Peter Canning- Mortal Men

Peter Canning, one of my favorite authors now and also a Paramedic in Hartford Connecticut, is at it again!! Another book!! This is a fiction novel and although I don't normally read fiction and prefered his non-fiction acounts of real 911 calls he had been on, this looks interesting. He is an amazing writer and knows how to keep the reader engaged from start to finish.

He has inspired me to someday write a book of my EMS adventures too!

Peter Canning Paramedic: On The Front Lines of Medicine Review

Peter goes back to real calls he had been on, some of which were just individuals abusing the system calling for an ambulance to act as a taxi but others were true emergencies everything from shootings to infants who had stopped breathing. This 368 page book is breath taking from start to finish aside from the very few pages in which Peter speaks of his 12 years of service spent in Washington, D.C., with Senator Lowell Weicker, which I found to be a bit slow and slightly dull, any talk of politics with me puts me to sleep. But he quickly picks it back up describing everything from drug administration to his thoughts and feelings about his partners and his own doubts in himself to make the right move. He recounts a wide variety of heart pounding calls he works, how he is feeling about them and exactly what he does during the process. He acknowledges the fact that although a paramedic, he is human. Humans make mistakes, he made mistakes with some of his patients but learns from his mistakes and goes on to better himself.

As a new EMT I found this book to help prepare me in a sesne for what I too may encounter and he has given me ideas of how to handle or not to handle a wide variety of situations.

For me personally, I found myself many times in this book. Often times I would jump off my couch saying to myself how much I could relate to him. As a new EMT all you want to do is do your best, give 100% effort yet at the same time there is at times this overwhelming fear of just being in the way of your partner or what if, God forbid, you make a mistake, which in this field could be a life threatening mistake for you, your partner, or your patient which can end your career before it even begins.

So many worries can get in the way of you learning. I experienced this while doing my ride alongs during EMT school. I was so worried I would be in the way or would make the wrong move that I look back on it now and see I missed a few opportunities to get some hands on experience. The nice thing about being a student and the lead paramedic knowing it, is yes they are watching your every move but they are doing so in order to guide you incase you do get off track.

From the Inside Flap:

"In this unforgettable, dramatic account of one man's experience as an EMT, Peter Canning relives the nerve-racking seconds that can mean the difference between a patient's death and survival, as Canning struggles to make the right call, dispense the right medication, or keep a patient's heart beating long enough to reach the hospital. As Canning tells his graphic, gripping war stories--of the lives he saved and lost; of the fear, the nightmares, and the constant adrenaline-pumping thrill of action--we come away with an unforgettable portrait of what it means to be a hero."

Biography

Peter Canning has been a full-time paramedic in the Greater Hartford area since January of 1995. His first book Paramedic: On the Front Lines of Medicine details his journey from speechwriter for the Governor of Connecticut to caregiver on the city streets. Rescue 471: A Paramedic's Stories is the sequel.

A graduate of the Iowa Writer's Workshop, Canning attended the Phillips Exeter Academy and the University of Virgina. He has worked many jobs in his life: tennis instructor, aide to United States Senator, taxi driver, meatpacker, line cook, telephone solicitor, book and movie reviewer, factory worker, health department administrator, speechwriter and political campaign director before finding his place in life as a paramedic.

Canning is currently at work revising a novel about EMS.

A lifelong fan of the Boston Red Sox, he and his family live in West Hartford, Connecticut.


His blog: Street Watch: Notes of a Paramedic
I am now going on to read Peter's following book Rescue 471: A Paramedic's Stories and this too is starting off just as heart pounding as the last.

DOA and a Bad Shot

I worked in the ER this weekend in a very busy ER department and I must say it was the best experience I have had yet. I ran IV's, drew blood, performed several EMT skills, many of which I have never done before except on a doll, and even saw something those working in the field have never and may never see!

1500-0300 was my 12 hour shift.

1645- Paramedics called the ER telling us to be ready. They were bringing in a cardiac arrest. Total down time so far was 35 minutes. He was dead. They brought him in the trauma room which was filled with doctors, nurses, a paramedic on staff and myself. I was first to perform compressions on the man. His eyes where open, he was intubated, his clothes completely removed.

The man was a referee during a football game and just dropped. Bystanders began CPR and hooked up an AED, the AED continuously told them "No shock advised." He was in asystole (flatline)  from the get go. He was DOA . As soon as he was placed on the bed in front of me I felt his arms, they were already cold. We worked him for what felt like hours performing CPR and pushing epi and atropine. Nothing worked. The doctor observing our life saving efforts said "Please stop CPR....Alright.....we will call it....4:45."

The man was a large man, which made compressions difficult,  but during our efforts we were getting some perfusion but there was no use, he was gone. With each compression I could hear him gurgling and had to remind myself a few times he was not coming alive again and gurgling but my compressions were creating the gurgling from the fluid accumulating in his airway now.

Later that night we discovered through his family he is a donor. His organs could don't be harvested due to the lack of perfusion during his down time but his corneas were eligible for donation. (This is the part I mentioned earlier that some in the field have never seen and may never see.) I watched a man from a donor bank remove this man's corneas. It was amazing how they do it and it was fascinating to see the parts of a human eye as I did. Once the corneas were removed I held them up to the light and it was an eerie feeling knowing I was seeing through this once alive man's eyes.

1752- A supposed security guard was brought to us in the ER by paramedics because he had been shot in the face. The GSW was just under his left eye and he had about a 2 inch long gash along with an exit wound. His zygomatic bone was obliterated, which was clearly observed during CT scan. Three Police officers accompanied him and kept watch over him for the several hours he was there in our care. He was conscious and vitals were stable. The bullet had barely missed his left eye. He had no vision problems what so ever...lucky man.

So what happen? No one really knows but him. He claims he and his partner were sitting in a vehicle. He was the passenger. His partner was cleaning his gun, no cleaning equipment was found in the vehicle, and the gun accidently discharged shooting him in the face. Hmmm things did not add up based on the path the bullet traveled through the man's face. He later changed his story saying he was in the driver’s seat which still didn't make sense. He stuck to his story last I had heard.

We also had a female prisoner who had second and third degree partial thickness burns from a boiling water pot being hurled at her back thanks to another inmate. The rest of the night was fairly calm, one drunk who punched a wall fracturing her hand, we splinted a few other bones, had a few chest pains, a headache, a mentally ill patient and a few other minor complaint patient’s. I finished my shift smoothly.

That was my night in the ER. 

“The Ceiling”

Paramedic: On The Front Lines of Medicine by Peter Canning, pages 123-124, The Ceiling. “Failure haunts me.”Says Peter Canning.

 I cannot speak for any other EMT-Basic but I can speak for myself when I say failure, too, haunts me. I can’t tell you how many nights I spent staring at the ceiling worry and thinking about what I am preparing for and things I’ve already seen and how it has affected me. 

            By the very first day of EMT school I was completely overwhelmed, as I’ve mentioned in a previous post, by the amount of information I was going to have to plug into over the next three months. Becoming an EMT is a big deal, not something one should take lightly. People’s lives will be in YOUR hands, that is a heavy responsibility…I began questioning myself if I could truly do it. I am now out of EMT school and preparing to venture into the real world as an EMT-Basic actually working for an agency. But I chose to stick it out and this is the day I told myself “failure is not an option.”

            During EMT school I had the opportunity to sit in at the dispatch center to see how they do things on their end. (I recommend taking any opportunities to observe ALL areas of emergency services such as paramedic services, fire departments, police departments, ER and dispatch observation.) I sat with dispatch on two separate occasions, as I’ve mentioned before, and on the first sit in the dispatcher beside myself and dispatcher Molly Stock* a call came in that was chilling. I was able to read on our screen what the EMTs were seeing on scene and I was also able to see what the dispatcher beside us was saying back to them while she spoke to a frantic father on the phone.

            “Pt is obviously dead.” Read across the screen three separate times, written by EMTs on scene. The only time an EMT can pronounce a death is when it is obvious such as decapitation, a severed body, rigor mortis, or signs of lividity. 

            I hear the dispatcher beside us trying to calm the frantic father down and speaking in a calm but remorseful tone in her voice. “Ok, I’m going to let you go now, go call your wife.” I continue to read the screen. “Father found daughter had shot herself in the head.” “Pt was 14 years old.” 

            This call haunted me for weeks afterward. It seemed to really hit me at night right before I went to sleep. I was having trouble falling asleep and would stare at the ceiling thinking about that call. What must have been so bad in her life for her to do such a thing? Are her parents also having trouble sleeping reliving that moment they found out their daughter had perished? I felt a sense of guilt as if I could have helped her, saved her in some way. Days after the call I was watching the obituary section just wanting to see her face and to learn a little more about her.

“Do unto others as you would have them do unto You”

Paramedic: On The Front Lines of Medicine by Peter Canning, page 107 has motivated me once again to point out an important message.  Peter is speaking about a call he and his partner Glenn were dispatched to at a nursing home for a female with third-degree heart block, who is for the most part asymptomatic, pulse 34 and nurses state she is bedridden and her normal state of mind is one of confusion and do not think she has heart problems in her history. 

The Pt becomes combative with Peter as he tries to start an IV and Glenn attempts to offer her oxygen. Peter is frustrated because she won’t allow the IV to happen and he yells at her “Jesus Christ!” as she jerks her hand away once he had finally placed the IV yanking it from her vein. Peter feels bad for yelling at the woman and apologizes. 

            He then begins reflecting on how he feels while transporting the elderly. “Sometimes when I’m transporting an elderly male, I look down at him on the stretcher and imagine myself there in another forty years looking up to the eyes of a faceless EMT. Neither of us speaks.” Canning P. 107

            My point here is to remain calm and understanding, two of the best things you can do when caring for patients. Think of yourself in their situation and how would you feel if you had a cold EMT/Paramedic working on you. Think of your children, sisters, brothers, parents, grandparents…how would you want EMT/Paramedics to treat them?

Lesson 1

Currently I am reading an amazingly written autobiography of Peter Canning, a Hartford Connecticut Paramedic, called Paramedic: On the Front Lines of Medicine. He tells the tales of paramedicine through his eyes, things he has felt, things he has done and seen. I’ve only just began reading so throughout my reading I will post more about it. I also plan to do a full review at the end. Here is a passage I felt was important to share with any newbies like me!

 

Page 27 speaks of a *Pt he had within the jail system. The call to dispatch came in as a man having a seizure. Peter and his preceptor Tom approach the Pt to assess him. Peter automatically assumes “Well, they called dispatch saying he was having a seizure so it must be just that, a seizure.”

            The Pt is fully responsive and in panic mode. **BP high at 160/120, ***P 108, ****RR varies between 20 and 50, pupils are responsive, lungs clear and no sign of incontinence, which is common among true seizure Pts (as well as biting of the tongue.)

            Further questioning of the guards reveal the Pt had a visitor and was expected to be transported to another facility that day.

            Tom then asks Peter what he thinks is wrong with the man. Peter responds by stating it must be a seizure so I assume I should administer Valium per medical direction. Tom then informs Peter “This is a cocaine overdose.”

            Peter asked the guard if the Pt had done any drugs, the guard said no. He then asked the Pt the same question and received the same response, no.

            Tom then told him “Don’t trust what anyone says. Focus, rule out, do your assessment.”

            I too was taught this in EMT school. Never assume anything. If you get a call for chest pain you may be expecting a heart attack right? But then arrive on scene to find you are dealing with a Pt who is a shooting victim and now you may be in an unsafe situation. Be prepared for anything, be ready for the worst.

*Pt- abbreviated for Patient

**BP- abbreviated for blood pressure

***P- abbreviated for Pulse

****RR- abbreviated for respiratory rate