Code 3, Negative PMA...

My partner and I were responding to a "maternity" call in the south side of the city earlier this week when a vehicle pulled across the middle lane and directly in front of our ambulance. People do all sorts of crazy things when they see/hear an emergency vehicle...but this was pushing "stupid" into "suicidal". As I looked into the vehicle that had just risked coliding with a couple-ton vehicle I saw that the male driver and the female passenger were waving at us. It's one thing to make a stupid move because you don't know what to do. It's another thing to attempt suicide by pulling a small car in front of a large vehicle traveling at high speeds...but waving at the same time just doesn't make sense. Unless of course you are almost 9 months pregnant and about to deliver in a matter of minutes.

I quickly notified my partner that I thought that our patient had come to us. We had them pull to the side of the road where hopefully they would be a little safer (We are on a 6-lane road and they are facing the wrong direction.)

I jumped out of the front seat and began to ask some very important questions:

Me: What is the problem?
Female: AHHHHHHHH!!!
Male: She's in labor!!!! (duh?)

Me: How many months pregant are you?
Female: AHHHHHHH! Help me!!! Nine!!!!
Male: She's nine months pregnant. She was due a long time ago!!!!

Me: Shhhhhhhh. It's ok, calm down. I need you to calmly answer my questions so I can help you. How many times have you been pregnant?
Female: 4

Me: How many kids do you have?
Female: 3! Help me!!!!!

Me: Can you make it to the ambulance?
Female: Yes. (Runs to the back of the ambulacne and gets in.)

My partner then told her to lie on her side. I told my partner I thought we should just go since we were right around the corner from the hospital. We informed the male where to go and took off. Enroute I placed my patient on high-flow O2 and asked some more questions. As I placed the mask on her face she kindly informed me that there was now water all over my gurney and ambulance floor. I quickly assessed the situation and came to the conclusion that the infant would complete it's dramatic entrance in less than 5 minutes. Let's make it less than 3.

Now, I was calm and in control of the situation. However, my sympathetic nervous system decided to pump my system full of a chemical that makes it difficult to think straight, your heart race...and can even make it difficult to see details. As I opened the OB kit I found it extremely difficult to distinguish all the small, individually wrapped packages in the box. All I could see was a bunch of towels, the sterile gloves and the bulb syringe. I found this extremely frustrating as I wanted to do well and knew exactly what to do...I just couldn't see well enough to do it. Thanks epinephrine...much appreciated.

My partner parked the rig and opened the back doors. I grabbed the bulb syringe figuring at least I would be able to help protect the infant's airway in case she decided to make her entrance on the gurney between the ambulance and the delivery room.

Running through the sometimes narrow and many-cornered hallways was less than a smooth ride...but we were losing time...fast.

As we pulled into the delivery room the nurses quickly helped us pull the patient onto a hospital bed. No sooner than she was on the bed and the nurse pulled on some gloves the kid made her entrance. At 5 lbs, 14 oz and 19" long, she was a tiny but healthy.

I was mostly disappointed that I couldn't claim responsibilty for an amazing catch....but hey, we did most of the work as far as healthcare providers go anyways. Funny thing was we handled the call without waiting for ALS to arrive. Had we waited...the kid would have been delivered in the back of my ambulance, not in the hospital. It made a great illustration for the EMT class I had to teach the next morning about making transport decisions in the field. If your ETA to the MAR is less than the ETA of ALS...then go.

And we did.

Another step closer...

Today I recieved another envelope from the City of Los Angeles. Everytime I open my mailbox and see one of those City envelopes sitting there...I think my heart skips a beat. I tore it open to read: Background Investigation Complete - Final Panel Review. Basically, the panel review is the last step between me and hopefully a conditional offer of employment from the City of Los Angeles Fire Department.

...snap...I need to do more pushups.