Tuesday, April 14, 2020

Aliens

 A busy day in the city yesterday. I was in the fly car, which means I listen to the fire radio and dispatch myself to priority one calls. Because the fire department get the calls before our ambulance dispatchers do, a self-dispatched fly car medic helps considerably with the response times. Since I am already in my vehicle, I am often the first one to arrive. If I get there and the call turns out to be an accident with no injuries or a presumption/dead body, I can call off the ambulance. If it the ambulance gets there, but it turns into a refusal, I can take the refusal and get the ambulance back in service. If a crew needs a lift assist for a bariatric patient, I go help. If a BLS crew needs a medic, I can intercept with them, rather them having to wait for an ambulance with a medic to respond.

In the afternoon, I was sent out to suburb along with a BLS ambulance priority one for an unresponsive patient in a skilled nursing facility (SNF). I got there first and grabbed my monitor, house bag and new blue shopping bag filled with PPE. I entered the building wearing just my goggles, surgical mask, and gloves which I try to always wear. The staff directed me down a hall and through a set of double doors. Suddenly, it was like I was on a different planet. The hall was bright white, the people working there all wore what looked like space suits, Tyvek Protection suits with face shields.

Some of the aliens appeared to be nurses working feverishly at their med carts, while others appeared to be maintenance men, all holding spray bottles of bleach in one hand and a variety of scrubbing equipment in their other. Meanwhile I walked down the hall like a wild animal in the middle of a shopping mall, all of the aliens stopping to watch me pass like what strange naked creature was I. I had to go through a second set of double doors and the next hall wall was more of the same. When I came to the patient’s room, I set my isolation bag on and proceeded to try to put my yellow napkin gown PPE, which in order to fit on, I have to take off my jacket. I also needed the help of an EMT, who was there to pick up a patient in another room, to tie my gown in the back.

The nurse in full body alien suit just shook her head looking at me. My napkin gown doesn’t extend halfway to my knees. When the call is over I am supposed to put my gown in a biohazard bag. But what about the rest of me from mid femur down? Fortunately, the patient was no longer unresponsive, but she was still pale and diaphoretic and delusional and likely COVID positive. Her tongue was as dry as the desert so I gave her some fluid in the ambulance, her arm resting on my leg, which I tried to set my gown up on. At the hospital we went through the decon room, and moved to a hospital stretcher, where the nursing staff brought her to an isolation room. I doffed my gown and PPE, washed my hands and then went to write my run form. When this all started, we weren’t even wearing masks unless people had been to China. Now others are wearing space suits and the government has just relaxed the exposure rules to keep us working, to keep our ranks from being depleted.

CDC Issues New Return-to-Work Guidelines

Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19

I sure hope I have already had corona and it was either when I was sick in late Jan/early February, or I had an asymptomatic or mild case that presented like what a 61 year old normally feels like, because I don’t see how I can avoid getting it. I just don’t want to wake up with a raging fever, short of breath, and find myself six days later on a hospital vent with not much more than a 50% chance of survival according to the latest data. The PPE we have is inadequate, and we largely have to rely on ourselves, each other, our partners, other crew members and facility staff to keep everything in our environments as clean and germ free as possible.