100 Years and Counting

She took a fall in her apartment and called for help when she started having trouble breathing. We arrived and the First Responders were on scene. She is a frail lady lying on the floor thankful someone has come to help. We took all the usual precautions to protect her neck and back. My partner was patient man so he obtained a history while the rest of us obtained a set of vitals and secured her for transport. Her oxygen saturation was 85 so an oxygen mask at high flow was placed on her. It's funny to listen to people talk to elderly patients. The care givers tend to raise their voice and assume the patient can't hear them. They also assume the patent has never been to the doctor and doesn't know what a heart monitor is or a blood pressure cuff is.  I've found that getting a little closer to their ear and speaking in a normal tone keeps them calm and just seems more respectful. After all these people have been around the block and have most likely been to the doctor more than we have. I have a tender place in my heart for elderly people. I lost my mother to Alzheimers about ten years ago. It was hard to watch her dwindle way. As I listened to this patients lung sounds I found she had almost no air movement in the lower right lung. As we continued to gather information it was apparent she had at least one broken rib on the right side. Her lung was most likely collapsed, a pneumothorax, she could be in real trouble if it was left with no treatment. We loaded her into the ambulance and as we started transporting to the hospital I started an IV in her right arm. Her skin was very thin as would be expected with someone that is 100 years old. She was hooked up to the heart monitor and much to our surprise she had a text book normal sinus rhythm. As we made our way to the hospital I asked her a question that always intrigues me, "In the last 100 years,  what is the craziest thing you have seen?" Her reply was quite comical "The President's State of the Union Address last night." She didn't have to think about it and she seems very serious. We arrived at the hospital and transferred her care to the nurse. We bid her well and I went to clean and remake the cot.

I'm Off but I'm not OFF.

Today I 'm off duty but I have to go into the station to re-certify in PALS (pediatric advanced life support). Last rotation on we were busy running calls and I did not have time to get it done. Although, we did run some practice codes for adult patients. I will have to pick up a medication order before I go to the station. We are running low on a few medications and one of my duties is to order and inventory all of our medications. We have seven ambulances, two paramedic squads and four paramedic engines to keep supplied. So it begins.