Neck

A hot day and evening in the city. We got sent for an assault only to find no patient. We hung out for awhile while the cops searched the area. They said they'd gotten a phone call that five guys were chasing after another kid. When the cops finally cleared us, one cop said, heat like this, I'm sure we'll be seeing each other later.

Around ten, we got sent for a shooting. Found the kid sitting on a stoop with a bloody towell wrapped around his neck and shoulder. I removed the towell and saw two holes. One in the back of his neck, just to the right of the spine, and the other coming out the front of his neck. He was alert, talking, moving all extremities. I slapped a collar on him, we laid him on a board, and we were off. Total call time scene arrival to trauma room was ten minutes. Scene time was five. The kid was lucky. Through and through, and the bullet missed his spine, missed his major vessels, missed his trachea. Big holes too.

This is the second through and through neck shooting I've done where there was no major damage to the patient. I did another one, where the guy shot himself in the neck. The bullet missed all the big vessells, and missed the bones in the neck. But it completely severed his spinal chord. I had to intubate him, but he lived. I even took care of him again later.

This the third time I've been in the trauma room this week. I do like the traumas. I like the challenge of doing everything as fast as possible and on the fly. All the studies show paramedics make no difference on big traumas, so you have to be in BLS mode. It's all about time. I popped a 14 in just as we hit the hospital. Eveything else done before hand.

I talked to the kid's mother afterward. I told her how lucky he was. "Did you tell him that?" she asked.

I think she was pissed he was hanging with the crowd he was.

***

We did seven calls. Beside the shooting and the no patient assauly, we did two transfers, a guy whose fingers got mashed by a piano, a heroin addict sleeping under a tree, and another refusal for a lady who fell and banged her knee.

I felt bad about the guy with the mashed fingers later. He said his fingers just felt numb. He was in no pain. The fingers were already a little swollen. I didn't palpate them. I let my partner tech the call. No pain, no morphine. But then by the time we got to the hospital, he was starting to feel the pain, but we were already walking down the hall. They put him in the waiting room. I would have liked to have seen the xray. When my partner checked on him later, they said he had gotten angry about not being seen quicker and had left. If I had given him some morphine, he'd have gotten a bed right away, had his hand looked at quicker and not had to endure the onset of pain. I like tecking all the calls because I get to assess the patient longer and can find out more information, some of which as it unfolds changes my impression and sometimes treatment. If I had teched the call, I probably would have gotten the morphine out and ended up giving him some as his pain started to unfold.

***

I continued my Spanish food cravings, getting pork and fried green plantains -- tostones. Very good, except the lady gave me lots of pork skin, which was excellent, but very fatty, and gave me a brief stomach ache like I had a knife in my gut for a little while.

***

They asked me to train a new hire starting next week. He is just an EMT, but I guess they have so many new people coming on, they don't have a slot for him to hook up with a field training officer. Since I am a medic preceptor, they asked me. I had no objection.