2nd anatomy guru

We arrive to the crappy 4 plex in the crappy part of town. I am tired since it is almost 2am and this is the third call since I tried to go to sleep. We find our frequent user of EMS sitting in a living room chair. The original complaint was shortness of breath. I say hello and ask our 21 year old patient what can we do for you? She answers with a verbal dissertation covering her life events of the last 24 hours. In the middle of this she mentions that she has been short of breath since her doctors appointment at 1pm. Fantastic. Did you ask your doctor about this? I ask and she answers "No, but my oxygen level was low today" Me: "How do you know?" Her: "My face gets warm when my oxygen level drops; and that is what happened tonight" Me: "You don't seem to be having a difficult time breathing or speaking and your oxygen levels are 97%." Her: " I know, I told my brother to get me some water. I drink water when I am short of breath because I know there is oxygen in it"
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If you know your anatomy, clap your hands

40 something woman calls 911 and advises the dispatcher she is in active labor and delivery is imminent. A total of 9 responders in 4 vehicles respond code 3. Upon arrival I make entry into the small house. I find our patient writhing around the room in "discomfort". Attempting to guage the urgency of this call I ask the usual questions about previous children, contractions, mucous plugs and amniotic sac. She responds she has 3 children, she has no idea about the timing or length of her contractions. I have to repeat the amniotic sac questions several times. Still not getting an answer, I begin using the term "bag of water". She asks "whats that?" I (as a male) start to explain to this mother of 3 what a amniotic sac is and what happens during labor. I ask again to get a "yes, well, I think so. I mean, something has come out but I am not sure" I realize she is not having any contractions during this time; and she is no longer writhing around on the floor yelling about her discomfort. So all the extra people and vehicles are canceled as our patient walks out to the waiting ambulance. She finally has a witnessed contraction lasting 30 sec. Am I the only one that thinks this was a wierd conversation to have with a mother of 3???????

fighting with your lover?

It was about midnight and the temperature was below freezing. The engine was busy, so the ladder and rescue get tapped for a motorcycle accident on the interstate. The posted speed limit is 65mph on this highway. On the way we were discussing who would be out riding in this weather and that something wasn't right with the dispatch. As we approach we find a young female patient lying on the side of the freeway. She is dressed for party time (light half shirt and stretch pants), not motorcycle riding. Upon arrival our brothers in blue confirm no motorcycle accident, the patient "fell" out of a car. Quick look for injuries reveals nothing obvious with the exception of road rash from her chin to her knees. So we are packaging our patient for transport, and we get the story: she had been drinking(duh) and fighting with her boyfriend when she jumped out of the car to show him. I asked what she was showing him but she did not answer. So I start asking rapid fire pertinent questions to assess her level of consciousness i.e. address, phone number, where she was, birthday,etc. I then ask her what's her boyfriend's name. She says she doesn't want to answer. I ask why and she replies she doesn't want him to get into trouble. To which I reply: Why? It's not his fault you jumped out of his car.

Smokers, gotta love em!

My rescue company was on a call with the private ambulance at a convenience store in a near by district. The call was entertaining enough with a drunk patient who could not get their head around how they ended up on the floor. When one of our frequent flyers walks by (without making eye contact). She is well known to ems providers in the neighborhood for shortness of breath calls. She also has a laundry lists of medical problems mostly related to smoking. Today while shopping, she is carrying a medium sized oxygen cylinder (not designed to be a portable) and a oxygen concentrator. She has a nasal cannula in her nose and a nebulizer in her mouth. The neb is completely empty of any albuterol,saline or any other medication. The clincher? She is bying cigarettes! (inner dialogue) So about what time will you be calling for shortness of breath?

If your erection lasts more than 4 hours.....

Where I work we have a heavy rescue squad that is equipped with all the heavy rescue tools you can think of. Second in line for heavy rescue is our ladder companies. A couple of these units together are capable of some extreme rescues. They were called to the Level 1 trauma center the other day for a man who was being flown in from a nearby town. Apparently this individual thought it was a good idea to use a heavy duty commercial grade bearing race as a cockring. Once the desired affect was achieved it was realized that removal was impossible. I am sure this individual waited a good long time before seeking medical attention. This was possibly occuring since the night before. Small town hospital called for an air ambulance after the small town ER ring cutters didn't make a scratch. Our crews were called to the trauma center after additional failed attempts with manual ring cutters. Hydraulic cutters were not an option, (ouch) so last the FD heard the pt was being prepped for a manual drainage (syringes) procedure that will likely result in scar tissue and varying degrees of dysfunction. Poor bastard.

How do you know when you have had too much to drink?

So we met one of our local "urban outdoors men" the other night at a very convenient 2am. Our outdoors man was found to be under the influence of alcohol. I was surprised as well. Being the consummate professionals that we are, we initiate a thorough assessment. And as we are performing a mostly rhetorical interview with our pt, we notice there is a quarter in his right ear. So I ask our patient if he knows that there is a quarter in his ear. I assumed this was an appropriate question for this gentleman. He opens his eyes and looks at me like I have second head. He slurs at me the quarter is to indicate when he has had too much to drink. Obviously being new to this procedure I ask for more information and he was nice enough to enlighten us. The quarter in the ear remains until the wearer's gait becomes so unsteady or rapid contact with Terra firma, the quarter falls out indicating terminal intoxication. Now this is where the details are a little fuzzy. I was unable to learn if the indication is the sudden absence of the coin or the sound of the quarter hitting the ground. Or if the wearer has reached this level of intoxication, how are they supposed to hear or notice the quarter? And if you only have a quarter in one ear, what happens when you fall on the other side? Apparently this procedure was in the experimental phase and our researcher did not have the quantitative results at time of print.

Halloween 2009

So at about 230 in the morning last night during the full moon, we get dispatched to a motor vehicle accident. As we approach we find 2 trucks with severe damage from an apparent high speed head on collision. We arrive and make our way over to the truck with the most damage and find a female driver with a broken femur unconscious behind the wheel. The engine crew is talking to a beligerent guy from the other vehicle. We extricate the female patient from her truck. She goes with the first ambulance to the truama center. As the engine backboards the male driver, he goes unconscious. So he obviously also goes to the local trauma center. As we pick up the scene we notice a few odd items in the street. The first arriving private ambulance has left all their backboard, airway and oxygen equipment on scene. The police officers are talking about both drivers are likely drunk drivers. (Which is unique that they hit eachother instead an innocent family)And the last item strangely noticable in the middle of the scene? A squished dead black cat that was involved in the collision. Halloween, full moon and a black cat? You just can't make this up.