I'm precepting a nice young man who is very on the ball. He knows his protocols better than I do. I ask him the dose for Cardizem. He rattles it out. .25mg/kg first dose. .35mg/kg second dose after fifteen minutes if the first dose didn't work. Once the rate slows, you run a drip at 5-15/mccg/min. I glance down at my cheat sheet. "Yeah, that's right. Very good," I say.
He is as advanced as anyone I have precepted. He hits all his IVs the first week, runs the calls smooth as can be. I mean we are not doing codes, but still, he handles the routine ALS like a pro. In the second week, I bail him out on two IVs, but at least as far as treatment goes, he is still right on the ball, and the IVs were hard ones. I was lucky to get them myself.
"You know you're going to have a puckercall one of these times," I say. "Don't get too comfortable. Things don't go this smoothly."
"I know," he says. "I'm waiting for it."
We get called for difficulty breathing. When we pull up, we see the garage door is open. A cop comes out of the door in the garage and says, "Bring it in here. She's a little short of breath. Feels a little dizzy. I've got her on O2."
I let my preceptee go in to assess the patient while I help our other crew member try to manuever the stretcher in. We take the moniter and bag off the stretcher and set it down on the concrete floor.
The woman doesn't appear too badly off. She doesn't want to go to the hospital. She says she just passed out, and doesn't know why, but she is all right now. She appears extremely anxious about leaving her home.
My preceptee is persistent and gets her to agree to go. We get her into a johnny-top and while our crew member folds her clothes and tells her she will bring them with us to the hospital, the woman gets anxious again, and says she needs clean clothes, so we have to help her get clean clothes from the dresser by the door. We finally get her on the stretcher, and she is now worried about locking the house.
She tells me I need to hit the garage door button on the inside of the garage door, then go out through the front door. I tell her not to worry about it, I'll take care of it.
As they wheel her out into the garage and then out onto the drive where the ambulance is parked, I hit the button that closes the garage door, then I go upstairs and out through the front door, making certain it is locked behind me.
I open up the back doors of the ambulance to see how everything is going. "Where's my gear?" my preceptee says frantically.
"Ahh, You don't have it?"
"No, I thought you had it."
"I don't have it."
We look back at the garage door that is closed. I walk over to it and peer in through the window. There is the monitor and gear pack that holds all our medicine and ET supplies. I lean down to try to lift the garage door up. It doesn't budge. I walk over to the front door. I try to turn the knob. Locked. I walk back to the ambulance.
"They're in the garage. It's locked. Does she have a key?"
She doesn't have a key. Who does? Her daughter. They can't reach her on the phone. The cop has left the scene to respond to a car chase in progress. I look at the patient. She is definately short of breath despite the oxygen. My preceptee looks panicked.
"Let me check the windows," I say.
I am pretty good about holding off panic. Not admiting trouble. Besides, I tell myself, I didn't leave the gear. But then I think, well I am sort of responsible. I was the one who locked the doors and I am the preceptor.
The windows are all locked. There is no key under the flower plants. I try the doors again. Locked. I stare at the front door. I take my wallet out and take out a credit card. Well actually my plastic Wampum card from the local casino. I try to credit card the door.
There is no deadlock and there is just a little give in the door. I have credit carded outside apartment doors before, but never a front door. As I sit there working the door, I feel sort of foolish like what kind of idiot am I banging up my wampum card trying to open an obviously locked door. The door opens.
Whoo-hoo! I walk right in, go down the stairs, into the garage, pick up the monitor and gear bag, go back up the stairs and out, locking the door behind me.
"You're lucky you have a resourceful preceptor," I tell me preceptee, as I hand him the monitor.
He looks enourmously relieved.
"How did you manage that?" my crew member asks.
I wave the wampum card. "Let's just say I am well read in many fields. Someday I'll teach you how to pick the lock on the narc box with the clothespons from the triangular bandage package."
I am very proud of myself obviously.
"Why don't you get in front and drive now. We've been here long enough," I say, then to my preceptee. "How's it going?"
He is dripping sweat. "I can't get an IV," he says. "If you can, I'll consider you a god."
Naturally I take him up on the challenge. As we hurtle to the hospital, I inspect her arms. "There's a little one right here," I say, pointing to her hand. "I think I can get a 22 in here."
Aside from my growing interest in cat burglary, my secret pride is my IV skills. I am a good paramedic -- not a neccessarily great one, but I am a great IV tech. My goal is to put an IV in a stone. But as I rub an alcohol wipe over the woman's hand, and look at the flimsy little vein, I am starting to doubt myself. But no, I think, I just credit carded a door. I can do no wrong.
Bottom line. You got it. I missed.
Not a god today.
"I feel better about missing now," my preceptee says.
"Just don't leave your gear behind again," I say.
