Sun Spots/ The Pinch

There is a sun spot storm or some other kind of atmospheric flareup going on today because the radios are terrible. Can't hear anything but a lot of garble.

We've done two transfers to start the day. I put the stretcher back in the ambulance while my partner finishes the paperwork inside the nursing home. I notice we are missing our portable 02. I ask my partner if we left it in the nursing home or back at the diaylsis center.

The diaylsis center, he says. He knows right where he set it down.

We clear and tell dispatch we have to go back to diaylsis and get our 02. We hear some static from another car, who I think says they have our 02. Instead of arranging a hookup, dispatch sends us to a motor vehicle. I'm not too comfortable going on a call without portable 02, but it is a nonpriority motor vehicle, so I figure okay, we won't need it on this one. We'll get it later.

By the time we get to the accident on the other side of town traveling with regular traffic, we get canceled. We ask again about the 02, but are sent on a priority one for the unknown. I say we don't have portable 02, the dispatcher says they are holding priority ones. I ask if a supervisor can bring us some 02.

Again, the radios are full of static so I am hoping they are just not getting what I am saying, instead of hearing it and ignoring it. We ask if Fire is going to be at the call, figuring we can use theirs. No, it is a private emergency. I am very uncomfortable about having no 02 going into an unknown. As we put ourselves out on the scene, the dispatcher asks us to let her know if we need a paramedic.

Several years ago they moved our local dispatch to a statewide location. As a result, we don't know the dispatchers well and they don't know us. I have been a paramedic in the city for ten years. The dispatcher ought to know me by my voice. I'm guessing she is new and there is an error on the daily roster sheet that lists our car as BLS. I tell her we are medic truck and she seems pleased that she won't have to send us any help. She has forgotten about our 02, but fortunately a fly car medic that had overheard our distress calls for 02 is pulling up and leaves us a tank, which we use as our patient is diaphoretic with an altered mental status.

We aren't at the hospital fifteen minutes when we get paged for a priority one call. The problem is we still have a patient on our stretcher. Another crew coming in with a patient tells us they are calling for us. What are we going to do?
We get our patient on the bed, but then get a page cancelling us from the call. I am still writing my run form when we get a page for the next call -- another emergency.

We get out to the ambulance and tell them we are clear, and the new dispatcher asks what time we are getting off. I say not until a time four hours away. Okay, he says. I ask about the call we have been given. He sounds puzzled, but then looks at the board and says, yes, there is a call for us. A seizure. He apparently has just come on duty.

We sign on with the city, and they acknowledge us, and since there is no request for an ETA, we assume it is probably no big deal. The fire department is there, and the fireman left with the truck, tells us they are walking the patient down.

I see a mother carrying a child of about four and for a moment I panic. The child appears limp, and I recall a call I did several years ago, where I saw another mother carrying a child, also limp, as she walked with firefighters out of a house and toward our ambulance, and I ran to the child and tore her from her mother's arms, and started CPR and rescue breathing because I knew the child wasn't breathing, and she was in fact, in arrest. I don't quite get that feeling today, but I hurry my step, and when I touch the child she opens her eyes and starts to cry. The firefighter says she had a seizure, full tonic clonic, but that she cries, then goes completely unresponsive. I take the child from the mother and when I lay her down on the stretcher she is out cold. The hand drop smacks her in the face. I open her eyelids. Her eyes are still, seeing nothing. She's breathing though and has a good pulse. The mother is not the mother but a babysitting aunt, and she is very upset. This has never happened to the girl before that she knows of. The girl feels hot. It has to have been a febrile seizure. The fire guys look concerned. I'm concerned, but then I remember an old trick. I take a little bit of skin around the belly, and pinch it lightly, then turn it quickly as I pinch hard.

Wallah! The child opens its eyes and begins crying. It's eyes focus on me in terror.

I feel much better now.

This is a move I learned years ago from an ER physician at the Children's Hopsital. I had come screaming in lights and sirens with an unresponsive kid. The triage nurse was also freaking out when she saw the kid, then the doctor came over and did the pinch. The baby started crying and the doctor smiled and went back to his other patients. Later every time the doctor walked by the room, the kid started screaming again.

Countless times since I have arrived on the scene of unresponsive small children to find every cop car in town there and everyone frantic. I do the pinch, the baby opens its eyes and cries, everything is okay.

Bottom line, the kid has a febrile seizure, which tires the kid out so it just drops off to deep sleep. The pinch brings her back around.

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Seven calls, two cancelled, the above calls and a pancretitis.