Saturday, January 31, 2009

He said "Uh Oh"

He was young, way to young. 19 year olds are not supposed to be dead. Instead, he was supposed to be healthy, innocent, free, dreaming, imagining himself invincible. Now, he was tangled in a web of poor choices, poor decisions, bad rearing, inner-city crime, and violence that I couldn’t even begin to wrap my head around.
It was a horrible tragedy, never should have even begun. He had plans, dreams; he was going to escape the web that bound his entire family. He had scholarships, colleges, roommates, all lined up. An escape route planned, now thwarted by someone else’s twisted self.
I couldn't even begin to imagine the blasé attitude of those on the scene. To stand there and watch him get shot like that, by someone who was laughing. I couldn’t even begin to wrap my brain around it. Mom, siblings, girlfriend, friends; never stopped the other guy. In fact, they all initially helped make up a story about him shooting himself
EMS was called for “a guy not acting right”. Initially, he acted like he was drunk and high. Everybody else there was, so why not him? Except he didn’t smell like alcohol. Toxicity screens later proved, and 1 friend onscene said; he was totally sober. He had shown up at his childhood home, simply attempting to get in touch with his family, keep connected to his roots. They couldn’t stand the thought of him bettering himself, and shot him in the head. The poor EMS providers, they initially began trying to treat him as a drunk/high patient. Then, someone noticed the bullet hole in his head. Police were not even on the scene at the time. Then, the gunman scared them all by showing up and telling them what he had done while brandishing the gun. EMS quickly removed the patient and fled to the ambulance, while having to listen to the jeers and callous remarks of those who had stood there and watched the whole thing. PD soon arrived and dispersed the crowd so they could pull out and leave.
He was initially awake, but slightly confused. During the twelve minute transport, he quickly became unresponsive. I was the trauma nurse, me and me alone. Supposedly there were to be 2 of us, due to his condition. However, due to staffing, it was only me. Plus I had 4 other beds with sick, sick patients. Stressed already, my heart rate accelerated when I saw him; pale, thrashing, confused, mumbling. By the time we got him on our stretcher, be began posturing with his arms. He looked up, looked in my eyes and said “Uh oh”. Those were the last words he ever said, and I was the only one who heard them. Heard his last words as that bright, beautiful life was snuffed out in a senseless act of violence.
His eyes slowly rolled back as his limbs stiffened and then curled into posturing. Soon, they straightened out into even more ominous posturing. His BP sky rocketed, and his heart rate plummeted.
We worked as hard as we could, using all the resources we could. A second nurse stuck her head in, and was soon sucked into the activity.
We ran him to the CT scanner; while the neurosurgeon started scrubbing for the OR. I stood at his side, in a lead apron, and pushed Mannitol in as fast as I could while they scanned his head. Quickly, quickly we worked.
He briefly started to improved, then crashed again. Before we could get him to the OR (8 minutes door to OR), his heart rate plummeted again as his brain herniated.
The OR team was standing ready as we crashed through the doors. They were joking as they attempted to remove his skull fast enough to save him. It was all to no avail, he died on that table. He was spared the horror of a code due to the bullet in his brain. His CT looked like “brain mush” as one CT tech put it. Saving his heart wasn’t going to fix his brain problem. The OR team continued laughing, joking, as they cleaned up the mess.
I wanted to stop them, tell them of his last words, his dreams and aspirations, and the abrupt end of them. This was a talented, bright young man destined for brilliant success killed in senseless inner-city violence.
We called his Mom, who had watched him get shot. She said “another one dead?” totally apathetic. She never came to see him, and nobody else did either. We were the only spectators of the end of that bright, young life. We wheeled him down to the morgue, and left him there, alone, dead dreams crashing down around him. I was certain that if I stayed and listened, I could hear them slowly falling and crashing around his stretcher. Hear the cries and echoes of those who would never know of his brilliance, his friendship, his healing touch. For he had planned to be a doctor, he was headed to medical school. He had scholarships for all the way through.
Meanwhile, we went back to attempting to save those who did not want to be saved; leaving him, alone, dead-the one who wanted to live was gone.
It felt like such a failure, although we couldn’t have changed anything. Those words echoed and reechoed for days: “Uh oh,” “Uh oh,” “Uh oh,” words of desperation, words of hopelessness, words of one caught in a tangled web.

Thursday, January 1, 2009

NREMT-P Coming to your town!!!

I did it! I am officially an NREMT-Paramedic, and I have the card and patch to prove it!

I passed every one of my practical stations on the first try. I was still sick with mono, but I made it to the exam and passed every single station! I was proud of myself :)

I took the written exam 3 days later, and passed it with 82 questions in 45 minutes! The National Registry posted the results about 5 hours later on their web site. I wasn't expecting the results for several days, so it was a pleasant surprise to see it that day.

I received my card in the mail about 10 days later. I spent awhile jumping up and down and showing off my patch like an excited little kid :)

Now, I have sent off the stuff required to receive my state certification and am awaiting the card. I can't wait to start precepting at the rescue squad. I get so tired of sitting in the back and being unable to do the things I can do in the hospital. Last night, we joked about raiding the post office and grabbing the card so I could work a cardiac arrest that we were headed to. There were only 2 of us, and both were EMT-Basics, so it would have helped to be able to use my ACLS skills. Fortunately for the patient, the PD arrived before we did and found him merely intoxicated. He went to jail, and we were cancelled before we got to the scene.