What's all the fuss about?

You are dispatched for a 25 year old female having difficulty breathing.

The tones echo through your house awakening you and your spouse from a deep sleep. You peek through the curtains to see the first snowfall of the year. You splash some cold water on your face, jump into your uniform, quickly run a brush through your hair, and you’re off into the cold night. As you race to the ambulance dispatch informs you the patient is no longer able to talk. You throw a piece of gum in your mouth and prepare for the worst. You nervously chat to your partner about the snow, trying to hide the fear and anxiety you feel inside. As you get within a few miles of the patient the ambulance falls silent, no more talking, enjoy the calm before the storm.

After what seems like an eternity you arrive at your patient, she is a slender girl sitting in a recliner almost completely unconscious and seems to be gasping for air. You know the diagnosis soon as you see her, swollen lips, hands, and eyelids. Red bumps on the neck and chest, wheezes and stridor in the airways, tears streaming down her face, saliva running down her chin. Anaphylactic shock is such an ugly event.

As your partner starts oxygen therapy and attaches the ECG you draw up one mg of Epinephrine. You expose the deltoid muscle and plunge in the 1” needle, the patient does not even notice as you inject half the medication deep into her muscle. You watch as her heart rate increases and wait for the epinephrine to reach her Beta 2 receptors to cause the airways to dilate. After what seems to be forever she begins to take deeper breaths and the choking sounds subside from her upper airways. You load the patient onto your stretcher and begin the twenty minute to the hospital. With the patient beginning to talk you take a brief history as you fill a nebulizer with 5mg of Salbutimol. As she inhales the mist of medication deep into her bronchioles she starts smiling and crying at the same time thanking you for saving her life. She begins to talk about her family, reflecting on the important things in life like all people do after a near death experience. 10 minutes have passed now and even through the sirens and road noise you can hear the stridor returning in her throat. You pull out the syringe and administer the remaining .5mg of epinephrine.

You strike up a conversation with the patient in an attempt to keep her calm, she tells you of her new job at the post office stuffing mail boxes. She giggles as she reflects on how insignificant it seems to her as compared to your job. She says it is boring but the money is good at $19.80/hr.

After all is said and done you say goodbye to your patient. She states you will always be “My guardian angel”; a sense of accomplishment overwhelms you as you head back to the base.

As you crawl back into your warm bed you reflect on the call as you always do, doing a mental checklist to make sure everything was done according to protocol. You think of the first smile she threw your way and how it made you feel, but the good feelings soon subside as you remember the conversation of her new job.

You see as a new employee at a post office she receives $19.80/hr. That is what society chooses to pay her. That is what her job is worth to the community.

The paramedic on this call receives less than $17/hr.
Please take the time to educate yourself and your co-workers, please ensure you are part of the solution and not the problem.