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#81 Dr. Grant

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Posted 06 June 2018 - 09:55 PM

*I sit at the nurses station, working on my charts. I'm aware that there are two stabbing patients coming in. The trauma team is in the trauma bay working on the first patient who just got brought in. I got delegated to manage the second patient.*

 

*As the EMTs enter the ER I overhear the nurse in ambulance reception asking if this was the arm stabbing and I hear one of the EMTs answer affirmatively.*

 

'This is mine.' I say softly to myself as I logout of the computer and stand up. 

 

'Trauma 10' I hear the ambulance reception nurse tell the crew. I watch them wheel the patient over to the room and help him up into the room. He doesn't seem too bad. I walk over to the EMTs.

 

'So what do you have for me?' I ask Sjostrom.


Dr. Christopher Grant, DO, MPH
Associate Medical Director, Shiloh County FD (MD - 2)
Attending Physician
Emergency Medicine
Shiloh County General Hospital

#82 E. Sjostrom

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Posted 06 June 2018 - 10:15 PM

'18 year old male, with a wound caused by a knife in his arm. Last I checked vitals were 109 pulse, blood pressure was 107/68, and respiratory rate was at 22.  Patient's name is Jonathan Cooke.  Tourniquet and dressings applied on scene to help stop the bleeding.'


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EMT Erika Sjostrom

Medic 3


#83 Dr. Grant

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Posted 06 June 2018 - 10:41 PM

*I put some gloves on and make a line straight for his arm to take a look.*

 

'Hi, I'm Dr. Grant, I'm just going to take a quick look at your arm.' I say as I inspect it. I see a single wound, fairly large, but decently clean cut. Should be easy enough to suture. 

 

'What kind of knife was it? Any other injuries? Loss of consciousness?' I ask.


Dr. Christopher Grant, DO, MPH
Associate Medical Director, Shiloh County FD (MD - 2)
Attending Physician
Emergency Medicine
Shiloh County General Hospital

#84 E. Sjostrom

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Posted 07 June 2018 - 05:01 PM

*The doctor takes the patient and starts talking to him or at least I think he's talking to him.  If he's talking to me then things are going to be a bit awkward as I'm already on my way back to M2.  On the way I see a nurse heading to the room and I figure it'd be a bit safer to let him know just in case so he can relay it to the doc.*

 

'Alright, won't keep you long.  Not sure if he was asking me questions or the patient as I was leaving.  However, covering my ass a bit.  Not sure what kind of knife, no other injuries, he didn't lose consciousness'

 

*With that said the nurse gives me a nod and I start worrying that the new doc, even though he's almost been here a year, and I might have just gotten on the wrong foot.  As I get to M2 I hop in the passenger seat.*

 

'Alright Jackson, let's head back to the station.'


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EMT Erika Sjostrom

Medic 3


#85 Dr. Grant

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Posted 16 June 2018 - 04:37 PM

Sjostrom leaves without answering.

 

'Okay then.' I say to myself, not thinking too much into it.  I ask the patient instead and essentially get the same information. 

 

'Ok so you did get knocked out?' I ask the patient.

 

'I think so, Maybe for a minute.' he replies.

 

*I check his neck and head. Nothing seems out of the ordinary except for some dried blood, probably from his arm wound. He denies any pain and seems alert and oriented.*

 

'Ok so I want to do a quick CT scan of your head since you did get knocked unconscious. A blow hard enough to do that is more than capable of causing a bleed in your brain. I think it's unlikely but I'd really rather be safe than sorry with that. Other than that we're going to get that tourniquet off and see what kind of bleeding we're dealing with here. Once we get that under control hopefully it will be a matter of cleaning it out and stitching it up.'

 

*The patient agrees. I pull out a pen light to get an even closer look at the wound. I poke a prod it for a second. I see exposed muscle. This is going to require multiple layers of stitching.*

 

*I ask the man to move his hands and fingers. He does so. I check his feeling around the wound and below. Everything seems intact.

As a nurse finishes his vital I take a quick glance at them. Everything seems normal. I walk out of the room and over to a computer to start writing up the orders.*


Dr. Christopher Grant, DO, MPH
Associate Medical Director, Shiloh County FD (MD - 2)
Attending Physician
Emergency Medicine
Shiloh County General Hospital

#86 E. Sjostrom

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Posted 25 June 2018 - 12:14 PM

*Unloading the patient I hand in the PCR*

 

--------------------Call Info--------------------

Incident #: 20180618
Department: SCFD-EMS
Address: Oxnard Center Park, Oxnard
Dispatched As: Baseball Injury
First: Jackson
Second: Sjostrom
Third:
Other Agencies At Scene:
 

--------------------Patient Info--------------------

Patient Name: Joey Sanders
Date of Birth: 2/19/1996
Age: 22
Patient Address: 15 November Street, Oxnard
Conscious or Unconscious: Conscious
Trauma: Yes
Chief complaint: Ankle Injury
Signs & Symptoms: Visible Deformity, Swelling
Past History: None
Medications: None
Interventions: Splint, Ice Bags,
Transport or Refusal: Transport
 

--------------------Vital Signs--------------------

P: 79
RR: 21
BP: 122/83
Eyes: PEARRL
Skin: Pale
Lungs: Clear

--------------------Narrative--------------------

 

M2 dispatched to Oxnard Center Park for a baseball related injury.  On arrival we found the patient in the dugout with a deformed ankle.  As vitals were being taken patient states that he rolled ankle while rounding second base.  M2 crew used OPQRST tool, assessed CSM, and stabilized ankle using splints.  Patient was then transported to Shiloh County Hospital.


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EMT Erika Sjostrom

Medic 3


#87 R.Dunne

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Posted 05 November 2018 - 04:58 AM

"County Hospital this is Medic 2, how do you copy."
"Medic 2 this is County, we copy go ahead"

"County we're on scene with a male approximate age is 20, found to be acting violently. Police were involved, patient was tazed and continued to be combative. Vitals are as follows; pulse is 176, blood pressure is 196 over 108, and respirations are 26. Patient is warm to the touch and diaphoretic. We are about 5 minutes out. Anything further?"

"Negative Medic 2, we will see you on arrival."



#88 R.Dunne

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Posted 01 December 2018 - 06:33 AM

*As we drop off our patient and gives report to the staff, I start cleaning everything, doing a wipedown of the stretcher and everything we touched, putting on a fresh sheet and sanitizing the equipment before coiling it up and putting everything in its place. I move the stretcher and equipment to an out of the way stretch of hall and walk back towards my partner, standing nearby*



#89 A. Jones

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Posted 14 March 2019 - 11:54 PM

Incident #: 2/7/19
Department: SCFD

 

Address: 5 Points Ft. Shannon
Dispatched As: Unknown Injury
First: Ariana Jones
Second: Erika Sjostrom
Third: N/A
Other Agencies At Scene: Sherrif's Department
 

 

--------------------Patient Info--------------------

 

Patient Name: Evelyn Hawke
Date of Birth:
May 6, 1983
Age: 35
Patient Address: N/A
Conscious or Unconscious: Conscious
Trauma: No
Chief complaint: Transport for assessment
Signs & Symptoms: None
Past History: None
Medications: None
Interventions: None
Transport or Refusal: Transport
 

 

--------------------Vital Signs--------------------

 

P: 121
RR: 18
BP: 121/83
Eyes: PEARRL
Skin: Pale, cool, diaphoretic

 

Lungs: Clear

 

--------------------Narrative--------------------

 

35 Year old female. Transported to the hospital for assessment following involvement in a shooting. Vitals stable.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Incident #: 2/7/19

Department: SCFD

Address: 5 Points Ft. Shannon
Dispatched As: Unknown Injury
First: Ariana Jones
Second: Erika Sjostrom
Third: N/A
Other Agencies At Scene: Sherriff’s Department
 

--------------------Patient Info--------------------

Patient Name: Alyssa Breslin
Date of Birth:
July 23, 1991
Age: 27
Patient Address: N/A
Conscious or Unconscious: Conscious
Trauma: No
Chief complaint: Assessment after involvement in a shooting

Signs & Symptoms: None

Past History: None
Medications: None
Interventions: None

Transport or Refusal: Transport
 

--------------------Vital Signs--------------------

P: 118
RR: 18
BP: 123/78

Eyes: PEARRL
Skin: Pale, cold, diaphoretic
Lungs: Clear

--------------------Narrative--------------------

27 Y/O female transported for evaluation following involvement in a shooting. Patient appeared to be favoring her side but we arrived at the hospital before I could examine her.


Paramedic Ariana Jones

Shiloh County Fire Department

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#90 Dr. Grant

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Posted 15 March 2019 - 12:55 AM

I get up from the computer at the nurses' station after filing a long note on the last patient I just discharged.

 

We're busy, as usual, but we have a couple of open beds. The MI I had has been sent up to cath lab and is no longer my responsibility, the asthma attack patient seems to be doing pretty well now, and my 48 year old weekend warrior tackle football player is just waiting on the orthopedic surgeon to show up and chastise him for leading shoulder first into his tackles.

 

I take advantage of this rare chance to get up and stretch my legs and go for a quick stroll out to ambulance reception. I see 2 crews waiting to enter the psych ER and one crew checking in with the triage nurse. The triage nurse looks annoyed, but is nevertheless typing up the EMS crew's report. I walk over to see if this is possibly heading my way.

 

As I approach I see that both of these 'patients' are in uniform. My interest is sparked immediately. I stand nearby and overhear the report. They're just finishing up. The triage nurse has the patients take seats in some chairs against the wall until she 'can find a place for them'. A young (probably not a day over 18 years old) man in dark slacks and a white polo shirt approaches these patients and starts getting their vital signs. The kids obviously an EMT student. If it wasn't the cliche uniform he's wearing, it was a large Shiloh County CC EMT Program patch on his chest that gave him away.

 

I approach the nurse and inquire about what's going on. She fills me in.

 

'Where are you going to put them?' I ask.

 

'East is full, and so is North.' she replies as she looks at the computer, 'looks like South is the only thing open. 11 & 12'. 

 

'Perfect' I reply. Those are my rooms I think to myself as I start to walk back.

 

The EMT student gets all the vitals, and hands them to the nurse.

 

'Take them both up to South. Ms Hawke is going to 11' she points out Hawke to the EMT student, ' ...and Ms Breslin is going to 12.'

 

The two are escorted back into their appropriate rooms. After I give the nurse a few seconds to get started on getting her new patient situated,  I walk in to 11, figuring this should be the fastest one to see.

 

I knock on the doorway before pulling the curtain back and entering the room.

'Ms Hawke', I say as I enter the room.

 

I enter the room.

 

'Good evening, I'm Dr. Chris Grant.' I say as I close the curtain behind me. I stand back a little bit to give the nurse room to work.

 

Hawke is sitting on the side of the stretcher. Perhaps a little annoyed that she has to be here, but I can't tell for sure. The patient's nurse is having her take her uniform shirt and vest off, stripping her down to her undershirt.

 

'So what brings you in to see us today?' I ask.

 

I hear about the officer involved shooting.

 

'Oh no.' I say in amazement. 'Any pain or injuries?' I ask

 

I take a quick one-over look and see that she has no obvious injuries or bleeding. I pull out my stethoscope from my coat pocket.

 

'I'm just going to listen to your heart and lungs, is that okay?' I ask. I move in to listen and ask:

 

'So how are you feeling right now?'


Dr. Christopher Grant, DO, MPH
Associate Medical Director, Shiloh County FD (MD - 2)
Attending Physician
Emergency Medicine
Shiloh County General Hospital

#91 E. Hawke

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Posted 15 March 2019 - 01:05 AM

*As the hospital staff checks me over, brings me to a room, and helps me undress I start to feel a bit looser.  A bullet proof vest certain does make my chest feel very tight considering my size.  The doctor comes in asking me questions as he checks me over.*

 

'Not, sure, don't know.  How is one normally suppose to feel after taking a life?  I just can't answer that.  Can't find the words.'


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Deputy Evelyn Hawke

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#92 Dr. Grant

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Posted 15 March 2019 - 01:19 AM

I feel for her. How is one supposed to feel after a crappy situation like this?

 

'Yeah, no words are really necessary right now. I imagine you're still just processes this whole thing. I can't even begin to imagine what must be crossing your mind.' I say. 'Is this the first time time you've ever been in this situation?' I ask.

 

I start listening to her lungs and instruct her to take deep breaths.

 

Lungs are clear.

 

I place my stethoscope on her chest and start listening to heart sounds. 

 

A little fast, but normal sounding.

 

'Any aches or pains? Cuts, scratches?' I ask as I check the pulses in both her wrists.

 

'Any dizziness, shortness of breath?' I ask as if programmed to ask those questions.

 

I take a peek around to her back to make sure there's no bleeding or anything I'm missing.

 

'Just to be clear, you were not physically assaulted or actively shot at right? I only ask to make sure I'm not missing any injuries.'


Dr. Christopher Grant, DO, MPH
Associate Medical Director, Shiloh County FD (MD - 2)
Attending Physician
Emergency Medicine
Shiloh County General Hospital

#93 E. Hawke

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Posted 15 March 2019 - 01:24 AM

'Nope, no injuries or pain anywhere, no to the other questions and I wasn't shot at.'

 

*Pausing for a second*

 

'The suspect seemed to only be focused on shooting one person.'


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Deputy Evelyn Hawke

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#94 Dr. Grant

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Posted 15 March 2019 - 01:56 AM

I take a look at the vitals.

 

Everything is good. She's fine physically. Emotionally...oh boy...she seems strong but I'm sure taking a life can have its toll even on the strongest.

 

There is a chair in the corner of the room. I pull it over next to the bed side and sit on the edge of it, putting me just below her eye level.

 

'Any medical problems?' I ask. 'Allergies?' Her history seems unremarkable until I ask the magic question:

 

'Any hospitalizations or surgeries?' She starts to tell me about heat stroke incident in 2017, and how she was shot before, and even a close encounter with sexual assault. Damn, she's been through a lot. She's one tough person.

 

I make it through her history and find nothing else really of concern.

 

I make eye contact.

 

'Physically, you're fine, and I think you knew that already when you came in right now.' I pause. 'What I'm concerned with is how you're going to be after all this has sort of processed and you've had some time to think about it.' I say sincerely. 

 

'This is not an easy situation. I'm not familiar with the details of the case, and frankly that's not my concern, but I'm sure you did what you had to do.' I pause and take a breath.

 

'Within the next few hours or even days, I want you to know that it's perfectly reasonable and normal to feel....doubt....guilt...or even a bit of anger about the whole situation. Being involved in a shooting is a really stressful event and different people handle it in different ways. Some are able to shrug it off pretty quickly, and for others it takes more time.'

 

I pause, look down at the floor, then make eye contact again.

 

'With that said, I'm sure your department will have you meet with a therapist within the next day or two, either a psychiatrist of psychologist, whatever they have arranged. I highly encourage you to meet with them at least this first time, even if you feel like you're doing well. I also encourage you to participate in any group debriefs that are held with the other responders that were involved. This will not only give you the support you need, but also allow you to help some of the others involved. So please be cognizant of yourself, and do not be afraid to seek help.'

 

I pause for a second to let that sort of sink in hoping that it's sticking.

 

'Okay?' I say to break the mood a little. 'I'm not exactly sure what policies your department has as far as any special testing that has to be done. Once I confirm that we have everything we need, I'll let you go on your way.'

 

'Any questions for me? Or is there anything else I can help you with?'


Dr. Christopher Grant, DO, MPH
Associate Medical Director, Shiloh County FD (MD - 2)
Attending Physician
Emergency Medicine
Shiloh County General Hospital

#95 E. Hawke

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Posted 15 March 2019 - 02:06 AM

'No allergies except for bee stings'

 

*The Doc then asks about previous hospitalizations and I tell him about the crap that's happened to me since I moved here in 2015.  This county is probably trying to kill me.  After going through my history I listen to Dr. Grant as he tells me what I should expect from here on out and what should happen.  When he finishes he asks if I have any questions of if there is anything else.*

 

'No question and I have no other things to bring up.'


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Deputy Evelyn Hawke

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#96 Dr. Grant

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Posted 15 March 2019 - 02:25 AM

'Okay then. I wish you the best, and if you need anything feel free to ask me if you see me or your nurse and we'll be glad to help you out where we can.' I say with a smile as I retreat out of the room. I nab a little hand sanitizer as I leave the room and rub my hands down. 

 

I make a couple notes on my note pad and proceed back to the nurses' station and log into the computer. I peek at the next patient's triage information.

 

'Breslin' I say to myself. 

 

I log out of the computer and make my way to room 12. I see Hawke's nurse: 'Hey Angie, when you get a moment can you double check to make sure we have everything we need for the patient in 11 before we get her discharged. There should be something in our papers from the Sheriff's department about what we need for officer involved shootings.' 

 

'Yea, I just got to push these meds in 10, and I'll look into it.' She says as she continues on her way. 'Thank you.' I say as I continue towards room 12.

 

I knock on the door frame out of habit as I go to enter the room.

 

'Ms Breslin?' I say as I enter the room.

 

'I'm Dr. Chris Grant...'

 

I pause. Breslin is sitting at the edge of the bed. She looks at me. Her face is really familiar. I see the EMS uniform shirt laying at the foot of the bed. I know her, she's one of the medic supervisors! We've worked together before. I don't know how I didn't recognize her from the start. I try and keep my composure and to treat her just like any other patient.

 

'So what brings you in today?'


Dr. Christopher Grant, DO, MPH
Associate Medical Director, Shiloh County FD (MD - 2)
Attending Physician
Emergency Medicine
Shiloh County General Hospital

#97 A. Breslin

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Posted 16 March 2019 - 05:20 AM

*Sitting on the edge of the hospital bed ears still ringing. I hate being on the receiving end of healthcare. I really didn't want to come but was stuck in the back of an ambulance before I could say anything. I mean I guess me spacing out scared the new girl. Whatever I'm here and the crew that brought me in here was kind enough to give me an ice pack. I take off my uniform shirt and put it at the foot of the bed and ice my ribs through my tank top as I text Callie that I'm in the hospital and didn't know when I would be home but not to worry. I hear a knock on the doorframe.*

 

 

'I'm Dr. Chris Grant...'

 

*I look up and I see Dr. Grant. Kind of surprised and happy that he's a familiar face. I can see he has the same reaction*

 

'So what brings you in today?'

 

'Hey, So I was involved in that shooting. I was about 3 feet away from the gun when it went off. As soon as I saw the guy pull it I started to run off and I tripped and came down hard on my side on the sidewalk. Thats the main issue aside from a few scrapes and bruises and wanting to get the fuck out of here.'


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Paramedic Lieutenant Alyssa Breslin
EMS Duty Officer (EDO-1)


#98 Dr. Grant

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Posted 16 March 2019 - 05:45 AM

'Wow. That's terrifying, and I'm glad you're okay.' I say to her. I can see the frustration in her face.

 

'Yeah, I know you're used to dropping people off here, not the other way around...let's see what we're dealing with here and hopefully I can get you out of here pretty quick.' I say reassuringly.

 

I start to move in closer and gesture to her side

 

'May I?' I ask as I move in to do an exam of her side.

 

'Which side is it?' I ask.

 

I get her permission to examine her side and start lifting up the side of her shirt to look at her injured side.

 

The skin overlying the middle of her side is red with some scrapes. I don't notice any gross abnormalities or bleeding.

 

'Any trouble breathing?'

 

I begin touching her side from top to bottom, first with the palm of my hand. I start with the upper portion, then the middle, then lower.

 

I apply light pressure.

 

'Breath in for me' I ask, making sure that everything expands normally and hopefully with minimal pain.

 

Chest expansion is normal and symmetrical.

 

I then reach behind and start feeling the side of the spine where the ribs attach to the vertebrae. Back muscles seem a little tense, particularly in the mid thoracic area. One rib, about mid back, appears to be more prominent than the others. I don't think much of it. It's not anything that's serious but something I might want to treat at the end.

 

'Any health problems? Allergies? Medications?' I ask as I inspect the opposite side for comparison.


Dr. Christopher Grant, DO, MPH
Associate Medical Director, Shiloh County FD (MD - 2)
Attending Physician
Emergency Medicine
Shiloh County General Hospital

#99 A. Breslin

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Posted 16 March 2019 - 06:04 AM

*I pull my shirt up on the right side so he can examine my ribcage.*

 

'It's my right side.'

 

'Any trouble breathing?'

 

'No.'

 
*I feel him place his hand on my side and move down slowly. I cringe because the area is sensitive*
 
'Breath in for me'
 
*I take a deep breath in and hold for a moment then exhale.*
 
Any health problems? Allergies? Medications?
 
*Dr. Grant gestures that he wants to see the other side so I pull my tank top down and switch sides.*

 

'No health problems. I mean I was in a bad car accident when I was a teenager but that was almost 10 years ago. And no to both'


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Paramedic Lieutenant Alyssa Breslin
EMS Duty Officer (EDO-1)


#100 Dr. Grant

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Posted 16 March 2019 - 06:15 AM

Uninjured side looks the same as the injured side, minus the redness and scratches. Looks good so far. I lower her shirt back down.

 

'Where else are you scratched up?' I ask.

 

She shows me a couple areas. Nothing but superficial scratches. Didn't even draw blood. 

 

'Alright, let me just have a listen.' I say as I pull out my stethoscope.

 

'Take some breaths' I say as I listen to her lungs. Clear.

 

'Now just breath normally for me' I say as I listen for heart sounds. Normal.

 

I quickly put my stethoscope in my large coat side-pocket and reach for her wrists. I feel both pulses.

 

'So you didn't hit your heard or lose consciousness, right?'

 

Pulses are strong and regular.

 

'Are you hurting anywhere else? You were walking around okay when they showed you to this room just now?'

 

'Any weakness, dizziness, Nausea or vomiting?'


Dr. Christopher Grant, DO, MPH
Associate Medical Director, Shiloh County FD (MD - 2)
Attending Physician
Emergency Medicine
Shiloh County General Hospital




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