U.S.A.! / White Hat / Water

We are back in the U.S.A.! Australia was G R E A T, but I am glad to be back home.

In my absence I could not properly defend myself against being nominated for an assistant chief position. So, now I am a "white hat". Be very afraid...


Just as we were settling in and feeling like the 14 hour time change was being absorbed the floods that have swamped the East Coast hit. Tuesday night was spent down at the station as the village was put in an official "state of emergency". It took me a LONG time to get home as most roads between my house and the station were closed (for good reason). Lots of water damage, but no loss of life in my village. Wednesday things were still a mess when the state called and asked if we could head to Broome County NY to help relieve some of their ambulance staff who had been going HARD for quite a while. My agency sent an ALS rig down to help out and spend 24 hours taking calls as "first due" for an agency just outside of Binghampton. The politics of this were interesting. The agency had not asked for help (as far as I could tell), but the providers were clearly tired. I don't know if we really helped them much, as things were fairly quiet while we were there. I do hope our being there allowed at least one crew to stay home with their families and/or get some sleep.

I had call while there that bugged me and I've had this problem before: Patient with CHF history, with new onset edemia and rales bilaterally. Patient ALSO has fever, recent history of pneumonia, and stopped taking her antibiotics after only two days. What's the best way to treat this patient? Other information: O2 sat in low 90's, no signs of wheezing or air trapping, patient reports the swelling in her legs started right before the difficulty breathing, and that the DB had a sudden onset. Patient is currently hypertensive, perfusing well, and denies chest pain. I gave nitroglycerine and lasix with partial relief which lasted for 10 minutes or so and then symptoms returned.

DJ