Shaky Hands, Part 2

Shaky Hands, Part 1

I like to think that I'm a good paramedic. Now, that's not to say that I'm cocky or overconfident. But I have had fellow paramedics, coworkers, and firemen tell me that I do a good job, that I always remain cool and calm, and that I always seem to know what to do. Sheepishly, I'll say thank you as I blush a little and turn away. I know that a lot of what they're seeing is the show that I'm putting up for everyone else's benefit. "Act like you know what you're doing, even if you don't," my Basic instructor always told me.

Having spent time in the field as a Basic and an Intermediate before becoming a Medic, I knew how scenes were supposed to go. I knew how to form a treatment protocol into a treatment plan in the field. I knew the operations side of things--how to run the equipment, talk on the radio, and give reports. I knew how to conduct patient interviews, how to interact with the firemen, doctors and nurses. I like to think that I had a pretty good handle on things when I was done with medic school and had a brand new patch on my shoulder.

My very first call as a medic straightened me right out.

I've been a medic for less than a year. If I take a shift off and have a long weekend, I come back to work nervous about how I'm going to do. There are still lots of skills that I've never performed and lots more than I've only done once or twice. There's plenty of calls that I've never had, lots of treatment protocols that I've never used in real life. And every time one of those calls comes up, my hands shake a little.

Wendy is now on my gurney now, barely breathing, barely conscious, and unable to speak. My heart rate, blood pressure, and respirations are up as my adrenaline starts to kick in. Using one hand to dig out a 14 gauge catheter from the house bag, I grab my portable radio with the other.

"Fire dispatch, medic 4." No response.

I'm feeling for the landmarks on Wendy's left chest, thinking back to the text book. Second intercostal space, mid-clavicular line. I notice that my hand is shaking as I press my fingers into the void space. I'm also thinking holy shit, I've never done this before.

"Fire dispatch, medic 4." I need a fire EMT to ride into the hospital in case she becomes apneic or arrests. As it is, I'm already thinking I'll be assisting her or RSI-ing her on the way in. Fire Comm can't hear me though, my partner and I are on our own.

I open the orange catheter pouch as the med-aid asks me what I'm about to do. My hands are still shaking as I bring the needle to the patient's chest. I start to rattle off a text book answer and she gets wide eyed as she realizes I'm about to stab this little old lady. My partner has been feverishly working to get the patient strapped to the gurney, on high-flow oxygen, and on the heart monitor.

I apply slight pressure to the needle and I'm in... and that's it. That's not right I'm thinking. That's not how the book said it would go. There was no pop, or hiss, or woosh of air. No sigh of great relief from the patient. There was no hitting the rib and sliding over like you're taught. There was no muscle mass to strain against, the needle just went right in, almost on its own before I could stop it. With the catheter sticking there, like a little flag planted in her chest, I prop it up with gauze, hastily repack the house kit and start fast walking Wendy to the ambulance. The problem is, she's not getting any better.

Oh fuck has now become oh holy fuck, now what?

to be continued...