Lights, Sirens, and a Dislodged Prosthetic

Yesterday I worked my first 24 hour shift as a paramedic. I've never done 24s before, I have to say I rather enjoyed myself. It was definitely a learning opportunity, adapting to a new service and how to function with the prosthetic.

That brings me to the big lesson of the night. Allow me to paint the scene...We were called for a patient with an active arterial bleed. Most times when you get these calls the first reaction is to doubt it's authenticity. Most facilities will call any type of bleeding arterial...but when they follow up with they are using sandbags to hold pressure and the patient is very hypotensive, then this starts to feel real. This information, along with the fact that this is a facility not known for calling for an ambulance for every sniffle and bump, made me get a little nervous. This is my first real run since I've been back on a truck. I've done the ALS transfers, the fall down go boom, the "stats of 66%" only to find an o2 saturation of 96% on room air. This was different. This was a legitimate chance to make  a difference, this is why I'm a medic...now time to see if I can still do this.

We arrive on scene to find the patient being circled by the staff. She is bleeding and doing a good job of it. She's pale, diaphoretic, and generally looking like death warmed up. Pressure is tanked, so we apply pressure to the site, control the bleeding, and get moving. I'm able to get a 16 gauge IV placed in her EJ (external jugular for the non-medical folk...it's in you neck), at this point we are arriving at one of our many local hospitals. Here's where things are markedly different for me since returning. My leg fell off...yes you read that correctly...my prosthetic came off of my leg and is lifelessly hanging there inside my pant leg. This means I can no longer walk, there's no fixing this at this moment, and then the panic sets in. My preceptor for the service agrees to take the patient inside with our EMT partner and leaves me to my own shattered thoughts inside the truck.

I panic, this is my biggest fear coming true...a legitimate reason why I can't perform my job task (at least in my mind at the time it is). For the first time in a long time, well, in 8 months, I feel disabled. I can honestly say I haven't felt this way since I took my first steps on my new leg. I felt destroyed, I had done the medicine part to the best of my rusty ability, I felt good about that. Then with that leg sliding off, I truly had to face the fact that I am different, I can try to be like all those able bodied people but I'm not. I did what I always do, I made fun of the situation. I rolled my pant leg up, left my prosthetic sitting proudly in the center of the back of the truck, and hopped around cleaning up the back from the mess I made. I joked with my crew mates and moved on. Hopped into the station, put my leg back on, and moved on.

My preceptor said, that is what makes me different than most people, I laughed and moved on. That has been the status quo, bad things happen so laugh and move on. I'm going to the prosthetic office tomorrow to find out what we can do. As unacceptable as this situation is, It had to happen. Just happy that it happened now instead of later. With wearing the leg over 24 hours straight, the size of my stump is going to change. It gets smaller and so the prosthetic doesn't fit as well, we will find a way to fix the issue and I will move on.

That's our first major hurdle in the return to EMS. I really can't imagine one much worse than losing the ability to walk while treating a critical patient. Stay tuned for further educational lessons from your friendly neighborhood Prosthetic Medic...