Injuries

I’ve only had a few injuries at work.  Mostly, I’ve had to deal with soreness from a standing fall on an icy driveway, or that kind of thing.  I get soreness at my low back and SI joint when I carry obese patients down narrow circular staircases.  Doesn't everyone?  I’ve only had two injuries that have made me stop patient care, though.

My first needle stick was a scary event for me.  I was an EMT and starting a line on a patient on the way to the hospital.  I can’t even remember what was wrong with the patient.  I got the IV catheter inserted and reached across the patient to my left for the sharps container.  It was on the wall by the back door then.  There was another needle that hadn’t been completely swallowed by the red box.  Doink!  A jab in the thumb.  

I went through a range of emotions.  Elisabeth Kübler-Ross should have watched an EMT get a dirty needle stick, rather than study grief.  Confusion – what was that?  Irritation – dammit, that was a needle.  Pondering - which patient was that needle from?  Different confusion – wait, we haven’t used a needle this shift.  Fear – whose needle was it, then?  Hope – maybe it just hurt and didn’t break the skin.  Disappointing return to fear – nope, that is blood on my thumb.

See where it says 'Lift to Assure Disposal'? The ass who had my bus last didn't do that.
(By BrokenSphere, Public Domain, via Wikimedia Commons.)

I was just stuck by an unknown needle.  Well, the brand new second patient in the back of the bus with the bleeding thumb had just been triaged pretty high by this EMT at that point. 

Glove off, peroxide being poured everywhere, alcohol rubbed into the (admittedly very minor) puncture, muttered curses and oaths, and wishing I had bleach to soak my thumb in were the steps I followed, rather than continue whatever patient care I had in mind before the event.  I’ve had five or six other needle sticks in my twenty years of EMSing, and my personal self-treatment protocol is pretty much unchanged.

Needle sticks suck, but the other time I stopped patient care was especially stupid.  I was transporting an extremely ill CHF patient to the hospital.  She needed to be intubated, but was conscious, so blind nasotracheal intubation was the choice.  No problem, the patient was sitting as upright as the pram would go and I nasally intubated her. 

I had the grand idea to stabilize myself while I was doing this two-handed procedure.  In order to be properly stable, one needs three points of contact with one’s surroundings.  My normal procedure in this setting is left foot (one), right foot (two), and my hips (three) against the back of the upright bed.  My spectacular idea this night was to not use my hips as the third point of contact. 

I used my head.

That isn't a figure of speech.  You see, I pressed my head against the ceiling of the ambulance.  Two feet, one head: three points of contact.  I am a little taller than the inside of the bus, so it worked fine.  I was stable.  It was awesome – so much better than being bent over.  Bending and hunching always killed my back (and still does).  I think I may have wondered why ambulance manufacturers didn’t set this up with a head-shaped cup on the ceiling.  Awesome!

The patient was intubated, the placement was confirmed, and I was tying the tube down when we hit the speed bump.  Apparently, my partner didn't see it in the dark.  So we crashed into it at 40 mph or so.  I think we got air.  

My neck crunched and I was blinded by pain.  I might have peed myself a little.  My arms went numb.  I sat down into the captain’s chair and rested myself.  I had never felt so stupid.  I realized why people didn’t brace themselves like that.  I could move my arms, but my neck was pretty stiff and I couldn’t feel anything from my upper extremities.  The firefighter who was riding in with the patient and me saw me flop into the chair and probably thought I was really relived to have the patient intubated.  I just sat there to the hospital while he squeezed the football.

After arriving to the ED, I got myself out of the bus, walked into the ED, gave my report, and wrote my PCR.  I got myself some ice from the lounge, put it on my neck, and went back in service. 

I didn’t tell anyone about my neck pain.  I was too embarrassed.  I still haven’t (until now).  My arms were numb for two days and then got better.  My neck bothers me from time to time, but not bad enough to get it checked.  I know that I got lucky.  I don't know which was stupider, crunching my neck in the back of the bus or not telling anyone (or even getting it checked out).  Wait, yes I do.

Anyway.  Lesson: Look at sharps containers and don’t wedge yourself in the back of the bus with your head.