Calls with AMR...7/29 6pm to 7/30 6am

18:45 - Possible AMI outside Harborlight
We arrive on the scene in several minutes to find a 51 female experiencing mild shortness of breath, long term nausea/dry heaving. She was fairly stable and ambulatory, so we immediately loaded her into the rig for a cold transport to Providence. During transport, we established an IV and applied O2 by nasal cannula at 2L. Vitals: Pulse 103, Resp 18, and BP 180/122, SPO2 99%. She explained that she has had substernal chest pain for the past three days. We arrived at Providence and transferred care to the ED. After paperwork was completed, we cleared and were back in service at 19:30.

21:13 - Fall patient at assisted living center
Arrived at scene to find a 72 male, fairly alert, who has fallen repeatedly today, and most recently into an end table. He appeared to have a diminished LOC, but was normal for the patient. Negative for loss of consciousness, no physical injury. Crew performs thorough physical exam and determines c-spine unnecessary. We loaded him onto the stretcher, moved to the rig, and began a cold transport to the Veteran's hospital. Vitals: Pulse 80, Resp 12, BP 110/65, SPO2 94%. We applied O2 at 6 liters by nasal cannula (did not cooperate with NRB). 2 minutes of O2 therapy produced a noticeably more uncooperative patient. Everything that had been explained earlier had to be explained again. We transfer care to the VA ED (nearly empty) without incident. We cleared the VA at 22:10.

Multnomah County (home to the urban Portland, Oregon) uses an automated rotating assignment system to control and dispatch all 20 units covering the county. Over the computer the county relays information to each unit regarding the status of every other unit. "County Ambulance Level" is a term to simply describe the number of units available for calls. In the hour from our last dispatch to our clearing the VA, Multnomah County ambulance level was reduced from 14 to 1... and "1" referred to us. We knew a call, quite possibly with a 30 minute response time, was only moments away.

22:12 - Assault patient
The call is for an assault victim outside a Taco Bell on Division & 125th, which, in the hard rain, was a 25+ minute response time from the VA hospital. We maintained 65mph with lights on the freeways. We made it to the Division exit off of I-205--13 minutes into response--and we were canceled by the fire department. They made no effort to inform incoming ambulance units regarding the status of the patient, and did not reduce us to a code 1 (cold) response.

00:15 - Sick Person, canceled en route

03:15 - Chest pain
We arrived on scene in 6 minutes, and the fire department was already clearing the patient for RMA. She exhibited severe nausea/vomiting but the symptoms had subsided by time the fire department arrived.

04:30 - Shortness of breath
We were called to a subsidized housing unit by the manager of the unit for a resident who had reportedly stopped breathing several times during the night. Dispatch information reported CPR was performed. We arrived at the 3rd floor room to find an uncooperative female, who insisted she was fine and refused our care. Several residents insisted we take her to the hospital because she had stopped breathing and that one of the residents had performed CPR earlier. It was later determined that the patient had a diagnosed condition of sleep apnea and that there is no way to transport an alert patient without consent. This call was my first experience using the fold-down feature of a Rugged stretcher. There was no way it was fitting in the elevator full length.

I thoroughly enjoyed my ride experience, and would do it again if I got the chance! I had originally been afraid my wisdom teeth (removed two days before) would bug me, but it wasn't all that bad.

Rides with TVF&R

I rode with Engine 64 first on July 4th, as a way to see some fireworks. They were scheduled to standby at the annual Oak Hills fireworks show and I had no firework plans at home. I didn't get to see many fireworks though, since the first call came in just before the show started. It was for a tree fire threatening a structure. Once we made it out of the neighborhood--with double-parked cars, traffic, and pedestrians it took 8 minutes--we were canceled en route. We drove back to the show, and were toned out for a second call, an invalid assist. We arrived to find a 400lb man who had fallen in the bathroom and couldn't get up with the help of his 90lb wife. The crew assisted him into bed and we cleared back for the show. At 158th and Walker we were toned for a 3rd call to a possible residential fire, in a neighborhood next to the firework show. We were first on scene since it took the other crews another 8 minutes to make it out of the show. The residents saw burning embers fall from the sky, some of which hit the roof. The crew walked the roof and found nothing.

I rode a second time during a day of my work at the station. The crew only received one call while I was at the station...unconscious person at a nearby office building. The patient told the crew that he had taken some Vikadin in the past 24 hours. Doing the math from how he described, it appeared he had taken 4 full doses since that midnight, and exhibited some textbook signs of mild overdose. MetroWest arrived and transported him to the hospital.

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