Yesterday my preceptee didn't come to work. He told me he might not come in. That was okay because he is pretty much done. We're just waiting for the hospital coordinator (who officially cuts him loose) to come back from vacation and sign the paperwork.
The truth is it was great being the medic again. While I love precepting, I also love being a solo medic. You get tired of standing back watching someone else handle the call. I like talking directly to the patient, putting my hand on their forehead, feeling their skin temperature, then holding my finger tips at their wrist, feeling the pulse waves from their beating hearts. I like having them look to me to help them.
It was a busy day, back to back to back to back calls. Nothing out of the ordinary, but all with their own unique challenges. A possible broken arm, a case of vertigo, an elderly fall with change in mental status and a rapid afib causing weakness and lightheadness.
I carefully splinted the woman's arm, which wasn't deformed, but had point tenderness near the elbow and was causing her to wince when she moved it. I used a cardboard splint, some towells as padding and an ice pack. Her pain wasn't great when she was still -- only a 2 on the 0-10 scale so I held off on morphine.
The woman with vertigo and nausea I gave Zofran, making certain to push it nice and slow. Her nausea cleared up and she only felt a little dizzy.
The elderly man who fell had severe kifosis so we had to really pad him to get him comfortable on the board. He ended up in the trauma room. It was an unremarkable fall, but he wasn't the same person afterwards as he was before so he really did need the special attention that comes with being an alert. I am curious what his CAT scan showed.
The man with rapid afib was on a beta blocker so I got to use Metoprolol for the first time. Our new protocol calls for Metoprolol for rapid afib before Cardizem if the patient is already on a beta blocker. I felt the excitement I always do at pushing a new drug or using a new devise for the first time. I pushed it slow -- over five minutes, but it didn't seem to have any effect. He was still cranking along in the 160's-170's. We were at the hospital in a short time so I was still waiting to see if the Metoprolol would kick in by the time we rolled through the doors. They ended up giving him Cardizem and that did the trick.
He and his family thanked me afterwards. When I was walking out the woman who'd had the vertigo was in the hallway with her husband who was getting ready to take her home. She thanked me also, and introduced me to her husband, who shook my hand, placing his other hand on top of mine as we shook.
Back at the station, I restocked the truck, and then punched out. Driving home, I thought I would surely miss this work if I couldn't be a paramedic anymore.
