Sunday, December 15, 2013

Trained for This

Right outside my house, an elderly lady tumbled off a curb in her wheelchair in a poorly lit area. She screamed in pain for help and thought that her legs were broken. Her screams alerted a few people, including the elderly woman's daughter. She asked someone to call 911 which I did and an ambulance was dispatched. They arrived and started checking her for blood, breaks, head and spine injuries, etc. One neighbor turned to me and started commenting on their work.

"I've been trained at this. I took a few EMT classes a few years back. (inhales cigarette) The best thing to do right now is to not panic and that's why I'm smoking."

"Really? That's why you're smoking?"

"Look at them. She's showing signs of shock." (inhales cigarette again)

A paramedic calls out. "Blood pressure is 182/120, heart rate 82."

(What I think: Shock?! She's coherent, answers questions appropriately, and is not hypotensive or tachycardic. And you think he's in shock?! What did they teach you in those classes you took? What is in that cigarette you are smoking?)

At about that point in my thought process I realize that I was doing to him what my preceptors must be doing to me -

"You want to keep giving him metformin?! With a creatinine of 1.5?!"

"You don't think there's an ischemic cause for his chest pain?! With a troponin of 0.4?!"

"You want to increase his O2 sat by giving him even more oxygen? With a 50 pack year history of smoking?!"

"You want to immunize this kid even though he finished steroid treatment for croup one week ago?!"