Bus Ride

I'm not sure if I have mentioned this to ya'll before but I come from a family who is waist deep in Emergency Medicine. My dad helped found the rescue squad in his hometown and he has been an EMT, ED RN, Flight Nurse, and ED Director, among others. My older sister has been an EMT for 5 years and is currently a Paramedic. I always enjoy hearing my dad and sister talk about life on the street and the excitement of being in an ambulance and secretly I have always been a little jealous. Well, Monday I got to ride in a ambulance during an emergency transport of my patient to the closest hospital with a neurosurgeon!

It started with a call from an ambulance crew stating they were brining in a patient with a severe headache and left sided weakness that had started 30 minutes ago. The patient was a gentleman in his 60s who was visiting from up north with no prior health problems except an enlarged prostate. After he arrived we started to work him up and we saw that he was experiencing decerebrate posturing only on his left side, meaning his left arm and leg were involuntarily spasming and rigid. His pupils were unequal and sluggish and he was lethargic but oriented.

We scurried around to initiate the Brain Attack protocol and soon enough I was accompanying him over to ct scan. I am no ct tech but even I could see the bleed in his brain as the images from the scan scrolled across the screen. After I rolled him back to the resus room, I had to start him on a drip to keep his blood pressure below 120 mmHg systolic. The secretary quickly made arrangements and the patient soon had an accepting physician at the nearest hospital with a neurosurgeon. The ambulance crew soon rolled in and as I gave the lead medic report he stopped me and said that he would need a nurse rider because the blood pressure drip the patient was on wasn't in their protocols so he wasn't allowed to titrate it.

I was excited because I've been looking forward to my first ride-along and this was the perfect patient because he was relatively stable, I just needed to keep an eye on his pressure and adjust the drip as necessary to keep it down. Plus I knew the ambulance crew better than most so I was comfortable with them.

They loaded the patient up and I hopped in. We drove all the way to the hospital lights and sirens and I was surprised how bumpy it was in the back of the ambulance. I don't know what I was expecting but definitely not such a fast and crazy ride. The patient remained stable for the duration of the transfer and I only had to adjust his meds a few times. The ride over went super quick and we arrived before I knew it. I gave report to the nurse, transferred the patient over and headed home.

I felt like a grown up nurse, doing my first transfer. I cannot wait until I get to do another because then I won't be as nervous and I'll know what to expect the second time around. It gave me taste of life on the streets and I got to see why the unpredictability and excitement of bus life is so enticing. Someday, I think I would like to be a flight nurse. I haven't made it a definite goal for my future but I am keeping it on the back burner. We shall see...