Tuesday, March 22, 2011

More Old Business

 One of the posts, or rather series of posts, that have gleaned the most readership on this blog is the group of posts regarding my experiences on my paying job with respect to setting up a proper response system for my co-workers in the event of an injury or medical issue. I summarized it with this follow-up last month.
 Now the only reason I bring this up is because these posts continue to get hits, so I figure there is still some kind of interest. For those that may be following this saga, I thought you might be interested in the next installment:
 A couple of days ago we had a "CODE 88" in the plant. CODE 88 is the catchy term the ESHW came up with for an announcement to alert the First Responder Team to an emergency somewhere in the plant. They get on the paging system and announce "ATTENTION, THERE IS A CODE 88 IN THE WINGNUT DEPARTMENT, I REPEAT, THERE IS A CODE 88 IN THE WINGNUT DEPARTMENT."  (No, we don't have a wingnut department.) This should bring the whole team with the equipment (Trauma Bag and an AED or two). I had conducted drills just the day before this incident for both the day and night shift. We set up a scenario of some sort of accident and let them work through it. It is useful and keeps them thinking. These are laymen, and trained in First Aid, CPR, and AED. Their job is to cover the first 5 minutes of the job, get the notification out, and direct the responding unit(s) in to the proper location in our large plant. They actually do a pretty darn good job, even though they lack confidence in their skills, I am impressed with the quality job they do. I trained them as best as I was allowed with the thought that if I go down, they are taking care of me, and unlike anybody else in the plant, there will be no EMT responding from inside the building to help me out. I am the only one with current rescue experience and training.
 So, if you recall, the powers that be had me remove all my 'advanced BLS equipment' from the building such as OPA's, NPA's, BVM, Blood Pressure Cuff, Stethoscope, oral glucose, etc. Whereas I did comply and removed all that stuff "which I might cause harm with" from the trauma bag a I keep in my office (my stuff), I did a little foot-dragging on taking it out of the company trauma bag. I just kept 'forgetting' to get it done. My memory is not what it used to be, it seems.
 So we get this CODE 88 called and I can hear the fear in the person's voice that made the page (it wasn't excitement, it was definitely fear). I lefte my office and start walking toward the area. I see lots of folks running and nearly got sucked up and started running myself. Nearly. So I get there and find a co-worker in severe chest pain and distress, sudden onset, 10/10 pain, she can't even lift her head to look at me. Nobody on my time can think of anything to do in the way of treatment. They have all jumped on the physical tasks quickly. They made the 911 call and gave good info to the dispatcher, they have sent folks to guide the Fire and EMS folks in, and they have cleared some working room, but treatment, nada.
 That's because there was nothing they could do in that vein within their training. They all looked at me, as usual. I got down on one knee and started talking with my patient, I went through the pain stuff (severity, quality, radiation, onset, etc.), got her medical history, meds, pulse, respirations, and anything else I could think of. Now we are waiting. I am not getting a good idea of what is going on and I don't like not having a B/P or knowing her O2 sats. I now there is a B/P kit in the bag next to my foot so I pull it out and do the deed, which I was told I was not allowed to do. I get 130/68. OK, I am relaxing a little. Fire (BLS) shows up, I go through the information I have and offer the written copy I have to the EMT, he completely ignores me. He doesn't listen to anything I offer, just shoulders me out of the way. "OK, asshole", I think, "I'll just have to work around you" so I reach behind him and grab the airway bag, set up the O2, put a mask on and fill the reservoir, and set it on 15 LPM (12 wasn't an option on their cheap regulator) and hand it to the tech. He looks at me and says "You've done this before?" "Yeah" I said, "Former Lt. and Captain for several years at Podunk EMS, now Fire Lt. at the same Department, County EMT of the year in 2007, Nationally certified Fire Service Instructor Two, County Fire Instructor. Any other credentials you need to hear, or can I give you a turnover report now?" He apologized and changed his tune. The medic came in, another one with an attitude who only brought half the equipment she should have. (Who does an industrial plant call for a cardiac issue and leaves their stretcher in the rig, 500 feet away?!)
 So we finished the job and sent our patient off for definitive care. As I was cleaning up and packing the gear, the EHS Boss was standing there and saw me folding up the B/P cuff. I caught her eye. This was the cuff she had told me I needed to remove from the building. I rolled it up and put it in the bag. "You know", I said, "You might think you saw me doing a B/P, but the truth is I was just checking her circulation, it just LOOKED like I was taking a B/P. Besides, I REALLY needed to know in order to get a full picture." I waited for the lecture that I knew was coming and would include some political double-talk.
 She looked at me, looked at the cuff in my hands, then looked down the aisle where the stretcher had just disappeared around the corner. She then looked back at me and said "I'm sorry, I have no idea what you are talking about. By the way, nice job, we're lucky you were here."
 So, I am assuming that I am safe in going with my original plan: If the outcome is good, I can do whatever I see fit (within protocols, of course), but if the outcome is bad, I am on my own. I can live with that, I just hope all my future patients can.


  1. Strong work. They need to teach listening skills in EMT/Paramedic courses. You would be amazed (well, maybe not) at the positive reactions I get from making eye contact, and keeping my mouth shut for the first minute of so when I arrive on scene, especially in a big plant where the people have been with the patient a lot longer than me. Not only do I get a positive response from the coworkers, I actually learn something about the patient!

  2. Wow, learning about the patient! They should teach that in a class or something, oh wait......

    Yeah, it was funny after the fact. I didn't mention that I had sent somebody to meet the medic and specifically tell him/her that we had a cardiac, please bring the drug box, monitor and stretcher. (It's a long walk to be making second trips.) The medic brushed my messenger aside and said "I need to make my assessment first." I had to go get their stretcher for them.
    When the medic arrived I gave her a brief report and told her that the b/p was 130/78 so she was clear for NTG. Again I was ignored and the intro didn't get on board until 2 minutes out from the hospital. For this patient, it offered almost complete relief.
    Follow-up: the pt. is still undergoing tests, but the Doctors tell her she has some kind of cardiac issue, they're just not sure what it is yet. She was in the Hospital for 36 hours.
    Thanks for checking in Cap, it's great to hear from you. I hope your partner is doing well now that's he's back in the saddle.