Rescuing Providence

What in the world have I let my wife talk me into this time?

http://www.warwickonline.com/view/full_story/6617662/article-At-SUNKissT-TANS-get-the-tan-you-ve-always-wanted?instance=secondary_stories_left_column

“Rescue 1, Respond to 677 Manton Avenue, at the salon, for a child who had her ear pierced complaining of “ear pain.”

“Surely they jest.”

“That’s the exact opposite end of the city!”

“That it is.”

We dropped whatever it was we were doing and started the journey. All of the other rescues were out, some gathering drunks from the sidewalks, some taking perfectly fit forty-year olds to the emergency room to treat their abdominal pains and sniffles. It was just one of those days.

“Rescue 1 on scene.”

It took nearly ten minutes but we had arrived. We are required to do an emergency response no matter what the call. I felt silly as cars moved to the side to let us through the busy streets, knowing our reason for endangering the citizenry likely ridiculous. Suffice it to say, I was a bit peeved when our patient, a beautiful one year old with a smudge of blood on her freshly pierced ear was presented to me by her Spanish speaking mother, grandmother close behind, literally screaming, also in Spanish, about the incompetent fools who ran the salon. I think.

I focused on the baby and felt my anger dissipate. Using a trace of peroxide on a sterile 4×4 I rubbed the blood off the ear, rewarded by a giant smile and infectious giggle. My teachers used to tell me that tuning out the world would lead to nothing but trouble, but teachers aren’t always right. My portable came to life as I handed the baby back to her mother.

“Engine 15, Respond with an out of town rescue to 1676 Smith Street for an Infant having a seizure.”

“That’s right around the corner.”

“Let’s go.”

We arrived thirty seconds behind the 15’s. Another one year old had gone unresponsive, turned blue and had stopped breathing. The parents were hysterical, even after the febrile seizure stopped and their daughter began breathing on her own. We helped them. Simple as that. Right place, right time. We took mom and baby to Hasbro Children’s Hospital, dad came later in the car. The baby was fine, but it was good to be close when the emergency happened.

Karma, I guess.

With no support, little direction and blatant  contempt from our Mayor, the rank and file of The Providence Fire Department continues to put of the fires, protect the citizens and handle the ridiculous amount of Emergency Medical calls that pour in daily.

There are no Chief officers in the stations making sure we hit the poles and get out the door in thirty seconds every time the bell hits, no EMS Supervisor on the streets ensuring quality control on the thousands of rescue runs we respond to daily, no Mayoral Staff providing equipment or technology to keep track of these things.

I actually have to apologize to my patients while transporting them to area hospitals, advising them to “hold on tight,” it’s a bumpy ride due to my truck’s lack of suspension. There is no CPAP  http://www.ems1.com/ems-products/medical-equipment/articles/390898-A-Look-at-CPAP-for-EMS/ on the rescues to which drastically help COPD patients. We have no on board computers, relying on seventies era hard copy reports. Our stations are falling apart, paint falling from walls and ceilings, bugs, broken windows and screens, doors that barely open.

With Zero communication between te administrative Chiefs and the firefighters on the streets we still manage to maintain the trust and respect of the citizens of the city, not by the endless press conferences, Mayoral support  and funding enjoyed by the Providence Police Department http://newsblog.projo.com/2010/03/four-providence-officers-on-de.html rather by doing the job we are paid to do, maintaining the highest level of personal responsibility and earning the respect of the people.

I started my career with the Providence Fire Department in 1991. At the time , we were one of the most respected departments in the country. Morale was high, coming to work something to look forward to. Over the years, through complete lack of leadership I’ve watched the department sink to a level I could never have imagined.

The senior members have to lead by example, or the new people will fall into the trap of disillusionment, anger and entitlement. We are fortunate to be physically and mentally able to perform the duties of firefighters. Nothing the administration can do will change that. What could destroy our ambition needs to be fought with every bit of strength we have left. That strength comes from 99 Printery Street, headquarters of Local 799, The Providence Firefighters Union.

Stand Strong, Brothers and Sisters. If we don’t take care of this city, nobody else will.

“I can’t walk.”

“Yes you can.”

She shuffled down the stairs, out the door and into the side door of the rescue, plopping onto the stretcher.

“What’s your name?”

She wouldn’t answer. The wrist band from this afternoon’s visit to the ER was still there so I cut it off and wrote down the information.

“Why are we going back to the hospital?”

“I can’t walk.”

This is where my reports get interesting. I have to come up with some sort of cohesive narrative to give to the triage nurse.

“Pt. is a thirty-seven year old female, found at home, returning to the ER for unknown malady.”

It was the best I could do on short notice. She lived three blocks from Rhode Island Hospital. We moved her onto the hospital stretcher, I started to give my report.

“She can’t walk.”

An alert security guard asked,”Why are her shoes tied together?”

I looked over. He sneakers were indeed tied together, leaving about eight inches of space between them.

I’m going to have to do a more thorough primary in the future.

This month’s Handover is being hosted by Mack at Notes From Mosquito Hill. Stop by and have a look, you’ll be glad you did!

http://notesfrommosquitohill.com/2010/02/the-handover-passion-edition.html#disqus_thread

Wish I’d thought of this years ago. I’ve contacted THE GOVERNMENT, expect to see my sign everywhere within a couple of weeks.

DO NOT CALL 911 FOR ANY REASON OTHER THAN LIFE THREATENING EMERGENCIES.

PERIOD.

Highlights from last week.

Mother calls 911 because her four children have abdominal pain. Coincidentally, she lives 1/2 mile from hospital and called from HER mother’s house, three miles from hospital.

Thirty year old male had a headache.

Twenty two year old female had a toothache.

Forty year old male scraped his hand, wanted antibiotics.

Two year old vomited. Once.

Numerous no damage MVA’s, Dewey, Screwem’ and Howe suggest immobilization and transport via 911 to nearest appropriate trauma center, even though there were no injuries.

Emotional sixteen year old female having cramps.

I could go on, and on, and on…but I think you get the message.

His skin was gray, eyes bleary, shoulders hunched and as stubborn as a mule. Forty-four years old, wearing a denim apron flecked with gold specs thrown from the machine he was operating, obviously hurting. He saw me coming and focused on his work, much like an ostrich sticking his head into the sand.

“He passed out,” said the supervisor.  Twenty or so souls sat in the factory at six in the morning, their lunch pails nearby, fluorescent light casting shadows in the corners, boxes full of medallions and badges, waiting to be shipped. The workers kept working but would steal a glance in our direction now and then before re-focusing on the machines that could easily lop off a finger or two, or crush a hand if not careful.

“He’s new here. He’s got to go to the hospital,” said the boss as the patient vehemently shook his head no and tried to keep working.

“Tell him we have to take him to the truck to run some tests,” I asked an interpreter, an older gentleman that barely understood me but managed to convey the message in Portuguese. Spanish and Portuguese are similar, but not enough for me to make any sense of the conversation.

After the usual negotiations my patient reluctantly agreed to come along, giving in to his new boss’s glare and my persistence.

“I stay,” he said. “I need to work.”

He had worked for twenty-three years in a nearby factory, sitting at the same machine, doing the same job, never complaining, meeting his quota. A good honest man making a living.

The factory closed last week. The bank put a lock on the door, no warning to the people whose livlihood depended on the factory and emptied the place out.

Jewelry is big business in Rhode Island, casting, plating, design and finishing companies once flourished here. Now, only the strong have survived. Empty factory buildings line the once vibrant streets in the Jewelery District. Some have been converted into trendy nightclubs or fashionable lofts, but most sit empty, ghosts of their former selves, hollow shells covered with graffiti and filled with rats.

In a previous life I tended bar in one of the best Italian restaurants in Rhode Island. The owner of the closed factory was a good customer. He and his family stopped by a couple of times a month, drank the best wine, ordered the best meals and left the best tips. Good people, enjoying the fruit of their labor. His company was his pride and joy, and he spent long hours there making it successful.

I helped cater a few parties at his house. I always felt at home there, even though I was hired to do a job. Mercedes Benz vehicles littered the garages, gardens, swimming pools and every luxury you could imagine filled the property, a three acre lot with a giant house in the middle.

Gone now.

The man in my truck was almost gone as well. His blood pressure had spiked to 230/150 in one arm, 240/140 in the other. He said he had a headache but had to keep working, there were no jobs, he was lucky to get the one he had and was afraid to lose it.

I don’t know what saddened me more, the patient’s medical condition, his employment condition or the condition of a friend from long ago whose fortunes had changed.

We took the factory worker to the hospital, hoping he could be fixed. I’m not so sure about the factory owner.

Saturday morning, 10:00. Twelve calls last night, two so far today. Ten yesterday. Seven hours to go. An overdose, heart attack, numerous drunks, a fall or two and a guy who smashed himself in the head with an ax three times before stabbing himself with a key hole saw and slashing his wrists with a razor knife. Those are a few of the calls I remember. MVA’s, maternity’s and kids with fevers filled out the rest.

10:01, gunshots. Rescue 1 and Engine 10 staged at Elmwood and Ontario. Cops speed past. Private auto’s speed past. Two teenaged girls, one critical, the other shot in the arm and shoulder taken to the ER.

10:10, a man jumps to his death from the Crossroads building, narrowly missing the crowd he fell in front of. How he missed I’ll never know.

10:15, a man attacks his girlfriend’s sister with an ashtray and vase, splitting their heads open, blood everywhere, hysterical family members gone mad.

The day goes on, a man gets third degree burns to his legs trying to stamp out a fire that he started.

An elderly lady with the first signs of Alzheimer’s worries she is going downhill. Her blood pressure, normally normal is 225/120, then 230/130 with weakness and facial droop. I don’t think she’ll have to worry about the Alzheimers.

A guy on a bike is struck by a car, at least thirty stitches and some plaster to put him back together.

I left at five. I was full.

Twenty-four hours from now I’ll do another thirty-eight hours.

Maybe things will quiet down.

At least it’s quiet here, at home.

“It appears we have an open and shut case, Mr. Watson! We’re being sent to Pekin Street for a man who has stopped taking his medications.”

“Ah, Mr. Holmes, a quick ride to the hospital and back in service.”

“Elementary, my dear Watson! Tally Ho!”

“There sir, standing by the side of the road. That must be our patient!”

“Of course, Mr. Watson. Who but a man out of medication would be standing outside at two in the morning.”

Watson wheeled the vehicle next to our man.

“You sir! Are you in need of assistance?”

The man, an impeccably dressed forty-four year old walked toward us. He didn’t outwardly appear a lunatic, but Bedlam knows the criminally insane are are tricky lot.

“Let him in, Mr. Watson, and let’s get to work!”

“I’m having chest pain,” said our victim, seating himself on the stretcher.”

“Ah…chest pain. Is this a result of your not taking your medication?”

“I ran out.”

“And what, pray tell is this medication you ran out of?”

“I don’t know, pro..something.”

“Prozac?” I asked, fishing for clues.

“No. I had a heart attack last month. It’s for that.”

“Delusional,” I whispered to Mr. Watson as he prepared to inflate the cuff.

“Are you hearing voices?” I asked.

“No. I’m having chest pain.”

“Mr Holmes! Look here!” said Watson, pointing toward the monitor.

168/120 with a pulsox of 92%. The clues did not make sense. We were sent to this address for a man not taking his meds.

“Sir, I said, chomping on the end of my pipe. “Are these delusions causing your blood pressure to rise?”

“What delusions? I’m having chest pains. I had a heart attack last month.”

“Simply impossible. You’re three years younger than me, thin and vibrant. We were sent for an emotional male who isn’t taking his meds! It just doesn’t add up!”

“Mr. Holmes, perhaps I should look for more clues. A witness is at the door holding a bag of pills.”

“Elementary, Mr. Watson. Gather the clues and bring them to me.”

Mr. Watson returned, spilling the contents.

“Eurika! Plavix. Nitro. Prevastatin. Metoprolol.”

“Sir. These are heart medications! Are you sure your delusions are not actually  chest pains?”

“I had a heart attack last month. They did surgery, put a stent in.”

“It all adds up! Mr. Watson, We’ve got work to do! The game is afoot!”

We started an IV, administered aspirin, nitro and 02, ran an ekg and brought him in.

Another case solved and not a moment too soon!

What Should Have Happened:

An eighteen year old girl, an adult according to law, is admitted to the hospital for tests and follow up for severe abdominal pain. Initial tests lead the doctors to consider kidney stones. Days go by, the symptoms remain, the doctors reassess their initial diagnosis, order more tests and ultimately arrive at the correct diagnosis, treat the girl and send her home to fully heal.

What Could Have Happened:

The eighteen year old patient’s mother, unhappy with the delay in treatment and concerned with her daughter’s progress decides to find a second opinion at a different hospital.Dissatisfied but rational she arranges transportation to a different facility, or takes her child herself in the mini van. The patient is ultimately diagnosed, treated and sent home to heal, days later than if she had stayed in the first hospital but none the worse for wear.

What Might Have Happened:

The eighteen year-old patient’s mother, dissatisfied with hospital A decides to make a scene, drag her sick child out of bed, storm out of the hospital. call 911 and wait for the ambulance drivers to take her child to her hospital of choice. The ambulance drivers show up, spit and polished, calm the mother, carry the patient from the mini-van to the ambulance, start an IV, administer oxygen comfort her and take her to the next hospital.

What I wish Happened:

Rescue 1 responds for a woman ill at the door of Hospital A. Upon arrival they discover a very sick eighteen year old sitting in a mini-van, pale, diaphoretic and just plain looking awful, and an out of control mother outside of the mini-van demanding her daughter be taken to Hospital B.

The crew from Rescue 1 has the hysterical woman held by police for creating a public disturbance, takes the sick eighteen year old away from the chaos, puts her in the rescue and takes her to the emergency department of the same hospital.

What Actually Happened:

Rescue 1 responds to Hospital A. Hysterical woman demands to be taken to different hospital. Rescue 1 tells woman it’s a free country she can go where she wants.  Hysterical woman demands rescue 1 take her. Rescue 1 asks if shs is crazy, or something like that. The eighteen year old sits in the back of mini van, sick and miserable, waiting for somebody to put an end to this maddness. Mother decides to finish this, abruptly gets in the van, slams the door and speeds out of the hospital parking lot without her lights on.

Rescue 1 goes back in service.

Wish I had a Mulligan.