Ambulance stories in Mexico

No sleep.

2011-10-24T14:07:00.000-05:00

Wehn you are a student here in my EMS system you learn some songs to sing while you run. One of those goes like:

"If in EMS you want to be you will have to get used to no sleep"

God how true is it. Its amazing the slow motion state that you enter after no sleeping for more than 24 hours straight, I have always tought that its dangerous to work under some circunstances and sleep deprivation is one of them. Think about the last time you worked at night shift and you were sleeping when you got a call. Remember everything about the call? Guess what you remember almost nothing because you were not paying attention and were not fully awake.

Be careful with that my fellow paramedics sleep deprivation could push you to make a bad call with a patient or even with your own security. Always be sure that before you exit the ambulance for the 4 a.m. call you are fully awake.

If you are not, you can ask for a couple of slaps from your partner.
That would solve it.

A good call.

2011-08-29T18:14:00.000-05:00

We were dispatched to a house for a medical call, dispatch told us it was a man unconscious, medical problem unknown. When we arrived we found something very different from what we expected.

I was an aparment building that was not finished yet, was under construction. An officer told us the patient was in the 1st floor with some of his partners. The problem here was that they had to jump a fence to get there.

The fence was closed with a lock and a chain. No problem.

First step: Secure the emergency scene and gain acces.

We took out our electric saw and tried to cut trought the chain. It didn´t work.

Well, seconds later we decided to open the fence the hard way.

Crowbar + Lots of muscle = Problem solved.

We enter the building and went upstairs. There, on the first floor, was lying a man, beaten up as hell. It had been a while since I saw a man so beaten up. Police officers told us they didn´t know what happened, they were called because the neighbors heard someone moaning and then they found him and called us.

Well dispatch obviously had it wrong, this was not a medical call, it was a trauma call.

We tried to secure his airway but he still had some reflexes. We ventilate him with a bag valve mask and then lowered him on the ambulance. (By the way, great help from the PD, they get a lot of smack from the citizens in Mexico, but when paramedics need help they always step up)

In the ambulance on route to the hospital we realize that his airway needed better care, we hook him up to an I.V. line and push him some meds to sedate him. Then was the time for the tube.

Intubation in a trauma patient is hard, if the person has a suspected spine injury you can´t move the neck, this makes it more difficult than an uninjured patient (Like a cardiac arrest or a stroke).

To add more problems to this slightly no-moving neck situation the man had his face all swollen and bloody. So we decided to go for a supraglotic airway. (For all the folks reading this that are not in the medical field, this device is a tube that is placed just before the trachea, not inside it.)

We went for it and worked out great.

After 4 or 5 minutes we arrived to the trauma center, when we walked out the door we had no idea if he was gonna make it.

This call was a great teamwork call, every each one of us knew what to do and did it right away. Even the PD helped out and they were great.

I hope he makes it.

Your poor heart.

2011-08-10T21:37:00.000-05:00

You were the wake up call from a morning sleep.

Chest pain in the subway, was all the information we got, when we arrived it was clearly a infarction. You got each and every one of the pieces of treatment you were supposed to, but the problem really started in the hospital.

Those $%#&/%"$.....

I walked away as your heart stopped in the ER.

First day.

2011-06-14T23:35:00.000-05:00

Tomorrow i will take out on their first day of practice a couple of new paramedics.

And because of this I was remembering my first days. Those were so amazing, everything was so new and there was so much to learn, everything that i had studied just fell in the right place when caring for the first patients. Of course at the beginning I felt a little bit overwhelmed, but with a little practice I was a confident provider. It was just great to see all that training and all those hours spent practicing really paid off.

I am really exited about this, i hope they learn a lot and can really begin to love this job.

Almost everything

2011-06-01T01:09:00.000-05:00

During my career as a paramedic in this busy and chaotic city i have seen a lot of injured patients. I came across almost every type of patient in the books and i have seen quite a lot of each and every one of them. Each and every one but two.

Burns and childbirth.

I cared for patients with small burns that didn´t really place themselves in danger. But today i saw a patient that had a electic burn. He was working in a construction site and by mistake he touched a high voltage cable with a steel pole. He had the entry wound in the right hand and exit wounds in the right and left feet.

I couldn´t do much for him because we were very close to the hospital, but it really shocked me how he endured the pain.

I will now sit every shift waiting for the most amazing one that i am missing. I look forward to the day that i hold a little baby in my arms and say to the mother "congratulations".

I will wait. For every life i have seen lost in front of me I think now it is the right time for the circumstances to change and be on the other side of natures hand.

Patience.

Bored.

2011-02-21T17:45:00.000-06:00

We were just sitting in the ambulance.

Parked on the street waiting for a call to come.

We were there for 5 hours and nothing happened. Saying we were bored would be an under statement. He was lying down inside the ambulance and I was on the outside leaning on the open door chatting about something really not important. Time went by so slow.

Then a little girl that was walking by the ambulance stopped and asked her mom if she could see it from inside. Her mom told her to ask us. She was a little bit shy but she came right in front of me and said "Can you show me your ambulance?"

She was the cutest little girl.

"Of course, jump in" I replied.

The next 10 minutes were just great. She was so happy. So was I.

Not everything in this job is blood and sorrow.

Being away.

2011-02-18T17:07:00.000-06:00

Hi everybody.

It has been two weeks since my last ambulance run.
I can feel the tremors now and every night i get all paranoid waiting for the tones to go off while i am at home.

I need to get back on the rig.

They made it.

2011-02-18T16:58:00.000-06:00

Well remember how i tell you about being in charge of an ETM-I class.

The results are as follow:

15 presented final.
10 passed in 1st or 2nd rounds.
5 failed.

Not too bad. Not excellent. Lets hope the next time i have more time.

The odds.

2011-01-19T17:06:00.000-06:00

A firend of mine that lives in Canada is on the town. He is also a Paramedic and he enjoys the Mexican EMS system because of the diversity of the patients that you can come across. I told him to ride with us that day.

It was past midnight when we got a call.
A 80 year old lady has fell.

We made more or less 8 minnutes to the scene. When we arrived and entered the room it was obvious dispatch had it all wrong. She was in cardiac arrest.
(Of course she fell but is different falling because you tripped rather tha falling because your heart stopped. You suck dispatch!)

My friend got her on the ground of the 3 x 3 room and started the CPR. I hooked up the cardiac monitor to see what was going on with her heart. Two minutes later the CPR stopped so we could see the electrical activity that her heart was having.... she didn´t had any. She was in asystole. In the world of cardiac resusctation that is closer to being in the grave than anything else. Its a very long shot, i tought, but well, lets give it a shot, every one deserves an opportunity.

We carried on, my friend switched with another parter for CPR, he placed a tube on her throat, i placed an i.v. in her arm. The meds went in. I pushed a couple of times epinephrine while my partners switched positions a couple of time so better CPR is performed by someone who is not tired.

6 minutes went by, cpr stopped for the 3rd time so we could see what was going on with her electrical activity (EKG). Everything just froze, everyone looked at the cardiac monitor. Then we saw it. We heard a "beep", YES!, thats it, an organized beat. We got our fingers on her neck to see if there was a pulse....

There was none.

Well, we are making some progress, lets give her another 2 minutes of CPR and more epi.

2 minutes later everyones attention was again on the cardiac monitor. When the cpr stopped we looked at the screen and it was clear as normal saline. She had a very good rythm. Again our fingers went for the neck. And there it was; A pulse!!. Not normal, a little weak, but a pulse.

After a couple of more medications and a switch to a transport ventilator we got her out of there and into the hospital. The way out was not easy, it has a very small house. But with a little help from another unit we could manage to get out of there smooth and safe. We arrived at the hospital.

Out of the hospital return of spontaneous circulation in the USA is very low. Imagine here in Mexico, where no witness CPR is performed, where no instructions are given over the phone, where only one of every 10 ambulances has a cardiac monitor and sometimes the "paramedics" don´t know how to use it.

But still, there we were, we gave her an opportunity, she took it.

I wish with all my heart that you can make it out of the intensive care unit and give a hug to that son of yours that got out of the way the fridge with one push when we asked him if he could make some room for the stretcher.

Half.

2010-11-24T20:45:00.001-06:00

Well. Half the examination is done. Now the hard part. The practical examination.

We all have suffered/enjoyed it. The chills before it, the random toughts as your turn is called.

I am very glad that a lot of my students made it trough the first half. Now lets really see what they are made of.

Its almost time.

2010-11-18T12:53:00.000-06:00

I am an instructor for a EMT-I course.

As a previous post says this is the highest level in paramedicine that you can achive here in Mexico city, we have some medics or EMT-paramedics but they are very few and i don´t trust too much their knowledge and skills. but thats for another post.

A couple of months ago i had the opportunity of taking a group. It was a big surprise for me but well i love teaching and i couldn´t resist.

The class that was supposed to last for 10 months was a year old when i came to the picture.
"We have had a lot of problems with this group in particular, a lot of problems with the pople that were before you, a lot of administrative issues and a lot of internal issues." Thats what the head of the school told me when he asked me if i wanted in.

"I will take it." Thats what i told him.

The first day i took over the class i got to know all the problems. They were frustrated and angry with the system.

(Guess who was impersonating the system?)

So i received a lot of complains and a lot of questions. One of those was:

"¿Why you?, ¿Who are you to take this class in your hands?"

I just answered honestly. "Because I love to teach and I have the knowledge and the skills to pass it to you."

Almost every one looked me with that face. That "i don´t beleive a single word" face.
I said almost because i knew a couple of the students, they work with me, we have worked some shifts in the past, they just smiled at me.

The classes wen´t on for a couple of months and the trust build up. I know i am not entirely trusted by everyone, but what the hell, i only have them for a little more than two months. We practiced, we learned, we laughed, we cried and we shared.

I ask them to share with me why they were doing this job, why they were in the ambulance countless hours without knowing whats gonna happen next. They all shared their stories in private in a piece of paper, ones were great and touching, some others were not that insightful but i loved each and every one of them.
Then it was my turn, on the last class we were ever gonna have I told them why, why I am here and why I love this job. It is a great deal for me talking about my love for the job and I really don´t share it too much or too often, but i told them. I told them my story. Some tears left my eyes when I told them about the awful things I have seen and how they affected me and some smiles came across when I told them of my most great calls, when you can really see what mankind is made from.

The end is near. They have the examination on Saturday, and i am sure as hell i am as nervouss as they are. I don´t know how this will result. I really don´t know well my class as to have an acurate prediction of who is gonna make it, who has a good chance and who should enroll for the next one. I really don´t know.

I just hope they make me very proud and pay me back all my effort with their grades.

Let´s wait until Saturday.

Teeth

2010-11-09T19:42:00.000-06:00

We were called to a supermarket a few blocks away from our "station". We arrived ther in a couple of minutes.

Man down. Said dispatch when we got the called.
We entered the supermarket and in they told us the patient was in a coffee shop at the other end of the building, we hurried up.
When we got there we found a man lying on the floor next to a table and a worried family, he was 90 years old. He fainted, his son told me, but then he regain consiousness. My parter was performing a physical exam while i was talking to him. At some point to evaluate if he had a stroke my partner asked him. ¿Could you show me you teeth?
From the far side of the table we heard: "Hey!" "Hey" "Excuse me mister"
I turned around and saw the patients wife with something in her hand.

"The teeth" "You wanted to see them?" "She handed me her husband fake teeth"

The old lady was laughing as loud as she could, she was just messing with us.
The husband was also laughing.

"Well they seem pretty normal for me?" i told them.
"Do you need anything else" i asked my partner.
"No, thanks" he told me trying not to laugh.

Thats a good attitude.

Thanks.

2010-10-15T12:02:00.000-05:00

We were getting ready for the night.
Getting all our stuff and medical gear inside the ambulance.

We got an early call.

Pedestrian hit by a car.

He was not as bad as it could be. He was very scared because right next to him, before the car hit was a girl, his nephew. The girl was ok she didn´t was involved in the accident, just an inch or two saved from it. We talked to him and told him that the little girl was ok and there was nothing to worry about. He was so scared.
A little bit dissoriented and with a fractured anckle we took him to the hospital with his brother riding with us.

It was not one of those amazing calls where it seems that you use every skill that you learned. Insted was of those calls where you talk a lot.

After he was recevied in the hospital his brother saw us leaving an walk toward us.

"Thank you".
"Really really thank you"

Not in every patient we care for we have that.
Thank you is an amazing expression that people don´t use as often as they would.

200 years.

2010-09-14T18:08:00.000-05:00

September 15.

This is the date that Mexico is about to celebrate with all its heart.

This has been a big deal since the beggining of the year. Mexico is celebrating the first 100 of its revolution and 200 for its independence. 3 million people are going to be in the downtown or close to it partying, enjoying being from this great country.

I will be in an ambulance, waiting. Hoping that nothing goes wrong as so many people, including myself, think. That there is no massive attack from the druglords, that there is no multi cassualities incident.

Lets hope it ends up being the greatest celebration in years and nothing else.

Tomorrow there will me more on duty ambulances in the city that there has ever been. We don´t have any type of coordination. We even fight sometimes between ambulance services. I think that is gonna bring hell on us and we deserve it because we don´t "talk" to each other.

Its gonna be a long and interesting night.

I got my gear ready.
I got my head ready.
I got my hands ready.

I´m ready.

Its time to share.

2010-09-07T18:52:00.000-05:00

Your´s truly is now an instructor.
Well i have been an instructor for some years, but now i am an instructor in the biggest school of EMS in Mexico, and that´s a big deal for me.

This is a very important step to me, i think it opens a lot of pathways I can take to be a better EMT and also to share my knowledge with a lot of people. I like sharing and i like the fact that i am working to make a better system with more trained EMT´s.

I will be teaching a class for a group of emergency medical technicians that are taking the intermediate level (this is as far as you can go in Mexico, there is no advanced level nor paramedic) and i think they will do great.

Now you will not only read about ambulance stories but also some classroom stories. The questions are always the best part.

I always say that there is no dumb question, but hey, people try hard than you think, jejejeje.

31

What we don´t have.

2010-09-03T13:14:00.001-05:00

We don´t have fancy ambulances, nor the best equipment. We lack of safety gear sometimes. Our many defiiciencies complicate our lives every day as emergency workers.

We don´t have moderns defibrillators, nor the best and most modern rescue gear. Not a multiposition stretcher, not a oximeter in every ambulance, god, not even a BP cuff in every one.

But we have this.

Courage.

Thats right, you may lack all the material, all the technology but if you have courage you can get wherever you want.

Bring it!

12 shots.

2010-08-31T16:34:00.000-05:00

Those were the ones i could count in his chest before we could enter the Emergency room.

"You are gonna make it man, hang in there!" his friend yells are still heard at the darkest hour of my nights....

Long time away form home.

2010-08-20T12:08:00.000-05:00

It has been a long time since i posted something. I really think that the last post was one of the best i have every written.

Well tonight is Friday night and i will be in the ambulance 12 hrs. i know some good post will come after that.

Until that moment get´s here i will wait.

Patience is one of my greatest qualities.

In your shoes.

2010-05-21T16:38:00.001-05:00

20 year old man. Young and healthy.
You like to go out with your friends and have fun on Friday night and some times on Saturday nights. You have big expectations for your life (like anyone at that age) and you have goals and dreams that fill your life. Some good friends, some partying friends and a beautiful girlfriend. A normal life for your age, nothing very big but you enjoy every moment of it.

One night you go out clubbing with your friends. You don’t drink a lot because you know you just don’t like to get wasted, you have one beer and you stop there. A lot of fun, a lot of chatting a lot of dancing and finally the night is almost over. You leave the club at 4:00 am and decide to give a ride to one of your friends that is way to wasted to walk or take a cab. You are driving to his house, just 10 min drive from the club. And then; destiny/god/karma/life strikes.

Going at 70mph you see a couple of lights coming your way very fast, its pitch dark and you are caught by surprise. You try to get out of the way. There is no time for the brake. You realize you are not going to make it as you see the other’s car driver right in the eye.

A lot of noise, a lot of movement.
Silence.
You faint.

You regain consciousness when the paramedics, rescuers and firefighters extricate you out of the car. You are in bad shape. You leg hurts like hell and your head too. You see blood, flashing lights and unfamiliar worrying faces interrupting the night sky.

You scream as they move you into the ambulance. Now a lot of bright light and pain, that’s all you can focus on. You can hear far, far away when a paramedic tells you "Open your eyes, can you hear me?" You slightly open your eyes, the pain is still there but the light is less blinding.

His face gets close to your face and asks you question after question, you try to respond as fast as the questions come but you are getting overwhelmed.

The pain fades a little bit and a thought in the back of your head runs straight to your tongue.
"Where is my friend?"

"Where is my friend? My friend, he was riding with me."

The paramedic tells you that he doesn’t know how he is; he’s been taken to the hospital by another ambulance.

You are rushed to the emergency room.

They place you an oxygen mask. Take your blood pressure. You see the paramedics face as he tells the other one a number that just sounds random in your head but you realize he worries because of that "random" number. They tell you “You are going to feel a little pinch”. Little pinch! Auch. That hurts. They are giving you intravenous fluid.

The 10 minute ride in the ambulance seems to last a year or two and you feel every speed bump and pothole in your bones (literally). Your head is about to explode. The siren and the bright light right in front of your eyes are just too much.

You hear the siren goes off. Maybe you are fainting, but then you feel a bump and see the sky night again. Now there is only one thought in your head. Pain.
You don’t really know if your leg hurts more than your head. It doesn’t matter at all to you, it just hurts everything hurts. You scream again.

You enter an emergency room. You think its an emergency room, you really cant know for sure because you are strapped down to a stretcher and cant move an inch. You hear a familiar voice, well not so familiar. It’s the paramedic saying something. It’s a doctor, you can tell because the paramedic addresses him as that. You are moved again, more light, a lot more. You enter a room where there is a lot more people. You can hear them as they pass along and discuss “the case”. You can’t think straight because of the pain in your leg.

Another scream.

They just moved you to the hospital stretcher.

Doctors ask a lot of questions, you can’t keep track of them your head is hurting so much, so much. You start feeling dizzy and the pain is fading away. something is not ok, you know, you know that something is awfully wrong. You hear in the distance:

....crashing....

Craving

2010-05-17T15:24:00.000-05:00

We were just chatting in the ambulance. Talking about everything and nothing.

We got a call. Motorcycle skid.

A pregnant 17 year old was lying on the cold pavement. We aasesed her and realized that she had nothing serious, just a sprained ankle.

Everybody asked her why she was riding a scooter so late ar night if she is pregnant.
The Doctor asked.
My partner asked.
The nurses asked.
The social worker asked.
Even other patients asked.

She could only deffend herself saying:

"I had a craving for pie."

She totally won my heart. She was still a kid.

Hope with this she understands that midnight cravings have to be resolved by boyfriends or husbands or even friends.

Newspaper.

2010-04-26T10:46:00.000-05:00

Late in the night we were called to a car crash. On route the police informs us that there is a guy trapped in the car and that they will require the fireman to assist. When we arrive the scene is quite a view. There is newspaper all around the car, i dont mean some newspapers around, no, there are hundres and hundreds of them scattered all over the floor. The car that crashed was about to deliver them and had like 1000or more.

They hitted the sidewalk, then they smashed a tree head on, then the car went sideways and tumbled a couple of times until another tree stopped it.

In all that motion, the driver was expelled from the car. He was lying next to the car. There was nothing we could do for him.

The car´s roof was the thing that kept the other guy pinned in the car, it collpased so bad the drivers seat couldn´t be seen and the only thing we could see of the trapped guy was his head, neck and a couple of inches of his torso.

He was unconscious but breathing. My partner jumped into the wrecked car and cleaned his airway, just moments later, before the fire department arrived, he stopped breathing and his heart stopped.

The cardiac arrest in patients with that much trauma is almost impossible to reverse. Here we could do nothing, he was trapped.

We saw him take his last breath.

Domestic violence.

2010-04-12T11:57:00.000-05:00

Midnight.

We are dispatched to a beaten up person.

We arrive and there is a mid 20´s girl lying on a couch with her husband trying to comfort her.

We asses her. Nothing serious, a couple of bruises, a little cut in the lips. I ask her if she is comfortable with all the people in the room. She answers me: "My children, they saw everything... He was so drunk... he went crazy..." Two little ones aged 4 and 8 are on the other side of the living room scared as hell.

The police files a report but she doesn´t want to file charges. Police leaves. We also do.

She stays there with her husband and the children.

Come on.

2010-04-08T00:07:00.000-05:00

He was wasted. (More drunk than a cucaracha in September 15th)

They called us because he had a fight with his neighbor, traded some insults, some fists and then the neighbor released his dogs...

Dog bites in the arms, back and legs. Not that bad but one of those bites needed stitches. So here we go to the hospital.

On route he told us he was a very agressive person.

He repeated over and over again:

"That Motherf*** thinks he is so mean, well i will teach him... I am also a dog"

After a hearing this a dozen times it happened.

He started barking.

He made my night.
:)

Its just time.

2010-04-01T14:01:00.000-06:00

Are you an emt or a paramedic? What is missing in your ambulance service? You want/need a new toy, a new monitor? Something top of the line and ultra expensive that would make your patients outcome better? You need a new 100k ambulance? a new 10k stretcher?

The place that i volunteer for doesn´t has defibrillators, not one.
According to the health dpt in my country the heart related deaths are in second place taking the life of more than 55,000 people each year.
(This number only is succeded by deaths relating diabetes, the real silent killer > 60,000.)

And with all this in Mexico the "public" ambulances don´t have defibrillators nor cardiac monitors, nor medication for your chest pain nor for your infarct.

We are left with nothing to withstand the beating that cardiac illness is giving us.

The new monitor.

2010-03-26T16:55:00.002-06:00

A patient’s husband tried to “tip” us tonight. He was trying to give us the great amount of $1,000 pesos (Mexican) that’s about $90 dls. (That’s what a paid EMT does in five 12 hrs shifts)

We all turned the money down. It is not a rule and you don’t get suspended nor get in trouble if you accept a tip but we really don´t like it. Personally I am not a waiter and I don´t like to be tipped. I am a volunteer and I do it for a lot of reasons and neither of them is money.

So we turned down $90 dls. The monitor/defibrillator we want to buy is about $500 dls. A not so new but very functional Zoll PD 1400 or 2000.

I rather pay it with money I earn that with money that is given to me as a tip. I know it will taste better.

I hope soon there will be a post announcing the arrival of the monitor/defibrillator.

The dog.

2010-03-26T16:55:00.001-06:00

A couple of friends thought it was a very good idea to go out and have some
( 10 < some < 20) tonight. A guys night. Bobby, John and Spike (Labrador).

(All the names were changed to keep the privacy of Spike)

It was one of the funniest calls. One of the guys was sitting on a chair inside a bar at 5:00 am and when I entered the room I could clearly saw that his ankle was broken (Unless you are a yoga instructor or something like that you cant bend you body like that).

We tried to convince him that he had to go to the hospital, but he told us he was ok that there was nothing wrong with him, “I just tripped, that’s all. I am ok, come have a seat I buy you a drink”.
His buddy on the other hand was hysterical. Yelling all over the place, telling everybody that his friend need urgent help.
And on the other side (yes this coin has 3 sides) my partners were loosing their patience because of the constant negatives of the patient to be transported and with all the yelling of his friend.

I really enjoy watching my partner loose his very small portion of patience over a situation that involves late night calls, alcohol and attitudes. She is not that friendly with drunks. And yes they were VERY intoxicated.

The patients friend told us something like this about the broken ankle.

“He went outside to fight with the dog because it was barking a lot, then, the next thing I know is that he is sitting inside with his ankle like that.”

If that was a fight clearly the dog won. By far.
It was just sitting there on the sidewalk watching the police officers and us going back and forth.

All of a sudden our patient tried to stand up so he could go home. Well this was the moment I got serious and place my hand over his shoulder and didn’t let him rise so he couldn’t hurt himself no more. I finally, after 20 minutes of my endless patience, convinced him of going to the hospital. In route he said he was “so ok” that he will buy a drink to the paramedic that was driving the ambulance.

His friend kept looking back from the front seat to see how his buddy was doing. I just gave him a thumbs up and a little smile.

Later on the night I laughed so hard my stomach hurt. It was so funny watch one loosing it hysterically the other sit there and invite drinks to everyone and my partners go nuts trying to cope with them both.

There are basically two types of drunks, the nice ones and the nasty ones. A lot of times the one that you will get depends totally on how you treat them and your attitude.

Hope you get well. I know that in that moment it didn´t hurt a bit. I am convinced that once the alcohol was washed off your system this morning you were in hell.

Cheers Bobby.

Sad music.

2010-03-14T15:23:00.000-06:00

Have you ever played residentevil, or doom?

We are called to a suicede attempt and when we arrive we find a male in his 30´s that has cut his wrists and feet several times and has been drinking to dead in the last 4 days.

Finally he couldn´t resist no more and called for help to a neighbor.

When we got into his room it was a bloody scene. There was not a single square meter without blood and music staff pages.
Thousands of notes covered in blood witnessed his sadness.
His suicide note was not already finished.

He was so afraid.
Im sure we could have done more to help him.

Chivalry.

2010-03-14T15:13:00.000-06:00

An early call. around 1 am.

A man is sitting on the floor, from the ambulance we can se his head dripping blood.

He has street and jail tatoos over his body.
His slang tells you that he is the "thug" type.
He confesses being a drugadict.
Today he smoked crack and weed.
He was beaten up with a 30 inches pipe.
It was all because of a woman.

The best lessons are learned unexpectedly.

He got beaten up for defending his girl.

His 6 inches laceration to the head makes me realize me that no matter what kind of life you live, you can always stand up for the people you love and do the right thing.

He cried when he told us he was a drugadict...
He was very worried about his girl.

Hey Mr street thug, you just earned some points in my book.
Hope you get well soon.

Some of the things i did today.

2010-02-26T22:45:00.000-06:00

1.- Today i got the chance of easing the pain of someone. 16 hrs in the ambulance were worth it.

2.- Saw more than 10 patients that didn´t require transport to an emergency room in ambulance.

3.- I realized that sometimes when you buy an expensive car you are buying a lot of safety.

4.- I still smile when i am riding the ambulance all lights and sirens...

5.- A female patient tried to "make a move" on me. I was flattered and very uncomfortable. A funny partner didn´t help with the situation.

6.- I spent a lot of time in my shift thinking about the most beautiful girl i had ever seen and how much she makes me happy.

7.- I remembered that here in my country most of the fractures are set in place without any type of anesthesia or analgesics. (I still hear a high pitched tone because of that patients scream).

8.- I love my job.

Today.

2010-02-25T12:44:00.000-06:00

I will spend 16 hrs in an ambulance today (and tomorrow).

I expect to have a very good shift.

Let´s see what life brings.

Cheers.

Dealing with it.

2010-02-17T09:45:00.000-06:00

In the past few months i had a bunch of calls involving death.

I have seen a lot of people struck by the news of paramedics and cops telling them that there is just no human power to save their loved ones and witnessed a lot of reactions to this events in a lot of different circumstances. Each head is a world, each one takes the news different.

Screams and tears i have seen most. Swears and "i´m sorry for..." also have crossed my path. And a few "he went as he liked" came also.

I know it is part of my job, but i just want and need a very good call so the screams can be dulled.

Slip.

2010-01-31T00:16:00.000-06:00

All day without a call.

Just sitting there watching time go by, minute by minute, second by second. Me and my partner talked a little but then the silence slowly got into our ambulance.

Hours go by.

Suddenly the radio calls for us.
We speed trough the city, lights and sirens all the way.
We arrive there very fast. (ETA < 8 min)

Is a teenager who slipped on the roof of her house. She fell 3 stories head on collision with the concrete floor.
Too little i could do for her.
She coded on the way to the hospital.
Never came back.

You can loose it all in one simple and plain slip.

Life is darker and brighter today.

Things we learn

2010-01-27T21:18:00.000-06:00

You can learn a lot of things in the paramedic/medical/nurse school, a lot of knowledge will be placed in your hands so you can use it to treat the sick and injured, you will learn tons and tons of skills and manual tricks that will help you trough an amazing job in healthcare. Tons of hours in books and in patient contact will grant you great knowledge and skill that will be useful to form a professional career and aid those in need.

But I have noticed that you can´t learn something, there is something that can´t be learned in any book, not because it is to complex or because it is too simple, it is just because if you don´t have it now you will never do.

That is to be kind and loving with the people you treat. I have seen some of the best physicians, nurses and emt´s in my city wrapped in terrible human beings forms that just don´t have the right attitude towards the people who they are supposed to bring relief. They are not people that bring aid to the ones that are suffering, they mistreat patients, are rude and sometimes even disrespectful.

To those people here is a word of advice.

Quit your job.

Work at a desk.

Work via internet where you don´t have to interact with people.

We are not guilty because you suffered trough medical/emt/nurse school or even kindergarden, we don´t deserve to be objects of your twisted self conflicts and self-esteem problems.

And to those who are actually loving and caring, thank you. I will always admire someone who can share a smile of empathy and can hold a hand in the worst situation you can imagine.

Its not all about healthcare....

2010-01-24T14:41:00.001-06:00

You learn a lot of skills in emt school, from recognizing a true emergency to extricating an injured person of his wrecked car, but as time goes by you really know that what saves people on this job is time...

All that knowledge is worthless if you can´t get to the sick and injured fast, less than 10 mins. preferabbly between 4 and 7 minutes.

I hate the mexico city traffic conditions, i am sure that we have some of the worst emergency response times (talking about big cities in the world). In a regular day it can take you up to 30 minutes to get to a patient, and that plus the time you take getting to the hospital, its just depressing.

The other day i had a call, a patient seized, vomited and didn´t regain consciousness, he died 5 minutes later drowned in his own vomit, when we arrived he was long gone.

In Mexico people die because of the terrible traffic conditions.

Least expected, most unwanted.

2009-12-17T11:29:00.000-06:00

It was supposed to be a very good day.

I was on my way to some friends house where we planned staying all afternoon, cooking dinner and have a great time just because we deserve it.

So here i was thinking that the trauma bag that i always carry in the car didnt had gloves. Yes you know latex gloves, those that you wear when bloody situations. Well, i tought, i am just going to that friends house and when i come back i will place some gloves on the bag....

After 1 hr of driving we got there. The place that he lives is a very fancy condo complex so there is some security at the entrance. As we aproached the entrance we saw that the security guys were pale and running like chikens without head, so trying to make a joke on them i aproached one and told em "Hey where is the accident?" and to my surprise the answer i got was not the expected.

"Two workers just fell down from a platform"

And there i was trying to make a joke just when things couldnt be more serious. So immediatelly i told him that me and my friend were paramedics, he told us to park and some security guy will take us where the accident was.

We carried my trauma bag and walked into the condo complex a couple of turns a couple of stairs, a lot of walking a running, while we walked i asked the security guy what have happened, he told me that there were two workers painting on the side of the building and that they fell. I asked him, how many floors they fell. He didn´t know, he just told me it was quite a fall.

We got there. The view was disturbing.

There were two workers.
They fell from the 16th floor (40 mts aprox).

A very young paramedic was trying to do something for them. They were not breathing, I took my stethoscope and tried to hear a beat while checking for a pulse. Then i told the young paramedic that there was nothing to be done, they were already gone. They were in traumatic cardiac arrest and one of them had injuries that were not life sustainable.

The picture that now lies in my head is, as i said, disturbing.

I will try to set it apart with my other bad memories.

I hope god has mercy on those guys souls.

Good morning.

2009-12-09T00:38:00.000-06:00

I was sleeping in the back of the ambulance waiting for the next call.
It was about 4 a.m. and everything was quiet as it should be.

Suddenly the radio interrupts my sleep by shouting our ambulance number and directions for an emergency.

I am still sleepy when i hear the engine awaking from its well deserved sleep. Buttons click. Shifts to drive. Brake is off.

A loud high pitch scream penetrates the silence of the morning, its our siren, hauling its way through the few cars left in the road.

He steps on the gas. The siren sound is followed by the engine roaring and the ambulance runs like a devil in four wheels who spits fire that is reflected in the houses and cars windows. It keeps eating miles, getting us closer to someone that needs us.

Drinks a gallon of gas and asks for more, shifts trough 2 and 3 gear. Asks for more...

The siren changes tones from a there i go to a here i am behind your neck.

Drivers make space for us, sometimes right, sometimes wrong, making our ambulance shift lanes quickly and smoothly to avoid the sleepy cars.

Getting closer, a few corners, a few more speed bumps. A few more gas.

We get there. It is hot, hot and still roaring, knowing that it did good and that was a hell of a ride....

I love my job.

Safety.

2009-11-29T19:11:00.000-06:00

When you arrive and there are 50 people telling you what to do, you know that there is a problem with the safety of the scene.

This because some people have the idea that you are a fast taxi ride to the hospital, so you don´t have to do a thing on the scene of the emergency just scoop and run, other because they know "a thing or two" and know that the patient has to go as soon as possible, why, just because.
And in the other and mos recent case, because they might want to gun down your patient again.

Yesterday i was at an emergency scene where my safety and my partner´s safety was in great deal of danger.

The first thing they tell you in the emt school is no to enter the scene if it is not safe.
In Mexico the cops are as bad as you can imagine in scene safety, they don´t specify a zone where the emergency scene starts so it is always crowded with people that have nothing to do with the situation. Now when things get a little bit rough like in yesterdays emergency you really hate them for not doing their job right.

Once more, i placed my safety in the line, knowing that it was absolutelly wrong.

Will talk to the boss about this.

Slow shift...

2009-11-28T19:14:00.000-06:00

There are just a nomber of things you can do when you have a slow shift and there are no emergencies. Here is a small list so you get an idea.

1.- Talk with your partner.
2.- Check that the ambulance equipment is complete.
3.- Share a story with the third on board (paramedic student tha rides with you to get experience).
4.- Show and tell with the third on board about something of the equipment he or she doesn´t know well.
5.- Go and buy some food or chips or gum or whatever to chew...
6.- Eat what you just bought.
7.- Talk to your partner again.
8.- Tell the third on board that there are slow shifts and not because he keeps bitching about it its going to change.
9.- Check the ambulance equipment again.
10.- Play with your cel phone.
11.- Text someone that cares for you and have a mini text conversation.
12.- Re-read the text messages in your cellphone.
13.- Delete text messages.
14.- Text someone that is not so close to you and tell them that you are bored to hell.
15.- Call your girlfriend of boyfriend or wife or husband.
16.- Tell again the third on board to stop bitching.
17.- Wake up your partner and tell him that you are bored.
18.- Rub your arm until you can feel it normally again because of the punch that your partner gave you for waking him up.
19.-Change the rado station and sing.
20.- Say hi to the drivers that you see.
21.- Tell the cops that you were just saying hi, and that was not a sign of distress.
22.- Go aout and stretch your legs.
23.- Go in and bitch about how cold/hot is outside.
24.- Take a nap.
25.- Hit your partner for waking you up just to say he is bored. He is so unthughtful.
26.- Go back to your nap.
27.- Get up like a spring when you hear the dispatcher calling your ambulance.
28.- Spit a curse to the dispatcher for waking you up for a false alarm.
29.-Talk about false alarms with the third on board.
30.- Tell the third on board that this is the third time you tell him to stop bitching and there will not be a fourth.
31.- Go back to the nap.
32.- Hit the third on board, and tell him the fifth is always harder and in the face.
33.-Laugh about the third on board that woke up your partner to tell him that you punched him and got another punch for free.
34.- Spit another curse to the dispatcher just for remembering that false alarm.
35.- Nap again.
26.- Return to your base knowing that you did absolutely nothing and bitch about it with everyone.

I hate slow shifts...

Brothers of blood.

2009-11-26T15:21:00.000-06:00

We met some years ago. He was a very experienced paramedic and i was just a trainee trying to get a grip on this job.

I was his trainee for almost 6 months. In this time we get to know each other very well, we get along just fine and in the end we were very good friends, we had a few very good calls, and a few very bad ones.

In the end I think i owe that guy a lot of things. The way i drive, the way i talk to patients, the way i try to have fun doing what i love the most. The way i can´t let go.

I ran my first code with him. He taught me never to speak of the patient as if he/she wasn´t there (even if uncounscious).

I learned a lot from him. But the most i learned from that very funny and caring guy was respect. Not to give it away so easy, and to understand fully what it meant.

Thats why now a days years away from that time i can tell you all:

I will respect him all my life.
To the best i have ever met.

Drinks!

2009-11-19T16:31:00.000-06:00

--He just had a few drinks.-- The patient brother told us a little tipsy and with slurred speech.

--We are not the cops, you can tell us, there is no problem-- We told him, trying to convince him to let the truth out.

-- Just a few.-- He lied once more.

-- Just a few are like 10 or 15 or a few like 2 or 3?-- One more little push to see if he comes around and tells us the truth.

-- I don´t know. Not much.-- Lies again.

Later in the scene of this emergency the daughter of the man that was unconscious confessed that the man had two hole bottles of whiskey.

I hate drunks that lie to me.
But i hate more the ones that throw up in my ambulance! ¬¬

Why the worst...

2009-11-12T19:55:00.000-06:00

I have been on this job for a while... and have treated a lot of patients and got involved in a lot of emergency situations. A lot of screams and tears are remembered.

And with all this said there is a thing that surprises me a lot. Every time i tell somebody "new" in my life that i am a paramedic they ALWAYS (note the always in capitals to emphasize) ask me about my worst call. My worst patient.

"What is the worst thing you have seen?"

And this really gets me thinking why people want to know the most horrible thing you have ever seen. Why they don´t ask for the most amazing, the most fun, the mos thrilling, the most rewarding.... they always want to know the worst. Even if they know they can´t take it and at the middle of some of the horror stories we live on this job they ask me to stop.

I have had some very touching calls and some very bad ones that i tell people when i know i can take the emotional beating of remembering those situations.

But why? Why the worst?

From the sky.

2009-10-24T01:22:00.000-05:00

A 13 year old boy was washing his hands in the sink on the restroom in the 2 floor of his home. All of his family was downstairs in the celebration of a birthday. 3 or 4 kids were playing on the roof top. They all were having a lot of fun. Until a smashing sound was heard.

One of the kids stepped on a skylight dome.

This dome was directly over the stairs from the 1st to the 2nd floor.

A smashing sound was heard.

The dome didn´t hold.

She went down a little bit more than 7 mts.

The kid finished washing his hands and went downstairs to the party.

Halfway trough the stairs he caught a little frightened girl.

He raised his arms just in time. And hold the girl.

He told us his arms hurt... a little bit.

An angel fell from the sky. Another one was there for her.

Just amazing.

I am so sorry.

2009-10-21T22:20:00.000-05:00

He was laying there

not moving,

not breathing,

long ago his heart stop beating.

His wife couldn´t see him, she was isolated in her room across the hallway beacuse of a disease.

Trough the door she screamed and cried.

She couldn´t see. But she knew he was gonne.

We were just ther to confirm it.

I love you baby....

2009-10-13T16:53:00.000-05:00

It was late.

Too late actually, even for me, 4 or 5 in the morning. Well maybe it was too early instead.

We were dispatched to an hotel, a not very nice one near downtown. When we arrived a man opened the door, he was not from town, you can easy saw that because he was almost 2 mts and had a very strong accent. He told us that she was not breathing ok.

She was on the bed, her mouth had a little blood, she was not responding. She didn´t open her eyes when we talked to her adn was shaking violently.
.
.
.
Hold it right there and stop worring for her, she is not responding because she doesn´t want to.

This is the true story. She is not having a seizure.

They had a terrible fight he pushed her, she pushed him, he punched her hard on the mouth and then on the back.

Her instincts told her to fake an "attack". What type of attack? It doesnt matter, the purpose is to trigger a response in him a change of attitude. So the result is he starts worring awfully and stops hurting her.

When we were evaluationg her we convinced her that it was safe for her now because we were there. He was so worried and so embarassed he start crying.

We call the cops. In the 20 mins we were on the scene they didn´t arrived.

When we were leaving we told security at the hotel that the cops were called so they knew. He was so gratefull with us because we "fixed" her. He repeated on and on: "I love you baby, i am so sorry, i really really love you, i am an idiot."

I was thinking, how bad someone can hurt the people they say they love.

"In the name of god."

2009-09-18T23:28:00.001-05:00

The title of this post are the words that Luis pronounced before opening fire upon a policeman stationed in the mexican subway.

5 injured and 2 dead is the total of this senseless attack.

One ambulance was at the scene minutes after the first shot and they could hear the next 6 to 7 shots fired inside the subway. They did not enter the scene until the gunner was held captive by the "policia judicial" one of the most famous police in mexico (not the good type of fame).

Caos is the word that i am looking for. The policeman that was supposed to confront the perpetrator scaped running for his safety receiving 2 bullets in the back and leaving an unarmed civilian strugling with the gunner. He lost the battle when the gunner shot to his head.

We provide care to a bullet injured patient.

I am amazed of what kind of things are done in the name of god....

Saving a life....

2009-09-12T00:05:00.000-05:00

A lot of people believe that the work of paramedics is saving peoples lifes.

Thats just like saying that architects build the world.....

I cannot descibe what accuratelly means saving a life because i don´t even understand it. I have never been sure of "a save" as some emt´s put it. Its just an idea that fades away with hundreds of circumstances and variables, not being medicine an exact science you can´t expect an exact result after an intervention. And being emergency medicine one of the less exact lets say that i am not very sure of that one "save" that all the emt´s brag about.

Thats why i really don´t put a lot of mind on the "being a hero, saving lifes" part of the job. I just don´t buy it, i place my hard work on the other part of the job that is making a difference. I think that making a difference in someones life ranges from holding a hand in a very tough time to practice the latest skills learned to improve patient outcome. You may only be a hand that holds another and tells words of comfort, or you can be a skilled worker that gives about every inch of himself to make that was tought almost impossible in the worst situation just look easy.

With that said, i can now go to sleep, knowing that maybe i will never save a life, but i will make a big difference.

Two kids, two wheels.

2009-08-31T21:59:00.000-05:00

Cold rainy night.
About 23:30

A car is speeding down a bridge at about 120 km/hr, other is just going at 50 km/hr in the night traffic tring to get on the bridge.

One has just left his girlfriend home and its returning to his home.
The other one is going to buy some supplies for a party.

They both are kids, not even 21. They are not drunk or under the influence, not even tired.

Then suddenly one car in the bridge changes lanes without notice. The kid behind the wheel makes a sudden movement trying not to hit the changing lane car. He looses control, road is wet and he starts spining, 4 or 5 spins later he is jumping over the other side of an avenue.

The other kid is just seeing some lights getting close too fast. Then in the blink of an eye, he realizes that the spining lights are from a car that lost control, and worst of all, its going to hit his car. He grabs the steering wheel with all his strenght.

The last turn, and the spining car crashes the other car with its tail.

In one second both cars totalled and on opposite sides of the road.
A police car was some cars behind. He gets downs and inmediatelly calls for an ambulance.
We were 2 blocks away, and arrive the scene 1 minute later.

No one gets hurt.

We close this story saying:

If it is your turn, it is your turn. When its not, simply it is not.

A mechanic?

2009-08-24T18:54:00.001-05:00

Where we were.

It was around 05:00 and we were thinking what to eat, because we had a couple of early calls and we couldnt eat before that, so there we were really hungry and deciding where to go. Paramedics are known for their excellent knowledge of all the street stands and "fast food" restaurants in the city, but sometimes being a bless and sometimes a curse we couldn´t decide where to go in our universe of more than 100 posibilities.

So that´s right, we didn´t take our chance and the radio start hauling. We will be spending another call with our stomachs empty, the ambulance driver, picked up the ardio and reply to the call of the central.
"Proceed with caution, lights and sirens, to street Hidalgo number 00"
"What are they reporting central?"
"Its a female crushed by a car"

In that moment i started to ask myself; Crushed? why she didnt said ran over... or hit or struck by a car.....

A moment later the siren and the movement took me back to the ambulance. We were going trough the special lane only used for public transport buses, this is the best way of getting by some roads in extreme traffic conditions, and we were going fast. The look in the other cars drivers was of envy, we could use the public transport lane and they were stuck there in the city´s traffic.

15 minutes later, we were on the scene. Yes i know 15 minutes its a lot of time, but we were far far away and were the only ambulance aviable.

The EMT and driver get down from the ambulance, so as the other EMT and me.
We saw a female lying on the ground covered in grease and oil, and my first tought was, she is a mechanic and the jack went down or something like that, so i got close, and then something told me i was wrong, mechanics dont use high hills neither jeans and tank tops...

We start our assessment and in some point she told us how this had happened.
"I give it a couple of tries but the car didn´t started, its a very old car, so i figure out why not give the starter a couple of hits. i have done it before and it worked, it sometimes gets stucked, so i got in the front of the car, then crawled below it and then i give the starter a good strike. But i forgot something. I left it on the first gear....."

The car started and dragged this poor woman 2 and a half meters before stalling, bending her at the point that her ankles were in front of her eyes. She started screaming and the neighbors realized that something was awfully wrong, so some of them got there in a second and saw that she was trapped down there in a terrible position, so in a brave and quick move, a bunch of guys lifted the front of the car with their own hands and one of them took her out.

We placed her a cervical collar, gave her O2, got her in a stretcher (spineboard), and went to the hospital. In the way to the hospital she complained about a lot of pain in her pelvis, we couldn´t find any signs of internal bleeding so we were only partially worried. She could develop a mayor loss of blood over minutes so we constantly assesed her.

In the end she had the pelvis fractured in several places, but no internal bleeding.

She ended up realizing the terrible mistake she commited,
and where no one else could hear us we got to express what crossed our minds when we got down of the ambulance, that was:

-I tought she was a mechanic...-

"And remember, in the most difficult situations people do unbelievable things...."

It all started in darkness....

2009-08-24T17:29:00.000-05:00

Hello.

This is the first post of the ambulance stories in Mexico.

Let me tell you a little about me and this blog.

Fist of all, who I am. I am a Mexican EMT-Intermediate that lives and works in Mexico CIty. I have been an EMT for 5 years and have worked at several places. Right now i am a volunteer in the busiest emergency medical service of Mexico. This ambulance company treats and transports over 5,000 patients a year just in Mexico City.

This blog is just an reach out to the world so they can see what is like to ride an ambulance in one of the biggest cities in the world and its also a escape valve... so i don´t go mad while doing what i love most, and thats caring for the sick and injured. Most of the stories are patients that i have treated over time, and a little number of them are stories shared by someone else that i think deserve beeing here. Some others are intended to get you inside the mexican emergency medicine system. And some others are just for the experience of writing.

All the stories are real, but my ethics mandate that all the names are changed, the locations are not accurate, and so on, so the confidentiality every patient deserves is respected and honored.

You will find here some medical terminology, but as i write in english that is not my mother language i expect to keep it simple. So if you are not a health care provider don´t worry, it won´t be so hard to read. If you are a health care provider i hope you enjoy reading this, i love exchanging experiences with other nations EMT´s or paramedics and if you have a good story that want to share, contact me.

Well, with that said its time for our first story.

Comments are always welcomed.

And remember, in the most difficult situations people do unbelievable things....