Day Five - Such a Storm

I tell myself no surprises today. I get in my ambulance an hour early and check it out from top to bottom, then set it up the way I want it. I am pleased to find this ambulance has Haldol in its jump kit -- a day too late. The ambulances are from many states as is the gear, so each day is an adventure in what you will have to work with. While the Haldol is the good news, the bad news is the intubation kit only has the crappy disposable intubation blades (We tried them a few years back and had several cases of the blades bending) and an old Life Pack 10 lacking even the hands off pads. If I have to shock someone it will be the old fashioned way, lubing up the paddles with gel, and pressing them hard against the chest. BAM! I do confess I liked doing it that way.

Our first call is to one of the relief centers where we were at two days before, the one with the army people. I get an awesome report from the army medic, top to bottom assesment, history, almost down to the color of the patient's last poop. I complimented the medic on it. I was very impressed. The patient is an obese woman in her late sixties with some breathing difficulty. She is supposed to be on oxygen at home, but since the storm has had no power, consequently no oxygen. She also has been out of her inhaler. I give her a treatment and she is doing much better. As we go to the hospital we have a bit of a dialogue, though I have a hard time understanding her deep Mississippi accent. Here's about what it sounds like:

##############Since I was a chile##############such a storm################our boys over there######that man.#######################Thought I'd never see the day#################################It done takes the cake.####

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More traffic. Unbelievably slow.

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We get called for a guy who fell off a roof. These calls have been going out all day. There is hardly a roof that doesn't have someone up on it, working to repair or replace it. The man has fallen through the roof and landed on concrete twenty feet below. He may have had a brief period of unconciousness, but he remembers falling and is complaining of pain in his side and back. He has some welling and redness on his left flank. When I palpate his pelvis he feels pain and he can't lift his legs without pain, although he is able to move them. I find it curious that he already has a c-collar on while we are the first unit there. We c-spine him, and take him on a priority to the hospital. He is grey, clammy and has a pressure of barely 90, yet he is thanking me for coming down to help, and asking me where I am from. A little poke, I say, as I put a 16 in his wrist. That wasn't a little poke, he says. Sorry. He keeps his good manner.

It turns out he has a broken pelvis, broken ribs, and later a hemothorax. My partner solves the mystery of the c-collar. It seems a fire truck came by, ran in, put a collar on the guy, then said they were actually on another call and help would be there soon. Interesting.

We get sent on a priority one for an unknown and I don't know whether they have us in the wrong area or all the other cars on on calls, but it takes us 40 minutes to get there through the traffic, through my misreading the map (our map books were by quadrants, so you had to keep flipping pages), and one street sign turned around pointing the wrong direction. Anyway, it turns out to be a psych. He is bipolar and we have quite a conversation. He is down on a mission to help people, but claims his partner is holding all the cash and he hasn't been able to afford his meds. I'm sure his partner has a different story. He is from Boston and we talk about the Red Sox and before the ride is over I am assured he is personal friends with half the most famous sports figures in New England History.

Our last call is for a possible stroke. It is a small ranch house on a street just a block or two from other streets where all the houses have been destroyed. We find a woman in her forties sitting in a chair like she is paralyzed. Her mouth is shaking, her eyes look very scared, and she is crying. She seems very spastic. But her pupils are equal and reactive, her skin warm and dry, her grips equal. She can answer me in brief words, that are not slurred. The neighbor who called us said they were talking about their lives and they were both crying, and then suddenly she started acting wierd. She tells us the woman's boyfriend in on an off-shore oil rig. There is a new hurricane, already named Rita that is threatening to be as big as Katrina. I don't know what to think. The woman's pressure is good, but her heart rate is in the 140's. I'm guessing it is some sort of psychological episode, but I work her up anyway. IV, 02, monitor. At the hospital, when I walk by her room, she follows me with her eyes.

We have spaghetti for dinner. Every one is talking about the hurricane and where it will hit. It is projected for Texas, but one big turn to the right and it will right at us. "I hope it hits us," one of the guys says. He lost everything in Katrina. "We're already destroyed. No one else should have to go through that."

There is talk of moving some resources to Texas. I think about what the company has set up here and I have to hand it to them. I don't know what kind of arrangements they have with FEMA, but whoever is in charge of seeing that things get done in Mississippi, can easily put a check mark by EMS and say, "We got it covered."