saving a life doesn’t happen that often even after many years as a paramedic. I still miss the road every day. But thankfully I will always have the memory of that patient (who was blue when we found him), giving us a hug with a second chance at life.
Paramedic Nat 