The First

The tone dropped.

"Dispatch to Station 5. Be advised we have a sixty year old male having a seizure out on really far county road."

"That's damn near the county line." He keyed up the radio, "EC-6 will be responding." Then he turned to me while throwing on his jacket, "Come on Browncoat, it's time you got your feet wet."

My feet wet? I've been doing this for over a year and a half. Aren't my feet wet enough by now? That's when I realize that I'm starting to think exactly like my old partner from the private service. I throw on my coat and take off out the door, then hop into my designated seat in the back of the truck.

Ride alongs are the worst. You've got to show them your pretty face and that you're not a complete boob if you want to get the job. I had the advantage over newbies because I already had experience with an ambulance service. Many others have the upper hand on me because they've worked with a public service, not a private.

We're rushing down the road now. I'm not used to curves like this where I normally work. Big cities don't have a lot of curves. Being in the back of the truck makes it worse. Focusing on what to do for a seizure patient is hard when you haven't eaten in a few hours and you're starting to get motion sickness. I can get worse though.

"EC-6, be advised the caller has stated the patient has stopped breathing and stopped responding. CPR will be in progress when you arrive."

"EC-6 is clear."

Oh great. I'm thankful to have a patient with urgent needs for once. Today has been full of transports and weak elderly ladies needing a ride to the ER. I just wish they could have waited until after dinner, or maybe until the next shift came on, or maybe just any day that I wasn't here. That's when it hit me, and it really only took a second or two, that I had never worked a full code and I wasn't sure if I was ready to work this one.

Just as quickly, I realized that this was it. I didn't have a choice any more. I had made the choice long before I stepped foot in that truck, or before I walked in the door that morning, or before I even took the job at the private company. A code could happen at any time. It had just been my luck (or bad luck) of the draw that I had not gotten one so far. I had to get my head straight and start focusing on the new task at hand: how to assist the two medics I was riding with in saving a life.

We finally got to the house. I wasn't sure on what part of the county we were in, but I knew it was pretty far out. It had taken long enough to get there. I could hear the screams from inside as soon as I opened the door. One medic had grabbed the monitor, one the Auto-Pulse, and I had the jump bag. They were way ahead of me. Winding through the garage and into the living room brought me a great deal of shock.

A man lay on the carpet, trying to die. He was overweight, in his late fifties or older, his shirt was raised up a bit probably from the compressions, and his skin was just not right. I've never seen skin colored like that. It was like somebody had removed the pink and tan colors, and replaced them with ash and blue. His eyes were open and fixed and he was staring at me, but I don't think he knew it. His tongue was parting his lips. His wife screamed his name behind us, but I couldn't tell you what she was saying.

What kept me moving, I will never know. That image could have frozen me for a lifetime. My preceptor was doing compressions, the other medic was setting up a BVM and bagging him. I starting piecing together the monitor. The pads weren't already attached and I felt dumb setting it up, but there was nothing else for me to do. I wasn't touching that Auto-Pulse. It was the one piece of equipment my preceptor knew I wasn't familiar with, and it was the one piece that we had decided we would "get to later." Later was happening sooner than either of us had predicted.

The medic with the BVM wanted to set up to defib and tube, so I took over airway. Immediately, I noticed the breaths weren't making it into the airway. It was that tongue. The tongue was blocking his airway. I had never threw an airway adjunct before either. First time for everything. I was surprised at how easily the OPA slid in. The other medic had attached the defib pads and my preceptor had the Auto-Pulse halfway ready. The monitor wanted us to shock.

"I'm clear. You're clear. We're all clear." I didn't know people actually said that exact phrase. The medic at the monitor hit the shock button and the man's arms flopped like he was lazily reaching for the ceiling.

*****

That man didn't make it. Another crew arrived, the Auto-Pulse performed it's compressions, and we took a trip to the local ER. The ER Doc had him pronounced after being in there for less than 30 minutes. The medic who was with us didn't take it so well. He had gotten a pulse in the back of the truck on the way there. It was faint, it was irregular, and it didn't last, but he got it. It was his fifth code since he had become a medic just a few months ago.

I wanted to write this down. It's important to me to remember. We learn from our past experiences and the experiences of others. Although this didn't happen long ago, I could have written it at any time and it would still been as vivid in my mind.

I'll have to say that those medics I rode with that night certainly fit the bill for Big Damn Heroes. It doesn't matter whether you save the victim you're trying to help, what matters is that you try your best to save them.

In the Saddle

As I mentioned before, I became the Browncoat for the purpose of speaking my mind without fear of retaliation and to protect the names of services I work for, people I work with, and myself. This move was partially influenced by a white shirt who felt what I was writing under my own name was too... racey for their service. Obviously, I didn't want to lose my job, so I made changes to what had already been said and stopped writing as much as I had been.

The funny thing was, it wasn't good enough. The private service I work for decided to let Ol' Browncoat go yesterday on suspension under a false and absurd accusation. That was the service's way of telling me, "We're going to fire you. There's nothing you can do about it. You can't defend yourself either. We just need three more days to push the papers through."

I'm not going to go into details about what the accusation was, because it's really not important. Suffice it to say that it was in regards to my level of patient care. This tickles me a bit. The one that sent me off had been watching me and my involvment with a group called EMS 2.0.

The whole goal of this organization is to constantly improve pre-hospital care by being knowledgable of every skill we train in, and then using that information to help us provide the best patient care possible. It strikes me as odd that a person doing the best they can to improve their skills and provide the best patient care possible would be let go for those same exact reasons. Of course, there are other cirmcumstances that played their part in the mess, but that is for another day.

Long of the short, Browncoat wasn't hung up to dry completely. He used a couple of references, dropped a couple of names, and landed himself two part-time jobs at the local hospital and with the county EMS service in the same day of being suspended.

Funny how that works, ain't it? I've managed to put a thorn in a purple bellie's paw and landed myself a great gig all at the same time.

Got to go for now. I've got to be at work in an hour!

-Browncoat

Enter The Browncoat EMT

What is a Browncoat?

In the series "Firefly", Browncoats or "Independents" were named after the simple, brown dusters they wore as uniforms during the War of Independence. The simplicity of their gear was greatly due to the fact that technology and resources were scarce on the Outer Planets. Conversely, the Alliance's soldiers were called "Purple bellies", because of the purple-tinted body armor they wore on their chests.

This may sound a bit "geeky" to some, but to me it has a great deal of meaning. I used to go by a different name when I wrote about my experiences in EMS, but I ran into issues with censorship from my employer. They viewed my blog as a liability to their company and the people working there. They implied that if I were to continue, I would be reported to the state EMS Boards.

This became my "war" for independence. I felt that it was a mockery of sharing and education to not be able to write about what myself and so many others did in EMS. The purpose behind EMS blogging is to see what others do, how they do it, why they do it, reflect on ourselves, and apply that new information. It is about growing as EMS providers. Unfortunately, we are all being monitored and censored in some way, shape, or form. We are led to express ourselves minimally out of fear of what might be done to us by our employers and EMS governing bodies.

The stories and the truths; they must be shared somehow. If this is how it must be done, then so be it. There will be a day in the future when we can express our thoughts and share our ideas freely without fear of outrageous consequences.

Until that time, I remain the Browncoat EMT.

Let's go be Big Damn Heroes.