FlightEMS.com

It is an accepted fact in the world of EMS (emergency medical services) that you never mention something bad for fear of it coming true in short order. For example, the fastest way to have all hell come down upon your head is to walk into any random emergency room and state, “Man, it sure is quiet in here!”

After a very in-depth conversation with my preceptor about the management of, and our roll in, a mass casualty incident (MCI) I made the off handed comment that we needed to not discuss these things until AFTER the fact. Too many weird coincidences had already materialized.

Imagine my complete terror when I answered the phone this morning in a half-conscious state and heard my mom say, “Emily, a bus full of kids rolled over a few minutes ago.”

Car and school bus collide

Yes, in a small town, news travels DAMN fast. (It also had something to do with my dad being on scene.) I felt nothing but extreme impotence as I realized that the bus was probably full (due to the time) and my old school district is in the middle of no- fucking-where. The nearest trauma center is a 40+ minute drive and almost every surrounding school was on a 2 hour fog delay. Yes, we are one of the few local flight organizations that can fly under IFR, but response to this scene was beyond even us (if we were called).

My father, who used to work volunteer ambulance went to the scene with his friend who is a volunteer firefighter. The big teddy bear of a man was almost in tears talking to my mother. He was comforting a little girl who was crying uncontrollably from a minor cut on her finger. Knowing my dad, he was almost crying with relief because that was all that was wrong with her.

As the story states, everyone involved was lucky. No major injuries were reported. Believe me when I say I am so relieved that my services, offered to my local hospital on a volunteer basis after I heard what happened, were not needed. It was all I could think to do to help.

I used to be somewhat critical of the local community for fighting a full-time, paid paramedic staff. Now, every time I land on scene, I am more and more grateful that we have so many local folks willing to volunteer their time to make each of us a bit safer. Without them arriving at the bus roll over, those children would have had to wait well past the golden hour for any treatment whatsoever.

As the dust settles, and something else replaces this as the big town story, I will find a particular flight nurse plodding her way down to the local tattoo parlor to have “shut the hell up!” inked in the middle of her forehead.

Talk about the perfect photo to represent my career coming full circle. A bit strange that I was able to take this just days after posting the last two photos.

Flight Nurse Emily, meets Flight Medic Emily…

This is very close to the same aircraft I crewed while on active duty. Main difference? Mine wasn’t nearly as nice as this one.

Apparently this MEDEVAC Black Hawk crew was tasked with escorting a one star general (see small red placard with white star).

Wish I could come up with something more profound. I am just too damn tired.

With my first real flight nurse shift series over, I am still attempting to shut my mind off and come up for air. First priority was to readjust my sleep schedule away from that of the vampires. My second has been to make sense of the last few days.

For the uninitiated (aka: yours truly) the variety of chief complaints was overwhelming. I am an ADULT Acute Care NP. Taking care of kiddos is going to be one of my weak points…that and anything dealing with cardiology. Jesus do I need to be sticking my head in my books.

A bit of terminology explaining the differences between missions: Transfer–pick up patient at one hospital (either on unit/floor/emergency department) and take them to the “Big Hospital” (aka: BH). Scene–patient is picked up at the scene of accident. Cheap Scene–care of patient is transferred to us usually at a rendezvous point, usually via ambulance (patient has NOT been seen in a hospital).

With out further adu, here is how the holiday weekend shook out:

Day One:
Transfer: One month old with apneic periods
Transfer: 70 something female, post arrest

Day Two:
Transfer: 40 something male, self-inflicted GSW to thigh
Transfer: 60 something female, bowel perforation

Day Three:
Transfer: 80 something female, MVC with pelvic fractures, subtrochanteric fracture and (at the time) unknown C2 fracture
Scene: 20 something male, MVC with dusted C2, C3, right wrist fracture, post code
Transfer: 1 y/o male, respiratory arrest due to mechanically obstructed airway

Day Four:
Cheap Scene: 40 something male, head laceration/possible seizure activity

Although I am understandably overwhelmed with what I was exposed to, I am so happy about the amount I was able to learn. Imagine learning more in four days then in over an entire year. I know that this is just a sketchy list, but there are stories to be had here.

Teaser: One of the above patients was my first experience at a real life saving intervention. This was the first time in 13 years that I can actually say “we” did something dramatic that was the IMMEDIATE difference between life and death…

Over the past years of my medical career, I have committed to memory those things which were useful in practice depending on the position I was in. Overall, I simply despise memorization for the sake of memorization so would learn enough for whatever test was next on my schedule. By taking this flight position, I am not only facing some of my past demons but am also tackling my inadequate knowledge base like a pee-wee field goal kicker taking on an NFL lineman.

Over the past two shifts and four flights, I have come face to face with all of the things I don’t know. Hell, tonight even doing a simple patient assessment was a challenge. Granted, it WAS at 3 a.m. and the first time my preceptor has given me the reins. In my heart I feel like I failed miserably. In my head I know that this is truly day number two and I need to give myself some slack.

Patrick always laughs at me when I get the “cherry syndrome.” (Cherry Syndrome: orientee suffering from knowledge deficit disorder, related to patient care situations not previously encountered.) When in the SICU I came home one night and expressed great fears that I would never be able to learn/manage everything. He constantly reminds me that within 3 months I was begging to be off of orientation. After 6 months I was getting somewhat bored.

I don’t think boredom will be an issue for quite awhile (never) with this job.