Working in different places can be unsettling, especially if you are in a place for the first time and aren’t used to the lay of the land. For the next few hours, at least, I am finding myself in that place.
My employer – the one I work for full-time – in addition to covering a number of communities in the Merrimack Valley region of Massachusetts, also covers six towns in southeastern New Hampshire. By virtue of being licensed in New Hampshire as well as carrying certification in Massachusetts, I have the opportunity to work in both coverage areas. As I write this I am posted at the Hampstead Fire Department’s quarters. Hampstead is located in southeastern New Hampshire, roughly halfway between the towns of Salem and Exeter. In addition to Hampstead, we also cover Atkinson, Danville, Newton, Plaistow, and Sandown. There is a second ambulance up here located in Plaistow. Between the two trucks the area is reasonably well covered. If it gets out of control, one of the two free range trucks out of Haverhill, Massachusetts, will post on the state line until everyone is back in service.
I am usually always on one of those Haverhill trucks.
Like yesterday. I took care of a patient who needed to be brought into Boston. Increasing difficulty breathing. Came from one of the hospitals in our area. This was a pretty tough guy; his history included multiple organ transplants. Performed in the same surgery. He was sent to Boston because he is followed by the transplant team there. Plus he had some indicators that required him to be brought there. A low hemoglobin level, which in itself isn’t a necessarily alarming issue, but he additionally had an elevated D-Dimer level.
If you aren’t familiar with the term, it is defined as follows:
D-dimer: A fragment produced during the degradation of a clot. The D here stands for domain. Dimer indicates two identical units, in this case two identical domains. D-dimer result from complete breakdown of the clot. Monoclonal antibody to the D-dimer fragment provide the basis for the main methods of detecting it. The presence of D-dimers in the blood is a reliable clue that clotting has begun. Sometimes used as a clinical marker for pulmonary embolism (blood clot in the lung) or deep venous thrombosis (DVT) (blood clot in the leg) Sometimes written d-dimer or D-Dimer
Considering his history, it made sense to send him down. Plus, he knew the routine as he had done this multiple times in the past. And he was an easy patient, which made a big difference.
For now, I sit and wait. Trying to relax is key, but more often than not it is a challenge to do because you never know what’s going to happen. And in a few hours I will be heading to Haverhill from here as I am covering for the Paramedic normally on this truck at this time.
Here is to sitting and thinking.