transcript

Speaker 1:
[00:00] That is truly how I know you guys are friends.

Speaker 2:
[00:02] We're just like, fucking get lost.

Speaker 1:
[00:04] But anyways. Oh God, this is a full room. We have kind of a special episode we're doing. This is the Master Year Medics sponsored episodes turned up to like 11, and I have a special introduction that I'm going to absolutely wing on this whole thing with music playing and everything. So it could go effing horribly, but we'll see.

Speaker 2:
[00:26] But we're doing something special today, and I think I'm just going to let Spencer kind of explain what we're doing, but maybe after we introduce who's here.

Speaker 3:
[00:36] Yeah, let's do that.

Speaker 2:
[00:38] Yeah, you guys might remember a little while back, we were very privileged and had a great time on a wonderful podcast that is called something that I clearly remember because of the great time that I had.

Speaker 1:
[00:53] And I'm not just running upstairs from putting my kids in front of a television set to eat pizza so I could make this happen.

Speaker 2:
[00:58] But that's RideAlong?

Speaker 3:
[01:01] The RideAlong EMT School Podcast. Yeah, the RideAlong EMT School. Yeah.

Speaker 4:
[01:06] Oh yeah, yeah, exactly. There's another RideAlong. So we had to be RideAlong EMT School.

Speaker 1:
[01:10] But yeah, but it was really fun.

Speaker 2:
[01:13] And so we have Mike, Max and John all here and they're here from that podcast. And we had a ton of fun with them on there because you guys basically documented your lives going through EMT School. And it's so right in line with what we do on this podcast like and the same audience that, you know, when you guys were graceful enough to have us on your show, we couldn't pass up the opportunity.

Speaker 1:
[01:35] And now you're on our show.

Speaker 2:
[01:37] And I'll let Spencer explain exactly why.

Speaker 3:
[01:40] Yeah. So you guys are in the hot seat. So that Chris and I don't have to do it. We are doing, interestingly enough, a group scenario on this. But the same rules apply. There is an EMS god that I guess I'm going to play the role of. Chris is going to be my voice actor. So he'll have to come up with all of the names for all of the people. And then yeah, we are going to put you through hopefully challenging scenario. I'll be very sad if you're like, nailed it.

Speaker 1:
[02:25] Yeah. Yeah.

Speaker 2:
[02:28] Cause that's going to mean a couple of things.

Speaker 1:
[02:30] One, well, the main thing that it's going to mean is that Spencer, I guess the hard scenario. And then when it's not, we're going to be like, we're not good at this. This is, we thought it was hard because we're not good at our job, so.

Speaker 3:
[02:47] But, so let me explain the, sort of the system that you guys are working with before we start the scenario, so that everyone's on the same page. Cause you guys are going to be playing yourselves working through the scenario. So Mike and Max, you guys are both EMTs and John, you're a paramedic, yes?

Speaker 5:
[03:07] Yep, correct.

Speaker 3:
[03:08] Perfect. All right, so in this system, you guys are a dual EMT crew, and John is going to be on a paramedic fly car. The BLS crew is going to have BLS equipment and BLS medications. There might be some ALS equipment stored in your ambulance, like you'll have a monitor, but the monitor is on AED mode, but there's like a visual rhythm screen on it. The ALS fly car will carry narcotic medication. You'll have your own cardiac monitor, IVIO supplies, ALS airway stuff. RSI is possible in this scenario. Do you guys have RSI where you work? Because I know that some places are limited.

Speaker 4:
[03:58] I'm not familiar with that.

Speaker 5:
[04:00] Yeah, so yeah, they've switched the terminology to drug-assisted airway. Okay. Kind of to emphasize that this should be a controlled procedure. The word rapid gets people, you know, rushing through things, but-

Speaker 2:
[04:16] It does send the wrong message. It really does.

Speaker 5:
[04:19] Yeah, yeah. So, but yeah, so there are some stipulations for doing RSI in the places that I work, which is two RSI-trained paramedics performing that procedure together. So that is a limitation for me, but I think we might be able to work something out. If that is the case.

Speaker 4:
[04:41] Is that rapid sequence intubation?

Speaker 3:
[04:43] Yes.

Speaker 2:
[04:44] But if you're doing it right, it's actually really slow intubation.

Speaker 3:
[04:47] Yes.

Speaker 2:
[04:49] So, if you're doing things right.

Speaker 4:
[04:51] Just to hold us out to, we're in Pennsylvania, Max and I, so we're most familiar with Pennsylvania BLS protocols. Jonathan's in Virginia and North Carolina. So, there may be some confusion there, but we'll try and work through it. And we're well versed in the national EMT curriculum.

Speaker 3:
[05:16] So, this is a really large service area.

Speaker 1:
[05:19] Yeah. Well, so basically, basically what I'm hearing is that whenever something goes wrong, you're like, well, actually, that's just what we do in our protocol.

Speaker 6:
[05:26] Yeah. You're not familiar with it. That's the candid answer, for sure.

Speaker 4:
[05:30] In Pennsylvania, we just throw them out the back of the ambulance, and someone else comes and picks them up when it gets too hard.

Speaker 7:
[05:34] Absolutely. Yeah, that's not it.

Speaker 3:
[05:37] You guys don't do that? It's weird, huh? Perfect. So, I'm going to give you some hospital information. So, 20 minutes away from your scene.

Speaker 5:
[05:48] Whoa, whoa, whoa, whoa, whoa.

Speaker 2:
[05:49] We haven't even done the intro yet.

Speaker 3:
[05:51] Oh, fine.

Speaker 2:
[05:52] We haven't even called for an intro yet.

Speaker 1:
[05:56] My goodness, I had one job that I barely prepared for and I need to do it, all right? So, here we go.

Speaker 3:
[06:06] I'm so excited.

Speaker 2:
[06:08] Hopefully, you guys can hear this.

Speaker 6:
[06:09] We can.

Speaker 1:
[06:14] Do we hear it?

Speaker 8:
[06:16] Perfect. Welcome, everybody, to EMS 2020 Theatre. I am your head thespian, Chris Pfingsten, and today we have special guests from the RideAlong Podcast, Max, Mike, and John.

Speaker 7:
[06:28] Damn it.

Speaker 2:
[06:31] Max, Mike, and John. On today's episode, which is sponsored by Mass Geomatics.

Speaker 8:
[06:37] Originally, we used to use the 100 patient scenarios books, but we just found those to be so pedestrian.

Speaker 2:
[06:44] They still may be useful to you, so head on over to www.massgeomedics.com, check out their bookstore and see all the good literature that they have to offer. Now, I, Ezra Thespian, should also let you know that I am just an actor, and my host Spencer and the other people on this podcast are also just people you found on the Internet.

Speaker 8:
[07:01] We are just a group of morons trying to relay information out there, and we really don't replace anybody, not a doctor, not your doctor, certainly, not even your best friend when it comes to delivering care in the field. So please listen for entertainment only, take what you know and do with it what you will. But at the end of the day, don't fucking blame us. You're the asshole who followed a bunch of guys on social media when it came to saving a life. And with that, and see.

Speaker 5:
[07:33] Oh, bravo, bravo, sir.

Speaker 4:
[07:35] Bravo, bravo.

Speaker 2:
[07:39] All right, buddy, welcome to EMS 2020.

Speaker 4:
[07:44] Brilliant.

Speaker 1:
[07:45] On this show, we do weird shit. And that's it. All right. Perfect.

Speaker 2:
[07:51] Yeah, absolutely. Do we explain like the dice roll mechanism? Because most people listening by now probably know what the dice means. But every now and then these guys are going to ask for something and we're going to roll a dice. And that's going to determine if it goes well or not. That's it. Yeah.

Speaker 3:
[08:06] You're going to say, hey, I'd like to check a blood sugar and I'm going to roll and go, you got an E3 error, which you would have because you rolled a two.

Speaker 6:
[08:17] I'm heartened by the fact that you're rolling an actual dice. It just makes my heart warm.

Speaker 8:
[08:22] Yeah, it's real. Actually.

Speaker 2:
[08:23] So it's funny when we started this thing. So Spencer, Spencer has played D&D quite a bit. And when we, this was his idea and it's actually gone really well, which I have to admit, for the longest time, I was kind of like, I don't know if it's going to go well or not.

Speaker 1:
[08:37] But then it went significantly well.

Speaker 2:
[08:40] But when it comes to like the D&D stuff, we initially didn't, he was the only one that had dice. And then people heard we were doing this and people just started sending us like a ton of dice.

Speaker 1:
[08:55] So I have dice. In fact, what size of dice would you like? Because I have some that are like this big. They're just more nice.

Speaker 2:
[09:03] What's a murder dice?

Speaker 4:
[09:05] Oh, well, that's that's what OK. So I'm a bit of a nerd, too. And that's what made me fall in love with your guys' podcast, by the way. And nice. I had a I don't know if everyone else calls them this, but my DM used to call them murder dice.

Speaker 6:
[09:18] Yes.

Speaker 4:
[09:18] He wanted us to die.

Speaker 6:
[09:20] Yes.

Speaker 4:
[09:20] And do a party wipe. He would take out a D20, the size of a softball, and roll it on the table.

Speaker 1:
[09:27] Damn. Fair enough.

Speaker 3:
[09:29] The number can't be doubted.

Speaker 4:
[09:32] He's like, OK, well, listen, you could try and dispute this, but it is here is the dice of God.

Speaker 1:
[09:38] Yeah. Yeah. All right.

Speaker 2:
[09:39] Well, we have the well today.

Speaker 8:
[09:42] Gosh, I don't know.

Speaker 2:
[09:43] Murder dice might be really appropriate for what we're doing.

Speaker 1:
[09:47] Hopefully not. Anyway, that that that derailing aside.

Speaker 2:
[09:52] Please continue, Spencer.

Speaker 1:
[09:54] All right.

Speaker 3:
[09:55] Perfect.

Speaker 1:
[09:56] Yeah.

Speaker 3:
[09:56] So you guys will be playing yourselves in this system. We've got that dual EMT car. We've got the ALS fly car that Jonathan's going to be in. And I'm going to give you your hospital. So 20 minutes away from your scene, there's going to be a level three center, trauma center that has a a cath lab and some ICU services. And then 60 minutes away from this scene is a level one trauma facility. Flight is an option, but that is dependent on weather. And I hope you ask. I hope you don't ask. We'll see. You also will have a BLS volunteer, like a BLS volunteer fire department that responds in this area or can respond in this area. And so with that, we're going to have the paramedic fly car fly away for the time being. Jonathan, I'm going to kick you off this podcast. Did you do it?

Speaker 4:
[11:03] Man, I hope my radio works when we need that ALS internship.

Speaker 3:
[11:09] Let's see. Hold on. Before we kick you off, we should probably make sure we have a way of bringing you back. Oh, yeah.

Speaker 1:
[11:15] You guys got his phone number?

Speaker 2:
[11:16] Yeah, we were we chat regularly like we're already planning on cheating and just telling him what's going on. That's what I do. And I should warn you guys, Spencer and I have a separate chat window open that you can't see. So if we want to plan something deviously, we can. Yeah, don't you worry.

Speaker 3:
[11:35] All right. So here we go. All right. Farewell.

Speaker 2:
[11:43] Farewell.

Speaker 3:
[11:45] For now.

Speaker 2:
[11:45] Carry on my way where Jonathan's gone.

Speaker 4:
[11:49] How do we mess with him?

Speaker 8:
[11:51] We can.

Speaker 4:
[11:53] It's an MCI, right? Like we're like, it's total.

Speaker 8:
[11:57] Yeah.

Speaker 2:
[11:58] So tell you what, let's see how the call evolves.

Speaker 7:
[12:00] And then let's see where we can go from there.

Speaker 1:
[12:02] OK. Sure.

Speaker 2:
[12:03] Yeah. Because, yeah, we can mess with him.

Speaker 1:
[12:05] But we also we have got to made some level of integrity to the call, too.

Speaker 4:
[12:08] Oh, yeah. But yeah.

Speaker 1:
[12:10] But we'll just set whatever.

Speaker 3:
[12:12] Whatever it is, we'll just add fire to it.

Speaker 4:
[12:15] Oh, yeah.

Speaker 1:
[12:19] So when you say fire, do you mean fire department or just literal fire? Like a fire.

Speaker 3:
[12:24] Yeah.

Speaker 1:
[12:24] OK.

Speaker 4:
[12:24] Yeah.

Speaker 1:
[12:24] Yeah.

Speaker 3:
[12:25] Yeah. All right. So, Mike, Max, you are on an ambulance and you are dispatched out at nine in the morning. That was a dice roll that determined that. Yeah. You are dispatched out to a 70 year old male. This is an altered mental status with abnormal breathing at a private residence. The distance is about ten minutes away. And that is the information that you start this scenario with.

Speaker 4:
[12:56] OK. OK. All right. I have a couple of questions for you. Do do we have we been on shift and like is there somebody that has taken the last call?

Speaker 3:
[13:10] You know what? It's nine in the morning. That's a fair question. It's nine in the morning. I'd say you guys have been on shift for an hour and I don't know that no calls have happened. You've checked out your rig. You have found that you have everything that you need.

Speaker 4:
[13:24] OK.

Speaker 6:
[13:25] Nice.

Speaker 4:
[13:26] Because, I mean, it seems to me like the first thing we need to figure out is whose chart is this?

Speaker 6:
[13:33] Like, yeah, you are the senior EMT, sir. So therefore, I will drive and you can lead.

Speaker 2:
[13:41] You know what? I got a nice. Let's roll. OK. So Mike, Mike, here you go. Mike, you got a 10 max. You got a 15.

Speaker 6:
[13:51] I'm late empty. Everyone's dying. Let's go.

Speaker 2:
[13:54] No, no, no. You get to choose.

Speaker 1:
[13:56] Oh, yeah.

Speaker 6:
[13:57] Oh, oh, Mike's lady and Mike is definitely the EMT and Charlie. I will drive.

Speaker 3:
[14:02] There you go. All right. He already does have its privileges, right?

Speaker 6:
[14:06] Yeah.

Speaker 3:
[14:07] Or the higher dice.

Speaker 4:
[14:08] Anyway, yeah, if we ever get to run together on an ambulance, there will be a D20 and we will have to use it to determine whose call it is.

Speaker 6:
[14:15] I'll bring my own.

Speaker 1:
[14:16] I appreciate this. I appreciate this.

Speaker 4:
[14:18] All right.

Speaker 7:
[14:18] OK, so we've established that.

Speaker 4:
[14:21] All right. So how is this dispatched out? Is it emergent or do they do the emergent? OK, OK. So lights and sirens?

Speaker 3:
[14:30] Yes.

Speaker 1:
[14:31] How far?

Speaker 3:
[14:32] Ten minute drive.

Speaker 1:
[14:34] OK.

Speaker 4:
[14:35] All right. So just to make sure I heard you, it's a 70 year old male with altered mental status and difficulty breathing. And 10 minutes out.

Speaker 3:
[14:45] Yes. Yep. That is the information that you are given initially.

Speaker 4:
[14:50] All right.

Speaker 6:
[14:50] Lights and sirens with due regard.

Speaker 4:
[14:53] Yes.

Speaker 3:
[14:53] Oh, nice. Yeah.

Speaker 4:
[14:54] Yeah.

Speaker 3:
[14:54] Good call on the due regard. I'll cross that and counter off my list.

Speaker 1:
[14:59] He rolls a dice. Gotten an accident on the way there. The entire episode is you explaining it to a supervisor and then taking a P test.

Speaker 3:
[15:11] All right. So in route, you're about five minutes into the street or five minutes into the response. You get this information from Dispatch. CPR instructions have been given to the caller.

Speaker 4:
[15:27] Okay.

Speaker 6:
[15:29] Okay.

Speaker 4:
[15:30] Interesting. All right. So part of the drive, as the guy in the right seat, A, I think I should be trying to help Max as much as I can in terms of navigating there, which doesn't happen nearly as much as I hope it does or hope it would in this profession.

Speaker 6:
[15:50] Window mount, phone, GPS. Yeah.

Speaker 3:
[15:54] Okay. Yeah, yeah, yeah.

Speaker 4:
[15:55] Assisting him in that, but also, I think it'd be good to go through like a rundown or what do you guys call it? It's the pregame.

Speaker 3:
[16:04] Pregame. Yeah.

Speaker 6:
[16:05] Okay.

Speaker 4:
[16:06] So, Max, I think when we get there, if we can really just make sure that we are chatting with each other, if we see anything, I'll call out what I'm doing, you call out what you're doing. That's, I think, the first and foremost, just so that we don't make any mistakes or double work. Right?

Speaker 6:
[16:25] Got it.

Speaker 4:
[16:26] When we get there, if you could focus on ABCs, ex-ABCs, primary, if you see something with the airway, because we're getting difficulty breathing, make sure that you're focusing on that, and we'll trade off stuff from there. And yeah, I think that'll be how we work that problem. And if there's nothing that we need to start doing, if you could start getting vitals, while I assess the situation, and if we need to, hopefully we'll get the chance to go into a secondary assessment, I'll start going into a secondary assessment.

Speaker 6:
[17:02] And can we call medical command to get that BLS volunteer group on the way? Because if we're doing CPR, let's get more hands on scene.

Speaker 4:
[17:09] Well, actually, I would, just to amend that, in our protocols, I would, this would be something that I would call ALS for right now.

Speaker 6:
[17:18] Yeah, yeah.

Speaker 4:
[17:20] Because reading problems in Pennsylvania are like an automatic ALS call.

Speaker 6:
[17:25] Yep.

Speaker 4:
[17:26] And something I'm like, well, that's serious enough that I would probably call ahead. And if we don't need them, we can cancel them.

Speaker 6:
[17:33] Yeah, but if CPR instructions are going out, we should definitely get ALS moved.

Speaker 2:
[17:37] And so actually, unfortunately, and Spencer correct me if I'm wrong here, your ALS flight car is actually already on another call right now. So it's going to be a bit of a delay.

Speaker 6:
[17:45] Of course.

Speaker 2:
[17:46] Yeah, absolutely.

Speaker 1:
[17:47] You have earbuds and you don't need to add the headphones on just to look cool.

Speaker 3:
[17:51] I felt left out.

Speaker 6:
[17:52] I know.

Speaker 4:
[17:56] That was nice. Oh, and just to add on to that to that pregame Max, if CPR being that we heard that CPR instructions have been given when we get there, let's grab everything, all the stuff, all the kit because everything goes in the structure, everything goes in the house. Also, I know we will get bonus points from Chris. And let's bring all the stuff in. Make sure we grab the Lucas, the heart monitor and whatever, whatever primary bags that we have.

Speaker 3:
[18:30] All right, so we're going to, so Chris is right, ALS is actually on another call. So they're going to get them to you as soon as possible. Let's roll to see your fire department response. So, availability, you need to get above a five. And then from there, I have different things. So you got an 18, so you are actually going to have a volunteer EMT crew of two additional people who will be responding. So they have been added to the call. Their ETA to the scene would probably be about like five to seven minutes after you arrive. But they are there. And then dispatch just says like, we'll get you ALS as soon as possible. So, yeah. That's great. All right.

Speaker 2:
[19:23] So also, can you guys expedite this call after this, I have a transfer pending.

Speaker 1:
[19:29] You could.

Speaker 3:
[19:31] That'd be great. Okay.

Speaker 4:
[19:35] So you got. TPS reports.

Speaker 1:
[19:38] Well, well done, sir. Well done.

Speaker 3:
[19:39] Yep.

Speaker 4:
[19:41] Lumbered.

Speaker 3:
[19:43] All right. So you guys arrive to a single story residence. There's a car parked in the driveway. There isn't room for another vehicle. So you probably will have to park on the street, but it's a short distance from the street up the driveway, up to their front porch and then into the house. So here you are. You have arrived.

Speaker 6:
[20:14] Nice.

Speaker 4:
[20:15] Any difficulty with parking? Like can we park the ambulance in a way that will not delay us in getting inside, but will allow for rapid egress if we want to?

Speaker 3:
[20:26] Yeah, you could do that if you like parking along the street. How would you park along the street since you can't really pull into their driveway?

Speaker 6:
[20:37] Park along the street just past the driveway or just back across the grass.

Speaker 3:
[20:44] We'll roll for rain.

Speaker 2:
[20:46] I will say so in the Northwest, because so much of our soil is very, very saturated and loose, grass is just a great way to never get your ambulance away from residents.

Speaker 1:
[20:57] And so like it's just we'll sink them right to the axles.

Speaker 2:
[21:00] Ask me how I know.

Speaker 1:
[21:04] I've never done it, but I was a supervisor and so many calls.

Speaker 7:
[21:07] I like people being like, hey, so there's some mud. I already know what happened.

Speaker 2:
[21:13] The best part was, so brief tangent, that was a call that happened. They went around like a code, like out in the mud and like declaring someone found this guy in a bush.

Speaker 7:
[21:23] And there's like, oh, he's been super dead.

Speaker 2:
[21:24] And then we finally got them unstuck. And then the ambulance came back, it's covered in mud. And I'm like, where's the monitor?

Speaker 7:
[21:29] And they're like, oh, fuck.

Speaker 1:
[21:31] And so we go back on scene, we find the monitor just buried and caked in mud as well.

Speaker 2:
[21:35] Jesus.

Speaker 1:
[21:35] It still ran. Philips MRX 2, it did great.

Speaker 2:
[21:38] But anyway, it's sponsored by Master Eometics, not Philips, so we can read that.

Speaker 3:
[21:46] All right. So yeah, no. Okay. So you park, we'll say you park along the street. And as you described, so you have easy access to get in the gurney up the driveway. Okay.

Speaker 4:
[21:58] Great. Max, I'd say the gurney is well, we'll probably want that, but let's being that we got called for CPR, I'd say, let's get in there. Let's see what's going on. If we need to, we can come outside or the volunteer teams right behind us. So we can always tell them to go get the gurney. All right. So I'm going to grab probably the first in bag.

Speaker 6:
[22:20] And I'll grab the Lucas Neo 2.

Speaker 2:
[22:24] Okay. Really quick, can you guys elaborate on what's in a first in bag for you guys?

Speaker 4:
[22:27] Oh, so for us, this is actually a topic that we talk about often on our podcast because we find that there is differences in everywhere. For us, a good BLS bag would be something that has things that take care of the XABCs. So a trauma pocket that has, that can take care of exsanguination, an airway bag, the airway should be in that first in bag for us because that's one of the things that you need to take care of first, which is strange because we've come across first in bags that do not have airway stuff in them that's sometimes in a separate airway bag, but yeah, so it would be, you know, trauma pocket, airway stuff, probably some basic meds, like the nitro if we can carry it, and aspirin, that type of stuff, and wow, now I'm blanking on what's in our first in bags.

Speaker 6:
[23:28] So you have an IV starter kit with fluids, you have-

Speaker 4:
[23:31] Yeah, but that's ALS stuff.

Speaker 6:
[23:33] Yeah, but that's our first in bag.

Speaker 4:
[23:34] There's usually a lot of ALS stuff in the bag.

Speaker 6:
[23:36] Yeah, there's a lot of ALS stuff in our first in bag.

Speaker 4:
[23:41] I ignore those pockets, but the ones that I'm really worried about are the assessment tools, the things that we're going to be using on the BLS side.

Speaker 6:
[23:49] Yep.

Speaker 3:
[23:51] Okay.

Speaker 4:
[23:53] Sorry. So I'll grab that and I'll head in. Is there anybody waiting for us, anybody flagging us, anybody telling us what's going on as we come inside?

Speaker 3:
[24:02] No. So that is the thing is you arrive to find, there's some lights on in the house, but there is no open door, there's no one waiting for you.

Speaker 4:
[24:13] So the front door is closed?

Speaker 3:
[24:16] The front door is closed.

Speaker 4:
[24:18] Okay. I guess I'm going to just double check whatever notes that I took to see if it's the right house.

Speaker 3:
[24:26] Yeah. So how would you do that? What would be your?

Speaker 4:
[24:31] Well, probably check versus my CAD, my computer aided dispatch. Usually I have that on my phone and then the house number and I try to pay attention to what street we're on as we come on there. But I'd want to make sure that the house number is on the house before I barge in through the front door.

Speaker 3:
[24:49] Yeah. No. So all of that lines up. Yeah. It is the correct house.

Speaker 4:
[24:55] So I'll walk up to the front door, knock, knock, knock. Any answer?

Speaker 3:
[25:00] No answer.

Speaker 6:
[25:01] So as he's doing that, I would probably go around the side door, see if I get any response if there is one there.

Speaker 3:
[25:07] Okay. Yeah. So you go to the side door and you knock, there is no response.

Speaker 6:
[25:12] Is the door locked?

Speaker 3:
[25:14] The door is locked.

Speaker 4:
[25:16] Is the front door locked?

Speaker 3:
[25:17] The front door is also locked. I'm glad you asked.

Speaker 6:
[25:23] All right. Well, I guess circle the house. Just see if there's any other entrances, exits.

Speaker 3:
[25:28] Okay. Yeah. So on a seven, you guys circle the house and unfortunately you don't see any other entrances that are open. You don't seem to see like there's some windows that you can look through, but there's no one visible through those windows.

Speaker 6:
[25:46] All right.

Speaker 4:
[25:46] So I'm going to I'm going to call county or dispatch and let them know like, hey, we're at the address. We well, I would also tell them we've responded and that we've arrived. But just to make sure like, hey, there's no response to the door. All the doors are locked. No access. You know, advise for further.

Speaker 3:
[26:07] Yeah. Okay. So I'm going to let's see what happens. All right. So on a six dispatch says, yeah, we're not on the phone with the person anymore because they were doing CPR. We'll try and call them back. Yeah.

Speaker 6:
[26:29] Okay, I might go. Is there is there a house is closer than any of the others?

Speaker 3:
[26:35] There is a neighboring house.

Speaker 6:
[26:37] I'll go to the neighbor's house, knock on the door.

Speaker 3:
[26:39] Okay. Let's see if anyone's home. I'm going to roll and on a 12, we'll say that someone is home. And Chris will be that someone.

Speaker 6:
[26:50] Hey, hey, how you doing? We're here for.

Speaker 7:
[26:53] By the way, by the way, I need to describe the person you're seeing.

Speaker 2:
[26:57] You open the door and a gentleman who he has, basically he has a sweater on, a pair of tighty whities and nothing else. He smells like a full carton of camels. It's been lit on fire on one end.

Speaker 6:
[27:11] Got it. So hey, we're responding to your neighbor's house. They were saying something about they were having some kind of an issue with breathing.

Speaker 4:
[27:18] Do you know anything about it?

Speaker 7:
[27:20] No. I mean, you guys are you guys have been here before, so to her house. Yeah.

Speaker 6:
[27:28] His house.

Speaker 7:
[27:28] Yeah. No, not my house. Their house.

Speaker 6:
[27:31] Gotcha. Do you happen to know a phone number or do you have a key?

Speaker 7:
[27:36] Maybe. Oh, I mean, like, I can call. I don't have a key, but I did. Uh, uh, I dog sit for them once. I got your dog died like a year ago, so I haven't been back or at least that's what I'm assuming because they haven't asked me to come back, which I think is fucked up because I did a really good job. I bet you did. Yeah.

Speaker 4:
[27:58] But if you go into the house when dog sitting.

Speaker 7:
[28:02] Yeah. So so let me be clear.

Speaker 2:
[28:04] Like they didn't ask me to dog sit.

Speaker 7:
[28:05] I just assumed they really needed it when they left.

Speaker 6:
[28:08] Gotcha.

Speaker 2:
[28:09] And then they were like pissed off about it, which is pretty stupid.

Speaker 6:
[28:12] How did you get in?

Speaker 7:
[28:14] So if you go to the back, there's there's like a door.

Speaker 2:
[28:18] It may be locked, but if you grab the door handle and you just pull up really hard and then push in, it comes off every time.

Speaker 6:
[28:23] And that's awesome, man. I really appreciate the info.

Speaker 7:
[28:27] Yeah. Do you like have a dog?

Speaker 6:
[28:29] Yeah, I do. Yeah.

Speaker 2:
[28:30] Anything?

Speaker 6:
[28:31] Yeah. I need to go check on him real quick. So yeah, just let's go.

Speaker 3:
[28:36] I'll let you go when you're done.

Speaker 2:
[28:38] Just come on back. We'll talk.

Speaker 6:
[28:39] You got it. Thanks.

Speaker 1:
[28:40] All right. Cool.

Speaker 6:
[28:42] Go to the back door. Try and open as instructed.

Speaker 3:
[28:46] OK. On a 15, the trick works from the dog sitter.

Speaker 6:
[28:54] All right. Enter the home.

Speaker 3:
[28:56] OK.

Speaker 4:
[28:56] Hello, EMS. Dad, here. OK, we're we'll start walking through any anything potential dangers, scene safety type stuff that would be concerning.

Speaker 3:
[29:11] Nope. This looks like a very regular, well cared for at home. No presence of a dog.

Speaker 6:
[29:18] OK. I'm going to go to the front door, unlock it and open it.

Speaker 4:
[29:23] And I'll head towards the voice.

Speaker 3:
[29:25] OK, gotcha. So you guys are kind of splitting the party at this point. OK, so the front door is easily unlocked with the latch. And Mike, you proceed into a bedroom where you find the following scene. There is a gentleman who is on his knees performing CPR on a 70 year old male.

Speaker 8:
[29:51] Mom, what was the song?

Speaker 1:
[29:53] Stay It Alive? OK. Hi.

Speaker 7:
[29:55] Hi.

Speaker 2:
[29:56] Stay It Alive.

Speaker 1:
[29:57] You just keep going, Spencer.

Speaker 2:
[29:58] I'm just in the background, man. I got this.

Speaker 3:
[30:00] Yeah, no, I love this. I love this. So this is a 70s male. He's about, we'll say, like 5'10, 180 pounds. You see him there on the ground, supine.

Speaker 8:
[30:14] Mom, just have a seat.

Speaker 1:
[30:15] It's okay. All right. Just don't freak out.

Speaker 3:
[30:18] There is a mid 40s gentleman performing CPR. And in the background, there is a very distraught spouse.

Speaker 4:
[30:29] Okay. Okay. So first thing first, hey, what's your name?

Speaker 2:
[30:37] Sean, but it's spelled like like seen like it's not the S-H-A-W-N. It's S-E-A-N.

Speaker 4:
[30:43] Okay, see on I'm going to jump in here. Can you pause CPR for a second?

Speaker 2:
[30:48] So tired. Go for it. And he immediately just gets up and walks away.

Speaker 4:
[30:52] So I'm going to I'm going to kneel down.

Speaker 6:
[30:55] I would have come by now.

Speaker 4:
[30:57] Yeah. And I'm going to I'm going to check for carotid pulse. Listen for breathing. Look for chest rising full.

Speaker 6:
[31:03] I'm going to get the AED ready.

Speaker 3:
[31:05] Okay. So you check for a pulse. Where would you check for a pulse?

Speaker 4:
[31:10] Carotid artery.

Speaker 3:
[31:12] Okay. Carotid pulse check. You you don't feel any pulse.

Speaker 4:
[31:18] Okay. No pulse. Well, I'm going to jump on the chest then and start compressions at 100 beats per minute and let Max know, Hey, man, I'm starting chest compressions here.

Speaker 6:
[31:29] Roger, Roger. I get the AED out, place pads and then break out the BBM and get on breaths.

Speaker 3:
[31:38] All right. So, Mike, you are doing compressions 100 a minute. Max, you have placed the AED pads on and then you have grabbed the BBM out. Okay. And go ahead and describe for me the AED placement and then the BBM breaths.

Speaker 6:
[32:01] I would have one pad on the patient's right chest and the other pad on his left side, on his ribs.

Speaker 3:
[32:09] Okay. An anterior lateral position. Got it? Okay. And then...

Speaker 4:
[32:20] It's a shame that people cannot see this.

Speaker 6:
[32:23] Yes.

Speaker 1:
[32:23] Oh no, they will. This is the one that I've got to make sure this happens in case anyone was like... Yeah.

Speaker 4:
[32:29] I didn't realize Mother Teresa would be in the corner.

Speaker 6:
[32:31] It's a grape of bush, I have to say.

Speaker 1:
[32:33] This is hair.

Speaker 2:
[32:34] This is the one with hair.

Speaker 3:
[32:36] Yeah.

Speaker 1:
[32:36] So you know.

Speaker 3:
[32:36] And gray. It's perfect.

Speaker 6:
[32:38] Yeah.

Speaker 1:
[32:38] Okay. Absolutely.

Speaker 3:
[32:39] So describe for me BVMing this patient.

Speaker 6:
[32:41] I'm gonna do BVMs once every six seconds.

Speaker 3:
[32:46] Okay.

Speaker 6:
[32:47] Or once every 30 compressions.

Speaker 3:
[32:51] Gotcha. Okay. Once every six seconds. Okay. So, yeah, I'll start. You guys be doing that.

Speaker 6:
[33:00] And I'll start talking to the I'll ask the the question questions like, could you tell us what happened, ma'am?

Speaker 2:
[33:07] I don't know. I just I've been married to Teddy. Teddy's. Teddy's his name for so long. And he was coming down. And like at first, like he calmed down. He said he wasn't feeling very good. He was kind of like, like grabbing his chest or something. I'm not sure. And he said he couldn't like catch his breath. So I tried to like have him like sit down and I had him like, oh, I see the second. But anyway, I had him sit down and then he just got like really weak and then he laid back. And then he was like asleep, like he was maybe snoring or something like that. And then I tried to like do chest compressions. And I forgot that Sean was here. And it's, but I tried to do like, he just like, he wasn't breathing. So I called 911. They told me to like do the thing and push on his chest. I got exhausted. And then like Sean came down, I was like, mom, what are you doing? And then he got on the phone with, with you guys, I think.

Speaker 6:
[34:08] Got you.

Speaker 2:
[34:08] And then he started doing it. And I've just been sitting here, just trying to catch my breath.

Speaker 6:
[34:13] Well, you did a great job. You did a really great job.

Speaker 2:
[34:15] I don't know.

Speaker 4:
[34:16] How long ago was it, ma'am? How long ago did he fall down?

Speaker 2:
[34:19] Oh my gosh. I don't know. Like maybe, I mean, I think, I called you guys like right, like right away when, well, he didn't like fall hard. Like he kind of like, like I was able to like lower him down the ground. He just got weak and then fell. But I don't know, maybe 15, 20 minutes tops or so.

Speaker 6:
[34:34] Okay.

Speaker 2:
[34:35] Actually, wait, Spencer, what was the distance?

Speaker 1:
[34:36] How long did they have to drive to get here?

Speaker 3:
[34:38] 10 minute drive to get there.

Speaker 2:
[34:40] Yeah, so 15 minutes, 20 minutes tops.

Speaker 6:
[34:44] Does he have any history of heart disease, heart attacks, is he taking any medications?

Speaker 2:
[34:51] His whole family does. He does have some medication. Sorry, I just have to catch my breath.

Speaker 6:
[34:56] Do you have to catch your breath? I'm going to put some O2 on maybe, well, when the volunteers get here, have them put some O2 on the wife.

Speaker 2:
[35:06] I'll just, you need to first focus on him. I'm fine, but he's got, he's got medications. He has, there's like a, like a, there's a pill that he takes that dissolves under his tongue.

Speaker 4:
[35:19] So, at this moment, Max, do you have oxygen on the, on the BVM?

Speaker 6:
[35:22] I can put it on there. I do not currently. I will.

Speaker 4:
[35:25] Get 15 liters going on the BVM too.

Speaker 6:
[35:27] You got it.

Speaker 3:
[35:28] Okay, perfect. So 15 liters per minute of oxygen has now been added to the BVM. And at this point, too, okay, we're going to have a. We're going to. Oh, I get to pick what should. We're going to have two EMTs come in. One of them is going to have a California accent, like a Valley girl accent.

Speaker 4:
[35:57] Stuart, what are you doing here?

Speaker 3:
[36:03] I'll let dealer's choice for the for Chris for the other one. But perfect. Yeah.

Speaker 1:
[36:07] All right.

Speaker 2:
[36:08] So now I'm first responders.

Speaker 3:
[36:10] Now you are two EMTs.

Speaker 1:
[36:12] All right.

Speaker 8:
[36:14] So guys, what's going on?

Speaker 2:
[36:16] Anything I can help out?

Speaker 4:
[36:20] Hey, brother, can you jump in here? Yeah, just compressions for me.

Speaker 2:
[36:23] Yeah, no problem. By the way, my name is Tanner. And this is my this is my guy. He's like my my ride or die.

Speaker 8:
[36:30] This is this is Avery Avery.

Speaker 1:
[36:32] Say hi. Sup, y'all.

Speaker 2:
[36:33] How's it going?

Speaker 1:
[36:36] Looks like you guys have yourself a little miss up here.

Speaker 6:
[36:39] Something like that.

Speaker 1:
[36:40] What can we do for you?

Speaker 6:
[36:41] If you can just help help my partner Mike here with compressions, that'd be fantastic. And if the other one of you could, it's not a problem.

Speaker 4:
[36:47] I need someone jumping on chest compressions here.

Speaker 6:
[36:49] Yeah.

Speaker 1:
[36:49] All right.

Speaker 2:
[36:50] Sounds good. I'm on it.

Speaker 4:
[36:52] All right.

Speaker 2:
[36:55] Apologies, any Texans and or Californians out there. I understand these are stereotypes and that all of you fall under this. This is me just doing a terrible impression.

Speaker 6:
[37:05] This is fantastic.

Speaker 4:
[37:08] Tanner's jumping on on on chest compressions. I'm going to try and jump up into a role of trying to coach the team to make sure that we're all we're all staying in line. How's Max doing with chest compressions or sorry with with BVN ventilations?

Speaker 3:
[37:25] Well, let's take a roll and see. So on a 13, he has good mask seal and he is getting when when there are breaks in the compressions, you do see that there's some chest rise that is a.

Speaker 4:
[37:40] Okay, cool. And does does Tanner look like he's, you know, going at 100 beats per minute?

Speaker 3:
[37:48] Yes, yes.

Speaker 4:
[37:49] What is his song? That's the most important part.

Speaker 3:
[37:52] It's Baby Shark.

Speaker 2:
[37:54] Oh, that's I just love that because I like to surf, you know, you know, and so I'm just like, Baby Shark, did it did it did it baby shark did it did it did it.

Speaker 1:
[38:03] This is more like a grandpa shark to me, though.

Speaker 4:
[38:07] My my my personal favorite, the whole time I was doing chess compressions, by the way, it was Enter Sandman by Metallica.

Speaker 6:
[38:14] Yes.

Speaker 1:
[38:15] Another one bites the dust.

Speaker 4:
[38:18] That's I guess. Well, Enter Sandman is kind of in the same category.

Speaker 3:
[38:22] I'd like it's more likely to be the case.

Speaker 6:
[38:24] I like this Avery to go get the stretcher out of the ambulance and get that deployed towards the front of the house.

Speaker 1:
[38:32] He's on it.

Speaker 4:
[38:34] Actually, yeah, Avery, get the get the stretcher. And then when you come back with that and prep it, can you can you come in here and start setting up the the Lucas for us?

Speaker 6:
[38:43] Is the AD sent? Is it saying it need that there's an appropriate moment for charge or how is it reading?

Speaker 3:
[38:50] So the you put the pads on.

Speaker 4:
[38:54] Oh, we didn't hit the we didn't hit the button.

Speaker 6:
[38:56] Ah, yeah, yeah.

Speaker 4:
[38:59] We should turn that on.

Speaker 2:
[39:00] I'll just let you know when you go ahead and get that stretcher right quick. But I also want to let you know that in Austin, Texas is going to be fast 26, a co-habitatant with EMS World. And you should get your tickets now by going to fbefast.com. All right, I'm going to go get that stretcher now.

Speaker 3:
[39:16] All right.

Speaker 4:
[39:16] Let's so so in trying to to kind of back away for a second, I'm going to make sure the D still go and hit the hit the start button on that. I'm also going to make a radio call to County to let them know that CPR has been initiated and to expedite ALS.

Speaker 3:
[39:32] OK, gotcha. Yes. So County says, yes, we will. We're trying to get one out of the hospital right now. They're just dropping off a patient. They will be coming. They will be in route to you shortly. Then the AED says, oh, hold on. Chris, you're the AED. Oh.

Speaker 2:
[39:54] Plug in pads connector. Did you already do that?

Speaker 3:
[39:58] We'll say yeah.

Speaker 2:
[39:59] Perfect. Apply pads to patient's bare chest. Done.

Speaker 3:
[40:03] Already done.

Speaker 2:
[40:05] Analyzing heart rhythm. Stand clear of patient.

Speaker 4:
[40:09] All right. I'll tell everyone to stand clear of the patient.

Speaker 2:
[40:13] Shock advised. Stand clear of patient. Press shock button.

Speaker 4:
[40:25] All right, I'm gonna say everyone clear. I'm gonna double check, make sure that no one's touching the patient, and hit the shock button.

Speaker 3:
[40:32] All right, and we're gonna roll for-

Speaker 8:
[40:33] Shock delivered.

Speaker 6:
[40:35] Battery's dead.

Speaker 3:
[40:40] In true private EMS fashion, yeah, that was good. Okay, so the AED delivers a shock. What happens next?

Speaker 6:
[40:50] Check vitals.

Speaker 3:
[40:52] Okay.

Speaker 1:
[40:54] Actually, I'm sorry.

Speaker 4:
[40:55] We would jump right back on to compressions.

Speaker 2:
[40:58] Yeah.

Speaker 1:
[40:59] Check for a pulse.

Speaker 2:
[41:00] If no pulse, start chest compressions.

Speaker 4:
[41:04] Okay, well, we'll do what the AED tells us to do. So, Max, can you check a pulse?

Speaker 6:
[41:08] Checking for pulse.

Speaker 3:
[41:11] No pulse.

Speaker 6:
[41:12] Continue compressions.

Speaker 3:
[41:13] Okay. Who is on compressions?

Speaker 6:
[41:17] I believe that is still Tanner.

Speaker 3:
[41:19] Okay. Tanner will continue compressions.

Speaker 4:
[41:26] Tanner, on the next round, after two minutes, swap out with Max and take over airway. And Max, you'll jump on chest compressions.

Speaker 6:
[41:34] Got it.

Speaker 3:
[41:35] Okay. Perfect.

Speaker 2:
[41:36] Hey, y'all. Just want to let you know, I'm back with the stretcher too. If you guys need me for anything, I'm here. Really happy to help. Just bought my tickets to FBE Fest. Sorry, go ahead.

Speaker 4:
[41:47] Avery, can you do me a favor? Can you go assist Max with the airway and make sure that he doesn't have to do mask, seal and ventilations at the same time? Just help him out.

Speaker 2:
[41:56] Come on, boss.

Speaker 4:
[41:57] Awesome.

Speaker 3:
[41:58] Okay. So Avery goes over and kneels down and assists Max with essentially holding seal so that Max, you can ventilate without difficulty. At this point, Dispatch does say, hey, we do have an ALS unit in route. They are clearing that closest hospital. So they're, which is about 20 minutes away. So they're in route to you.

Speaker 4:
[42:25] Got it. All right, 20 minutes out. So I'll let the team know, hey guys, ALS is in route 20 minutes. Side note, is there any standing protocols for discontinuing resuscitation or things that we should be aware of in this instance? Or do we have to go a minimum amount of time before using a Lucas?

Speaker 3:
[42:55] So the question would be, and I'm just wanting to make sure that I quote, like I'm capturing this correctly. So it's like, hey, do we have, is there something that we would be looking for that would tell us, hey, we shouldn't work this code anymore? Like we should stop this code?

Speaker 4:
[43:16] Well, so really just seeing what the protocols are, if there are any ones that we have to adhere to in terms of, hey, like in Pennsylvania, we have to, we can't use a Lucas, or we're not supposed to use a Lucas until we've done manual chest compressions for 10 minutes. So that's one thing. And then like, you know, there's other protocols for like, okay, it's a minimum amount of time before, you know, requesting discontinuation. Not that I think we're there yet, but I'm just saying like, you know, knowing the system, is there anything we need to be aware of?

Speaker 3:
[43:47] So I will, I'd say, you know, the Lucas is fine to put on right away, like you have. I think that's a pretty common thing to do. Discontinuation is usually in the protocols where I've seen it, it's usually like 45 minutes or so, like 30 to 45 minutes of compressions with no response.

Speaker 4:
[44:11] Okay, and just to double check myself, what was the wife's name?

Speaker 3:
[44:18] What was the wife's name?

Speaker 6:
[44:19] We didn't ask her name.

Speaker 2:
[44:21] No one asked.

Speaker 6:
[44:21] Man, what's your name?

Speaker 2:
[44:24] My name is, it's Rose.

Speaker 4:
[44:27] Hi Rose, I'm Mike. We're working on your husband right now. What's his name?

Speaker 2:
[44:32] His name is Teddy, the wolf Theodore.

Speaker 4:
[44:35] Okay. Okay. So we're trying to help Teddy right now as much as we can. Can you give me a little information? By any chance, does he have any advanced directives, medical power of attorney? Does he have a DNR?

Speaker 7:
[44:47] Can you just, Sean knows. Just talk to Sean for a second if you can.

Speaker 4:
[44:50] Sean, okay. Hey Sean.

Speaker 7:
[44:53] Yeah.

Speaker 4:
[44:54] Hey Sean, is this your dad?

Speaker 2:
[44:56] Yeah, that's my dad. That's my dad and my mom.

Speaker 4:
[44:58] So Sean, hey listen, there's some things we're just trying, we're trying to work on your dad. We're trying to help him the best we can. We got the team working on him. We got more people on the way we're gonna get the best care here possible. Can you do me a favor? Can you let me know, does your dad have any advanced directives, DNR, anything like that?

Speaker 2:
[45:16] Oh, no. Like not, you mean like the thing where like you don't help him kind of thing?

Speaker 4:
[45:21] Yeah.

Speaker 7:
[45:22] Yeah, no, he doesn't have anything like that that I've ever heard of.

Speaker 6:
[45:25] Okay, awesome.

Speaker 7:
[45:25] So, hey, just really quick, my mom's kind of tough, but she looks like to me, she looks kind of pale and she doesn't look good. Like she was down here like working, like she doesn't move much and maybe that's it.

Speaker 2:
[45:39] But I don't know, like my mom doesn't look good right now.

Speaker 6:
[45:43] Maybe we have Avery get a set of photos on her or Tanner when he comes off compressions.

Speaker 4:
[45:48] Well, I'm going to go check on Rose while you guys take care of Teddy and I'll see how she's doing.

Speaker 3:
[45:58] Okay. So Mike, when you look over at Rose, you can see that she does look more pale than when you first encountered her. And she has kind of a sheen of sweat. Okay. And just sort of looks ill.

Speaker 4:
[46:17] Yep. Okay. Hey, Rose, how are you feeling right now?

Speaker 2:
[46:20] I'm just tired.

Speaker 8:
[46:21] I'm fine.

Speaker 2:
[46:22] Just focus on Teddy. Like we've been together for 50 years.

Speaker 8:
[46:26] And and yeah, just focus on Teddy.

Speaker 2:
[46:29] I'm just I think I'm just exhausted and just sore from doing chest compressions.

Speaker 4:
[46:35] Okay, I'm going to while I while I'm talking to her, I'm going to I'm going to hold her wrist and try to get a sense of pulse, pulse rate, respiratory rate.

Speaker 3:
[46:43] Yeah. So pulse rate is 80. Respirations are 20 to a minute. And she's she's breathing kind of shallow.

Speaker 4:
[46:54] Okay. Hey, Rose, we're going to we're going to get some oxygen on you. Do we have another oxygen bottle?

Speaker 6:
[47:01] We have the oxygen bottle, I'm sure we can get another oxygen bottle from the from the volunteers.

Speaker 4:
[47:06] I was asking the D.

Speaker 6:
[47:07] Oh, sorry.

Speaker 1:
[47:09] But no, shut up, Max.

Speaker 4:
[47:11] Yeah, I'm like, yeah, we could go grab the other ones that we know are there.

Speaker 6:
[47:17] Focus on the BVM, dude. No, you roll.

Speaker 3:
[47:20] Yeah. So, yeah, if you want to ask the the EMT crew because you, Max, they are both by you. So, Mike, if you're asking for oxygen, then one of those two, either you would have to go get it or one of those two would have to go get it.

Speaker 6:
[47:36] I'll replace Tanner on compressions and have Tanner go get O2.

Speaker 3:
[47:41] Okay.

Speaker 4:
[47:43] All right. Then have they gotten the Lucas on yet?

Speaker 3:
[47:46] Yes, the Lucas is on.

Speaker 4:
[47:48] Okay.

Speaker 6:
[47:48] Okay.

Speaker 3:
[47:50] The AED is requesting to analyze.

Speaker 6:
[47:54] Push the button.

Speaker 2:
[47:56] Press the analyze button.

Speaker 6:
[47:58] Hit the button.

Speaker 2:
[47:58] Good job, Max.

Speaker 8:
[48:00] Analyzing now.

Speaker 6:
[48:01] Wait, you know my name?

Speaker 4:
[48:04] So this is...

Speaker 8:
[48:05] No shock advised.

Speaker 4:
[48:07] This may sound like a silly question because I haven't used one in real life yet. Do you have to pause the Lucas to...

Speaker 3:
[48:12] You would have to pause the Lucas. I'm going to assume that that would be the case. You guys would probably be like... I don't think it can analyze when it's... It's easy to overlook turning the AED on. It's kind of hard to miss the Lucas pounding into someone's chest.

Speaker 6:
[48:29] This is very true.

Speaker 2:
[48:31] No shock advised.

Speaker 1:
[48:33] Check for a pulse.

Speaker 2:
[48:34] If no pulse, resume CPR.

Speaker 6:
[48:37] Check for pulse.

Speaker 3:
[48:39] Okay, no pulse.

Speaker 6:
[48:40] Okay. Unpause the Lucas.

Speaker 3:
[48:44] Lucas is unpaused. All right, and at this point, no one is necessarily a compressor. So Avery is the one that is now bagging the patient.

Speaker 6:
[48:55] Yes.

Speaker 3:
[48:55] And you were going to be the compressor, but the Lucas is on. So you're freed up. Okay. And Mike, we'll cut back over to you. So oxygen is on its way.

Speaker 4:
[49:07] Okay. Great. And then, hey, Rose, we're gonna get you some oxygen over here because I think it might help you feel a little bit better. I'm gonna take some vitals on you just to make sure you're okay.

Speaker 2:
[49:19] I'm just gonna sit down. I don't think I can say standing. I gotta sit down.

Speaker 4:
[49:22] Oh, you've been standing this whole time?

Speaker 2:
[49:25] That's a missing part.

Speaker 4:
[49:25] In the corner. You should sit down. How about we go sit down over here in the hallway so you don't have to be in the same room as Teddy right now.

Speaker 2:
[49:31] I'm just gonna sit down right now. I'm just gonna.

Speaker 4:
[49:33] Okay, I'm gonna catch her. Are you gonna get a hand? No, you take care of Teddy and I will take care of Rose.

Speaker 3:
[49:42] Okay, gotcha. So you assist Rose down to the floor where she is sitting up on the floor now. And you said you would get some vitals on her?

Speaker 4:
[49:52] Yeah, actually, before we get vitals, I'm gonna definitely call dispatch again and let them know that we now have two patients that we're assisting.

Speaker 3:
[50:02] Dispatch is very displeased with that because now that transfer really can't fucking happen. So they say, hey, we've got that one ALS unit, their ETA, I just asked this about five minutes out, we will try to get another one free, but it will be an extended time.

Speaker 4:
[50:26] Cool, thanks, Dispatch. Always helpful.

Speaker 3:
[50:33] Meanwhile, at the Dispatch Center, in the Dispatch Center, like, call them back, that transfer is definitely not happening now. God damn it. Okay, all right, so, yes. So there you go, you have called them, and then you said you want vitals.

Speaker 4:
[50:55] Yeah, well, actually, before I get too deep into vitals, is there anything from primary assessment perspective that would be concerning for, like, out of craziness? Is there any exsanguination, any bleeding that I might be missing?

Speaker 3:
[51:10] Other than the samurai sword in her mouth.

Speaker 4:
[51:13] Oh, she, it was seppuku, oh.

Speaker 8:
[51:17] The whole time.

Speaker 7:
[51:18] Gosh, what are they teaching in EMT school these days? Not much, apparently.

Speaker 3:
[51:23] Yeah, so, no, what you see is there's no exsanguination. She seems a little short of breath. She's very pale, she's fairly diaphoretic. She looks just like, she looks like she's in pain and tired. So, and now she's sitting on the floor abruptly. So, that is your, that would be your primary assessment. If there's something specific you're looking for, let me know.

Speaker 4:
[51:50] No, no, I just, like anything, you know, exsanguination wise was like, you know, I wasn't specifically looking for it, so I just wanted to double check. Okay, so let's continue getting the rest of the vitals. Blood pressure, pulse ox.

Speaker 3:
[52:06] Okay. Yeah, so you earlier, you got a heart rate of 80. That is confirmed on the pulse oximeter. Assuming you've got one of the little portable ones. She is 93%. She was, excuse me, she's on oxygen now, right? How much oxygen would you have her on?

Speaker 4:
[52:26] I'm gonna give her six liters via nasal cannula.

Speaker 3:
[52:30] Okay. So that is happening. And so she is now at 98% on the six liters per minute. Her blood pressure is 134 over 76, and her breathing rate is still like 22, 24 a minute.

Speaker 4:
[52:49] Gotcha. Okay. So I'm gonna take, I'm gonna have Rose, you know, lie down. Hopefully that'll help her feel a little bit better. I think she's going into shock. And, you know, I'm gonna ask her, hey, how are you feeling? Are you, you know, is that oxygen helping? Are you feeling a little bit better right now?

Speaker 2:
[53:09] I suppose. You know, it's not, I just, I just, I'm sore.

Speaker 7:
[53:14] Like my chest is just, oh, it just doesn't feel good.

Speaker 4:
[53:19] Okay.

Speaker 1:
[53:19] Yeah.

Speaker 4:
[53:20] So well, with that, that information, I'm going to grab, well, the heart monitor is on Teddy, correct? That's what we're using for an AED.

Speaker 1:
[53:29] Yep.

Speaker 3:
[53:29] AED is on Teddy.

Speaker 4:
[53:31] Gotcha. So I'm going to, I feel like I'm a broken record here, but I'm going to I'm going to call dispatch and let them know, like, hey, we have a, we have that second patient is having cardiac symptoms and we need a ALS unit with a cardiac monitor.

Speaker 6:
[53:49] I would ask the volunteers, do you have an AED on your truck?

Speaker 4:
[53:54] Well, do they have a cardiac monitor?

Speaker 6:
[53:55] Yeah, a cardiac monitor on your truck.

Speaker 3:
[53:58] Hold on. So for a cardiac monitor on a volunteer EMT truck, I'm going to say that that's going to be a pretty high roll. I'm going to make that like a 18, 18 or higher. For an AED, that seems like a more reasonable thing. Let's find out.

Speaker 2:
[54:15] What about AED with a readout?

Speaker 3:
[54:17] Readout, I'm going to say AED with a readout. Go ahead.

Speaker 2:
[54:22] They should have an AED. It would be rare they wouldn't even have like an AED. So I think it should be fair that no matter what, they should get at least an AED. An AED readout should be the mid-range. That's what I would do if I was DM, which I'm not.

Speaker 3:
[54:38] Chris, we did review a call where a volunteer company did not have an AED.

Speaker 1:
[54:43] That's totally accurate.

Speaker 2:
[54:44] That's 100 percent.

Speaker 3:
[54:45] But you know what, I find your point compelling. Less than five, they don't have an AED. They're that garbage service. Greater, we'll say 12 or higher, they'll have the readout. 18, they'll have a cardiac monitor. You rolled a two.

Speaker 1:
[55:08] Yeah, no, bro.

Speaker 2:
[55:09] We actually don't have any of that kind of stuff. We just kind of roll and we just kind of go off vibes. You know?

Speaker 1:
[55:14] Yeah. Yeah.

Speaker 4:
[55:15] I mean, that's that's totally the way that, you know, I really think it should be, you know?

Speaker 1:
[55:19] Yeah. Avery, Avery, my ride or die.

Speaker 8:
[55:22] Can you do a vibe check on that guy?

Speaker 1:
[55:24] Yeah.

Speaker 4:
[55:24] You do that. I could use a big vibe check over here, honestly. Like I think Rose is having a little bit of trouble.

Speaker 3:
[55:29] And I mean, realistically, what it probably would be is like, hey, they they took our AED and put it in like it's out of service because it needs to get repaired. We just don't have the funds for another one because we're a volunteer agency. I didn't do that in the California accent. I apologize.

Speaker 1:
[55:49] Yeah. Okay.

Speaker 2:
[55:55] So you're not the thespian this time around, buddy.

Speaker 4:
[55:57] So hey, Chris, can you put your hair back on for a sec?

Speaker 1:
[56:01] Yeah.

Speaker 2:
[56:02] Yeah. Not a problem. Hang on.

Speaker 4:
[56:03] Okay. Great. Oh, it brings me. Oh, yes.

Speaker 2:
[56:08] Rose, it changes every time.

Speaker 6:
[56:10] Yes. Rose.

Speaker 4:
[56:11] Okay. I can you do me a favor? Can you tell me how the pain feels right now? Like, can you describe it for me?

Speaker 2:
[56:18] Is Teddy okay?

Speaker 4:
[56:20] You know what? We're doing the best we can Teddy. Max is over there. He's he's helping Teddy. He's he's working on Teddy for you. And we got more people on the way to help. But can you tell my priority is you. I want to make sure you're okay.

Speaker 2:
[56:31] Okay. What was your question?

Speaker 4:
[56:33] How does your chest feel like? What does the pain feel like?

Speaker 2:
[56:37] It's not I guess pain maybe wasn't the right word. I'm sorry. That's not what I really meant. It's just more like like a pressure. Maybe it's not that bad.

Speaker 7:
[56:48] You know, like I'm laying down.

Speaker 2:
[56:49] Maybe it's a little better. I don't know. I just it's just yeah, it just feels like like a weight, you know? And I think I'm just I'm just nervous. You know, I have anxiety. Like, I don't know what's going on with Teddy. And I'm just anyways.

Speaker 4:
[57:06] No, I hear you. I hear you. Does that does that pain? Does that pressure just stay in your chest? Or does it go anywhere else?

Speaker 2:
[57:13] I think like like kind of like maybe my back a little bit. And then like my left my left my left arm, actually. And maybe even up to my jaw a little bit. But that's just because like I haven't I don't I don't work out at my age.

Speaker 4:
[57:28] Yeah.

Speaker 2:
[57:28] You know, like I'm 68. I'm going to be 69 in like two weeks. And I have like an old shoulder injury. I mean, it's the other shoulder. But still, like this shoulder is not that great. So I think I just heard it when I was dead. I think that's all it is. It's really just some chest pressure goes over the shoulder.

Speaker 4:
[57:45] Let me ask you a question. Have you ever you ever take aspirin for any of that pain? Like, are you allergic to aspirin by any chance?

Speaker 2:
[57:52] I don't think so.

Speaker 7:
[57:53] No, no.

Speaker 2:
[57:54] OK, I've never had this pain before, though.

Speaker 4:
[57:57] Do you have any other allergies?

Speaker 7:
[58:00] No.

Speaker 1:
[58:00] Well, yeah, I have.

Speaker 2:
[58:03] So there's certain tapes that will make my skin like really red and and like and like that's not very good for me.

Speaker 1:
[58:10] Yep.

Speaker 2:
[58:11] There's also like some foods like like nothing that makes me like hard to breathe. Medicate. Oh, I don't take a lot of medications. I don't think I have any allergies.

Speaker 4:
[58:21] And are you on any medications right now?

Speaker 2:
[58:24] I'm on one medication. It's just it's for my thyroid. I don't remember the name of it, but my thyroid is just my doctor just says it doesn't quite do its job. So I take an extra an extra tablet for that. But that's really all I take. I take a multivitamin each day.

Speaker 4:
[58:44] Yes. No, that's great.

Speaker 2:
[58:45] Hey, Rose.

Speaker 4:
[58:47] So what I'm going to do, I'm going to ask you to take some of this aspirin here. I'm going to give you four tablets of baby aspirin. Max, do me a favor. Can you just take a look at this pill bottle real quick? Make sure it's aspirin.

Speaker 6:
[58:59] It is definitely aspirin.

Speaker 4:
[59:00] So I'm going to give her four tablets of baby aspirin at 81 milligrams each. So for a total of 324 milligrams. Can you put this and just chew it up and then swallow it for me?

Speaker 2:
[59:13] Yeah, I can do that. That's no problem.

Speaker 1:
[59:16] Perfect.

Speaker 3:
[59:16] At this moment, with that aspirin being chewed up, Jonathan walks in.

Speaker 4:
[59:24] Oh, great.

Speaker 3:
[59:24] So we got to invite him in.

Speaker 1:
[59:26] It would be best if he just decided to fuck off.

Speaker 7:
[59:28] He's off playing a video game somewhere.

Speaker 2:
[59:30] He's just like, you know what?

Speaker 1:
[59:31] They got it. They're fine.

Speaker 6:
[59:32] Well, we're ready for Jonathan to come in. I'm going to hit Analyze on the ED again.

Speaker 3:
[59:38] OK, perfect. Yeah. So it is Analyzing.

Speaker 2:
[59:43] Analyzing heart rhythm. No shock advised.

Speaker 1:
[59:49] Check pulse.

Speaker 2:
[59:51] No pulse. Continue CPR.

Speaker 6:
[59:53] I would have paused the Lucas. Check for pulse.

Speaker 3:
[59:56] Yes, there is no pulse.

Speaker 6:
[59:58] All right. Unpause the Lucas.

Speaker 3:
[60:00] All right.

Speaker 6:
[60:01] And check on Avery and see how he's doing with the BVM.

Speaker 2:
[60:07] Yeah, I'm over here begging, not having much trouble at all. Looks like his face just wants to have this mask on it, so I'm just not going to take that away from him.

Speaker 6:
[60:13] Are you seeing a decent chest rise and fall?

Speaker 2:
[60:15] Yeah, I've got some good chest rise and fall. There's no problem there, so it seems to be working out just fine. So, yeah.

Speaker 4:
[60:21] Avery, you're doing a great job, buddy.

Speaker 6:
[60:22] Yeah, perfect.

Speaker 2:
[60:23] All right, thanks, brother.

Speaker 1:
[60:24] Appreciate you saying that.

Speaker 3:
[60:26] Now we're going to time travel a little bit. We are going to go back in time. Jonathan, you have just cleared a hospital after turning over a patient who hopefully just didn't talk very much.

Speaker 1:
[60:42] Hopefully, he just shut the fuck up.

Speaker 3:
[60:47] It's very, very just a yes or no kind of a person. Okay. And Dispatch tells you, hey, like they rushed you out of this hospital as quick as you could because there is a CPR in progress at 123 Made Up Street, which is about 20 minutes away from the hospital.

Speaker 2:
[61:07] By the way, it's make believe Avenue.

Speaker 3:
[61:09] Yeah. Thank you. Yeah. All right. So go ahead.

Speaker 5:
[61:18] Yeah. Before before we get started, I'd like to roll to see if I got to get an uncrustable from the EMS room. And I'd like to roll to see. I'd like to roll to see if I restocked my my equipment.

Speaker 2:
[61:32] Everybody welcome experience into the podcast right now.

Speaker 1:
[61:36] That's that's what that is right there, dude.

Speaker 3:
[61:40] No. So it rolled another two. So well, your first two. So no, there is no uncrustable. What there is, is there is an open cheese stick. That somebody, it doesn't, it doesn't look like teeth mark, but it doesn't not look like it was clean cut. Not at all. And as for, as for restocking your equipment, dispatches requests that you would leave, you would expedite over there, but I leave that up to you because this would be something you would know beforehand.

Speaker 5:
[62:23] Well, I would have done it, so.

Speaker 3:
[62:25] Okay, yeah. Fuck those guys were restocking. I'm sure it's fine. I'm sure it's nothing. Okay.

Speaker 4:
[62:33] We don't have enough blankets on the bus.

Speaker 5:
[62:35] Yeah.

Speaker 3:
[62:37] So, so you hop in your your fly car at this moment and you start heading down there and about ten minutes out from the from the residence, you get this fun update. Hey, it sounds like there's a second patient on this scene. Sounds like a possible cardiac. So we're trying to get another unit tapped out, but there's they're on that long transfer with the other ambulance.

Speaker 5:
[63:16] Okay.

Speaker 3:
[63:16] They're almost getting to that level one. So it'll it'll be like an hour before they get there. We're trying to see if there's something else. But yeah.

Speaker 5:
[63:26] So we have our BLS Fire Department. Have they been dispatched to this?

Speaker 3:
[63:32] Yeah. BLS Fire Department is on scene with their with our ambulance crew.

Speaker 5:
[63:37] Okay.

Speaker 7:
[63:38] And you've got Tanner and Avery.

Speaker 4:
[63:41] Avery's pretty on point.

Speaker 6:
[63:43] Yeah, Avery's awesome.

Speaker 2:
[63:46] Tanner's vibes are on point though too, man.

Speaker 1:
[63:47] No cap.

Speaker 6:
[63:48] Oh, man.

Speaker 5:
[63:51] Okay.

Speaker 2:
[63:56] All right.

Speaker 1:
[63:56] And John Rolls for resignation.

Speaker 5:
[63:58] Yeah. So I'm going to call on the radio and I'm going to ask them for a patient update as well as, you know, dispatch, give me the demographics on this if they have them.

Speaker 3:
[64:15] Okay. So unfortunately, because of the way that this time traveling and all of this works, you were just unable to get through on the radio to the crew, probably because they're busy. And yeah. And your question to dispatch was like demographics. They say, yeah, it sounds like there's, we have an elderly gentleman, 70 years old, CPR is in progress. And then it sounds like his maybe the wife or there was another, there was another adult on scene. So one of them may be having chest pain.

Speaker 5:
[64:53] Okay. All right. Okay, so I'm going to continue to respond to the to the residents. Let's see, that's that's about as much information as I've gotten from dispatch. So I think the best thing is to expedite and and continue to respond. I'm so I'm 10 minutes out. I, you know, that 10 minutes goes by and I pull up to the address. I'm sitting in the fly car at the address, getting my stuff together and marking on scene.

Speaker 3:
[65:34] Okay. So you are on scene. You notice that there's an ambulance parked out just to where the stretcher can get into the ambulance off of the driveway. There's a fire department that is parked. Because of a nice roll, they are parked actually with leaving enough distance for that stretcher to get into the ambulance. And then you can park somewhere near there. There is a neighbor house.

Speaker 5:
[66:04] All right. So I'm going to gather my equipment. So I'm going to take my cardiac monitor, my ALS jump bag and my drug kit with me as I exit the fly car. Okay.

Speaker 3:
[66:17] Perfect.

Speaker 5:
[66:18] Yeah.

Speaker 3:
[66:19] As you head in, you do see the silhouette of a gentleman in a sweater and white...

Speaker 1:
[66:26] Just tiny whities.

Speaker 3:
[66:27] Tiny whities, smoking a cigarette, eyeing you. But, you know, unless you want to stop and engage, we'll put you inside the house.

Speaker 5:
[66:36] Oh, man. Oh, additionally, I would like to take... It would be on my radio strap, but my CO2 monitor is coming in with me.

Speaker 3:
[66:46] Okay.

Speaker 1:
[66:48] Hey, bud.

Speaker 2:
[66:49] If you're going in there as a trick to the door, if you need help, you just let me know.

Speaker 5:
[66:53] Thank you, sir. I'm going to go check out what's going on now. All right.

Speaker 1:
[66:57] So you have a dog?

Speaker 5:
[66:59] I do not have a dog.

Speaker 7:
[67:01] All right. When you're done with that, you come talk to me.

Speaker 5:
[67:05] Okay.

Speaker 1:
[67:07] All right.

Speaker 5:
[67:08] So I'm going to walk into the house. Do I observe anything that may be dangerous to me or anybody else?

Speaker 3:
[67:17] No. It looks like a normal house. No dog. Yeah. You can hear the sounds of a Lucas doing compression noises in just one of the rooms back there.

Speaker 5:
[67:33] Okay. So I have two patients. Definitely want to emphasize, hey, dispatch, we really, really need that second unit here. I'm going to go make contact with, are the patients separated or are they in the same room?

Speaker 3:
[67:52] So as you enter the room, you can see that- We're in here. You enter the room and this is what you see. You see that there's a gentleman who is laying supine about 70 years old. I said about 5 foot 10, 180 pounds. He has a Lucas attached to him with AED pads on a AED monitor that does have the visual screen. So you can see the underlying rhythm when it analyzes. Additionally, you have, and Max is over there, along with two of the volunteer firefighters, Avery and Tanner, who of course you would recognize because they're Avery and Tanner. And then you have Mike over by a 68-year-old female who appears ill. She is definitely pale. She's diaphoretic. And she is now laying supine on the floor with a non-rebreather mask, excuse me, a nasal cannula, six liters per minute on her face.

Speaker 5:
[69:04] All right. So the Lucas device, is it in placed properly?

Speaker 3:
[69:12] Did you guys place it properly?

Speaker 6:
[69:14] We would have attempted to.

Speaker 3:
[69:16] Yeah. You know what? Yes. Yes, it is.

Speaker 4:
[69:20] OK. I feel like that dice roll would have happened a long time ago.

Speaker 5:
[69:23] Yes. OK. So would anybody be providing ventilatory assistance and do we have a security way?

Speaker 3:
[69:43] So from what you observe, it's a BBM that is being bagged into the patient connected to oxygen.

Speaker 5:
[69:52] OK. All right. Hey, Tanner, has a shock been delivered for this individual at all? Can you tell me what happened?

Speaker 6:
[70:06] I would pipe up and say, yeah, he received one shock, it has not advised another since then.

Speaker 2:
[70:12] Sorry, bro, I was just in the zone.

Speaker 6:
[70:15] You're vibing, man. I get it.

Speaker 7:
[70:16] Yeah, dude, you're harsh in my mellow and that's kind of honestly low key rude.

Speaker 6:
[70:20] Gotcha.

Speaker 5:
[70:24] Have we got any history related to either of these people?

Speaker 6:
[70:29] No.

Speaker 5:
[70:30] No, okay. Did you walk in and was he in cardiac arrest when you got there?

Speaker 6:
[70:35] Yes, the sun was performing CPR compressions.

Speaker 5:
[70:38] Okay. Is the sun still there?

Speaker 6:
[70:43] Yes.

Speaker 5:
[70:44] Okay.

Speaker 7:
[70:44] I'm right here, my name is Sean.

Speaker 5:
[70:46] Okay. Sean, could you tell me, does your dad have any medical history? Yeah.

Speaker 2:
[70:52] No, sorry.

Speaker 7:
[70:52] You guys asked me about that earlier. And then like my mom, like I noticed my mom wasn't looking good and I totally forgot about that.

Speaker 2:
[70:59] Yeah, he does. He gets, he's got, had like chest pain before, like in the past. I don't know if that's what's going on today, but yeah, he has chest pain. He's had like surgery done like quite a while ago. I want to say, you know, probably in his 50s and he's 70 now. He's had surgery done. We have a long history of like heart problems as well.

Speaker 7:
[71:21] I know his blood pressure is really high.

Speaker 2:
[71:23] Like my mom's always getting on about like what he eats because like his cholesterol and like that kind of stuff.

Speaker 7:
[71:29] So yeah, yeah, he has those things.

Speaker 5:
[71:31] Sean, can you describe to me what happened today that made you concerned about your dad and you called 911?

Speaker 7:
[71:38] Yeah, like I was telling the other guys.

Speaker 2:
[71:41] So he was, well, I'm not 100% certain. My mom kind of knows more than that.

Speaker 7:
[71:45] I was upstairs and my mom yelled for me and I came down and she was on the phone with you guys or like whoever 911 is.

Speaker 2:
[71:54] I think that, I don't know if we talked to you or whatever, but like she's on the phone with somebody and they were telling her to do like chest compressions. I could see like she was getting really tired doing them and I'm like, look at my mom, she's tiny, she can't do that shit. I walked in there and I started doing it instead. She said that he was complaining about like he couldn't catch his breath or something like that and then he got like dizzy and really weak and like sat down on the floor and then she helped like lowered him a little bit. Then she called 911. It all happened really fast.

Speaker 7:
[72:32] And then I was just like, I was upstairs playing Fortnite and I heard her yelling for me. And so then I came in here.

Speaker 2:
[72:41] I like, I don't really quick. I don't live here. I'm just here temporarily. And so that's it.

Speaker 7:
[72:50] That's totally fine.

Speaker 5:
[72:51] Okay. Thank you, Sean. All right. So priority number one, we're going to continue to work our cardiac arrest on this individual. I want to, I want to look at the readout on the AED at the next rhythm check, or we're going to pause the Lucas device during the next rhythm check. And I want to see what the underlying rhythm is on this individual.

Speaker 6:
[73:17] All right, we can pause and then hit the monitor.

Speaker 3:
[73:21] Yeah, we're probably right about the, where it would request to analyze again anyway. So yeah, the Lucas has paused. The AED is saying analyze, but you can see on the screen while it's doing that, that it is now in a PEA, slow, wide.

Speaker 5:
[73:41] Okay, all right. So we're going to go ahead and continue with the Lucas. I'd like to work on securing an airway with an eye gel right now. And then I would also like to add capnography to that between the BVM and that.

Speaker 3:
[74:04] Okay, so an eye gel, capnography gets added, so your cardiac monitor is going to be over with this patient then, with the capnography on it. Okay, so capnography reading comes back at we'll say 22.

Speaker 5:
[74:22] Okay, all right. So I've got good compliance with my eye gel. CPEA, how long have we been working that code?

Speaker 6:
[74:35] I think it's been about 10 minutes.

Speaker 5:
[74:36] 10 minutes, okay. All right, I'm going to go ahead and get my IO drill out and I'm going to correct that because it would be probably about 20 minutes or 20 minutes with okay.

Speaker 4:
[74:51] Hey, John, I need help.

Speaker 5:
[74:53] Okay, I'm going to leave this to Max Tanner and Avery and I'm going to go over to Mike and see what's going on.

Speaker 4:
[75:02] Hey, John. Listen, I got Rose here. She's a 68 year old female. She is Teddy's wife and she started feeling sick after he went down. So we've been working on Teddy and then we-

Speaker 2:
[75:15] You can call me Rose by the way.

Speaker 4:
[75:18] Yeah, no, she's Rose. Yeah, you're Rose. So she started looking diaphoretic, pale and was not looking good. She wasn't feeling good. And she got weak and went down to the ground. Looks like she's suffering from shock. She is complaining of chest pain and back pain. I'm concerned that she's having a cardiac event. So my left shoulder to a monitor that we might want to get her on.

Speaker 2:
[75:49] Yeah, my left shoulder also doesn't feel very good.

Speaker 4:
[75:52] But again, I think pain from her chest.

Speaker 2:
[75:55] But I think that's just because I did chest compressions. I'm sorry to interrupt, dear. You go ahead.

Speaker 4:
[75:59] No, no, no. It's great, Rose. Thank you for all the information. And I gave her three hundred twenty four milligrams of aspirin. Yeah. So I don't have a monitor here to get her on. So I just want to give you a heads up.

Speaker 5:
[76:11] I'm going to disconnect my my capnography from that and from that original patient. And then I'm going to go over to Rose and we're going to do a 12 lead EKG.

Speaker 4:
[76:25] So, OK, OK, John, I'll start putting on 12 lead for you.

Speaker 3:
[76:28] All right.

Speaker 5:
[76:29] Thank you.

Speaker 3:
[76:30] OK, so Mike places the 12 lead and what you the readout that you get shortly after that says, acute MI, anterior, lateral.

Speaker 5:
[76:53] Oh, man, okay. So, I am going to call for air medical or call dispatch to see if they will check the availability of air medical.

Speaker 3:
[77:07] Okay. Yeah, so let's see, because earlier I put this. So, it depends on the weather. So we're going to have to see what the weather is like. You want higher than a 12.

Speaker 6:
[77:28] Nice.

Speaker 5:
[77:28] Yes. Clear blue skies, baby.

Speaker 4:
[77:32] No wind.

Speaker 6:
[77:33] Nice.

Speaker 4:
[77:33] Does that mean you can live on the roof?

Speaker 3:
[77:35] They're actually just flying around looking for work, so.

Speaker 4:
[77:40] And they have a really big backyard.

Speaker 1:
[77:41] We have a vendetta against jet A. We're just going to burn as much as we can.

Speaker 3:
[77:48] So actually, you know what? With the 20, hold on, I could do this with the 20. They were actually on their way back to base after having dropped off a different patient. So their ETA is actually not that far. They can. They say they can be there in like 10 minutes.

Speaker 5:
[78:07] Okay, what's our closest landing zone?

Speaker 3:
[78:15] Another 20.

Speaker 5:
[78:17] What?

Speaker 7:
[78:18] Whoa.

Speaker 2:
[78:21] They have a self-landing policy and there is a field right behind the house.

Speaker 5:
[78:25] Oh, okay.

Speaker 2:
[78:27] Also, they have some extra uncrustables from the last time they did a call.

Speaker 7:
[78:32] Yes.

Speaker 1:
[78:34] So if you guys would like some.

Speaker 4:
[78:37] Grape. Grape is the only right answer. I'm just saying.

Speaker 1:
[78:40] Absolutely.

Speaker 3:
[78:41] Well, but they have strawberry too.

Speaker 1:
[78:48] Oh, wow.

Speaker 3:
[78:49] Twos and twenties. Twos are...

Speaker 2:
[78:51] Yeah, you guys are just...

Speaker 1:
[78:52] There's no in-between for you guys today. Yeah.

Speaker 4:
[78:56] The EMTs get twos, just saying.

Speaker 6:
[78:59] Yeah, the paramedic gets 20s.

Speaker 5:
[79:03] So the strawberry uncrustable, huh?

Speaker 1:
[79:06] Yeah. There you go.

Speaker 5:
[79:08] Oh, that's the worst.

Speaker 7:
[79:09] Got some uncrustable.

Speaker 4:
[79:10] You know they have honey flavored. Those are okay, too.

Speaker 5:
[79:13] Okay.

Speaker 7:
[79:14] Really?

Speaker 5:
[79:15] So I wanna go ahead and re-tone the fire department to set up an LZ in the backfield if possible.

Speaker 3:
[79:24] Okay. Let's see if there are more volunteers. I'm gonna say, higher than a 10, there are more volunteers. There are not more volunteers available. Avery and Tanner are it.

Speaker 5:
[79:38] Okay.

Speaker 3:
[79:39] You rolled a six.

Speaker 5:
[79:40] All right. Ooh, that's not good. All right. What is my... Oh, man. Okay. So...

Speaker 3:
[79:50] Now, Chris was not wrong when he said that this is a HEMS service that does, that can self-land. Okay. So if you give them a field...

Speaker 2:
[80:00] That was not exaggeration. That's true. Yep.

Speaker 3:
[80:03] Okay.

Speaker 2:
[80:03] So with the self-land policy, and this just might be like different areas. So Spencer and I work in a self-land area. And so just because we're all coming from different parts of the country and different policies, I'll kind of explain this. If you have a self-land agency, that means you could have nobody at the LZ at all and they'll take care of it. And so all it means is that we have a procedure for how we con as we come down. It's just kind of a spiral pattern and we check everything. And then we just expand our requirements for what the LZ is. So if you're self-landing, you just need a broader area that you can see. And we usually won't land into long grass or anything like that, but if it's short grass, which is what you're going to have, then you can keep everybody inside and they'll take care of it.

Speaker 5:
[80:46] OK, perfect. All right, so back to our 68-year-old female. So you're saying anterior, lateral. What's my elevation on my ST elevation on that?

Speaker 3:
[81:00] OK, so it's going to be you see ST elevation in leads V1, V2, V3, V4, V5, and V6, as well as one and AVL.

Speaker 1:
[81:17] There's actually just a middle finger with each of the rest that comes by. It's just like this.

Speaker 5:
[81:24] Oh, man. Do I have reciprocal changes in 2, 3, and AVF?

Speaker 3:
[81:29] You do have some reciprocal changes.

Speaker 4:
[81:31] OK, all right.

Speaker 5:
[81:34] OK, Mike, what are Miss Rose's vital signs?

Speaker 4:
[81:40] All right, last vital signs that I got from her were a 134 over 76 BP. She had a pulse ox of 98% on 6 liters via nasal cannula, respiratory rate of 22, and pulse of 80.

Speaker 5:
[81:59] OK, all right. Mike, I am going to delegate to you that we haven't given any medications. She hasn't taken any medications prior to this. Is that correct? Other than the aspirin?

Speaker 4:
[82:19] Yeah, she's she's taken. I gave her 324 milligrams of aspirin. She is on thyroid medication. She could not name the thyroid medication, but she did say that she takes it.

Speaker 5:
[82:30] OK, all right.

Speaker 4:
[82:33] I wouldn't know other allergies.

Speaker 5:
[82:34] OK, perfect. I would like to give her one dose of sublingual nitro. OK, so we're going to give her one dose of sublingual nitro and going to continue to monitor her. And then I'm going to jump back over to the 70 year old male and help them out for a second.

Speaker 4:
[83:00] OK, just to confirm, do you want 0.4 milligrams?

Speaker 5:
[83:03] 0.4 milligrams, 0.4 milligrams of sublingual nitro. Yes, please.

Speaker 4:
[83:08] OK, I'll start getting that out of the bag and administering.

Speaker 5:
[83:11] And Mike, go ahead and get me a second set of vital signs after administration of that nitro and kind of keep an eye on her blood pressure for me, please.

Speaker 4:
[83:21] Copy.

Speaker 5:
[83:23] OK, so we're going to go back to her cardiac arrest and I'm going to place a humeral head IO.

Speaker 3:
[83:32] OK.

Speaker 5:
[83:35] How's my compliance on my bagging? Is that still good?

Speaker 3:
[83:39] Compliance is still great.

Speaker 5:
[83:40] OK, perfect. All right. So I'm going to see if I do. Do I have a patency with my IO?

Speaker 3:
[83:54] Greater than five. You got it. It's a twelve. So yes. All right.

Speaker 5:
[83:58] Perfect. So aspirated marrow and we've got good compliance. I'm going to go ahead and administer one milligram of one to ten thousand epi.

Speaker 3:
[84:13] OK, one milligram, one to ten thousand epi.

Speaker 5:
[84:17] So we're going to do that. I'm going to mark the time for that. And then in five minutes, we're going to administer another milligram of epi.

Speaker 3:
[84:25] OK, gotcha. All right, so Mike, what would you do next? So you've given the, are you giving the patient the nitroglycerin?

Speaker 4:
[84:39] Yes, so I'll be administering the nitroglycerin sublingual. I'll take a look at the vial, have someone check, double make, you know, make sure, all the things that we should do with the medication, and then ask Rose if she has any trouble swallowing or any trouble with, you know, breathing right now, or I would check that. And if there's no problems with that, I would have her place it under her tongue and let it dissolve.

Speaker 3:
[85:06] All right, hold on, we'll let Chris don the gray hair.

Speaker 4:
[85:09] Rose, where'd you go?

Speaker 2:
[85:13] I don't know how to answer this in a way.

Speaker 1:
[85:15] I can accept pills without issue.

Speaker 4:
[85:18] Yes, well, what I need you to do is I need you to place this under your tongue and not swallow the whole thing, but I need you to let it dissolve and then just, you know, if you have, you know, if you salivate and just make sure that you swallow it.

Speaker 2:
[85:30] I know, Teddy takes these. I know how they go.

Speaker 4:
[85:33] Okay, great.

Speaker 2:
[85:34] I can do that, yeah.

Speaker 5:
[85:35] Hey, Miss Rose, did Teddy happen to take any of his nitroglycerin before he collapsed?

Speaker 2:
[85:44] Actually, like over the past couple of days, he's been eating them like candy, but he says it's fine. So I don't know if he took any today or not. But like he does that from time to time where he'll just, he'll do like a bunch in a day, but then he's fine. But this time he just, I guess, I don't know, I don't know. But yeah, he probably took some today. I know he definitely took some yesterday.

Speaker 5:
[86:05] Okay. So all right. Ms. Rose, do you know some of your husband's medical conditions? Your son was telling me a little bit about those. Do you know any more specifics?

Speaker 2:
[86:18] Honestly, like my son's probably the best source for that information. He's just distracted right now. He actually takes really good care of us. That's-

Speaker 4:
[86:26] Guys, I want to check myself on something I missed first. I just want to make sure that, well, I know this is a funny, like I should check a couple of things before I give her nitro, by the way.

Speaker 3:
[86:38] Okay.

Speaker 4:
[86:39] So her BP is above 100 systolic still, correct?

Speaker 3:
[86:44] So that was the last time you checked it before John arrived.

Speaker 4:
[86:50] Okay. Can I, I'd like to check that again before, well, I should have checked that before administering the nitro and Okay. asking her if she has used any ED meds in the last 24 to 48 hours. All right.

Speaker 3:
[87:05] So. That's fair. So the blood pressure, if you took it beforehand, it would still be around like 130 systolic. I'll say 130 over 80.

Speaker 4:
[87:23] Okay.

Speaker 5:
[87:24] Thank you.

Speaker 3:
[87:26] All right. And then rechecking it again, because I heard John ask you to do that.

Speaker 5:
[87:32] Yeah.

Speaker 3:
[87:32] Rechecking it again, a few minutes after the nitroglycerin, her blood pressure has dropped to 110 over 50.

Speaker 5:
[87:42] All right.

Speaker 4:
[87:43] Hey, Jonathan, looks like Rose's BP is coming down a little bit, 110 over 50.

Speaker 5:
[87:47] Okay. That's, I'm still okay with where that's at. So let's hold off on any more nitroadministration for right now. Hey, Rose, has that nitroglycerin started to alleviate some of your pain?

Speaker 2:
[88:00] Well, it's not really like a pain, like I was telling these fine young gentlemen, Max and Mike, or whoever was talking to me, Mike, like I was telling him, it's just more of a pressure.

Speaker 5:
[88:14] All right.

Speaker 6:
[88:14] Yeah.

Speaker 2:
[88:16] It's a little better, though.

Speaker 6:
[88:18] Yeah.

Speaker 5:
[88:18] So, Rose, based on your 12 lead, it does look like you are also having a heart attack. We're going to continue to take care of your husband. But so I'm telling you that because I've called for some additional help and the helicopter crew is going to come to your house here and...

Speaker 2:
[88:39] Oh, I'm afraid of... I do not want to go in a helicopter.

Speaker 5:
[88:42] It's okay. The big thing about it is that you need to... You definitely need to get to an appropriate cardiac center so they can start to give you some care. Every flight crew that I've worked with so far has been pretty great. And if you're a little anxious, I'm sure they can give you some medicine to help you feel a little less anxious.

Speaker 2:
[89:05] Can Teddy go... Is Teddy going with me?

Speaker 5:
[89:08] We're going to take care of him here for right now, OK?

Speaker 3:
[89:13] All right. The AED at this point says, analyzing.

Speaker 5:
[89:18] Push the button.

Speaker 2:
[89:19] Sorry. Analyzing heart rhythm.

Speaker 3:
[89:23] Thank you, AED.

Speaker 8:
[89:25] And shock advised.

Speaker 1:
[89:28] All right.

Speaker 5:
[89:28] So we're going to go ahead and administer that shot.

Speaker 6:
[89:32] Make sure it was clear. Everybody.

Speaker 1:
[89:35] Boop, boop, boop.

Speaker 2:
[89:36] To call my clear patient and press shock button.

Speaker 6:
[89:39] Press the shock button.

Speaker 2:
[89:42] Shock delivered. Check pulse.

Speaker 6:
[89:45] Checking pulse.

Speaker 2:
[89:46] If no pulse starts CPR.

Speaker 5:
[89:49] Now we're going to keep continuing. Yeah, we're going to continue CPR immediately after that shock anyway. So got it. So we're maintaining with that. It's about time for another epi. So we're going to I'm going to go ahead and administer another one to ten thousand epi. And what was the what when we did that rhythm check, what was the underlying rhythm?

Speaker 3:
[90:14] It looked very coarse.

Speaker 5:
[90:16] OK.

Speaker 3:
[90:17] Like a lot of middle fingers just kind of going like, of course, like a like a V like like fibrillation.

Speaker 1:
[90:26] Yeah. Yeah. All right. All right.

Speaker 3:
[90:30] And just at this time, you hear the sweet angelic sounds of a helicopter descending. And I've been told that there's.

Speaker 1:
[90:48] Yeah, I hear that.

Speaker 4:
[90:50] Some real EMS professionals have shown up finally.

Speaker 1:
[90:53] That's what we are.

Speaker 3:
[90:54] We're going to roll for professionalism. Oh, no. No, no, no. Okay. So I'll let you continue, but in a minute or two, there's going to be some helmeted crews that come into the house.

Speaker 5:
[91:14] Okay. Is the sun still right here close by?

Speaker 2:
[91:19] I'm right here.

Speaker 5:
[91:19] Yeah. Yeah.

Speaker 2:
[91:22] By the way, I don't know if they told you my name is spelled S-E-A-N, it's not S-H-A-W-N.

Speaker 5:
[91:28] But it's pronounced Sean.

Speaker 7:
[91:30] It's pronounced Sean.

Speaker 2:
[91:31] Okay.

Speaker 5:
[91:31] S-E-A-N. All right. Sean, if you would write your father's information down from us, like just his name, date of birth, that sort of stuff. And then I'm going to go to Ms. Rose and get her demographic information for the flight crew.

Speaker 2:
[91:51] I've got all that information. There's this pink sheet up on the fridge upstairs.

Speaker 5:
[91:57] Okay. Would you go get that for me?

Speaker 7:
[92:01] Yeah, I should have told you about that earlier. I'm sorry.

Speaker 2:
[92:03] I can go get it.

Speaker 5:
[92:05] Yeah.

Speaker 7:
[92:05] Yeah. I'll go grab it.

Speaker 2:
[92:06] I've got one for mom and dad if you need.

Speaker 5:
[92:08] Okay. Yeah. Go grab both of those.

Speaker 7:
[92:12] Yeah. You got it.

Speaker 5:
[92:19] Okay. One thing I'd like to do, kind of going back to Ms. Rose, I would like to establish a line, if at all possible, on her. So I guess I'd like to roll to see if she has vascular access.

Speaker 3:
[92:38] All right. So Chris, you said that she was small, right?

Speaker 2:
[92:42] Yes.

Speaker 3:
[92:43] Yeah. What were you envisioning? How do you envision yourself as Rose?

Speaker 2:
[92:50] Rose has reasonably good vasculature. However, it may not be where it normally is and what's going on today. So that but she does say like, well, if you're going to draw blood, they tell me my veins are rollers and sometimes they have to poke me twice.

Speaker 5:
[93:04] Okay.

Speaker 3:
[93:05] All right. So with that 13 and you get it.

Speaker 5:
[93:11] 15. Ah, yes.

Speaker 4:
[93:13] Nice.

Speaker 5:
[93:14] Perfect. Ow.

Speaker 4:
[93:16] Jonathan, you want me to get stuff ready for a second line?

Speaker 5:
[93:21] Let's just hold what we've got. If the flight crew wants a second line, we'll do we'll let them take care of that. But I just wanted to have some access before she got in the air or anything like that.

Speaker 4:
[93:32] You got it.

Speaker 3:
[93:32] OK.

Speaker 5:
[93:33] Yep.

Speaker 3:
[93:33] And enter the flight crew.

Speaker 7:
[93:36] Stand by.

Speaker 2:
[93:38] It's not playing, is it?

Speaker 3:
[93:40] No way.

Speaker 7:
[93:40] Hang on.

Speaker 8:
[93:41] Maximum security stockade to the Los Angeles underground.

Speaker 1:
[93:44] Today, still wanted by the government.

Speaker 3:
[93:46] They survive.

Speaker 4:
[93:47] I can't hear it.

Speaker 8:
[93:48] But I believe it's the 18th.

Speaker 3:
[93:50] It is.

Speaker 1:
[93:50] All right.

Speaker 8:
[93:51] Perfect. All right. Here we go. Hey, my name's Hank. I can help you. This is my nurse, Cassandra.

Speaker 7:
[93:58] What's going on here? All right, Hank.

Speaker 4:
[94:08] Is he wearing a like a boombox on his back?

Speaker 1:
[94:13] I'll get the fade out in there at least.

Speaker 3:
[94:18] I mean, that just plays when we walk in.

Speaker 4:
[94:21] Oh, yeah.

Speaker 1:
[94:22] No, it's just what happens. You guys hear that too?

Speaker 4:
[94:24] Spontaneously starts playing the 18th.

Speaker 7:
[94:27] I thought that was just in my head.

Speaker 1:
[94:32] What's going on?

Speaker 5:
[94:33] All right, Hank, we've got quite the situation going on. We're working a cardiac arrest on a 70-year-old male, but we called for his wife, 68-year-old female. Once her husband went into cardiac arrest, she attempted CPR, but then she started to feel some chest discomfort, cool, clammy difficulty in breathing. They laid her down, and I got here and have been unraveling this mess as it has gone. No worries, brother. We're continuing to work this cardiac arrest on him, but we did a 12-lead on her, and it is showing massive stemmy, and she's got ST elevation in V1, V2, V3, V4, V5, V6, and reciprocal changes in lead 2, 3, and AVF. She's had 324 of aspirin. She's had one nitroglycerin sublingual, and then I've got an 18 established in the left AC. And that's kind of where we are, you know, thinking she probably needs to get to a cath lab. So, any help.

Speaker 7:
[95:47] All right.

Speaker 2:
[95:49] Yeah, we can do that.

Speaker 7:
[95:50] We can take her.

Speaker 2:
[95:50] If you guys just have, if you guys have like a set of vital science demographics and just like med lists, allergy lists, those kinds of things. And just then, Sean.

Speaker 7:
[96:00] Hey, here's those pink sheets. Sorry, man. They weren't exactly where I thought they were, but I found them both. Here you go.

Speaker 5:
[96:05] Okay.

Speaker 7:
[96:06] Spencer, I want to also have some chest pain.

Speaker 1:
[96:08] I'm just kidding. I'm kidding.

Speaker 5:
[96:13] Spencer, I want to look at these pink sheets. Will you tell me what they say?

Speaker 3:
[96:18] All right. So she has allergies to tape and some morphine. But and she's got kind of an extensive medical history as does he. But importantly, you notice on the pink sheet for him, there is no like DNR instructions. It's, you know, okay, it's as is same with hers. So we will we will talk. We will say that the med list and history are satisfied.

Speaker 5:
[96:52] Okay.

Speaker 3:
[96:52] Unless there's anything particular that you are looking for.

Speaker 5:
[96:56] So I'm going to one thing that I want to see is if there's a history of diabetes for the gentleman and if it regardless, I want either Tanner Avery or Max to check a blood sugar for me on this guy while we're while we're continuing to work this code.

Speaker 6:
[97:16] I will take a blood sugar.

Speaker 3:
[97:18] OK, there is no history of diabetes, but blood sugar is taken. OK, so I will let the scene play out. What I will let the scene play out with the are you flight crew? Are you taking this?

Speaker 2:
[97:38] Oh, yes, yes, yes, yes. Yeah, no, we're good. We're totally good. Yeah, we're going to go ahead. If we can just get we just got to get her out of here.

Speaker 7:
[97:49] That's the only thing. So we have we're flying in EC 135.

Speaker 2:
[97:53] So we have our own gurney. If you guys just help us get her upstairs and out that there is this guy out there that helped us get in.

Speaker 1:
[98:03] He do a trick with the door.

Speaker 4:
[98:05] You don't have a dog.

Speaker 7:
[98:07] Watch my dog.

Speaker 1:
[98:08] Yeah, he asked.

Speaker 7:
[98:09] I don't know. It's kind of weird.

Speaker 2:
[98:11] And I said the only big dog around here is so anyways, but I know he looks shifty. So if you guys can help us just get her up and out, then we'll be gone.

Speaker 1:
[98:21] We're going we're running hot.

Speaker 2:
[98:22] So we're set.

Speaker 5:
[98:23] All right. So Mike and Avery, because Avery is a Texas boy, he's going to be Texas strong big. He's going to he's going to help you guys like Mike and Avery help you guys get Ms. Rose down to the to the helicopter. And and me and Max and Tanner are going to continue to work this cardiac arrest.

Speaker 2:
[98:45] All right. Quick safety brief. Here we go. So what we're going to do is we're going to go up there. We're going to go to see the rotor disk. OK, as we're going under, we're going to wait for the pilot's thumbs up.

Speaker 7:
[98:53] We don't go in the road just till we get that.

Speaker 2:
[98:54] Long story short, stay behind me and you'll be safe. OK, we approach this helicopter from the nine o'clock position. Then we're going to head towards the rear. It's a rear loading helicopter. We only need one person back there with me. Who's that going to be? Avery. All right, sounds great, Avery. Like I said, my name is Hank or Hero, whatever you want to do. So once we get under there, there's no reason to walk back towards the tail rotor. It's an enclosed tail rotor, but still, you can hurt yourself. It can kill you. It doesn't give a fuck, right? It's like a honey badger. So when we're done, I'm going to do this. When you see that, that means walk right back out the way you came. Nothing on your head that isn't strapped down to your chin. OK, ready? Take the cowboy hat off. Exactly. Yep. All right. Let's go.

Speaker 3:
[99:32] Nice. OK, so with that patient off the scene, John, you have now this 70-year-old male with compressions being done on an AED.

Speaker 5:
[99:45] OK, so I'm going to switch him over to our cardiac monitor and I'm going to place my pads on him. And I'm going to put it in manual mode.

Speaker 3:
[99:58] OK, perfect. We will. That is done.

Speaker 5:
[100:03] What is my underlying rhythm?

Speaker 3:
[100:06] Your underlying rhythm is still VFib.

Speaker 5:
[100:09] OK. Let's see. We've we've delivered one shock.

Speaker 3:
[100:15] Yes. And you're coming up to on two technically shocks.

Speaker 5:
[100:20] OK.

Speaker 3:
[100:21] And you're coming up on that two minute mark.

Speaker 6:
[100:25] All right.

Speaker 5:
[100:27] Let's see.

Speaker 4:
[100:28] I'm going to have a I'm going to have a side conversation with Max. Max, did you see how cool that Hank guy was?

Speaker 6:
[100:33] Oh, my God.

Speaker 4:
[100:36] Man, I hope I can be flight someday.

Speaker 6:
[100:38] Yeah, he's a real hero.

Speaker 3:
[100:40] I hope he came in visor down.

Speaker 6:
[100:42] Oh, he for sure did.

Speaker 4:
[100:44] Do you guys even have eyes when you're on a plane?

Speaker 6:
[100:47] Did you hear the music to play when he lifted his visor? I did.

Speaker 1:
[100:50] Yeah.

Speaker 6:
[100:51] I think it was the A-team. I think it was.

Speaker 3:
[100:53] Yeah.

Speaker 1:
[100:54] All right.

Speaker 3:
[100:54] John, what are you doing?

Speaker 5:
[100:56] All right. So since we have V-fib refractory to two shocks, I'm going to go ahead and give 300 milligrams of amniotero.

Speaker 3:
[101:08] OK.

Speaker 5:
[101:10] And then if we are in time for a third dose of our epi, we're going to go ahead and give another milligram of one to 10,000 epi. And then I would like to start establishing Vital Sons on this guy as best we can, related to his end title. And really that's the best thing we can do as far as Vital Sons.

Speaker 6:
[101:38] Zero, zero, and zero.

Speaker 5:
[101:41] Yeah.

Speaker 3:
[101:42] All right, so you notice after the administration of the amiodarone and the epinephrine that your next rhythm is a systole.

Speaker 5:
[101:55] Okay, what's our timeline on working this? Where are we at?

Speaker 3:
[102:00] You are probably like, man, I am not good on timekeeping. Terrible job.

Speaker 4:
[102:06] It's got to be at least 35, 40 minutes.

Speaker 5:
[102:09] Okay, so protocol is local to me. We work it for 30 minutes unless there's some sort of odd circumstances. I'm going to consider my Hs and Ts.

Speaker 3:
[102:20] Okay, you did ask for end title, and you have noticed that his end title is steadily been decreasing down. It is now 15.

Speaker 5:
[102:30] 15. Okay. All right. I want to make sure with Tanner and Max, if we have a compliance issue with our with our iJail or anything like that.

Speaker 6:
[102:42] I'm still good. Good chest rise and fall.

Speaker 3:
[102:46] Yep. You are still getting good chest rise and fall.

Speaker 5:
[102:49] Okay. All right. Let's see. Okay. So 15, we still have good access regarding that. So what's the good chest rise and fall? All right. Let's consider some H's and T's. Did we have any in on our pink sheet? Do we have any narcotics that this individual takes?

Speaker 3:
[103:15] No. I mean, you've got like, you have like some oxycodone, but it's like the five milligram in the mixed with the, like the Tylenol. Tylenol, yeah.

Speaker 6:
[103:25] Norco.

Speaker 5:
[103:27] Okay. All right. Did we have any history of any like falls or anything recently?

Speaker 3:
[103:37] Mike, next.

Speaker 6:
[103:39] No.

Speaker 5:
[103:40] Oh, sorry.

Speaker 6:
[103:41] No, there was no, didn't give us any history of falls. And when he went to the ground, she lowered him down so he did not fall abruptly.

Speaker 5:
[103:49] All right, cool. All right. Let's see, is there a med list related to on that pink sheet?

Speaker 3:
[104:01] There is a med list.

Speaker 5:
[104:02] Would you read those off to me?

Speaker 3:
[104:06] Yeah, sure. So he's gonna take nitroglycerin, aspirin, we'll say some carvetolol.

Speaker 5:
[104:16] Okay.

Speaker 3:
[104:18] And HCTZ and, how about, yeah, we'll call that good.

Speaker 5:
[104:33] Okay.

Speaker 3:
[104:34] And Norco.

Speaker 5:
[104:35] And Norco, and Norco. Okay. All right. You know, considering all my H's and T's, I'm not catching anything off the top of my head, considering, you know, the cardiac rhythms we've been in. So, PEA and then VFib and now Assistally. As we approach our 30-minute mark on calling this, I'm going to have my BLS provider go ahead and continue to work it, and I'm going to start to gather my thoughts and give the ER a call to get medical direction on termination of resuscitative efforts.

Speaker 4:
[105:23] Do you want me to talk to the son?

Speaker 5:
[105:29] I can do that if you would want me to. Probably something that I should do, but I appreciate you asking.

Speaker 3:
[105:41] Sean, you're up. What's up?

Speaker 5:
[105:43] Hey. Hey, Sean. So we have been doing all these different things for your dad. We've been working CPR, and we've been breathing for him, and we've given him a bunch of medication, and given him some electricity related to the CPR and the AED. And at this time, our resuscitative efforts have not been positive. And I wanted to let you know before I called, but I'm going to say that we're reaching the point where we may have to make a decision to terminate resuscitative efforts. And I wanted you to be a part of that process and let you know what's going on. Oh, man.

Speaker 7:
[106:38] You guys feel like you've done everything you can?

Speaker 5:
[106:41] Yeah. I, you know, even if we were to take him to the hospital, they would have done everything that we've done here on scene. And I just need to confer with the doctor first, but I wanted to inform you of our kind of our next steps. The big thing is, you know, we were talking about your mom and the flight crews taking her to the to the cath lab. And, you know, we want to probably get you to check on her as well. So.

Speaker 7:
[107:13] Yeah, I don't know.

Speaker 2:
[107:14] There's just there's kind of a lot going on. I'm just trying to gather my thoughts.

Speaker 7:
[107:18] Like I'm the whole thing. But but I mean, like, like if you call the doctor and like the doctor's like whatever, then yeah, I mean, like time for dad to, you know, exit the chat, as they say.

Speaker 5:
[107:35] All right, John, thank you. I'm gonna go ahead and, I'm gonna go ahead and we're gonna do some final things, and then I'm gonna give the doctor a call, okay?

Speaker 2:
[107:46] All right. Speaking of exiting the chat, guys.

Speaker 8:
[107:58] Your Master Thespian now has to head out along his way, but I do want to thank all of you for joining me on this absolute exploration into theater and the very depths of our imagination, our hearts, and more importantly, our souls.

Speaker 2:
[108:12] I also want to thank Master Eometics for sponsoring this, literally week after week.

Speaker 8:
[108:16] I don't know why, but you do, and we appreciate that. So head on over to mastereometics.com, go ahead and check out their bookstore, and also get your tickets to Festively 6, because Jeff Murphy will also be speaking there as well. If you don't know who Jeff Murphy is, he's like the Master Eometics guy. He's also another bald white guy with facial hair, which literally everybody in this chat currently is, I just realized. So with that, thank you, and end scene.

Speaker 3:
[108:43] Well done.

Speaker 2:
[108:44] Guys, thank you so much for being here.

Speaker 1:
[108:45] I absolutely have to bounce, but it's absolutely awesome.

Speaker 2:
[108:49] I'm going to let Spencer break everything down with you guys. But I am gone, and everyone who's listening, I'm sure Spencer will mention again, please check out the, what's the full name of the podcast again?

Speaker 4:
[109:01] The RideAlong EMT School Podcast.

Speaker 1:
[109:03] RideAlong EMT School Podcast.

Speaker 2:
[109:05] It's on iTunes and Spotify. It's anywhere you want to get podcasts.

Speaker 4:
[109:08] It's on all of them. We distribute everything.

Speaker 2:
[109:10] It's on all of them. It's a fantastic podcast. We've been on there. We've listened to them. Especially if you are EMT curious, it's great. Honestly, having been through EMT School, it's just kind of nice to sit there and reminisce and just listen because it's important to go back to that mindset. Because we do talk about this. I believe we talked about this on your show as well. There are certain things that when you're right out of school, you will never be that good at those things again. Because that decays and it goes away. These guys come as close to it as you possibly can at bringing some of those things back just by listening to those experiences and living vicariously through them. Once again, guys, thank you for joining us here. Thank you for having us on your show. And with that, I'm out.

Speaker 3:
[109:54] All right. Well, that brings us to the conclusion. You would have contacted Online Medical Control and they would have said like, yeah, sounds like you did what you could. So with the end of this scene, with the end of this scenario, what are your thoughts? How do you feel?

Speaker 5:
[110:13] Oh man, that is chaos.

Speaker 1:
[110:17] Yes. Let's start here.

Speaker 3:
[110:21] Mike, Max, you guys were the EMTs that were dispatched out. Tell me about how that went.

Speaker 6:
[110:30] I think it went well. We saw what was going to happen to the wife before it happened, just in the way she was being masterfully portrayed by our master thespian. So it was clear which way that was going.

Speaker 4:
[110:46] Yeah, I got to give Max credit, because he caught that way before I did. Because we're coming in the room, he's like, she needs oxygen. I'm like, you know, we're working on the guy, right? So I'm like, oh, I totally missed that. And it wasn't until like, OK, let's switch out. Oh, yeah, your son's telling me that you're sick. Yeah, I wish I caught that a little earlier. But I think it was tough trying to make sure that we're doing, you know, making like all of a sudden, they're adding another patient. Thank God we had extra help.

Speaker 3:
[111:18] Yep.

Speaker 4:
[111:19] Yeah.

Speaker 3:
[111:19] Yeah. I also am glad that you had extra help because I don't know how I would have managed this with just like myself and a partner. That would have that would have sucked because yes, two people to do CPR. I mean, you need one technically, but to do good CPR, you need at least two. Yeah. So I'm glad that you got that. I thought when it came to this, that the division of labor went really well. Like Mike, you've arrived on scene, you had the struggle to get into the house. Holy shit. Max, you guys ended up talking to the guy who gave you the code. Yeah, and immediately took over compressions from the son who was exhausted. And then as soon as you could extricate yourself to step back, you did, which then gave you that kind of the room to think and consider all of these other aspects of the call. And then when you had that second patient, it really wasn't a detriment because while you were managing that, you were able to go over and address the surprise patient that you had. And with the Lucason and Max, you were able to then be like, okay, now this is my patient, and I'm managing this. And I thought that that went really well. I am glad that you brought up the oxygen because this is one of those scenarioisms. It's possible that you guys would have noticed that, you know, it's like, oh, hey, the AED is not on or, oh, hey, this BVM is not actually connected to O2. But I'm glad, Mike, that you caught that and corrected that. Sometimes in real life, that happens, you know, just like, you're like, all right, pads are on. And then someone's like, is that on? You're like, oh, fuck, yeah, there's a button on there. Or yeah, I plugged it into the cylinder and then forgot to actually like toggle it. Or I turned it and then it went shh and then ran out of oxygen. These are not things that I have ever done in my life. Just so you can understand, these are things that have happened. So, and then Mike, calling and getting help and, you know, reaching out to dispatch and making sure that the resources that you need were in route. And I'm sorry that dispatch was so unhelpful.

Speaker 6:
[113:54] Like every dispatch ever.

Speaker 3:
[114:00] Uh, sweet. So, were there other, like, moments in this scenario where you were like, man, this is going well, or like, oh, fuck.

Speaker 4:
[114:12] The one that stood out to me, I wrote it down as like, okay, this was a miss for me, was the administration of an eye gel or some other adjunct for Teddy? Like, I was like, oh, Jonathan came in and he knows what to do. And like, we had three BLS, or four BLS providers, and none of us thought of like, oh, we should probably, while we're bagging, like, we're looking for the right things, but really we should put in an adjunct too.

Speaker 5:
[114:38] Yeah. Yeah. The eye gel's not in your protocol, right? In Pennsylvania?

Speaker 4:
[114:43] In Pennsylvania, no, but OPAs and MPAs are, and those can, you know, that would totally be called for in that situation.

Speaker 6:
[114:52] The minute you mentioned that, as you came in, it was like, oh, we should have put an OPA in or something. NPA, probably, but yeah.

Speaker 3:
[115:00] Yeah. An OPA is perfectly reasonable to throw in on a, you know, on a CBR call.

Speaker 6:
[115:05] Unconscious.

Speaker 3:
[115:06] Yep. And it just kind of keeps that tongue out of the way, and it continues, you know. But yeah, no, I think, yeah, that's a, I wrote that down somewhere on here. My notes get a little messy when I have two patients, it turns out. Oh, yeah.

Speaker 4:
[115:22] Like my notes are like pages of two things going on here, with like managing two patients.

Speaker 3:
[115:28] Yeah. I got to keep track of the story and my notes, and it turns out I can do one of those. Okay. So when it came to the second patient, one of the things I did notice was that stuck out to me was, you knew that she was sick, but you weren't able to, you hadn't asked her about any complaints that she was having. She, and she was an awful patient. In fact, all of the people in the scene were terrible. And that they really, each and every one of them continued to give you information that you did not ask for.

Speaker 6:
[116:09] Eddie was more valuable than Sean.

Speaker 2:
[116:12] Did he?

Speaker 3:
[116:14] He's a man of few words. Just, you know, you knew what was wrong with him, he didn't need to tell you. I'm glad we didn't get Rosk and he woke up. Because sometimes dead is better. Pet cemetery was right. But trying to establish pretty quickly, hey, you know, what's bothering you? Like, are you having any pain? Are you having any shortness of breath? Because sometimes people are just incredibly vague to the point where they're like, oh, I just don't feel good. And you're like, that doesn't fucking mean anything to me. Yeah, yeah. So if, what I would say in this, and granted, this is a very difficult scenario with these two patients and having to divide and conquer. But that was just one of the things that I noticed was that it took a while for you to finally kind of, and she kind of, I think, prompted you by saying, like, I'm having some pressure in my chest.

Speaker 4:
[117:20] Yeah, yeah, well, yeah, there was definitely, it was not the first thing that I was relying on because I was like, oh, all the vital signs are telling me that something's wrong, and I was focused on that instead of necessarily just talking to her.

Speaker 3:
[117:32] So, yeah, yeah, yeah, but I think that's it. I mean, otherwise, you know, and granted, like, time is weird. And so, like, you know, there I'm there probably should have been on my part more like, hey, you're two minutes is analyzed. But what I did here was that, hey, we're switching roles until the Lucas got in and then Lucas can do the job. And that was great that you brought it in. And then, so there would have been more opportunities to analyze and to be told, you know, no, no CPR. So that's on me for not getting more of those in there. But I think overall, like that part was done really well is that that organization stayed. And once that kind of, once that organization happened, Max, your spot became very easy. You're like, yeah, just, just do this.

Speaker 4:
[118:33] Robot go.

Speaker 3:
[118:35] Yeah.

Speaker 4:
[118:36] I'm like, how did I get, how did I get roped into being the primary on both, like coming in on Teddy, and then all of a sudden, oh, I gotta jump to Rose. It's a mystery.

Speaker 6:
[118:45] It's a mystery to me too. I don't know.

Speaker 4:
[118:46] Max is like, I got to, I got to wipe my hands of both of them. One thing I do want to say is, the, the, the, the feeling of relief of when a more advanced provider comes in the room. I mean, this wasn't even real. And I was like, thank God. There is, there is somebody that came in this room. And I'm curious if the same thing, if Jonathan felt the same way when...

Speaker 5:
[119:14] As soon as Hank got there, I was like, oh, thank God.

Speaker 4:
[119:18] I mean, come on, Hank is, Hank's the real hero of this story. Obviously. But that was...

Speaker 3:
[119:25] Anybody who can come and uncluster my fuck is, I'm like, yeah, welcome. Take one.

Speaker 4:
[119:32] Take both. Yeah. Yeah. That moment, like here, like I know I was called like, hey, we need ALS. But like, you know, that coming in me like, okay, cool. I can then not have to be in this role where I am trying to stay cognizant of everything. And I can just help report and support him.

Speaker 6:
[119:52] That was, yep.

Speaker 4:
[119:54] That felt really good.

Speaker 1:
[119:57] Well Jonathan, how did you feel coming into this scene?

Speaker 2:
[120:01] You know, I feel like I've run some calls that are very similar to this with the level of chaos. Yeah. The neighbor was a good touch. That's I have encountered exactly that. Hey, he got us in. He did.

Speaker 3:
[120:22] So when Chris said, yeah, they didn't really appreciate me coming in and checking on their dog, which they don't have. I was like, so you broke into their house is what you're trying to say. It's the greatest neighbor ever.

Speaker 1:
[120:39] Worst neighbor ever, but yes.

Speaker 3:
[120:42] Greatest storyteller ever. The master thespian.

Speaker 2:
[120:45] So Spencer, to answer your question more fully. Something we talk about in our podcast and go back to is the acronym WIN, W-I-N, what's important now. And it just seems to be coming up a lot in my career. And as we talk through the podcast and stuff. So in my mindset, it came up tonight. And so I was like, all right, well, what is important now? I need to make sure that we're doing good quality CPR for Teddy and take care of that and make sure that's good. But that can kind of, it seems like everything's under control with that for right this second. But now I need to deal with the second patient and hop over and at least get a baseline assessment on her. And but yeah, I mean, bouncing between the two, that was tough.

Speaker 1:
[121:39] Yeah. No.

Speaker 3:
[121:41] Yeah. Just to add to that too, because that's, I think, something that I took away as a BLS provider where, like in my head, I'm going, okay, I don't think came in and obviously the big fish in the room is the cardiac arrest going on. And I was like, okay, I'm going to trust what he's looking at. But at a certain point, I'm like, I think he needs to pay attention over here for a second. So that's why I was like, and this is what I would probably do in real life too, and be like, hey, I need your attention over here just for a sec so I can update you. And like, I think that's, to me, that's like one of the things that I've never had practice in, but is probably a good takeaway for me to go, okay, that's probably a good thing to do in that situation.

Speaker 1:
[122:24] Yeah. No, and that was a great move. And so, Jonathan, I mean, it's difficult to come into a scene where you have a cardiac arrest and then a STEMI at the same time, because you're right, like you kinda, you can't just come in and be like, well, that guy's dead. Ma'am, how are you? Because questions will get asked, but likewise, you can't go in and ignore the STEMI. And I thought you split the difference pretty well. You came in, you're like, where are we at with this cardiac arrest? Because that kind of is the priority in this medical scenario to come in and go, all right, let's get an airway in there, let's get end title, let's see what our rhythm is. And then to be able to shift over to the other lady with Mike going like, hey, you know, over here, please, attention, because she is also sick and a critical patient. So I know the answer, or I think I know the answer to this, but what was your decision behind flying the STEMI versus the cardiac arrest? Because there are people who are not in EMS who listen to this, who will be like, that doesn't make sense.

Speaker 2:
[123:45] So yeah, we're already doing everything for the cardiac arrest on scene. And depending on the size of a helicopter you have, I've gotten a little bit of limited experience doing some ride alongs myself in some helicopters and with some crews. It's tight quarters. There's no way you can work a cardiac arrest really well in the back of a helicopter. And so the kind of the traditional thought as I've gone through my career is, well, we don't fly codes unless we get Rosk on them. And then, you know, okay, we'll consider it. But right now we were just taking care of him there, but she's having an active STEMI. She needs, you know, she needs to get to a cath lab. That's that's the whole thing. Like immediately she needs to get to a cath lab. So in that moment, she needed that higher level of care that that cath lab could provide. So that's why I wanted that that air medical asset.

Speaker 3:
[124:47] Would the same, would that, would that decision have been the same if there was another ambulance in route?

Speaker 2:
[124:55] Maybe not. We had our level through trauma center that was a cath lab. And so maybe we could have utilized that. But considering the dispatch information and that sort of thing, you know, I rolled the dice with the cath lab. We use air medical where I'm at quite frequently because we don't have a cath lab. And the closest cath lab is 60 minutes away. And our community is resource limited in transport ambulances. So we can't take a transport ambulance out of the rotation for 60 minutes one way. And then probably another 90 minutes to do handoff and get them back in service. So we use air medical pretty frequently for stuff like that. So just got lucky with the dice that on this call.

Speaker 1:
[125:43] Yeah. What if they hadn't been available? You know, like what if there was no one else coming? Because that was a very real possibility for this scenario. What would what would you have done then?

Speaker 3:
[125:57] Man, before you answer, Jonathan, can I can I take a stab at it? Yeah, yeah.

Speaker 1:
[126:05] Hell, yeah.

Speaker 3:
[126:06] Like this is this is me not being the like, you know, obviously we don't have ALS provider training or anything like that. But like, it's a logistics issue. To me, it seems pretty clear. Hey, we're working this code, you know, the to the most emergent patient, the one that probably can has the biggest chance of being saved is is the MI. If we knew it was happening. So to me, I would say, hey, we need like, we don't work codes in route. Like the best chance of getting Rosk is going to be on scene. So to me, I think, okay, we transport Rose, we get her to we get her to higher levels of care because that's who can help her. And then we hope for the best on seat for for getting Rosk.

Speaker 1:
[126:46] So the tricky part with that is that there is no ALS person. Yes, that he has come in, he has initiated ALS care on this patient. And so it would be patient abandonment. Yes, in some sense. Or you I mean, you could call and be like, well, I got a semi and a dead guy. Can I call the dead guy?

Speaker 3:
[127:09] But that's still calling it because I didn't think about that. That's that's rough.

Speaker 2:
[127:14] So Spencer, my line of thinking it's exactly that. It becomes an office of EMS compliance issue with patient abandonment. But the STEMI needs to get to a cath lab. So, you know, man.

Speaker 3:
[127:33] I mean, isn't that where we rely on our med command though? To be like, hey, listen, this is a situation. What are we doing here?

Speaker 2:
[127:40] Well, and that would have been a call for sure. I mean, like, this is the situation. I don't have a perfect answer. And if a doc had said, hey, I want you to bring me the STEMI and, you know, I want you to write it in, then I would have wrote it in, you know, up to the point of doing an IO., we had not done any ALS care for the cardiac arrest, but it's, man, it's still a sketchy thing, man. I don't like it. It gives me the, gives me the willies thinking about it.

Speaker 1:
[128:16] Yeah.

Speaker 2:
[128:17] But yeah, so to Mike's point, med control would be probably the thing to, to call and get some advice. But it is that compliance issue, because if I, if I split, you know, the team up and I go with one or the other, it's, it's potential patient abandonment. It's, I don't like it, but.

Speaker 1:
[128:37] And this, but here's a, here's another thought too. And this kind of, this does depend on what kind of ambulance you have, because there are some ambulances where this is just not possible. But, you know, it's like, take both. You know, like, hey, we got to move with her. Let's, let's load this person up. They can be on the stretcher, because they'll have the Lucas device. We can put her on the bench and, you know, continue to feed her that nitroglycerin, sweet, sweet nitroglycerin and aspirin, and see if, you know, like, let's just get them both out there, because then you're not abandoning, you bring as much help. It's terrible care. It's a horrible plan, but it's still, it kind of, it's the best, like, it would be the best that I could think of in that moment. I'm glad we didn't have to go down that route, because I don't think there are any right answers. There are probably some that are more wrong than others, but I don't know that there's a good answer. I'm curious if our listeners would have what their plan would be, because this is where I think EMS, we were like, all right, let's get creative. Who's got some duct tape? Who's got a paperclip? We're constructing a plan.

Speaker 3:
[129:54] We'll MacGyver our way out of it.

Speaker 1:
[129:56] We'll MacGyver our way out of it. Hey guys, Spencer from the future, breaking into this episode, because I realized that I totally whiffed a really important lesson. I thought about it as soon as we had finished recording. I was thinking, man, this was a lot of fun. And then I realized, oh my God, I didn't bring up this really crucial lesson point that I think needs to be brought up. I called Mike and said, hey, I would like to make an addendum to our recording. And he said, yeah, I think that's perfectly reasonable to do. Please do so. So the big lesson that I failed to bring up during this episode is this. The BLS crew absolutely could have contacted flight, and I think should have in this situation. You know, they showed up to a cardiac arrest. And I do know, I do recognize that there are some agencies, you know, in flight services that say don't call us if it's a cardiac arrest. That isn't the agency I work for. But I recognize that there are some out there. But that isn't every agency. And so, you know, that that point aside, I think that absolutely would have been a really good thing to do because they showed up, they found that this patient is in cardiac arrest, and they found that the ALS unit was a giant question mark on when it was going to show up. And then compounding things, they had a second patient who was having chest pain and looked sick. And so there was yet another opportunity for a flight service to come in, especially with a, you know, a still unknown ETA on when ALS could show up. But I do want to point out that I am sympathetic to the reason that Mike and Max never thought to activate flight, and that's because that's not something that they were trained on, that's not something that they use in their current system as BLS providers, and they're not alone. I think there are probably a lot of BLS providers who would feel uncomfortable with requesting flight, like maybe that's someone else's job to do, like an ALS provider's job to do. And I, you know, and I recognize that there are going to be systems that probably have, you know, more limitations on who can request and whatnot. But generally speaking, it doesn't matter at our service, you know, the level of provider who calls us to respond to a scene, we're coming. And, you know, we are perfectly happy to fly out there and, you know, work a code with you or transport a chest pain because you're a BLS provider and take them to the hospital, even if it turns out that it's not a STEMI, you know, we're happy to reduce out of hospital time and to show up and to provide a resource that isn't available to the scene. And I think I just want to make sure that that is something that people walk away knowing that, yeah, you absolutely as a BLS provider, you can summon flight. Other than that, man, I thought that the care was, and I don't even know why I said other than that, I thought that the care that was delivered was really good, especially given the circumstances of having to split your attention on both patients, and it's hard to keep track. It's hard to keep track on a tabletop. I think it's also hard to keep track on scene, where you're like, all right, fuck, how much time is. And in a real-life scenario, having, hey, Max, can you be our timekeeper since you're the PIC on this code, and just let me know when two minutes is up so that we can evaluate the rhythm and we can shock if we need to. And just keep me appraised of stuff, and then I'm going to focus on this more dynamic patient, because she's in transit to his condition.

Speaker 6:
[133:58] Yes.

Speaker 2:
[133:59] Yeah.

Speaker 1:
[134:01] But yeah, guys, great job overall. This was really fun, and I'm so glad that you guys could be our first.

Speaker 6:
[134:11] Yeah.

Speaker 2:
[134:11] Thank you.

Speaker 3:
[134:13] I'm so excited. Never did I ever think that a few months ago, when I'm listening to episodes going, oh my God, I love this.

Speaker 1:
[134:20] This is so great.

Speaker 3:
[134:21] And like, you know, kind of excitedly cheering along with whoever's like, I think it was probably one of the episodes. I don't remember if it was you or Chris, but just like loving it and going, man, that would be fun. And it was 100 percent. This was a blast. Yep. 100 percent. Like a true blessing. Thank you for doing this. Like you guys, you bring a lot of great education and a lot of great information to the guys like us of all levels. And it really made me excited about EMS, kind of going through the process. And like you listen to you guys helped me so much with going through the like just prep for scenario planning and doing the practical exam.

Speaker 1:
[135:11] Yeah, man, that's awesome. I'm glad that our our bullshit is helpful.

Speaker 3:
[135:18] It's fun. EMS can be fun.

Speaker 1:
[135:22] It is. It is a very fun job. It is. There's nothing like it. I mean, granted, I haven't done other jobs.

Speaker 3:
[135:29] Yeah, in a long time, I can tell you it's way more fun than like, you know, the corporate world. We're lifting appliances.

Speaker 2:
[135:36] I would I would have a hard time going back to like a regular day job. I've thought about it a bunch, and I'm just like, man, that I would struggle.

Speaker 1:
[135:46] Yeah, where you're just like, you're like, God, could one of these people collapse? Like, let's just get to something familiar, you know? But awesome. So guys, thank you so much. And thank you to Master Your Medics, who sponsored this episode, because without them, none of this would have happened. So please go to masteryourmedics.com, buy the patient care scenario books that I used to use before I realized that Chris had read all of them already, and I couldn't trick him anymore.

Speaker 3:
[136:25] You had to make your own, just so Chris couldn't cheat.

Speaker 1:
[136:29] Nice. We had to start getting creative, yeah. But they are great scenario books, and they are incredibly useful for tormenting your classmates and coworkers. So please check those out.

Speaker 3:
[136:42] If you want to learn more about our podcast, the RideAlong EMT School Podcast, you can go to ridealongemtschool.com.

Speaker 1:
[136:49] Do it. All right. Perfect.

Speaker 6:
[136:52] This has been a production of Long Pause Media, a division of FlightBridge Ed, leading the way in pre-hospital critical care and emergency medicine education.