For all the gripping, complaining and bitching I'm known for, you'll appreciate this one I hope.
I don't fit in where I work and I really just don't do well where I play. Surprisingly enough though, as a kid I got high marks in "Plays well with others". Maybe it's me, maybe it's them or I could just be a product of my environment. Who knows? However there is one thing I have come to realize. There are more people out there like me, and this should make a lot of you afraid...very afraid.
We were called to our local hospital the other day to transport a patient to another hospital because of an AMI. We get to the ER and naturally the first thing I look at is the monitor, and sure enough....FAT 'ol MI. The nurse gives me the run down. She tells me the patient presented to the ER with difficulty breathing via EMS and complains of no pain at all. Since the patient is 89yo...it makes sense to me.
We get the patient switched over to our stretcher, as well as the I.V. pump infusing Integrilin and a saline drip. I apply the monitor pads so that I could, well...monitor of course.
So there we are bopping on down the road. I asked the driver to not run lights and siren just as a measure to keep the patient from getting excited. As an additional measure I put his wife in back with us; they were just absolutely inseparable. Worked all the way around for everybody.
The drive took all of about forty-five minutes. We arrive at the receiving facility and hand off the wife to the son who will accompany her to the waiting area. We anticipate that he will be going to their ER for a work-up in that hospital....but, oooooh no, that was no to be.
As we entered the ER we were greeted by a smartly dressed lady who identified herself as the director of cardiac services and asked if we the ones coming in from M^pjlxsville. We said that we were indeed the ones. "Follow me" she said, "he's going straight to the cath lab".
She led the way through the emergency room stating loudly to a few doctors and others who were in our line of travel, "Excuse me...cardiac coming through....make way, cardiac".
Now, I'm liking this lady. She takes her job and the life of the patient very seriously and this is obvious. Yeah she came off as brash, but she had every right to and I liked that.
As we left the ER area, she quickened her pace and led us through a few twist and turns and then down a long corridor. "What took you guys so long?" she asked over her shoulder never breaking her stride. "They said an hour ago that ya'll were transferring the patient then...it shouldn't have taken you but thirty minutes to get here", she continued.
O.K., she was serious about this. I thought we were in for it now.
Then out of sheer ignorance the guy who was driving had to open his mouth; it's just his nature to not know when to shut-up. "Well, we were moving pretty good until we started hitting traffic and stop lights", he said as if he was dismissing her concerns.
"That's why ambulances have lights and sirens", she stated matter-of-factly. Again, she never broke stride.
The driver, not to be out done decides to open his mouth yet again, as is his nature. "If you wanted him here that quick, they should have flown him" he quipped.
She stopped dead in her tracks and spun to face him. "It's would take LONGER to fly him here than for you to drive him thirty-five miles", she said. Then she spun around and was off again at an even quicker pace as if to make up for any lost time.
Then she started in on a lecture about how we have 90 min. to get to a patient from the time of event, until the time of balloon insertion to avoid permanent ischemia damage.
I KNEW THIS SPEECH!! I had read about the "D2B90" protocol back when I was just an EMT-B a few years ago. I had also just recently read an article about this protocol and how it was making some big differences in patient outcomes, along with hypothermic stabilization.
Aaahhh, this lady was singing MY song. She finally conceded that maybe our not using a siren was a good idea...but we could have ran lights at least. Of course, she was right.
We entered the cath lab and she introduced the assembled team of nurses and the doctor, who began their job with ferocity.
I presented her with the patients medical records and obtained a signature for such. I told how hearing her singing "D2B90" was music to my ears and unfortunatly, we don't use that protocol where I come from...we don't even have a 24hr cath lab, not even an on-call cath lab. Most of our MI's are transferred north or south about an hour away.
She further explained her position at the hospital as the coordinator for Duke Cardiac Services in the region and that she would be more than happy to help me push for this locally in my area. I was beside myself to say the least. I told her that I was just a lowly field provider and that we need people with her passion to make a push for protocols like this. What she said next floored me. She told me "No, we need more people like you, to push this from the bottom up. Somebody has to recognise what's going on and immediately start the process".
We exchanged contact information and I was on my way. I left with a new sense of pride and optimism in my profession. Surely this pride will be bruised as soon as I notice my next STEMI and notify our ER. That's just the way it is. At best, I can hope to see an ER Tech. waiting for me when we arrive to do a 12-lead and verify my findings. At best the patient might be in a cath lab during the next hour or two.
I will follow up with her and see where this is going to go. Who knows...maybe a beautiful thing blooming around here. Unfortunately, we first have to get someone to actually answer the ER radio when we're calling in our patient reports.
"D2B90"...it's a beautiful thing.