I Tried Paramedic Academy
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FunTranscript
00:00 - Control your breathing.
00:02 [dramatic music]
00:03 - Everybody down? - Yes, good.
00:05 - When somebody calls for help, it's not a doctor,
00:07 it's not a nurse who shows up, it's us.
00:09 When those tones go off...
00:12 you need to be ready for anything.
00:14 [eerie music]
00:17 ♪ ♪
00:24 - Stalking? - No pulse.
00:26 - No pulse, all right, yeah.
00:27 - I'm gonna talk to a real doctor right now.
00:29 - Your scalp is live.
00:31 - Sir, can you hear me? Sir!
00:33 [eerie music]
00:36 ♪ ♪
00:38 - What's up, guys?
00:39 Welcome back to my YouTube channel,
00:40 and on this episode of "Challenge Accepted,"
00:42 I am in Colorado with South Metro Fire Rescue
00:45 to experience paramedic academy.
00:47 I will be going on a 12-hour overnight paramedic shift,
00:51 and at the end of this challenge,
00:52 I am going to experience not one,
00:54 but two final challenges.
00:56 My goal with this video was to highlight
00:58 the amazing first responders and the work that they do,
01:01 especially in the circumstances of a global pandemic.
01:04 Challenge accepted.
01:06 [eerie music]
01:08 - My name's John Curtis.
01:10 I'm the division chief of emergency medical services
01:12 here at South Metro Fire Rescue.
01:13 Michelle seems like a smart gal, that's for sure,
01:16 but I will just say, like,
01:17 this is not something that people learn overnight.
01:19 This is a career that takes years
01:21 to really master that kind of craft,
01:23 and to be able to do that under stress,
01:25 that's really hard to manage,
01:26 so I think it'll be a little wake-up call
01:28 to really understand all the pieces
01:29 that go into taking care of sick patients.
01:32 [eerie music]
01:34 - My name's Garrett Stowall.
01:35 I'm a paramedic firefighter here at South Metro Fire Rescue,
01:38 and I've been a paramedic for five years.
01:40 This is Station 21.
01:41 We call ourselves the Animal House.
01:42 We like to consider the experiences and the calls
01:44 that we run up here to be a little bit more wild
01:47 and unpredictable than the rest of our district.
01:49 - First of all, I want to make sure
01:50 that I'm as prepared as possible
01:52 to assist you in any way on any of these emergencies.
01:55 I think the best way to do that is go inside
01:57 and check out some of our stuff.
01:58 - Come on in. Hop in. I'll go around this side.
02:01 - All right.
02:02 Wow.
02:03 Have a seat.
02:04 We can show you just how to use, like, a four-lead,
02:06 which is how we check somebody's heart
02:07 so if they're complaining of chest pain.
02:09 It's a quick, easy task, and it saves us time
02:11 if, like, we have an extra set of hands
02:13 that can do that for us.
02:14 - And how quickly should I be doing this?
02:16 As quickly as possible, pretty much?
02:17 - That's helpful. That's helpful.
02:19 Show me what you got.
02:20 - Okay, Garrett, it's gonna be just fine.
02:23 We're taking you to the hospital.
02:26 - Communication is very important.
02:29 - One last sticker. Perfect. Awesome.
02:32 So what's about to pop up, you'll see,
02:34 is what Garrett's heart is doing.
02:36 You're a little dehydrated, aren't you?
02:37 - Probably. - Too much coffee.
02:39 So then we can print this stuff out,
02:41 so you can look at your own. - Oh!
02:43 So you give this to the physician.
02:45 - Mm-hmm.
02:46 - If we can go into a hospital and say,
02:48 "Look, I have point-of-care ultrasound.
02:49 I know this person has blood in their abdomen,"
02:52 that's gonna get the patient to the operating room
02:55 so much faster.
02:56 - What do you think?
02:57 You think you could do that on a person?
02:58 - Yeah. - Good.
02:59 - I like that they're labeled.
03:00 - That helps. - That does help.
03:01 - Yep. Do you know how to take a pulse?
03:03 - Without any tools?
03:04 - Without any tools. - I can take it right now.
03:06 - No.
03:07 My dad's gonna be embarrassed.
03:09 - Why? What does your dad do?
03:11 - My dad's a doctor.
03:12 - Oh, yeah.
03:13 - Ugh.
03:14 - Getting a pulse is as simple as counting it.
03:16 We look for beats per minute.
03:17 Count how many beats you get in 15 seconds,
03:20 times it by 4.
03:22 - 16, 17, 18 times 4.
03:26 Okay, 20 times 4 is... - Yep.
03:28 - 80 minus...
03:32 6--74.
03:33 Looks like he was at 81, so you're about spot-on.
03:36 - Okay. - Okay, yay!
03:37 - Pretty close, but it's the most basic skill we have,
03:39 but one of the most important.
03:40 So a typical shift here at South Metro is 48 hours long.
03:44 That includes us sleeping here, eating all of our meals here,
03:48 and constantly being available for calls.
03:50 In between those times that we're responding to help,
03:53 we're cleaning, cooking, working out.
03:56 - ♪ I see your hands up on the waist ♪
03:57 ♪ Come back, you don't understand ♪
03:59 ♪ That I'm doing what you can't ♪
04:00 ♪ When I'm getting up, these arms turn out of order ♪
04:03 ♪ You ain't even gonna know ♪
04:04 - Go, Michelle! You got it, girl!
04:06 - Run, run, run, run! - Get 'em, get 'em, get 'em!
04:08 Catch 'em! - Run!
04:09 - ♪ I'm getting too strong ♪
04:11 ♪ I'm getting too strong ♪
04:12 ♪ I'm getting too strong ♪
04:14 ♪ So it's up, you gon' figure it out ♪
04:16 - Boom.
04:18 [alarm blaring]
04:19 - Perfect. Let's go.
04:21 - ♪ I'm getting too strong ♪
04:22 ♪ I'm getting too strong ♪
04:23 ♪ I'm getting too strong ♪
04:26 - Oh, holy [bleep]
04:28 Control your breathing.
04:30 [dramatic music]
04:33 ♪ ♪
04:35 - Everybody down. Good?
04:37 - Yes, good. - All right, we're going.
04:39 [alarm blaring]
04:41 [laughs]
04:42 Trying to cool off.
04:43 Getting sweat in my eye.
04:45 Michelle, can you hear me? - Yep.
04:47 [siren wailing]
04:48 - Everybody's holding.
04:50 She sought help from her neighbor,
04:52 who was the one who called 911 for her.
04:54 All right, we're here.
04:57 Michelle, will you grab me that orange kit
04:58 that's in there? - Yes.
04:59 - Thank you.
05:00 When we first arrived on scene,
05:01 the neighbor was very agitated,
05:03 was upset that we used the wrong entrance.
05:05 Fire department!
05:06 [dogs barking]
05:09 [bleep]
05:11 I'm sorry, nobody told us that.
05:13 - Oh, most of this family was ignorant.
05:16 - When people call 911, they're at maximum stress.
05:19 They can be aggressive. They can be rude.
05:21 It's hard to go to somewhere you've never been before
05:24 and be treated poorly.
05:25 It's just gonna be you and I back here.
05:27 We'll take a nice, easy ride up to the hospital, okay?
05:29 One of the things that's unique about being a paramedic
05:31 or working in the back of an ambulance
05:33 is it's really the only time in the healthcare system
05:35 where it's one-on-one.
05:36 I only have one patient, and they only have one provider.
05:39 You're always gonna have some setbacks, so it's okay.
05:42 [sighs]
05:44 [door closes]
05:45 - There you go. - There you go.
05:47 - It was just really heartbreaking
05:49 to see someone having their worst day.
05:52 What was really beautiful to witness
05:54 was Garrett responding so well in this situation,
05:58 not being judgmental when she was being self-critical
06:01 of her own life choices.
06:03 - Okay, I wish you the best of luck, okay?
06:05 She's in a situation where she's exhausted
06:08 what she's capable of doing on her own,
06:10 and she doesn't know where else to go for help,
06:12 so she calls us, and that's not our job to judge or do anything.
06:16 We just try and point her in the direction of resources
06:19 that will actually help her.
06:21 - Hi, my name's Brian McCoy.
06:25 I'm an EMS district supervisor.
06:26 - Hi, Paul Folk, also EMS training,
06:29 EMS battalion supervisor.
06:30 - What we're about to do is teach you
06:32 how to manage a cardiac arrest as a paramedic.
06:34 - This is our fairly realistic-looking mannequin.
06:37 - There's definitely some uncanny valleys
06:39 of happening.
06:40 I feel like it's just gonna, like, wake up,
06:42 like, animate on at any moment.
06:44 - We look at the patient's ability
06:46 to maintain their own airway.
06:47 Without oxygen, the brain dies, and the body follows.
06:50 This is called the eye gel, or a supraglottic airway.
06:53 That means it sits above the epiglottis.
06:55 When you take a drink and you start to choke,
06:57 that's because the fluid went down your trachea.
07:00 Your epiglottis is a little flap
07:01 that protects that trachea from foreign objects going into it.
07:05 - There you go.
07:06 - All the way down to where this black line
07:08 meets the teeth right there.
07:09 And then we're basically gonna take this bag valve mask,
07:12 and we're gonna breathe for him that way.
07:14 - This is the equivalent of putting somebody
07:16 on a respirator at the hospital.
07:17 And you're gonna squeeze slowly.
07:21 Basically, you're his lungs now.
07:23 Think about how you breathe.
07:24 It's over a couple seconds, and you let it out.
07:27 - And how do you know when to escalate past this?
07:30 - So if they're vomiting and they're unconscious,
07:32 what we don't want is them to aspirate that fluid.
07:35 - So you're gonna take a look
07:36 and tell me what you see in there with the camera.
07:39 - Okay.
07:40 - Okay. - Definitely see stuff.
07:41 - All right, so we need suction.
07:42 - This is like going to the dentist.
07:44 - In the worst possible way.
07:45 So we're gonna start suctioning.
07:46 - Oh, wait. - Use your camera
07:47 to guide you where you need to clean.
07:50 What's that? - That's the epiglottis.
07:52 - Epiglottis, right?
07:53 - This is like watching one of those ghost shows
07:55 and they have one camera with a light
07:57 going through the haunted house,
07:58 except it's the back of someone's throat.
08:00 - Then you're gonna use this to inhibate.
08:02 So if you go in with that tip,
08:05 there you go.
08:06 Now push that whole thing forward.
08:09 Perfect.
08:10 Attach your Ambu bag next to you.
08:12 There we go.
08:15 Now we're breathing.
08:17 - We can see how much went into the lungs.
08:19 - Oh, my gosh.
08:20 - So we got way more out than went in,
08:22 which is about the best we can do at that point.
08:24 - So have you guys gone on calls COVID-related
08:28 and had to begin this process
08:30 on the way to the hospital to ventilate?
08:32 - Definitely.
08:33 COVID has been a kick in the pants.
08:34 For sure.
08:35 It's changed the entire ballgame
08:37 as to how we run calls.
08:38 Everything from personal protective equipment
08:40 to having to adapt on the fly
08:42 to medical protocols,
08:43 and that created a lot of fatigue
08:45 amongst the profession.
08:46 Not only nurses, doctors, but paramedics
08:48 are in that as well.
08:49 - So this is a COVID-positive call
08:52 that they're handling inside,
08:53 and it's just crazy how so much of the world
08:56 is still dealing with the repercussions
08:58 of this pandemic.
08:59 - COVID brought a whole new challenge to us
09:01 in a lot of different areas
09:02 that we'd never really considered.
09:03 First was the burden on the healthcare system
09:06 and trying to prevent our hospitals
09:08 from being overwhelmed.
09:09 The butterfly ultrasound that we carry on our rigs
09:12 has been incredibly helpful
09:13 determining the severity of COVID symptoms.
09:16 We're able to guide patients
09:17 to appropriate treatments
09:18 and even avoid some unnecessary
09:20 hospital visits as well.
09:22 - This is a mid-fidelity mannequin,
09:24 so he'll breathe, he'll cough,
09:25 he'll sometimes have pulses, depending on model.
09:29 - So this is the closest thing
09:31 to working on a real human.
09:32 - Pretty much.
09:33 You're gonna hit this yellow button.
09:35 - Charge?
09:36 - And it's gonna charge the monitor.
09:38 [monitor beeping]
09:40 So now you're ready to deliver
09:42 300 joules of electricity.
09:43 You gotta tell everybody on your crew to clear.
09:45 Everybody sees that on TV.
09:47 Clear, but it's a real thing.
09:48 Nobody can be touching this person
09:49 when we run this electricity through them.
09:52 - Clear? I'm shocking.
09:54 [monitor beeping]
09:55 - And then you look for changes.
09:57 Anything change?
09:58 - So is it delivered through the patches?
09:59 - Yes. - Oh, so it's not like
10:01 the-- - It's not the paddles.
10:02 - Okay. - We used to use paddles.
10:04 What we have now are these pads.
10:06 If we don't get oxygenated blood into your brain,
10:09 we can fix everything down here,
10:10 but if your brain doesn't work,
10:12 your quality of life isn't there.
10:13 So what we're shooting for is your quality of life
10:16 to be the same as it was before your cardiac arrest.
10:19 [monitor beeping]
10:20 We are gonna simulate a medical emergency,
10:23 somebody walking into a firehouse,
10:25 which happens quite frequently.
10:27 Somebody, they see a firehouse,
10:28 they see a door open, they come in,
10:30 and they shout for help.
10:31 - So I'll be responsible for directing the crew.
10:33 - You're responsible for our patient's life.
10:35 - Okay. Okay.
10:36 - So it's up to you.
10:38 - Station 41, we got a walk-in medical in the bay.
10:44 Station 41.
10:45 - Walk-in medical in the bay.
10:47 - Compressions here.
10:49 Now you're gonna get started on--
10:50 - No pulse. - No pulse, all right.
10:51 Yeah, go ahead and get started on the--
10:53 - Okay, what's going on?
10:54 - Male just walked in, said he was having chest pain.
10:56 All of a sudden, he just collapsed
10:57 and fell on the ground.
10:58 Just started compressions.
11:00 That's all we've got for you so far.
11:01 - Okay, great. - Oxygen's on.
11:02 Hooked up, got the monitor on there.
11:04 - 180. - Charging.
11:06 - And what is that rhythm?
11:08 - Very regular. - Is that a shockable?
11:10 - Yes.
11:11 Okay, everybody move.
11:12 - Clear. - Shocking.
11:14 Shock's been delivered.
11:15 - Down the chest. - Down the chest, sir.
11:16 - Michelle, I'm gonna spike you an IV.
11:18 [inhaling]
11:20 Good job.
11:21 175.
11:23 - Charging.
11:27 - Take your hand off.
11:29 Shockable or not?
11:32 - Not shockable.
11:33 - Tell him to resume compressions.
11:34 - Resume compressions.
11:35 - You have your IV established.
11:36 We need our first medication, epinephrine.
11:38 Push the air out,
11:40 and then you're gonna screw it into there.
11:42 Push and turn.
11:44 Now push that whole thing in there.
11:46 - Two minutes of passive oxygenation are up.
11:48 So now what do we need to address?
11:50 - The breathing.
11:52 - Bougie and a Mac.
11:53 - So look for your rhythm.
11:55 - Michelle?
11:56 - Uh, not shockable.
11:57 - Not shockable. Resume compressions.
11:59 - So much is going on.
12:01 - Take a breath.
12:02 Take a breath.
12:04 All right.
12:06 - Okay. - Sludge down there.
12:08 Good.
12:09 - Michelle, I'm gonna push your next round of epinephrine.
12:12 - Okay.
12:14 - Like that.
12:16 And now you're gonna advance.
12:18 You're good right there.
12:20 Pull your bougie.
12:21 Let's get an Ambu bag.
12:25 - He's gonna breathe now.
12:27 - Okay.
12:28 - 180.
12:29 - Charging.
12:31 - And go.
12:33 - 200.
12:35 - Not shockable. - Not shockable. No.
12:37 - Our rhythm is asystole, so we're still flat-lining.
12:39 So you are gonna take this probe,
12:41 stick it right here,
12:43 and we're gonna take an image
12:44 to look to see if there's heart movement.
12:46 200.
12:48 - Not shockable, but the heart is moving,
12:50 so we do need to transport it.
12:52 - One, two, three.
12:53 [dramatic music]
12:55 - Come up.
12:57 ♪ ♪
12:59 [siren wailing]
13:02 - So we got you the phone number for the ER
13:04 so you can talk to the doctor and tell him what we did.
13:06 - I'm gonna talk to a real doctor right now?
13:08 - Mm-hmm. Or a nurse.
13:09 - Okay.
13:10 - Hi, this is ER. This is Leah. Go ahead.
13:12 - Hi there. Can you hear me okay?
13:13 - Yes, this is Leah. Go ahead.
13:15 - So I have an unknown age male
13:17 who collapsed at the station.
13:19 Cardiac arrest.
13:20 We gave him the ambulance.
13:21 He's in a critical condition.
13:23 Cardiac arrest.
13:24 We gave him four tubes-- three tubes of epinephrine.
13:27 We're performing CPR, and he's intubated and IV.
13:30 - And you shocked him once?
13:31 - We shocked him once,
13:32 and we will be there in ten minutes.
13:34 - All right, we'll see you in ten minutes.
13:35 We'll have a room on arrival.
13:36 - Thank you.
13:37 ♪ ♪
13:42 - Watch your step.
13:45 Everybody good?
13:46 - Good, good.
13:47 - Hello.
13:48 - Come on, baby. Room one.
13:50 - Is everybody here?
13:51 - Yes, we're here.
13:52 - Michelle's gonna give you a report.
13:54 Loud, loud.
13:55 - Okay, so we had an unknown male,
13:58 unknown age, into the station.
14:00 Cardiac arrest.
14:01 We gave him three tubes of epinephrine.
14:03 Intubated, IV. That's all we know.
14:06 - Shocked him once?
14:07 - Shocked him once.
14:08 - One, two, three. Good.
14:09 - When was the last time you had epinephrine?
14:11 - Michelle?
14:12 - About 15 minutes ago.
14:13 We ultrasounded the heart, and there was movement.
14:15 - Do you feel a pulse?
14:16 - No pulse.
14:17 - So what they've done so far is confirm
14:19 that your tube is in the right place,
14:20 your IV's in the right place,
14:21 all of your medications are on board,
14:23 given that person every chance that they can have.
14:25 Now we wait and see how we do.
14:27 [coughing]
14:29 - So when was the last time we had a pulse, guys?
14:32 - At least 20 to 30.
14:34 - 20 to 30? Okay.
14:35 So we have no cardiac activity on the ultrasound.
14:38 We still have asystole on the monitor.
14:40 It's been 30 minutes since we've had any signs of life.
14:44 At this point, the chance of any meaningful recovery
14:46 is very slim.
14:47 Giveaway of asystole,
14:48 I think you should fall harm and death 1737.
14:52 [somber music]
14:55 - That's it. We're done.
14:57 ♪ ♪
15:04 So let's go clean up and get ready to do it again.
15:07 - That's it? - That's it.
15:09 That's the toughest part of the job,
15:11 is you do everything exactly the way you're supposed to do it,
15:14 and it still doesn't work.
15:16 - So you could watch someone die?
15:19 - A couple times a day.
15:21 Yeah, absolutely.
15:24 First one's always the hardest.
15:26 I think it's really difficult to describe what it's like
15:29 just because, like I said, it's very different
15:31 every single day.
15:32 Sometimes it can be very exciting, very thrilling.
15:35 Other times it can be scary and frightening,
15:37 and it can be sad or disappointing as well.
15:39 - Says difficulty breathing, no longer conscious.
15:43 [siren wailing]
15:46 ♪ ♪
15:52 Even before we arrived at the actual apartment where she was,
15:56 we could hear the family screaming, crying.
15:58 Initially, I saw the patient.
15:59 She was unconscious and responsible, lying on the floor.
16:02 My first impression was that she wasn't alive.
16:05 - Daughter said she was in the other room.
16:07 Heard her go down while she was eating.
16:09 - Okay. - Attempted CPR,
16:10 he took that to the other room. - Got it.
16:13 - I had my partners.
16:14 They were starting the IV, checking vital signs,
16:16 putting her on our heart monitor.
16:17 I had other partners who were giving her medications,
16:20 so teamwork is super important.
16:21 We're able to accomplish a huge list of tasks
16:23 that are vital to that patient in a really short amount of time.
16:27 - Hey, this is paramedic Stilwell,
16:28 South Metro Medic 21, coming to you non-emergent.
16:31 Altered mental status.
16:32 She's a GCS of 11.
16:33 This is a possible narcotic overdose.
16:35 Should be there in about five minutes.
16:37 - It was just like watching the tentacles of an octopus,
16:41 like, reach all around the ambulance.
16:43 You guys were, like, pulling everything out,
16:45 working together.
16:46 - Thank you, yeah, that's the best part,
16:47 is all of us have been working together for so long,
16:49 and we've trained together, and we practice this together,
16:52 and when it comes down to the real event,
16:54 it works seamlessly, so.
16:55 - Well, we should eat before we get another call.
16:57 - Yeah, let's eat dinner. I know,
16:58 'cause we may not get another chance.
16:59 - Okay. - Let's do it.
17:01 [upbeat music]
17:04 ♪ ♪
17:06 - Oh, my God, this looks so good.
17:08 - It's awesome.
17:09 - So it is true that firefighters can cook real good.
17:13 - Some of 'em. Some of 'em are terrible.
17:15 - You guys go to sleep tonight.
17:18 Do you actually sleep?
17:19 I don't know how I'm going-- I don't think I'm going to sleep.
17:22 - Yeah. No, I mean, honestly,
17:23 you just kind of have to go about your day-to-day life, right?
17:26 'Cause we're here for 48 hours,
17:27 so if it means that we go to sleep for 20 minutes
17:30 and get a call, that's great.
17:31 But you also get to take the chance
17:33 that you might not get a call all night,
17:35 and you get to sleep,
17:36 so you just kind of have to deal with it.
17:37 - You have to really learn how to handle
17:39 that type of emotional atmosphere
17:41 along with being ready to perform the next time.
17:44 Along comes with that just a true camaraderie
17:46 that is really bonded between those people.
17:49 - A one. - A one.
17:51 - A two. - Oh, no.
17:52 - No, you're triple dropping?
17:54 - No! - No!
17:57 - So he's gonna run out of bones the fastest.
18:00 - Working with a crew of 48 hours,
18:02 if you go through an entire year,
18:04 you spend a third of your life with these people,
18:06 so they truly become your family.
18:08 Things like playing dominoes or watching movies together
18:11 was a really important team-building moment for us.
18:14 - So HP thinks that the point of dominoes
18:17 is to just screw everybody else over?
18:19 - You're eating together, you're cleaning together,
18:22 and sometimes you're performing
18:23 on some of the most stressful events of your life together,
18:26 so that closeness translates into how we perform on the job,
18:29 just knowing that we can trust each other.
18:32 - 54-year-old male, conscious and breathing.
18:40 He has a pea sneaker and feels like he's having a heart attack.
18:44 - So, Michelle, we've got a 54-year-old male
18:47 that's been drinking in and out of consciousness.
18:50 [sirens wailing]
18:53 - John Country.
18:55 - We got canceled. - Oh, [bleep]!
18:57 - I'm out. [laughs]
19:00 - Oh, dang it.
19:01 Definitely when you're in a dead sleep
19:03 and you're trying to get some rest in between calls,
19:05 it can be really challenging to wake up and get ready,
19:07 get down to the rigs while you're still trying to figure out
19:10 where you are.
19:11 - So what happened exactly?
19:12 - We were called into an area that's close by
19:14 that's actually a different fire department's jurisdiction,
19:18 and then it's just whoever gets there first.
19:21 - Nothing like being woken up in the middle of the night
19:26 and it's a false alarm.
19:28 - So the next thing is gonna be a lot of trauma stuff.
19:31 So when we can't inhibate and we can't ventilate,
19:33 we do what's called a surgical cricothyroidomy.
19:35 We're gonna cut a hole in this person's neck,
19:37 and we're gonna cut through this membrane,
19:39 and we're gonna put a tube right into their neck,
19:42 going straight into their trachea.
19:44 It's a pretty invasive maneuver.
19:45 And this is our plan C.
19:46 This is the end of the line for us.
19:48 There's no plan D.
19:49 - So we had some kids at a tech high school
19:51 3-D print these tracheas for us,
19:52 and they're a hard plastic, anatomically correct
19:55 Can I point yours out?
19:57 Right there.
20:01 [laughs]
20:02 - Oh, my God.
20:03 You're literally Sweeney Todd-ing somebody!
20:05 - Pretty much.
20:06 So with your left hand,
20:07 you're gonna take and feel for that landmark.
20:09 Make sure you got a good target there.
20:12 There you go.
20:13 With your right hand, very carefully,
20:16 you're gonna make an incision about that big.
20:20 A little bit deeper, and a little bit higher up.
20:24 All right.
20:25 Without cutting yourself,
20:26 you're just gonna kind of stab through that membrane.
20:30 Other way.
20:32 And that way, we're creating a hole.
20:34 - Don't move your left hand.
20:35 - Yep. - Well, I'm not moving.
20:37 - Don't move.
20:38 You'll put that tube into the hole.
20:40 - You may have to push pretty hard.
20:43 - Is that okay? - Yep.
20:44 - And then remove this? - Yep.
20:46 Pull that out.
20:47 And then your partner will come and start to ventilate.
20:50 There you go. - Okay.
20:51 - You just did surgery in the back of an ambulance.
20:54 A collapsed lung can come from a penetrating injury
20:56 where it could be a sharp object,
20:58 sometimes a dull object, a bullet.
21:00 That force causes the air to leak out of the lungs,
21:03 and so as that space starts filling up with air,
21:06 it starts closing off the lungs.
21:07 So we use an anterior or the front of the body location
21:10 to basically needle someone's chest and remove that air.
21:14 So the front here--
21:15 - You're putting a needle into the chest.
21:17 - Correct.
21:19 - Girl.
21:22 That's pretty deep in there.
21:24 - Yeah, it's a big needle.
21:25 It's like a Capri Sun straw.
21:27 - I don't like this.
21:29 - Right here is our target,
21:32 and as you enter, you're gonna watch for your green valve.
21:35 It's gonna let up.
21:36 That's how you know you went far enough.
21:39 And that's good.
21:43 - Oh, but it didn't-- - Happened real fast.
21:45 - Oh, it did come back up. - Yep.
21:47 Happened really fast.
21:48 - Oh, my gosh.
21:49 - So that's how carefully you gotta watch it.
21:50 There's a heart in here.
21:51 There's large vessels in there.
21:52 We don't wanna poke holes in those.
21:54 - What you've done is just given a track for air
21:56 to come out of that chest cavity.
21:58 Those lungs can start to reinflate,
22:00 and they're no longer putting pressure on the heart.
22:03 Now that you ran a medical call, we're gonna move on to trauma.
22:06 So our next scenario we have planned for you
22:08 is a motor vehicle accident.
22:10 - So today I'll be the victim in a car accident.
22:13 Took about--probably about an hour
22:14 to get me fully dressed up here
22:17 and all the face makeup and wounds on there.
22:20 - Did you volunteer to do this, or were you told to do this?
22:23 - Uh, voluntold.
22:25 - [laughs]
22:27 - That's us.
22:33 - Her second scenario is gonna be a trauma scenario.
22:36 She'll be met with a significant auto extrication call.
22:39 She'll be in a vehicle, making sure it's safe,
22:41 making sure that she can access this patient
22:43 and manage that entire scene from a medicine standpoint.
22:46 - Oh, my God. The car flipped over.
22:49 - When you get in the back, start patient care.
22:56 - Okay. - I'll let you in on that right side.
22:58 - Okay.
23:00 - You can get in. You can stay close to the patient.
23:06 We're gonna start our extrication, all right?
23:08 - Okay.
23:10 - All right. Is his chest moving a little bit?
23:13 - He is breathing, yes. - Okay, breathing?
23:15 - He has trauma all over his face.
23:17 He's bleeding out. We need to--we need to plug it.
23:19 - Yeah. - With gauze.
23:21 - Cool. Okay.
23:23 They're about to take the window out.
23:26 Let's cover him with this blanket.
23:28 Cover him all the way up.
23:29 We don't want to get glass on him.
23:31 All right, take the glass.
23:33 You're gonna need to pack that wound.
23:43 Pack, pack, pack.
23:45 He's gonna bleed out if we don't stop that.
23:47 Keep packing. Pack, pack, pack.
23:51 Fast, fast.
23:53 - [grunts]
24:00 [dramatic music]
24:03 ♪ ♪
24:10 - Sir, can you hear me? Sir?
24:22 He's not alert to any of this.
24:24 What do you think about that airway?
24:26 - I think we're gonna have to go in through his throat.
24:28 - Definitely. It doesn't look like we're gonna get
24:29 very far with the mouth. - No.
24:30 - I'll set you guys up for a cry.
24:32 ♪ ♪
24:37 - All right.
24:39 Your scalp is live.
24:41 Same thing. Find that landmark.
24:44 Can you feel the membrane? - Yeah.
24:46 - All right, you got your target?
24:47 All right.
24:49 ♪ ♪
24:52 Make your crosscut.
24:56 Good. That's enough right there.
24:58 - Watch this finger. That's enough.
25:00 Put that finger in there. Don't lose it.
25:02 And it's gonna go towards his toes.
25:04 Keep going, keep going, keep going,
25:07 keep going, keep going.
25:09 Okay, we're in.
25:13 All right, stethoscope. Let Brian squeeze the bag.
25:16 We're gonna listen to his chest.
25:18 ♪ ♪
25:21 Okay, that sounds good.
25:23 Yep, sounds good. - Okay, sounds good.
25:24 - Let's get the left side.
25:26 This bag is getting hard to squeeze.
25:28 - Okay, I can't hear anything.
25:29 - Couldn't hear anything on this side,
25:31 but can hear on this side. - Yeah.
25:32 - So what's going on?
25:33 - There must be something. It's collapsing.
25:35 - The bag's hard to squeeze. The lung's collapsing.
25:37 ♪ ♪
25:39 - One. - Start tracking downward.
25:40 Count ribs. Second to third.
25:42 ♪ ♪
25:43 - Right here. - Needles ready.
25:45 Remember, hold the top. Watch your valve.
25:47 Watch the green. Go.
25:49 Hold the top. - Make sure she doesn't bury that.
25:51 - Go. - Pretty quick.
25:53 - And then pop back up.
25:54 So that's right where we need to be.
25:56 So you're gonna pull the needle out.
25:58 As I advance this.
26:01 And we're in place.
26:02 Is that bag getting easier to squeeze?
26:04 - Yeah, it feels easier.
26:05 - And we're transporting.
26:06 We're on our way to Sky Ridge Hospital.
26:08 - Sky Ridge here. This is Jasmine.
26:10 Heather, can you hear me? Yeah, go ahead.
26:12 - Okay, we have an unidentified male.
26:14 Looks to be 30s, involved in an NVA.
26:16 Bleeding out.
26:17 We performed a cricothyrotomy.
26:19 - Okay. - And...
26:20 - Needle decompression. - A needle decompression
26:22 on his left side.
26:23 - Okay, you're starting an IV,
26:25 and we'll get you in about 10 minutes.
26:26 - 15. - 15 minutes.
26:27 - All right, we will have a room ready for you on arrival.
26:30 - Good.
26:31 [siren wailing]
26:33 Now, when we get there, you're gonna need to be loud.
26:35 Big room, people.
26:36 They're all listening to you.
26:38 They want to hear what you have to say.
26:39 - My hands are getting tired.
26:40 - Do you want me to take over for a little bit?
26:42 - No, no, no, no, no. I'm just, like, saying
26:44 these are things I don't think people think about.
26:46 - Yeah, ambulances drive by you all the time
26:48 in your hometown, probably,
26:49 and you have no idea what's going on in the back.
26:51 This could be going on in the back.
26:53 Next one you see.
26:55 [siren wailing]
26:57 ♪ ♪
26:59 - I'm good.
27:01 - You're gonna go out on this left side,
27:03 and I'm gonna transition the bag to you.
27:06 So go ahead and step down.
27:07 - Watch your step. - Is he lower?
27:09 ♪ ♪
27:12 - You guys are going into room one.
27:14 - Room one.
27:15 - So we're gonna make a turn and go ahead first.
27:17 ♪ ♪
27:21 - Get back.
27:22 - Unknown aged male involved in--
27:23 - Louder. Much louder.
27:24 - Unknown aged male involved in an NDA.
27:27 Arterial bleeding on the right shoulder.
27:29 We packed it with Kwik Klots,
27:31 two IVs, we did a crike on his throat,
27:34 and a needle decompression on the left side.
27:37 - Vitals?
27:38 - Vitals are blood pressure 90 over 60,
27:40 heart rate 120.
27:41 - Let's get the floor back up.
27:43 - Where's OR?
27:44 - All right, we're coming, everyone.
27:46 - We'll get it ready.
27:47 - Get back going.
27:49 ♪ ♪
27:54 - We're good, guys.
27:56 - Thank you.
27:57 - That was amazing.
27:58 [applause]
28:00 - Thank you so much.
28:02 - Holy cow.
28:03 - You all are amazing.
28:05 Thank you so much for letting us--
28:06 - Oh, no, my pleasure.
28:07 - Experience a small piece of what you do every single day.
28:09 - Our pleasure. Our pleasure.
28:11 [sniffing]
28:13 - Oh, yeah.
28:14 - You can start peeling your face off.
28:16 - That final scenario was crazy.
28:19 - A lot going on, right?
28:20 - This week, I have learned so much
28:22 about what it takes to be a paramedic,
28:23 even though I just scratched the surface
28:26 of Mount Everest, of what it truly takes.
28:28 So thank you guys so much for taking the time.
28:30 - It was our pleasure.
28:31 You paid attention, you learned a lot,
28:32 you really took our lessons to heart,
28:34 and I think you did a great job with our trauma scenario,
28:37 so happy to have you.
28:39 [soft music]
28:42 ♪ ♪
28:49 [siren wailing]
28:52 ♪ ♪
28:59 (music fades)