One of my paramedic instructors said, “The very next call could be your last.” As cynically trite as that sounds, the wisdom of his words hold true. We could get into an accident on the way to the scene or on the way to the hospital. We could get stabbed or shot while on scene. We could sustain a career-ending injury from lifting a heavy patient. We could make a critical mistake with a patient and lose our privilege to practice as a paramedic.
There are days that I feel like I am working with a time bomb strapped to my back. I don’t know when or if it will go off…I just know that it might. Although I try not to dwell on this feeling of impending doom, the sound of the ticking time bomb is never far from my thoughts. It is like a continuous pressure….ever so subtle but always there….clawing at my conscience.
We approach an intersection with lights and sirens, stop and clear each lane, and then as we proceed forward a distracted driver that is oblivious to their surroundings pulls out from behind a stopped van. I say oblivious because all the other vehicles have stopped and it doesn’t register with this person that an emergency vehicle is entering the intersection. They are obscured by the van as I tromp down on the gas pedal to proceed forward and I don’t see them until that terrifying moment when we are about to collide. I let out an audible gasp as I jerk hard on the steering wheel and swing the ambulance to the right. It is a near miss and I am still not sure how I avoided a disastrous collision.
We walk into a house to check on the wellbeing of a 14 year old that didn’t show up for school, and suddenly the cops yell, “Gun! Gun! Gun!” and pounce on the kid. After the police have the kid sufficiently subdued they hold up a handgun that the kid had hidden behind him. The toxic fumes from huffing gold spray paint made the kid manically paranoid and he was convinced that we were there to kill him.
The patient is heavy and wheelchair bound, which means bringing the cot into the house via the front porch. The house is at least one hundred years old. The porch appears to be original. As we exit the house I feel the wooden planking on the porch start to protest the combined weight of me, the patient and the cot. One of the fire guys is standing behind me when the floor board gives way and I start to fall backward. Without the fire guy there to keep me upright, I would have tumbled down eight steps onto the concrete sidewalk with a cot and heavy patient on top of me.
The patient had fallen over twenty feet from a ladder onto concrete. He was in critical condition with fractures to both femurs and an open fracture of his right humerus. Blood was spurting from a severed artery in his arm. The patient was moaning but not alert or talking. His airway was open and clear but he was breathing in gasps. As with all trauma scenes, we wanted to quickly stabilize the patient and get the hell out of there. We placed him on oxygen and once we were in the ambulance then we would determine if he needed to be intubated. We stopped the arterial bleeding and secured the patient’s neck and spine. As we were lifting him to the cot, I overheard a co-worker say, “One minute he is changing a light bulb and the next he is on the ground.” No pun intended, but a light bulb goes off in my head. I feel for a pulse and find a very weak, thready one. We set the patient down and quickly place him on the cardiac monitor. He is in ventricular fibrillation. The metal ladder had come into contact with an exposed electrical wire and he had been electrocuted. Yes, it was a trauma scene. It was also a cardiac arrest scene secondary to electrocution, and I almost missed it.
“Ambulance A, truck five…you are en route on an unknown problem. Address flagged for previous weapons violations. Exercise extreme caution…”
“Units en route to the roll over accident…vehicle is on fire…victims trapped inside…”
“All units en route to the structure fire, be advised that a tornado warning has been issued for this area…”
“All units en route to the fight disturbance need to stage six blocks to the south….shots fired…”
It’s never ending; the pressure….the worry….the stress to remain vigilant at all times…the acute suspicion of every person…every driver….every call that seems routine and may be anything other than routine…because the next call might be the last. The ticking never stops….ever.