Read part one here.
On November 10th, I did my ride-along with the Oakland Fire Department. My ride-along was with Station 13 in Oakland’s Fruitvale district. For those of you who are current with your national (or international) news stories, Fruitvale is where Oscar Grant was unfortunately shot and killed on New Year’s day, 2009. It is a low-income area with a lot of un or under-employed individuals for whom 911 is the only source of health care readily available to them.
Interestingly, the big fear that I had going into it was that there would be some major trauma and I’d be unable to handle seeing it. I viewed the ride-along as my opportunity to prove to myself once and for all whether or not it would be an issue. So as you might imagine, I didn’t see a single trauma all day. We had nothing but medical emergencies, which, in most cases, weren’t really even emergencies (if you define an emergency as a life-threatening event.)
The first call of the day was a possible seizure which, as it turned out, the Fire Lieutenant said, was probably not a seizure but something drug related.
There was another call for a woman who was in severe abdominal pain and was histerical when we arrived begging us not to let her die. She had been eating regularly, but hadn’t had a bowel movement in several days. Abdominal pain doesn’t seem surprising. I found out later in the day that this patient was a “frequent flyer” who the fire crew knew. They also knew her to be a chronic crack abuser and apparently, crack stops up the works, if you know what I mean. Being incredibly uninformed about (and disinterested in) drugs, I did not know that. I suppose I’m going to have to learn about such things, but to be honest, I’m not at all sure how to do that.
The most memorable patient of the day was complaining of “difficulty breathing”. The patient wasn’t actually showing signs of having difficulty breathing but it’s not really surprising if he was, given that he weighed in excess of 600 pounds. Treating and transporting him to the hospital was a bit of a fiasco, but mostly on the part of the ambulance company who didn’t have a bariatric ambulance readily available and when it did arrive the operators on it didn’t know how to work the equipment. Fortunately, it wasn’t a true emergency because we would have been screwed.
One of my classmates did his ride along with Station 13. It happened to be the day after the Mehsserle sentencing was handed down and there was some speculation about whether there would be more protesting that day which could have taken place in the area Station 13 serves. No protesting took place but it seems likely that people were reluctant to go out, just in case. Whether it was because of that or random chance, my classmate got one call the entire day. It’s hard for me not to see this as a good thing as calls to 911 mean bad things are occuring, and while we were there to get the experience, someone has to be in distress in order for that to happen.
At any rate, when the first call came in about 90 minutes after I joined the Fire Fighters, the Paramedic on the crew told me in route, “So I’m just going to let you take it and we’ll follow your lead.”
I was stunned. “On the first call?” I asked. I had hoped to get to watch them do a couple calls before I jumped in, get a little bit acclamated first.
“This could be the only call you get. You just never know,” he replied. I couldn’t really argue with that logic.
Nothing we did in class could prepare me for the experience of working with the fire department on medical emergencies. We had practiced Medical Assessment a few times in class, but it’s always done by yourself or with one other student. It’s always done in a calm, safe environment, with a “patient” who isn’t really sick and who isn’t in distress.
With the fire department I was working with four experienced EMTs (one a Paramedic) who all knew what they were doing and were accustomed to getting right to work. I found that I was not prepared for the situation. Still being new to the whole thing, I had to think about what was happening, what I needed to be doing and what questions to ask. The experienced Fire Fighters on the other hand would dive right in and knew just what to do and just what to say and just what to ask, as you would expect them to. I found that more often than not, they had already done or said or asked everything that I could think of to do or say or ask. So it would seem I knew the steps, I just didn’t have the confidence or the certainty of what to do. When I wasn’t right on top of everything they stepped in to pick up the slack and when it was all said and done, it felt, however inaccurately, like I didn’t know what I was doing.
By the end of the day, I was pretty frustrated with myself for not performing better than I did. Of course I wanted to be a natural and to wow the fire fighters with my impressive ability. Instead I fell back on old patterns and shied away from the forefront due to my insecurity and lack of confidence in my knowledge and ability.
I asked the Fire Fighters for their honest opinion and by and large they were positive, but they agreed that I needed to assert myself more and be more confident. Unfortunately, only so much of that can be put on. The rest comes with time and practice.
I left the fire station about 5:45 in order to get to my class at six and I basically walked into the class just as we were starting. Little did I know that Mr. Williams, my teacher planned on skills testing that night. Dispite my fatigue and frustration with my performance and experience that day, I did all of my skills tests except for Medical Assessment and passed every one on the first try. I was, in fact, the only person to pass every skill I attempted.
I guess that’s enough for today. Tomorrow-ish I’ll tell you about my day in the county trauma center.
Read part 3 here.