Week 5: Dear Diary

Sofia R -

Howdy!

Coming back from spring break, this week has been very refreshing. Before I took my time off, my rides were going very slowly, and I was only getting a few calls per shift. This week was busier, and I got to see some new situations.

On my first ride, I saw my first potential stroke patient. In this case, this patient has been feeling sick and was not taking their blood thinners. They had a headache for a few days, which became alarmingly worse and so they called 911. When the crew got there, they took vitals and got history. Some questions asked were: Do you have any stroke history? What medications do you take? After doing this, one paramedic did the F-A-S-T test. This stands for:

F – Face: Ask the patient to smile. Is there weakness on one side of the face?

A – Arms: Ask the patient to raise both arms. Does on drift downward or does one raise higher than the other?

S – Speech: Ask the patient to repeat a simple phrase. Was there slurred speech?

T – Time: Determine when these symptoms started.

As the patient went through these tests, the crew noticed their left side was weaker, and so we transported them to the hospital. Before the transport started, a paramedic from Lifeline Ambulances and one of the medics on our crew decided to activate stroke alert. This allowed the hospital to learn that our patient might have a stroke and gives staff time to prepare for the incoming patient. When we arrived at the hospital, the patient got taken to the CT scanner, and our crew got to see the result of the scan. The image was clear, which means the patient did not have a hemorrhagic stroke. This did not rule out other stroke types. In this call, I got to see two new things, stroke alert activation, and watching a CT scan take place. One thing I have found very unique about EMS is that after we left the hospital, we never heard the outcome or cause for that patient.

 

On my second ride, it was much busier. A call that stuck out most to me was a potential heart attack case. In this scenario, our crew was called to a nursing home for a patient with chest pain right over their heart. As we gathered history, we learned that they had an untreated aortic aneurysm and cancer spread throughout their body. The patient presented to us as diaphoretic and cool to the touch, which is common to see in people experiencing heart attacks. The medics did a 12lead on the patient, so that they could better see what they were experiencing and also to figure out a plan of treatment during transport. Depending on what is shown on the 12lead, medics can see which medications can be ruled out. For this patient, Zofran, chewable aspirin, and nitro was given. Zofran is for nausea the patient is experiencing, aspirin is for reducing the damage to your heart by inhibiting platelet function, and nitro is a muscle relaxant. These drugs are often given to heart attack patients. After the crew loaded the patient into the ambulance, our medic and I rode in with the ambulance crew. For many patients whose cases could become worse, it is common for medics from the fire department ride in on the ambulance to provide assistance. After arriving at the hospital, we all took the patient into the ER and gave their nurse the information we had.

This past week, I saw more patients and better learned about how the ambulance companies work with the fire department to help the patients.

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Comments:

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    Toby Chang
    Sounds like you learned a ton this week! You mentioned that the CT scan did not "rule out other stroke types"; what can you do to definitively say what type of stroke it is?
    lena_t
    Very nice observations! I appreciate how you broke down FAST for us.
    yajaira_g
    That is very fascinating! What does stroke alert activation look like for you and the hospital? How is it done? are they different? Are there different alerts that you could also potentially activate?

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