Here's a life lesson I learned a year or so ago. I'm hoping everyone from a rookie to someone so seasoned they can cause hypertension just by looking at them.
I consider myself to be physically fit and damn lucky. Working in the rougher neighborhoods has toughened me up over the years. So has taking over a decades' worth of martial arts. First patient v. provider fight I got into involved me trying to calm down an irate family member after my partner had just pronounced them dead. The family member picked up a stool and went to show my partner that he was more than willing to "shove it somewhere". I reacted immediately for fear of my partners' life. I was sure that, if the guy had gotten her on the ground that it would've been over for her in a heartbeat. Why the cops left us alone; two providers versus ten freaking out family members were not odds we wanted in any situation. It was during the hasty retreat to the truck that the family decided that we were the best target to exact their anger on.
A set of bloody knuckles later, the cops were back on scene and I was checking my pulse to make sure I was still alive. I had never gotten into fights in school, so physical violence between myself and someone else was completely foreign.
After that, I felt slightly invisible. I knew I could handle myself no matter what happened. If a patient felt froggy, I'd sure as anything jump with them. I never went looking for the fight, but I was ready and willing when it came.
I was also told I had a way with psych patients. Even the most suicidal/homicidal patients were calmed and persuaded to get in the truck and calmly going to the hospital. That above anything else made me feel...well...invincible.
Jump forward a few years. I was working the late shift when a call came in for an assault at a nursing home. We arrived on scene to find out that a patient had assaulted another patient, and was now holed up in his room. The police were called, but they never showed. My partner at the time was not what someone would consider to be kind. He had an attitude the size of Kansas and the chip on his shoulder was even bigger. Top it all off with getting slammed all shift left me with one pissed off partner.
My partner swaggers into the room and within moments was running back out. The patient was getting violent and was talking about another assault if we didn't leave. Second phone call for the police were made and I then phoned in for backup. I knew that, at that moment, there were three very large men sitting at the station who were more than willing to help me make the patient more compliant. I had already gone ahead and gotten orders for chemical restraints, but if you thought I was going after the patient with a syringe full of Versed, you're crazier than you look.
In comes backup. The plan was to go in, grab the nearest body part and hold it down, while leaving me a fleshy piece of thigh in which to inject the Versed. Then, we'd all leave the room and wait for the med to kick in, then we'd put him on the stretcher and get him out of there.
Simple, right? I've seen train wrecks go better than this.
We all enter the room, trying to look non threatening. We explained to the patient that he was either going to come with us peacefully, or he was going to be given medicine that would make him come peacefully. After he verbally announced that he was unsure if both of my partners' parents were human, the guys held him down. As he was held down, he decided to question my heritage and called me more racial terms than I had the pleasure of hearing throughout my life. I nodded with him, making quips as he talked.
"Yeah, yeah, I know, you think my mother had carnal relations with a dog; No, I do know who my father is, no, my mother is not a female dog..."
And so on.
After we were done, I stood up and clicked up the sharps guard on the needle. Then I did something I had never done until then and have never done since.
I turned my back on a psychotic, violent patient.
Everyone else was filing out of the room, their backs to me. I turned around to my partners and said, "Okay, let's give it 5 minutes and we'll come back in."
Well, all I got out was, "Okay...*URGH!*"
The patient came up off his bed, grabbed me by the ponytail and dashed my head against a concrete wall so hard the paint chipped off, I was knocked out immediately, and as my partners told me afterwards that it sounded like a Watermelon had been thrown at the wall at over fifty miles an hour.
From what I was told, my body immediately seized up, then went limp. I woke up long enough to feel myself being choked by the patient as he began to bite my ear and neck while everyone else was jumping on him, trying to pull him off of me, or me out of his arms.
Being unconcious was weird. I could hear the occasional snippet of conversation, but it was distorted and off. Next thing I knew, I was lying on the floor, looking up at the lights on the ceiling. I know I got up, brushed myself off, and told everyone I was fine, but I felt off. I turned my head left, yet I felt like I was going right. I sat down, but I felt like I had stood up. I figure since I wasn't dropped off at the hospital initally, I convinced them. I remember driving back to the station in the front of the ambulance, but next thing I knew, I was laying in the back, on the stretcher, being looked over by everyone who was there.
One Trauma Room trip later, I discovered I had a severe concussion and BPV (Benign positional vertigo). The doctor believes I got my head cracked so hard that one of the calcium "stones" on the hairs in my cochlear cannals got knocked loose and are now bouncing around in my balance centers of my brain...on both sides. I am now on Antivert for the rest of my life and I don't go anywhere without a bottle of Dimenhyramine with me as well.
I screwed up that day. I was over confident in myself and I let my guard down. I preach scene safety and safe practices on the ambulance all the time. I'm the one smacking the rookie EMT upside his/her head when they charge into a violent scene without looking around and seeing their surroundings.
Please, please, PLEASE! Don't ever do this. If I was alone, say my partner went to the truck for something, or it was just the two of us, I could've been strangled to death, or had an even more severe head injury than I do now. Take this lesson from me, boys and girls; don't ever let your guard down. The one time you do may be all it takes to make it your last call.
Be safe out there, please.
Wednesday, June 30, 2010
Tuesday, June 29, 2010
Letter to the Engineers
Warning: One of the pictures below is NSFW (Not Safe For Work). It's a girl in a bikini. So, there you go, you were warned.
To the Designers/Engineers who have created MedTech, Wheeled Coach, International, Pierce, American LeFrance and other Ambulance/Fire Engine manufactures:
Hello! My name is Medic Trommashere. I have been riding around in your lovely vehicles for almost a decade now, and as a devoted user, I figured I could offer some friendly advice from a real life consumer.
Firstly, contrary to popular belief, your target demographic does not look like this:
Or this:
Or even this:
We come in various body sizes, especially height. Now. I am not exactly model height, hell, I still get called Munchkin, but it can get a little complicated trying to climb into the back of an Ambulance where the little tail step of the truck is nearly eye level with my chest. I am not saying there is anything wrong with your wonderful products, but a little consideration to those less fortunate with height would be a great thing. Either an extra step or some good rock climbing equipment would be great...jus' sayin'.
Also, to facilitate easier movement within the ambulance, a larger opening between the cab and the box would be great. I find that to be a good escape route when my, "he's so quiet, he wouldn't hurt a fly..." psych patient decides to rip off the arm rest on the Stryker stretcher and tries to bludgeon me with it, calling himself "The Caveman" and wants to take his bride back to the cave. Some days, my size 16 hips won't fit through the aptly named 'birth canal' with a radio, Leatherman holster, and Trauma Shears (The pink kind)strapped to my belt.
Lastly, can we get some more padding on those lovely corners of cabinets? I'm not sure how you test to see what happens when an appendage (usually the Occipital lobe or the not-so-funny end of the humerous) slam into one of those corners after a car decides to stop within three feet of the front of the ambulance while we're coding at a safe velocity (Read: So much faster than the posted speed limit that if my boss ever found out, he'd rehire me just to fire me for how fast we were going). I got a black eye so bad one time, the hospital we arrived at thought I had gotten beaten up by the patient. Those corners hurt like there's no tomorrow. So, I would like to recommend the following adjustments.
This:
Or this:
Just because we like Traumatic Injuries doesn't mean we want to have one.
All in all, I have no complaints about your wonderful products. They get me from point A to point B REALLY fast and I get to look cool doing it. Thank you for your hard work and dedication to your craft.
Sincerely,
M. Trommashere.
PS: MedTech...you gotta really work on that electrical system issue...having the entire box of the ambulance turn off including the main board suction while I'm using it really bites.
PPS: American LeFrance and Pierce; Big props for the little steps you can fold down so short people like me can get up in the hose bed or just get stuff from up high.
Have Fun and Be Safe!
To the Designers/Engineers who have created MedTech, Wheeled Coach, International, Pierce, American LeFrance and other Ambulance/Fire Engine manufactures:
Hello! My name is Medic Trommashere. I have been riding around in your lovely vehicles for almost a decade now, and as a devoted user, I figured I could offer some friendly advice from a real life consumer.
Firstly, contrary to popular belief, your target demographic does not look like this:
Or this:
Or even this:
We come in various body sizes, especially height. Now. I am not exactly model height, hell, I still get called Munchkin, but it can get a little complicated trying to climb into the back of an Ambulance where the little tail step of the truck is nearly eye level with my chest. I am not saying there is anything wrong with your wonderful products, but a little consideration to those less fortunate with height would be a great thing. Either an extra step or some good rock climbing equipment would be great...jus' sayin'.
Also, to facilitate easier movement within the ambulance, a larger opening between the cab and the box would be great. I find that to be a good escape route when my, "he's so quiet, he wouldn't hurt a fly..." psych patient decides to rip off the arm rest on the Stryker stretcher and tries to bludgeon me with it, calling himself "The Caveman" and wants to take his bride back to the cave. Some days, my size 16 hips won't fit through the aptly named 'birth canal' with a radio, Leatherman holster, and Trauma Shears (The pink kind)strapped to my belt.
Lastly, can we get some more padding on those lovely corners of cabinets? I'm not sure how you test to see what happens when an appendage (usually the Occipital lobe or the not-so-funny end of the humerous) slam into one of those corners after a car decides to stop within three feet of the front of the ambulance while we're coding at a safe velocity (Read: So much faster than the posted speed limit that if my boss ever found out, he'd rehire me just to fire me for how fast we were going). I got a black eye so bad one time, the hospital we arrived at thought I had gotten beaten up by the patient. Those corners hurt like there's no tomorrow. So, I would like to recommend the following adjustments.
This:
Or this:
Just because we like Traumatic Injuries doesn't mean we want to have one.
All in all, I have no complaints about your wonderful products. They get me from point A to point B REALLY fast and I get to look cool doing it. Thank you for your hard work and dedication to your craft.
Sincerely,
M. Trommashere.
PS: MedTech...you gotta really work on that electrical system issue...having the entire box of the ambulance turn off including the main board suction while I'm using it really bites.
PPS: American LeFrance and Pierce; Big props for the little steps you can fold down so short people like me can get up in the hose bed or just get stuff from up high.
Have Fun and Be Safe!
Monday, June 28, 2010
Yay! Comments!
Side note: I am and will address comments in a post fashion. I want to be able to bring attention to the comments/questions, and be able to give a well thought out and appropriate answer/response. Keep the comments coming! Thank you!
Murphquake: I looked into going to NYC before I moved where I did. They do not honor the NREMT other than not making you go through your Paramedic class. I would have had to take a 3 month program, then jump through even more hoops just to possibly get a job there. The sad part is, at least the way it was described to me by your EMS council, was that after I took all those classes, I'd have to live in NY for at least 3 months before I could apply for a job. Needless to say, I wasn't going to move somewhere where, even after jumping through the hoops, I wasn't guarenteed employment. Homie don't play that game.
The Happy Medic: Tell AD I said hello and thank you for stopping by. I have to agree with you, but at the same time, the NR sucks people in by telling them that this craziness won't happen if they take the test. I probably still would have gotten my NR in any case...don't feel like going through medic class again, but I would have been better prepared if I would've known what each state requires past the NR. A lot of people in my class have experienced the same thing. In the state where I'm from, you don't need the NR; you have to take it just out of Medic School to satisfy being accredited through the NR, but you don't have to stay NR to work. Most other states, except Ohio, which is where the NR is based out of, make you take a crap ton of exams and other tests/interviews even before anything else happens.
Lizzie: As far as my research has shown, most states accept the registry, but still make you go through classes/tests before you can practice. Some locations have border state resciprocity that would allow you to transfer over just because of the state you lived in. Problem with that is, it usually comes down to the bordering counties, the ones that touch the other state directly. Ohio is one of the states that I can speak of because of direct knowledge, that transfers the NR easily. You take a simple protocol test; they have some drugs that most states don't, and that's it. West Virginia is another one. I could've moved to WV and all I had to do was sign on with a service, send in a form asking for WV numbers, and within a few days, would've been a WV Medic, few questions asked.
All in all, the system as a whole is flawed. I believe that, for a state to say they conform to the NR, they should grant licensure/certification with minimal hoops to jump through. I am understanding of a protocol exam; not knocking that from ANY state. I can even see a skills review. Coming from a state that does not allow surgical crichothyroidotomies, moving to one that does, I am understanding of sitting down with a Command Physician to show them that I am proficient in that skill.
But telling a Paramedic who has worked their ass off for a year, in upwards of three or four, that to even apply for a job, they have to jump through more hoops than Shamu at Sea World is ridiculous. If the NR is to continue, I believe they need to mandate some serious changes across the board. My thought is; if you as a state want to continue to be in the NR, then they must create a written protocol test and/or a practical exam, and that is the only test used for incomming medics and EMT's. If not, then they can do all the frivolous testing they want, but they can't require someone to be Nationally Registered if they are not going to accept it for all it's worth.
Thank you everyone for your comments! I believe that, the only way to make positive changes in our chosen profession is to have dialogues like this, to fuel ideas and create new ones. I'm glad you all have stopped by my little slice of paradise, and I can't wait to hear more from you! You guys were wonderful! Thank you to Lizzie, The Happy Medic, and Murphquake for your wonderful comments!
Have fun and Be Safe!
Murphquake: I looked into going to NYC before I moved where I did. They do not honor the NREMT other than not making you go through your Paramedic class. I would have had to take a 3 month program, then jump through even more hoops just to possibly get a job there. The sad part is, at least the way it was described to me by your EMS council, was that after I took all those classes, I'd have to live in NY for at least 3 months before I could apply for a job. Needless to say, I wasn't going to move somewhere where, even after jumping through the hoops, I wasn't guarenteed employment. Homie don't play that game.
The Happy Medic: Tell AD I said hello and thank you for stopping by. I have to agree with you, but at the same time, the NR sucks people in by telling them that this craziness won't happen if they take the test. I probably still would have gotten my NR in any case...don't feel like going through medic class again, but I would have been better prepared if I would've known what each state requires past the NR. A lot of people in my class have experienced the same thing. In the state where I'm from, you don't need the NR; you have to take it just out of Medic School to satisfy being accredited through the NR, but you don't have to stay NR to work. Most other states, except Ohio, which is where the NR is based out of, make you take a crap ton of exams and other tests/interviews even before anything else happens.
Lizzie: As far as my research has shown, most states accept the registry, but still make you go through classes/tests before you can practice. Some locations have border state resciprocity that would allow you to transfer over just because of the state you lived in. Problem with that is, it usually comes down to the bordering counties, the ones that touch the other state directly. Ohio is one of the states that I can speak of because of direct knowledge, that transfers the NR easily. You take a simple protocol test; they have some drugs that most states don't, and that's it. West Virginia is another one. I could've moved to WV and all I had to do was sign on with a service, send in a form asking for WV numbers, and within a few days, would've been a WV Medic, few questions asked.
All in all, the system as a whole is flawed. I believe that, for a state to say they conform to the NR, they should grant licensure/certification with minimal hoops to jump through. I am understanding of a protocol exam; not knocking that from ANY state. I can even see a skills review. Coming from a state that does not allow surgical crichothyroidotomies, moving to one that does, I am understanding of sitting down with a Command Physician to show them that I am proficient in that skill.
But telling a Paramedic who has worked their ass off for a year, in upwards of three or four, that to even apply for a job, they have to jump through more hoops than Shamu at Sea World is ridiculous. If the NR is to continue, I believe they need to mandate some serious changes across the board. My thought is; if you as a state want to continue to be in the NR, then they must create a written protocol test and/or a practical exam, and that is the only test used for incomming medics and EMT's. If not, then they can do all the frivolous testing they want, but they can't require someone to be Nationally Registered if they are not going to accept it for all it's worth.
Thank you everyone for your comments! I believe that, the only way to make positive changes in our chosen profession is to have dialogues like this, to fuel ideas and create new ones. I'm glad you all have stopped by my little slice of paradise, and I can't wait to hear more from you! You guys were wonderful! Thank you to Lizzie, The Happy Medic, and Murphquake for your wonderful comments!
Have fun and Be Safe!
Why did I spend 150$ on this?
Before I became a Paramedic, I heard about this little thing called the National Registry of Emergency Medical Technicians. My state had just recently adopted their standards, and from everything I heard, it was great! If you moved, you could practice your EMT and Paramedic skills without going through another states' program, or jumping through hoops. All you had to do was show your shiny NREMT card and you were in. It was like holding the golden ticket of epic proportions.
Flash forward about eight years.
I am sitting in my new state of residence, waiting to go through a protocol class...a state exam...a con-ed update...ALS Skills Review...and a four to six week long Paramedic school.
I learned all of these drugs with their respective dosages in my Paramedic Class. I can do everything they can do...because I've been playing Paramedic for a while. I've only been out of service for a month or so...AND I have my little NREMT card! I'm in a bordering state, and I was told that resciprocity would be easy. Sign a piece of paper, flash my card like a cop badge, and I'd be legal.
They were wrong.
I spent 150$ on a test that caused considerable anxitey that I thought would be a good thing to have because I had planned on moving years ago when I took this class. The only thing it did was keep me from having to go through EMT and Paramedic school all over again. At this point, I have at least three months until I can play Paramedic again. Until then, I fortunately found a little service who was willing to take a homeless Paramedic in and let her run as a crew assistant. I get to fetch stretchers and play gopher for the other EMT's and Medics on the truck.
I was depending on the ease of transferability to get a job. I wasn't able to start the resciprocity until I was affiliated with a service, but I had to wait until I was here to start the hiring process. I was told repeatedly by the state that the whole process shouldn't take more than two weeks. The minute I get here, that's when I find out about all the hoops I have to jump through.
After doing some research, I found out that over 40 states require you to go through "refresher classes", which is code word for paramedic school, over time periods as short as 3 weeks, to as long as 14. On top of that, you have to jump through other hoops that the local heads of the EMS departments have in mind. Some require you to take multiple con-ed hours in addition to other classes.
What was the whole point of getting my NREMT if it doesn't transfer over easily. I understand doing the Hey, we want to make sure you actually know the difference between a nasal cannula and a non-rebreather mask class, but seriously...40+ hours of classes to get the job?
I'd do it no matter what...which is why I'm going through the craziness, but I'm lucky to be able to. Getting the job is hard enough, but getting to the promised land only to be told that you have to wait to pull a paycheck until you get through with three months of classes is just ridiculous.
I am so furious right now, I can't see straight. Every time I turn around, a new hurdle pops up. Part of me would rather go back through their Paramedic class than sit here and wait and pray that my resciprocity comes through soon.
Pissed off in Medic Land...
Flash forward about eight years.
I am sitting in my new state of residence, waiting to go through a protocol class...a state exam...a con-ed update...ALS Skills Review...and a four to six week long Paramedic school.
I learned all of these drugs with their respective dosages in my Paramedic Class. I can do everything they can do...because I've been playing Paramedic for a while. I've only been out of service for a month or so...AND I have my little NREMT card! I'm in a bordering state, and I was told that resciprocity would be easy. Sign a piece of paper, flash my card like a cop badge, and I'd be legal.
They were wrong.
I spent 150$ on a test that caused considerable anxitey that I thought would be a good thing to have because I had planned on moving years ago when I took this class. The only thing it did was keep me from having to go through EMT and Paramedic school all over again. At this point, I have at least three months until I can play Paramedic again. Until then, I fortunately found a little service who was willing to take a homeless Paramedic in and let her run as a crew assistant. I get to fetch stretchers and play gopher for the other EMT's and Medics on the truck.
I was depending on the ease of transferability to get a job. I wasn't able to start the resciprocity until I was affiliated with a service, but I had to wait until I was here to start the hiring process. I was told repeatedly by the state that the whole process shouldn't take more than two weeks. The minute I get here, that's when I find out about all the hoops I have to jump through.
After doing some research, I found out that over 40 states require you to go through "refresher classes", which is code word for paramedic school, over time periods as short as 3 weeks, to as long as 14. On top of that, you have to jump through other hoops that the local heads of the EMS departments have in mind. Some require you to take multiple con-ed hours in addition to other classes.
What was the whole point of getting my NREMT if it doesn't transfer over easily. I understand doing the Hey, we want to make sure you actually know the difference between a nasal cannula and a non-rebreather mask class, but seriously...40+ hours of classes to get the job?
I'd do it no matter what...which is why I'm going through the craziness, but I'm lucky to be able to. Getting the job is hard enough, but getting to the promised land only to be told that you have to wait to pull a paycheck until you get through with three months of classes is just ridiculous.
I am so furious right now, I can't see straight. Every time I turn around, a new hurdle pops up. Part of me would rather go back through their Paramedic class than sit here and wait and pray that my resciprocity comes through soon.
Pissed off in Medic Land...
Sunday, June 27, 2010
In Honor.
Yesterday in Colorado Springs, Colorado, new names were added to the EMS Memorial. At 7 pm, there was a moment of silence that I especially partook in this year, and had a great cry about it. While I would mourn the loss of any EMS provider, Fire Fighter, or Police Officer, this year was especially hard on me.
I knew one of the people who were being added.
He was my supervisor, a great man who built a service around volunteering. Even though the service began to pay some of their employees, many there stayed as volunteers for the good of the area. The area was one that outsiders drove past quickly with their windows up, doors locked, and eyes on the road ahead without even offering a glance to the city. Other EMS services would hesitantly come in, not even wanting to get out of the truck at night because of how bad it was and had gotten.
He held "First, do no harm..." near and dear to him. He attended every con-ed class he could, and if con-ed hours rolled over like cell phone minutes, he would never have had to take another con-ed hour for the rest of his life.
His life ended suddenly while on a call. His own service and many others; the ones who couldn't be bothered to come in on any other call answered the call that night on that roadway. All in all, twenty pairs of hands touched him, waging their war against the inevitable. A set of Flight Nurses and Flight Medics were called in, and they used their quick response vehicle to arrive at the scene, trying to lend a hand.
He was taken by his own company, his own hand picked crew that he spent months, if not years getting to know. In the hospital, the efforts continued, Medics, EMT's, Nurses and Doctors fighting together. 110% was given, if not more. Drugs were pushed, chests were compressed, everything was done and then some. No one wanted to stop, but we all knew what the outcome was going to be. The doctor ended the code at 2213, after his family, both by blood and by profession had gathered. That dark night, the world slowed for a moment, then continued its lazy orbit.
That world was changed for forever in that moment. A great man had fallen.
The next days for that service were filled with anguish. The service never stopped rolling. The crew that only moments before had worked feverishly on their comrade, answered the next call in his memory. The minute the tones went off, the doors to the bay went up and the big, white box went out the door. Other services volunteered their time and staff, helping to keep the station staffed so that the crew could go to the viewings.
The community pulled together. Honor guards were present at every moment. Those who knew him barely left the funeral home. The crew who worked him held the hollow look of a survivor of something so devastating. Most of them stood guard at the casket, tears streaming down their faces as they stood at attention.
The funeral was a rainy, cold day. The four on the crew were secluded in their own corner, trying to keep their emotions in check. The funeral went on, not a dry eye in the place. The ride to the cemetary was full of ambulances, fire engines, and police cars, all with their lights on, all with their sirens on in a final salute. They rode, sending their brother to the other side in a fitting tribute to the great man that his newest ambulance carried.
The bagpipes blew at the gravesite, the twenty one gun salute piercing the ears and minds of those present. Not a dry eye was to be had the entire time. How do I know all this, you ask?
I. was. there.
I was one of those four who worked on him in the dead of night. I was the crew cheif, the supervisor of the day. I had just talked to my supervisor two hours before after he stopped up at the station to check on his "babies". We exchanged pleasentries, and as he was leaving, he thanked me for all I was doing for the company. He shook my hand and departed. The next time I saw him, I was working on him.
I couldn't function. I broke my own rule about not drinking alcohol when stuff went bad. My crew and I hit a bar that catered specifically to those in public safety, having odd hours at which they opened. We sat around a table, haunted looks on our faces. I went straight for the hard stuff, Johnnie Walker Black Label. I rolled the ice around in my glass, my eyes foggy. We didn't talk to each other, we felt as if there was nothing to say.
Other providers from all sectors of public safety including in hospital workers came trickling in. They would glance over in our direction and nod silently. News traveled fast, especially since it was all over the 5, 6, and 7am morning news. Some came over and spoke in hushed tones, others just nodded in our direction. The death was the talk of the county by that point; everyone knew about it.
The bartender, Zac, came over as the news came on, showing our faces as we walked from our station. The caption read that we were the ones who worked on our boss. Silently, he went back to the bar, pulled down the bottle of Johnnie Walker Blue Label and came over, pouring each of us around.
"On the house, guys. Looks like you had a bad night."
We all looked at our glasses and raisied them.
"To C-1. God Speed my friend." I said quietly.
"To C-1.." Came the reply.
We all drank in silence.
*****************************************
To C-1, God Speed my friend. You were the best boss a girl could ask for. I was honored that I had the opportunity to work side by side with you. God Speed, my frend
"His master replied, 'Well done, good and faithful servant! You have been faithful with a few things; I will put you in charge of many things. Come and share your master's happiness!'
(Matthew 25:21)
I knew one of the people who were being added.
He was my supervisor, a great man who built a service around volunteering. Even though the service began to pay some of their employees, many there stayed as volunteers for the good of the area. The area was one that outsiders drove past quickly with their windows up, doors locked, and eyes on the road ahead without even offering a glance to the city. Other EMS services would hesitantly come in, not even wanting to get out of the truck at night because of how bad it was and had gotten.
He held "First, do no harm..." near and dear to him. He attended every con-ed class he could, and if con-ed hours rolled over like cell phone minutes, he would never have had to take another con-ed hour for the rest of his life.
His life ended suddenly while on a call. His own service and many others; the ones who couldn't be bothered to come in on any other call answered the call that night on that roadway. All in all, twenty pairs of hands touched him, waging their war against the inevitable. A set of Flight Nurses and Flight Medics were called in, and they used their quick response vehicle to arrive at the scene, trying to lend a hand.
He was taken by his own company, his own hand picked crew that he spent months, if not years getting to know. In the hospital, the efforts continued, Medics, EMT's, Nurses and Doctors fighting together. 110% was given, if not more. Drugs were pushed, chests were compressed, everything was done and then some. No one wanted to stop, but we all knew what the outcome was going to be. The doctor ended the code at 2213, after his family, both by blood and by profession had gathered. That dark night, the world slowed for a moment, then continued its lazy orbit.
That world was changed for forever in that moment. A great man had fallen.
The next days for that service were filled with anguish. The service never stopped rolling. The crew that only moments before had worked feverishly on their comrade, answered the next call in his memory. The minute the tones went off, the doors to the bay went up and the big, white box went out the door. Other services volunteered their time and staff, helping to keep the station staffed so that the crew could go to the viewings.
The community pulled together. Honor guards were present at every moment. Those who knew him barely left the funeral home. The crew who worked him held the hollow look of a survivor of something so devastating. Most of them stood guard at the casket, tears streaming down their faces as they stood at attention.
The funeral was a rainy, cold day. The four on the crew were secluded in their own corner, trying to keep their emotions in check. The funeral went on, not a dry eye in the place. The ride to the cemetary was full of ambulances, fire engines, and police cars, all with their lights on, all with their sirens on in a final salute. They rode, sending their brother to the other side in a fitting tribute to the great man that his newest ambulance carried.
The bagpipes blew at the gravesite, the twenty one gun salute piercing the ears and minds of those present. Not a dry eye was to be had the entire time. How do I know all this, you ask?
I. was. there.
I was one of those four who worked on him in the dead of night. I was the crew cheif, the supervisor of the day. I had just talked to my supervisor two hours before after he stopped up at the station to check on his "babies". We exchanged pleasentries, and as he was leaving, he thanked me for all I was doing for the company. He shook my hand and departed. The next time I saw him, I was working on him.
I couldn't function. I broke my own rule about not drinking alcohol when stuff went bad. My crew and I hit a bar that catered specifically to those in public safety, having odd hours at which they opened. We sat around a table, haunted looks on our faces. I went straight for the hard stuff, Johnnie Walker Black Label. I rolled the ice around in my glass, my eyes foggy. We didn't talk to each other, we felt as if there was nothing to say.
Other providers from all sectors of public safety including in hospital workers came trickling in. They would glance over in our direction and nod silently. News traveled fast, especially since it was all over the 5, 6, and 7am morning news. Some came over and spoke in hushed tones, others just nodded in our direction. The death was the talk of the county by that point; everyone knew about it.
The bartender, Zac, came over as the news came on, showing our faces as we walked from our station. The caption read that we were the ones who worked on our boss. Silently, he went back to the bar, pulled down the bottle of Johnnie Walker Blue Label and came over, pouring each of us around.
"On the house, guys. Looks like you had a bad night."
We all looked at our glasses and raisied them.
"To C-1. God Speed my friend." I said quietly.
"To C-1.." Came the reply.
We all drank in silence.
*****************************************
To C-1, God Speed my friend. You were the best boss a girl could ask for. I was honored that I had the opportunity to work side by side with you. God Speed, my frend
"His master replied, 'Well done, good and faithful servant! You have been faithful with a few things; I will put you in charge of many things. Come and share your master's happiness!'
(Matthew 25:21)
Saturday, June 26, 2010
Way back when....
Someone asked me today why I started writing a blog. I had thought about putting my experiences on paper, and maybe one day putting an EMS book out there like EMS writing hero's Peter Canning and Steven "Kelly" Grayson. Reading Graysons' work implanted the seed that maybe I could do this. I have funny stories, I have the ones that'll touch your heart, and on more than one occasion, I had brought work home to disasterous results.
To steal a phrase from the Navy, I created my blog to be sort of a "proving ground." If it works, and I get a lot of people saying, "Wow! That's awesome!" Then maybe I'll pick up my quill and actually write some of this stuff down and even put in some new stories, and see if I can get it published.
But that's a ways down the line. Right now, I just hope that you can enjoy the stories and random notes of the blog.
To Grayson and Canning: Thank you for paving the way to allow me to do this. You both have shown me and others like me that even a lowly "Ambulance Driver" can do something great in the Literary world, not just making addendums to Paramedic and EMT text books.
Have fun and Be Safe!
To steal a phrase from the Navy, I created my blog to be sort of a "proving ground." If it works, and I get a lot of people saying, "Wow! That's awesome!" Then maybe I'll pick up my quill and actually write some of this stuff down and even put in some new stories, and see if I can get it published.
But that's a ways down the line. Right now, I just hope that you can enjoy the stories and random notes of the blog.
To Grayson and Canning: Thank you for paving the way to allow me to do this. You both have shown me and others like me that even a lowly "Ambulance Driver" can do something great in the Literary world, not just making addendums to Paramedic and EMT text books.
Have fun and Be Safe!
Friday, June 25, 2010
Wow....just wow...
So, I think I made it in this world. I opened up EMS1.com and found this on their blog page:
http://www.ems1.com/ems-blogs/page-3/
Yup. I made it!
Better post to come later.
http://www.ems1.com/ems-blogs/page-3/
Yup. I made it!
Better post to come later.
Thursday, June 24, 2010
A sad day in EMS Bloggin History
A friend of mine called me eariler nearly screaming in the phone.
"OHMYGODLOOKATMARKSPAGE!!!"
I looked at the phone in the same manner that a dog looks at you while you are discussing with him why he shouldn't be licking his balls in public.
"Before I dose you up with Narcan, slow down and tell me what's going on."
"That really hot english dude we met in B-More who did that webcast thingy and had that cool blog isn't blogging anymore."
I immediately went to his blog and found this: http://999medic.com/2010/06/23/my-farewell-to-blogging/
Yeah. That sucks big eggrolls.
To all who don't know, Mark Glencourse is the other half to a Web Show called 'Chronicles of EMS.' I had the opportunity to chat with him for a few moments at the JEMS Convention in Baltimore. Like any other red blooded American female, I found the accent to be cute, but what I liked more was his drive to pull EMS together all across the world. Coming from an EMS arena where neighboring services want to kill one another, the idea of someone bridging the gap between services across the world was awesome to me in many ways.
To hear that he's leaving definately leaves a hole in the EMS world. As someone on the inside of EMS, I can understand his fears and concerns; with the advent of multi-media communications and the HIPPA monster, everyone has that opportunity to get burnt in many ways.
That's why, with the EMS stories I present, they are just that, stories. I have been through enough crazy shit in my nine years where I can take a cheif complaint, and meld many different scenarios together to make up a good story. I've even gotten comments from people through private e-mail asking me if the exact story happened. My response is: yes and no. I've had psych patients, multiple ones, but my initial psych patient story is a collection, melding, and blending of numerous patients.
Anywho, so to Mark; You are awesome! I am sorry that the proverbial fecal matter slammed into the rotating ocillating device. Have fun with your family, enjoy them. Hopefully one day you can begin blogging again. Until then, Cheers!
Have Fun and Be Safe!
"OHMYGODLOOKATMARKSPAGE!!!"
I looked at the phone in the same manner that a dog looks at you while you are discussing with him why he shouldn't be licking his balls in public.
"Before I dose you up with Narcan, slow down and tell me what's going on."
"That really hot english dude we met in B-More who did that webcast thingy and had that cool blog isn't blogging anymore."
I immediately went to his blog and found this: http://999medic.com/2010/06/23/my-farewell-to-blogging/
Yeah. That sucks big eggrolls.
To all who don't know, Mark Glencourse is the other half to a Web Show called 'Chronicles of EMS.' I had the opportunity to chat with him for a few moments at the JEMS Convention in Baltimore. Like any other red blooded American female, I found the accent to be cute, but what I liked more was his drive to pull EMS together all across the world. Coming from an EMS arena where neighboring services want to kill one another, the idea of someone bridging the gap between services across the world was awesome to me in many ways.
To hear that he's leaving definately leaves a hole in the EMS world. As someone on the inside of EMS, I can understand his fears and concerns; with the advent of multi-media communications and the HIPPA monster, everyone has that opportunity to get burnt in many ways.
That's why, with the EMS stories I present, they are just that, stories. I have been through enough crazy shit in my nine years where I can take a cheif complaint, and meld many different scenarios together to make up a good story. I've even gotten comments from people through private e-mail asking me if the exact story happened. My response is: yes and no. I've had psych patients, multiple ones, but my initial psych patient story is a collection, melding, and blending of numerous patients.
Anywho, so to Mark; You are awesome! I am sorry that the proverbial fecal matter slammed into the rotating ocillating device. Have fun with your family, enjoy them. Hopefully one day you can begin blogging again. Until then, Cheers!
Have Fun and Be Safe!
Fun Days are here Again...
So, I got to enjoy several Non-EMS related days. Here's a little snapshot of what I got to enjoy.
Yeah, that's The White Puppy laying on what has to be the most expensive dog bed EVER. He's the same one who will wait until the humans get out of the seat, then firmly affix himself to it. Then, he'll look up at you, just like in the picture, trying to make it so I or anyone else won't harbor any thoughts of homicide.
Got to catch some deer coming through the backyard, and I had a camera on hand. They are beautiful, majestic creatures...especially when prepared in gravy and mushrooms.
Unfortunately, I didn't have my camera when we went to the Bay. I had never been to the beach before, save for a week two years prior when I got into the water, and proceded to get right the hell back out because I was being stung violently by Jelly Fish. Hopefully I'll be able to get more pictures and posts out soon; who knows what I'll get to do today!
Have Fun and Be Safe!
Yeah, that's The White Puppy laying on what has to be the most expensive dog bed EVER. He's the same one who will wait until the humans get out of the seat, then firmly affix himself to it. Then, he'll look up at you, just like in the picture, trying to make it so I or anyone else won't harbor any thoughts of homicide.
Got to catch some deer coming through the backyard, and I had a camera on hand. They are beautiful, majestic creatures...especially when prepared in gravy and mushrooms.
Unfortunately, I didn't have my camera when we went to the Bay. I had never been to the beach before, save for a week two years prior when I got into the water, and proceded to get right the hell back out because I was being stung violently by Jelly Fish. Hopefully I'll be able to get more pictures and posts out soon; who knows what I'll get to do today!
Have Fun and Be Safe!
Tuesday, June 22, 2010
Legal Stuff
I feel as if I should get this out of the way before I go too much further. In my blogs about my calls that I have run, I have purposely changed the names of crew members, changed locations if I even mention one, names of companies, and even some of the minor facts about the story. I am not trying to receive a visit from the HIPPA monster here, so that's why it's all changed.
The basics of the story are still there; the heart wrenching moments, the hilarity, and even the more somber ones, the meat of the experience is still there, just the facts around it have changed to protect the innocent and even the not so innocent.
So please, no nasty-grams because you think that I forgot about you on a call, I just didn't say it was you for the sake of not saying it; if I'm not even going to put my name out there (for now), I'm not going to do the same to you. I say it to my EMT's all the time, "I'm not going to ask you to do something I won't or wouldn't do myself..." I still remember who was with me when, so don't think I'm not giving you the credit you deserve. In writing the stories, I feel as if I am thanking you in the highest degree; what you did was so awesome to me, that I had to tell the world about it.
In closing, please don't try to read more into the story than there is. I want to put my experiences out there to show you what I learned from them, or for you to have the most miniscule experience that I had.
Have Fun and Be safe.
The basics of the story are still there; the heart wrenching moments, the hilarity, and even the more somber ones, the meat of the experience is still there, just the facts around it have changed to protect the innocent and even the not so innocent.
So please, no nasty-grams because you think that I forgot about you on a call, I just didn't say it was you for the sake of not saying it; if I'm not even going to put my name out there (for now), I'm not going to do the same to you. I say it to my EMT's all the time, "I'm not going to ask you to do something I won't or wouldn't do myself..." I still remember who was with me when, so don't think I'm not giving you the credit you deserve. In writing the stories, I feel as if I am thanking you in the highest degree; what you did was so awesome to me, that I had to tell the world about it.
In closing, please don't try to read more into the story than there is. I want to put my experiences out there to show you what I learned from them, or for you to have the most miniscule experience that I had.
Have Fun and Be safe.
You did...WHAT?
I picked up my cell phone for the one hundredth time in the last twenty minutes. I had finished with my Mother-May-I portion of getting my medic. I had to get ten good calls out of my way with a more seasoned Medic riding with me until the deities at Medic Command decided I was good enough (read: out of my bleeping mind) to play on my own. I had been called in at 6AM to fill in for a Medic who had just gotten suspended. Until I got "the" phone call, we were a BLS service, and had to get back-up from our mutual aid service...and I didn't want to do that.
The long standing feude between the companies made the Hatfields and McCoy's look like an afternoon bridge party. The two areas were night and day. While our little slice of paradise held some of the more active gangs in the county, 98 percent of the residents were being assisted by the State for all their needs, and the mean age of girls having babies was 16. I had seen them pop as young as fourteen. The neighboring city though had beautiful homes, a good school, and minimal crime...until the citizens of our city crossed the street into their neighborhood.
After waiting what seemed like hours in the quietness of the city, one of the supervisors came down to the station. All he did was walk in the door of the station, pat his pocket where he held his cigarettes, and motion for me to come out to the bay and talk. I obediantly grabbed my blue Zippo lighter and my pack of Newports and headed to the garage. Greg, my supervisor, all without saying a word leaned over and lit my smoke as the filter touched my lips. We both finished half before he spoke.
"You feel comfortable yet?" Greg was a man of few words, but excellent skill. He had precepted me during Paramedic Class, and even during my Command Precepting phase. We got along great; it wasn't uncommon for him and his wife to come and make the crew dinner, or just hang out during the summer months to help play back-up. Help was sparse during the summers, and with all the calls we ran, we needed it. Greg was was almost thirty years my senior; he had been in EMS before I was even an itch in my daddy's pants. I hung on his every word as if his medical knowledge were gospel.
"Yeah. Fortunately the protocols run the same as what they taught us in class, dose wise and med wise. I'm not too sure how I'm going to do flying solo on a major trauma though. You and Tracy helping the crew out on calls made it easier."
"But you're comfortable, right?" He stated calmly as he ground out what was left of his cigarette, which wasn't much. I always wondered how he managed to smoke it down to the filter, and then some. I instinctively handed over what was remaining of mine; no sense in him fumbling with his lighter to light his own. He had been having issues with swelling in his hands and feet as of late; he was working nearly every day of the week and was having issues keeping up with his medication. We had all noticed, and were doing our best to help keep him on the straight and narrow.
"Yeah, I guess, why?"
"Just got back from the Mother Ship..." The Mother Ship was the nickname we gave the largest hospital in our region which ran Medic Command.
"Dr. Polazzi and Dr. Ilania are signing you off with their blessing." With that, Greg did the sign of the cross over me, smiling.
"You got your Holy Hazmaticus. Don't kill anyone, kid."
I beamed with delight. I got the blessing from the Mother Ship. Dr. Polazzi and I had been having fun over the past few weeks on Consults. I had a deluge of interesting calls that didn't even pretend to fit in protocol. Even though there were hundreds of people calling in every day to Medic Command, he always knew who I was.
With that, Greg handed me the service pin with the word "Paramedic" stenciled in at the bottom. I fingered the pin, but didn't put it on my collar. I had several superstitions, and one I developed over the years was seeing brand new medics who put their service pin on before their first call by themselves seemed to be cursed with a White Cloud. I liked having the nickname of Princess Dark Cloud, and I wanted to keep it that way. Greg knew, and he didn't question when I put the pin in my pocket.
"Tracy's making dinner tonight at the house. Steak, Potato Au Gratin , Green Beans...none with almonds so you don't die. Don't want a FUBAR like last time..."
I winced, remembering back to the first time Tracy brought dinner. She made green beans amandine, but the almonds were cut so finely I didn't even notice. With my severe allergy, I looked like the Michelin Man within three bites. Thank God we rode the three blocks to their home in the truck, because I had left my Epi-Pen at the station.
"She's also making brownies and that lemonade with the rasberries in it. Dinner will hit the table at 6:30, but we'll see you guys at 10..."
I had to laugh. Every time dinner plans were made, we got a call at the exact same time we were to be eating. Tracy could throw down on some serious food, and I didn't want to miss pigging out on it. Fortunately, Greg and Tracy were good about it; they were both night owls and were usually up until the sun rose, when they went back to bed...
"Alright, see you at 10..."
Greg sent me off with a hug and a swat on the ass. I walked in, proudly showing off the pin.
"I wonder what my first call will be...bet it's something really messed up..."
Truer words had never been spoken. Twenty minutes later, the tones went off. I hurridly hosed the suds off the truck as I listened to the call. Easy enough, I figured, a sixty year old male lethargic. I fingered my pin on the way to the call, all sorts of excited. Within the hour, I'd be able to put my pin on and say I had truly made it.
When we reached the residence, we were greeted at the door by a caretaker. I smiled and went about asking general questions while my partnet went for vitals. As I was gathering information, my partner called to me, his voice shaking. Without turning around I answered him.
"Yeah?"
"Uh...he doesn't have a pulse..."
I stopped. "What do you mean he doesn't have a pulse..." My voice rose an octave as I felt my asshole go on lockdown status.
"His heart stopped going thumpety-thump and he stopped exchanging Carbon Dioxide for Oxygen..."
I finally looked around the corner to look at the patient. He was sitting up on the couch, his chin resting on his chest as if he were sleeping. Only then did I notice just how pale he was, and just how not moving he was. For the very first time in my career, I swore in front of the patients' family.
"Oh Fuck..."
With that, I moved over and helped my partner get the patient on the floor. As I tilted his head back to listen, I noticed all these little white things rattling in the patients' mouth. I hurridly did a finger sweep, sweeping what looked to be little white pebbles from his mouth...with my ungloved finger. The little pebbles scattered across the floor, and we knelt amongst them to wage our battle with death.
As we fought, I noticed I just didn't feel right. My head felt all swimmy like and I started getting a headache. Before I could figure out what was going on, I saw the care giver reach into her pocket and pull out a little. brown. bottle. My eyes focused on the bottle and my jaw fell open.
"Are those...Nitro pills?"
"You mean the explody stuff? Yeah, the doc told me that if uncle was feeling funny light headed, to put these under his tongue. We lost the box they came in, but the doc said they'd work quick to make him feel better. When he wasn't feeling better, I figured I could give him more..."
"How many was more?"
"Uhm, 'bout ten, twelve."
I proceded to swear...again. Really loud this time. Not only was the patient on Nitro, but he was getting ED pills from his roommate! All I could do was shake my head and continue with the call.
At the hospital, the patient was pronounced dead on arrival. As a rule, I always made myself available to the family to answer any questions. I've found that, some ER Doctors really suck at giving bad news, so I try to be helpful when I can, but not stepping on any toes. The family asked the standard questions to which I had the best answers I could. As I was leaving, the caregiver stopped me at the door, pulling me away from the rest of his family.
"Can I ask you something?"
"Sure, what can I do for you?"
"Did the pills help? Did I do the right thing?"
So many answers went through my mind. Of course you helped him, you moron. You helped him cross over to the other side! or Well, he's dead so you figure it out. With all decorum I could muster, I explained that, what he did was right, if he felt it was right...all the while giving myself the face palm from hell.
******************************
Have Fun, and Be Safe!
The long standing feude between the companies made the Hatfields and McCoy's look like an afternoon bridge party. The two areas were night and day. While our little slice of paradise held some of the more active gangs in the county, 98 percent of the residents were being assisted by the State for all their needs, and the mean age of girls having babies was 16. I had seen them pop as young as fourteen. The neighboring city though had beautiful homes, a good school, and minimal crime...until the citizens of our city crossed the street into their neighborhood.
After waiting what seemed like hours in the quietness of the city, one of the supervisors came down to the station. All he did was walk in the door of the station, pat his pocket where he held his cigarettes, and motion for me to come out to the bay and talk. I obediantly grabbed my blue Zippo lighter and my pack of Newports and headed to the garage. Greg, my supervisor, all without saying a word leaned over and lit my smoke as the filter touched my lips. We both finished half before he spoke.
"You feel comfortable yet?" Greg was a man of few words, but excellent skill. He had precepted me during Paramedic Class, and even during my Command Precepting phase. We got along great; it wasn't uncommon for him and his wife to come and make the crew dinner, or just hang out during the summer months to help play back-up. Help was sparse during the summers, and with all the calls we ran, we needed it. Greg was was almost thirty years my senior; he had been in EMS before I was even an itch in my daddy's pants. I hung on his every word as if his medical knowledge were gospel.
"Yeah. Fortunately the protocols run the same as what they taught us in class, dose wise and med wise. I'm not too sure how I'm going to do flying solo on a major trauma though. You and Tracy helping the crew out on calls made it easier."
"But you're comfortable, right?" He stated calmly as he ground out what was left of his cigarette, which wasn't much. I always wondered how he managed to smoke it down to the filter, and then some. I instinctively handed over what was remaining of mine; no sense in him fumbling with his lighter to light his own. He had been having issues with swelling in his hands and feet as of late; he was working nearly every day of the week and was having issues keeping up with his medication. We had all noticed, and were doing our best to help keep him on the straight and narrow.
"Yeah, I guess, why?"
"Just got back from the Mother Ship..." The Mother Ship was the nickname we gave the largest hospital in our region which ran Medic Command.
"Dr. Polazzi and Dr. Ilania are signing you off with their blessing." With that, Greg did the sign of the cross over me, smiling.
"You got your Holy Hazmaticus. Don't kill anyone, kid."
I beamed with delight. I got the blessing from the Mother Ship. Dr. Polazzi and I had been having fun over the past few weeks on Consults. I had a deluge of interesting calls that didn't even pretend to fit in protocol. Even though there were hundreds of people calling in every day to Medic Command, he always knew who I was.
With that, Greg handed me the service pin with the word "Paramedic" stenciled in at the bottom. I fingered the pin, but didn't put it on my collar. I had several superstitions, and one I developed over the years was seeing brand new medics who put their service pin on before their first call by themselves seemed to be cursed with a White Cloud. I liked having the nickname of Princess Dark Cloud, and I wanted to keep it that way. Greg knew, and he didn't question when I put the pin in my pocket.
"Tracy's making dinner tonight at the house. Steak, Potato Au Gratin , Green Beans...none with almonds so you don't die. Don't want a FUBAR like last time..."
I winced, remembering back to the first time Tracy brought dinner. She made green beans amandine, but the almonds were cut so finely I didn't even notice. With my severe allergy, I looked like the Michelin Man within three bites. Thank God we rode the three blocks to their home in the truck, because I had left my Epi-Pen at the station.
"She's also making brownies and that lemonade with the rasberries in it. Dinner will hit the table at 6:30, but we'll see you guys at 10..."
I had to laugh. Every time dinner plans were made, we got a call at the exact same time we were to be eating. Tracy could throw down on some serious food, and I didn't want to miss pigging out on it. Fortunately, Greg and Tracy were good about it; they were both night owls and were usually up until the sun rose, when they went back to bed...
"Alright, see you at 10..."
Greg sent me off with a hug and a swat on the ass. I walked in, proudly showing off the pin.
"I wonder what my first call will be...bet it's something really messed up..."
Truer words had never been spoken. Twenty minutes later, the tones went off. I hurridly hosed the suds off the truck as I listened to the call. Easy enough, I figured, a sixty year old male lethargic. I fingered my pin on the way to the call, all sorts of excited. Within the hour, I'd be able to put my pin on and say I had truly made it.
When we reached the residence, we were greeted at the door by a caretaker. I smiled and went about asking general questions while my partnet went for vitals. As I was gathering information, my partner called to me, his voice shaking. Without turning around I answered him.
"Yeah?"
"Uh...he doesn't have a pulse..."
I stopped. "What do you mean he doesn't have a pulse..." My voice rose an octave as I felt my asshole go on lockdown status.
"His heart stopped going thumpety-thump and he stopped exchanging Carbon Dioxide for Oxygen..."
I finally looked around the corner to look at the patient. He was sitting up on the couch, his chin resting on his chest as if he were sleeping. Only then did I notice just how pale he was, and just how not moving he was. For the very first time in my career, I swore in front of the patients' family.
"Oh Fuck..."
With that, I moved over and helped my partner get the patient on the floor. As I tilted his head back to listen, I noticed all these little white things rattling in the patients' mouth. I hurridly did a finger sweep, sweeping what looked to be little white pebbles from his mouth...with my ungloved finger. The little pebbles scattered across the floor, and we knelt amongst them to wage our battle with death.
As we fought, I noticed I just didn't feel right. My head felt all swimmy like and I started getting a headache. Before I could figure out what was going on, I saw the care giver reach into her pocket and pull out a little. brown. bottle. My eyes focused on the bottle and my jaw fell open.
"Are those...Nitro pills?"
"You mean the explody stuff? Yeah, the doc told me that if uncle was feeling funny light headed, to put these under his tongue. We lost the box they came in, but the doc said they'd work quick to make him feel better. When he wasn't feeling better, I figured I could give him more..."
"How many was more?"
"Uhm, 'bout ten, twelve."
I proceded to swear...again. Really loud this time. Not only was the patient on Nitro, but he was getting ED pills from his roommate! All I could do was shake my head and continue with the call.
At the hospital, the patient was pronounced dead on arrival. As a rule, I always made myself available to the family to answer any questions. I've found that, some ER Doctors really suck at giving bad news, so I try to be helpful when I can, but not stepping on any toes. The family asked the standard questions to which I had the best answers I could. As I was leaving, the caregiver stopped me at the door, pulling me away from the rest of his family.
"Can I ask you something?"
"Sure, what can I do for you?"
"Did the pills help? Did I do the right thing?"
So many answers went through my mind. Of course you helped him, you moron. You helped him cross over to the other side! or Well, he's dead so you figure it out. With all decorum I could muster, I explained that, what he did was right, if he felt it was right...all the while giving myself the face palm from hell.
******************************
Have Fun, and Be Safe!
Monday, June 21, 2010
And I thought I lived in the woods...
My first home, the one I grew up in and know every nook and cranny of. The one that, at 8 years old, on the brand new sky blue carpet, I staged a homicide of Barbie Dolls...yes...ketchup and red food dye everywhere...on the carpet, with broken Barbies' scattered about. My reasoning: I saw it on Rescue 911 the night before, and I wanted to play Rescue 911 as well.
In my effort to clean up so that my poor mother wouldn't come home and have a Cerebral Vascular Accident, emphasis on Accident, in my bedroom, I had the choice of the following cleaning products; Bleach, Comet, Pine-Sol, Shampoo of the hair variety, Dish Soap, and Water. I decided to test them out, and lo and behold, Bleach worked pretty well. I had no clue, when it dried, it would leave spots the size of Texas in a photo-negative shade of the rest of the carpet.
Needless to say, that was not the best night in the Trommashere house-hold ever.
I thought that, because I had lived in a space where I had to actually walk to the neighbors house instead of taking three steps over my lawn and waving, having wild animals of all sorts crossing my lawn leaving lovely droppings everywhere for me to step in, and my dog eating a rooster because it had decided to roost in his dog house...on Thanksgiving day, that I was an old pro at this.
I. was. wrong.
I went out for an evening run with The White Puppy, and we went to the local lake that has a dirt running track around it that loops into the woods for a portion. The White Puppy is a young one, not even two yet, and he never had the experience of taking a jog through the woods. So we set off and went for a run. Once we got started, the White Puppy was loving it! I had never seen him look so happy while running since I got him.
We stopped for a moment when I heard this rustling noise. I looked around the corner and jumped back with a girlish shreik as who knows how many geese came flying past me to get down to the lake. Then, we stopped for about five minutes as this fawn wandered around on the track. I wasn't getting anywhere near it because I knew Bambi's mom would find a way to kick my ass if I even looked at it wrong.
I even saw this ugly little creature that I believe was a possum and I had to find the energy to run past a skunk. Fortunately it didn't feel threatened enough to spray, which I was thankful for. All in all it was an awesome run, but I still have to get used to the wild life. Now, if I can just find somewhere to take my first hunting trip...
Have fun and be safe!
In my effort to clean up so that my poor mother wouldn't come home and have a Cerebral Vascular Accident, emphasis on Accident, in my bedroom, I had the choice of the following cleaning products; Bleach, Comet, Pine-Sol, Shampoo of the hair variety, Dish Soap, and Water. I decided to test them out, and lo and behold, Bleach worked pretty well. I had no clue, when it dried, it would leave spots the size of Texas in a photo-negative shade of the rest of the carpet.
Needless to say, that was not the best night in the Trommashere house-hold ever.
I thought that, because I had lived in a space where I had to actually walk to the neighbors house instead of taking three steps over my lawn and waving, having wild animals of all sorts crossing my lawn leaving lovely droppings everywhere for me to step in, and my dog eating a rooster because it had decided to roost in his dog house...on Thanksgiving day, that I was an old pro at this.
I. was. wrong.
I went out for an evening run with The White Puppy, and we went to the local lake that has a dirt running track around it that loops into the woods for a portion. The White Puppy is a young one, not even two yet, and he never had the experience of taking a jog through the woods. So we set off and went for a run. Once we got started, the White Puppy was loving it! I had never seen him look so happy while running since I got him.
We stopped for a moment when I heard this rustling noise. I looked around the corner and jumped back with a girlish shreik as who knows how many geese came flying past me to get down to the lake. Then, we stopped for about five minutes as this fawn wandered around on the track. I wasn't getting anywhere near it because I knew Bambi's mom would find a way to kick my ass if I even looked at it wrong.
I even saw this ugly little creature that I believe was a possum and I had to find the energy to run past a skunk. Fortunately it didn't feel threatened enough to spray, which I was thankful for. All in all it was an awesome run, but I still have to get used to the wild life. Now, if I can just find somewhere to take my first hunting trip...
Have fun and be safe!
Sunday, June 20, 2010
Just because it's a duck 99 times in a row, doesn't mean it won't be a Zebra for the 100th time.
(As always, to keep the HIPPA monster from coming after me, patient names, dates, and locations have been changed to protect the innocent. Partners names have been changed except for in cases where they gave me their okay to protect the not so innocent...)
The 20 of every month used to come with one guarentee; Ms. Amanda. No matter what day of the week it fell on that month, whomever worked the twenty-four hour shift for the 20th was guarenteed to pick Ms. Amanda up between the hours of 2 and 4 AM. Ms. Amanda would call without fail for the same reason, psychiatric emergency. What we all knew was that she knew how to use and abuse the system. Call 911, have the nice men and women in the big bright white box come and take her to the local ER, and she'd get a months worth of her medication for free. Wash, Rinse, repeat was her game. Sometimes, if she didn't get what she wanted, she'd hospital shop for the next week until she found someone who wasn't familiar with her and gave her what she wanted.
The crews became so familiar with her that most of the times the patient information was taken down before the crew arrived on scene. She called from the same place, saying she felt like killing herself, had no plan to, hadn't talked to her social worker, and heard voices telling her that she'd be better off dead. Every month on the 20th, she'd go, get committed for 72 hours, then leave with free drugs to do it all again.
I know I began to lose my patience with her. One night, we took her over 20 miles away from our district, when a call came in for a possible shooting. The little slice of paradise I worked in only had one ambulance crew on at any given time, so we were running solo. The shooting was confirmed, and another company came in to take the patient while I was stuck taking Ms. Amanda, who had no "true" medical problems in my opinion at that time, to the hospital.
Almost 2 years of dealing with this woman angered many people in the service. Multiple crew members tried speaking to the ER physicians on duty about doing something with her. She was obviously in need of help, psychiatric and otherwise, but no matter what, within 72 hours, she'd be back on the streets.
I'll admit my own part in this; I became complacent. I just didn't want to deal with her. To me, she never gave me a challenge, a reason to take her to the hospital. She would just sit on the strecher and take up my precious sleep time. Even for a BLS trip, I'd still have to write a trip sheet on her, and because of the computer system at the station, a simple sheet could take an hour or more if the internet was acting up. If I was getting slammed that day, it was easily an hour or two taken away from my sleep.
The next month approached, and of course, I had the 20th again. This time, I told myself, I had enough. She was going to hear about how taking her was a waste of time; I could be out helping people who needed it instead of taking her to the hospital to just get drugs.
That night, I noticed the locals were out in force. It was a very hot night in the ghetto, and the natives were restless. We ran multiple assaults that day and into the night. Like clockwork, at 3 am, Ms. Amanda had gone out to the pay phone in front of her apartment and dialed 911.
As we pulled up, my partner and I both noticed she wasn't waiting. Usually we'd see her standing in the wash of the street light giving us a pittiful wave. Odd, but what could I expect from her? In my mind, she did it in spite, something just to piss me off. I noticed movement out of the corner of my eye, and I saw a bunch of people tear off from behind one of the row houses. I locked the doors of the ambulance and asked Dispatch to send PD to the location. Only then did I noticed that Ms. Amandas' front door was wide open, and the house looked ransacked. I rolled down the window and called out her name, but no one came to the open door.
I turned back to my partner, who was ready to get out of the truck, when I heard a noise. I turned around and jumped three feet out of my skin. Standing next to the truck was Ms. Amanda, covered from head to toe in blood, her clothes torn to shreads, and she was crying.
I jumped from the ambulance and took her into the truck. I began to bandage some of her wounds while trying to figure out what was going on.
"Ms. Amanda...what happened?"
"They beat me!"
She then broke into sobs. After some teeth pulling, she finally relented her story. Her family would take her psych meds from her, the minute she would get off her committment and sell them. Most of the time, they'd pick the drugs up from the pharmacy before she could get there, other times, they would wait until she was sleeping then nab them. In two years, the only time she would actually take her meds was when she would have to stay in hospital.
I felt like shit.
Because I somehow forgot that my own shit stank as much as the next person, I never asked the important question of why? I could ask all I wanted about the pathology of her complaint; What do the voices want? How long have you been feeling this way? Is this normal for you? but I never asked.
"How long has this been going on?"
"For years..."
"Why didn't you ever tell anyone?" I crooned to her softly. What she said next blew me away.
"No one ever asked. Most people don't even speak to me, no one, not even medical people care about me."
My heart broke. I couldn't believe what I had become. I was the helper; I was supposed to hold hands and help heal all wounds, but because I allowed the woman to become a bother to me, I didn't do my best to help her. We got her to the hospital, and we relayed exactly what was going on to the nurse and doctor.
I never saw her again after that night, but I do hope that Ms. Amanda finally got the help she needed.
The 20 of every month used to come with one guarentee; Ms. Amanda. No matter what day of the week it fell on that month, whomever worked the twenty-four hour shift for the 20th was guarenteed to pick Ms. Amanda up between the hours of 2 and 4 AM. Ms. Amanda would call without fail for the same reason, psychiatric emergency. What we all knew was that she knew how to use and abuse the system. Call 911, have the nice men and women in the big bright white box come and take her to the local ER, and she'd get a months worth of her medication for free. Wash, Rinse, repeat was her game. Sometimes, if she didn't get what she wanted, she'd hospital shop for the next week until she found someone who wasn't familiar with her and gave her what she wanted.
The crews became so familiar with her that most of the times the patient information was taken down before the crew arrived on scene. She called from the same place, saying she felt like killing herself, had no plan to, hadn't talked to her social worker, and heard voices telling her that she'd be better off dead. Every month on the 20th, she'd go, get committed for 72 hours, then leave with free drugs to do it all again.
I know I began to lose my patience with her. One night, we took her over 20 miles away from our district, when a call came in for a possible shooting. The little slice of paradise I worked in only had one ambulance crew on at any given time, so we were running solo. The shooting was confirmed, and another company came in to take the patient while I was stuck taking Ms. Amanda, who had no "true" medical problems in my opinion at that time, to the hospital.
Almost 2 years of dealing with this woman angered many people in the service. Multiple crew members tried speaking to the ER physicians on duty about doing something with her. She was obviously in need of help, psychiatric and otherwise, but no matter what, within 72 hours, she'd be back on the streets.
I'll admit my own part in this; I became complacent. I just didn't want to deal with her. To me, she never gave me a challenge, a reason to take her to the hospital. She would just sit on the strecher and take up my precious sleep time. Even for a BLS trip, I'd still have to write a trip sheet on her, and because of the computer system at the station, a simple sheet could take an hour or more if the internet was acting up. If I was getting slammed that day, it was easily an hour or two taken away from my sleep.
The next month approached, and of course, I had the 20th again. This time, I told myself, I had enough. She was going to hear about how taking her was a waste of time; I could be out helping people who needed it instead of taking her to the hospital to just get drugs.
That night, I noticed the locals were out in force. It was a very hot night in the ghetto, and the natives were restless. We ran multiple assaults that day and into the night. Like clockwork, at 3 am, Ms. Amanda had gone out to the pay phone in front of her apartment and dialed 911.
As we pulled up, my partner and I both noticed she wasn't waiting. Usually we'd see her standing in the wash of the street light giving us a pittiful wave. Odd, but what could I expect from her? In my mind, she did it in spite, something just to piss me off. I noticed movement out of the corner of my eye, and I saw a bunch of people tear off from behind one of the row houses. I locked the doors of the ambulance and asked Dispatch to send PD to the location. Only then did I noticed that Ms. Amandas' front door was wide open, and the house looked ransacked. I rolled down the window and called out her name, but no one came to the open door.
I turned back to my partner, who was ready to get out of the truck, when I heard a noise. I turned around and jumped three feet out of my skin. Standing next to the truck was Ms. Amanda, covered from head to toe in blood, her clothes torn to shreads, and she was crying.
I jumped from the ambulance and took her into the truck. I began to bandage some of her wounds while trying to figure out what was going on.
"Ms. Amanda...what happened?"
"They beat me!"
She then broke into sobs. After some teeth pulling, she finally relented her story. Her family would take her psych meds from her, the minute she would get off her committment and sell them. Most of the time, they'd pick the drugs up from the pharmacy before she could get there, other times, they would wait until she was sleeping then nab them. In two years, the only time she would actually take her meds was when she would have to stay in hospital.
I felt like shit.
Because I somehow forgot that my own shit stank as much as the next person, I never asked the important question of why? I could ask all I wanted about the pathology of her complaint; What do the voices want? How long have you been feeling this way? Is this normal for you? but I never asked.
"How long has this been going on?"
"For years..."
"Why didn't you ever tell anyone?" I crooned to her softly. What she said next blew me away.
"No one ever asked. Most people don't even speak to me, no one, not even medical people care about me."
My heart broke. I couldn't believe what I had become. I was the helper; I was supposed to hold hands and help heal all wounds, but because I allowed the woman to become a bother to me, I didn't do my best to help her. We got her to the hospital, and we relayed exactly what was going on to the nurse and doctor.
I never saw her again after that night, but I do hope that Ms. Amanda finally got the help she needed.
Saturday, June 19, 2010
I swear...I DIDN'T DO IT!!!
Here's a good story from the archives of my mind....(insert Twillight Zone theme song here with wavy squiggly lines notating a dream sequence)
It's late, I'm tired, and it's fricking cold. In February, 2002, I sat in the ambulance base freezing my non-existant clackers off. I had the immense pleasure of working with Byron; he was and still is my favorite Medic of all time. He taught me things that my 16 year old mind could barely wrap around. With a charismatic smile that never faded no matter what, he was my Johnny Gage. I ate up everything he said to me. If he told me the sky was purple, then by all rights it was, and I was going to tell EVERYONE that the sky was purple.
It was also Valentines' Day. I made dinner for "my boys" as I called them. I was third person volunteer for Byron, Matt, and Jason, and we were having a pretty non eventfull night. I was putting in time for my Senior Project. The bean counters at my high school decided that, to get more state and federal funding, that all classes must do a "Senior Project" which was supposed to take up the 4 years of High school. Most did it in the last 3 months, but I was all on it from the beginning. Becoming an EMT and volunteering for 100+ hours was my project.
I had finished my hours up months ago, but I was having way too much fun to quit.
Anywho...
We were watching some movie on television, can't tell you what, when the tones dropped for a female with chest pains. As I moved to the truck, I noticed the hairs on the back of my neck were standing on end, and I just had that sensation that something bad was going to happen. I satiated myself saying, because the roads were bad, I was in fear of our multi ton sled was going to tip over and entrap us all, turning the box of the ambulance into a large oven in which to roast me. (Thank you ambulance safety films from EMT class)
When we got to the location, it was a nice little house set a ways back from the road. I carried in the jump bag and monitor, while Byron carried the oxygen tank. This was my first chest pain call, so I ran over the particulars with Byron, figuring out what I'd need to get for him while still in the house. As we walked in, we were met by no less than twenty family members ranging in age from at most eight, up to our patient, who was in her late sixties. Byron let me ask the fun questions and do documentation while he took vitals. Our conversation went something like this.
"So, Ma'am, do you have any pain anywhere?"
"Not really, I just feel like I have heart burn. I get it after I eat strawberries, and I had a chocolate covered one a little bit ago. My son-in-law got nervous and called 911 to get the ambulance drivers to come out and check on me..."
"Not dizzy or light headed?"
"No."
"Sounds good..."
I turned and looked at Byron, a smile on my face. He showed me the monitor and asked me if I felt if they were in the normal range. Everything looked perfect to me. Looking back on it (I still have the strip after all these years) the strip showed the prettiest Normal sinus rhythm. Byron took over and started asking the more medic oriented questions, and everything was in line for a refusal. I started taking information, and I got to the part about past medical history. The patient stated that she had "sugar" and Byron asked me to take a blood sugar.
Now, I have never done it before on a live patient before this. I knew how to, but had never done it in practice. I knelt down, swabbed my site, and I stuck her finger. The minute I did, she went into convulsions with God awful snoring noises coming from her throat. The first thing I did, like any self respecting EMT would, was I stood up, cleared my throat and stated so that EVERYONE in the Eastern Hemisphere could hear:
"I swear to GOD I didn't do it!!! I just stuck her finger is all!!!"
And I screamed like a bitch. Not a loud one, I just punctuated the end of my sentance with a girly little squeel. Yeah, true picture of professionalism and decorum here.
Byron and Matt both took control while Jason ran out to the ambulance to call in for backup. We got her on the floor, and the first thing we all did was look over at the screaching monitor. What replaced the most perfect Normal Sinus Rhythm ever was the even straighter looking Asystole. I mean it was a complete laser trace.
Remember me saying I had never worked an arrest before?
I was told to get on the chest and start CPR. What they failed to say in EMT school was that, ribs will break when you do CPR. That first hard push, I felt the ribs break...and there I went squeeling like a bitch...again. We worked her, and hard. Drugs were flying every where. She had IVs in places I didn't know you could do one. After the perfect application of ACLS, while doing a pulse check, I felt something. It was very small, very light, but I felt it; it was a pulse.
The womans' eyes opened very slowly, and she blinked a few times, then she began vomiting...everywhere.
Did I forget to mention I'm a sympathy vomiter as well? At that time, even someone spitting could make the purge rise in my throat.
We had her in the ambulance by now, and we rolled her, on the back board, on her left side. I was sitting in the airway seat, my feet firmly planted on the floor. With one good heave, she proceeded to redecorate the inside of my boots. I had on these crazy boots that the tops weren't flush against my leg. They had a little gap in them, and that was all that was needed for her to fill my boot to the brim. Amazingly, I managed to not throw up. I talked to this woman the whole way to the ER.
We talked about her kids, her grand kids, her pets...anything I could think of to keep her talking. It became rhythmic. With the pitch and sway of the truck, Byron calling in the report, Matt driving...well...he was driving like he was trying to qualify, and Jason trying not to puke in the back because of motion sickness, these two little voices were playing a duet with each other.
"Ma'am...stay awake, please! Uh, tell me 'bout your kids."
"I have three, the oldest is..." and she'd trail off, going back into Lala land. I had her face cupped between my hands, and as she'd trail off, I'd hurridly speak to her, my voice rising a bit.
"No no no! Come on now, wake up for me!"
"Oh! *quietly* I'm so sorry dear, where was I?"
And that's how it played out. I can't tell you how long the trip was, I don't remember. To me, it was just the two of us. I couldn't tell you what else anyone did after she woke up. She was my whole world then. Every once in a while, Byron would throw me a bone, gently cheering me on for talking to her. I didn't know at the time, but that had the same theraputic value as doing all the ALS crap. In that moment I proved just how important BLS was. I may not have been pushing drugs or interpreting rhythms, but I was helping.
When we got to the ER, I remember standing just at the entrance to the room they put her in. The flurry of activity was incredible; doctors spewing out commands and everyone followed them. It was an organized symphony, and even though all I did was play the Triangle a few measures back for a few beats, I still had my part.
I will always remember the round of thanks we got from the family and even the patient. I felt odd, knowing I was getting the same kudos that everyone else was getting, when all I did was talk to the patient. After returning to base, I cornered Byron in the ambulance garage while he was restocking the truck.
"Hey. Why didn't you tell them that I wasn't involved. I mean, all I did was let her puke in my shoe and talked to her. You, Matt, and even Jason did all the hard work..."
"Hand me that saline, will you?" He gestured to the bag of saline on the stretcher. I handed it to him obediantly, waiting for an answer.
"Kari, what did they teach you in EMT class...about the difference between EMT's and Medics?"
"Uhm...you guys get to do IV's, push drugs, save lives, you know, the good stuff. EMT's drive the truck and are just over trained stretcher-fetchers."
He shook his head and closed the drug box. What he said next impacted my career, and I preach the same message to any EMT I've ever worked with who doubted themselves as having any impact on a patient.
"That is the function of your job. Yes, I do the drugs and all that other crap, but you deal with the bigger problem. I can push all the drugs I want, but if the patient doesn't feel that everything is going to be okay, it almost turns into a self-fulling prophecy. You sat there, through everything, and made the patient believe that she was going to be okay. I watched her smile at you every time you told her it would be okay. The bit where you talked about playing with her grandson in a week or so was brilliant. You gave her that drive, that focus that there was going to be a tomorrow, and you were going to help her get there."
I know I had the dumb dog look on my face as I went to change the portable oxygen tank. What could I say to that?
"Also, look at my patch, what does it say?"
"Emergency Medical Technician...Paramedic..."
"Exactly. What does yours say?"
"Emergency Medical Technician..."
"Exactly. I am an EMT-Paramedic...my EMT skills, the BLS stuff, always comes before the ALS crap. I can push all the drugs I want, but if the basic stuff...the Airway, the Breathing, and the Circulation are left behind, nothing I do ALS will fix that. You kept the BVM going even though I could've shoved a lump of coal up your ass and you could've produced a diamond on demand. When she started yacking, you helped roll her over and then suctioned it out. If she would've aspirated, I would've been dealing with a mess. You were on the compressions for the CPR for a while. If the blood ain't goin' around in a circle, the drugs can't get to the heart."
He double checked the regulator, making sure it was on tight before putting it back in the sleeve.
"Just because you didn't do the IV doesn't mean you didn't help save that life. Just because you don't have those nine little red letters doesn't mean you deserve less credit. You did great, especially since it was your first time. Now, let's go reheat dinner, and I'll show you how to write a tripsheet."
I grinned happily. I could honestly say I saved a life, and on Valentine's Day, no less. As I started to go back in the crew room, I found the strip from the monitor, the code summary showing every rhythm change. I handed it to Byron.
"Hey, you dropped this..."
"I don't need it. Why don't you keep it and use it for your project?"
"Really?"
"Sure, why not? By the way, Happy Valentine's Day, and thanks for everything. I couldn'tve done it without you..."
*************************
Eight years later, I still feel all warm and fuzzy when I think about that night. The patient made it, fortunately, and as far as I know she's still alive and kicking, playing with her grandson. I've had many cardiac arrests since then, some with me as Medic, others as an EMT. I've saved as many as I've lost, but nothing can compare to that first save. That night, I was bitten by the bug, the EMS bug. It was barely six months into my life as an EMT, but I draw on that strenght I had then.
I hope the EMT's I have worked with over the years know that, even though I had my nine little letters on my patch, I respected them with everything I had. I was there once. I was where you are or were; a fledgling EMT who wanted nothing more than to make my mark on the world. You made your mark on my world at least. I thank you from the bottom of my heart.
Have a good one, and Be Safe!
It's late, I'm tired, and it's fricking cold. In February, 2002, I sat in the ambulance base freezing my non-existant clackers off. I had the immense pleasure of working with Byron; he was and still is my favorite Medic of all time. He taught me things that my 16 year old mind could barely wrap around. With a charismatic smile that never faded no matter what, he was my Johnny Gage. I ate up everything he said to me. If he told me the sky was purple, then by all rights it was, and I was going to tell EVERYONE that the sky was purple.
It was also Valentines' Day. I made dinner for "my boys" as I called them. I was third person volunteer for Byron, Matt, and Jason, and we were having a pretty non eventfull night. I was putting in time for my Senior Project. The bean counters at my high school decided that, to get more state and federal funding, that all classes must do a "Senior Project" which was supposed to take up the 4 years of High school. Most did it in the last 3 months, but I was all on it from the beginning. Becoming an EMT and volunteering for 100+ hours was my project.
I had finished my hours up months ago, but I was having way too much fun to quit.
Anywho...
We were watching some movie on television, can't tell you what, when the tones dropped for a female with chest pains. As I moved to the truck, I noticed the hairs on the back of my neck were standing on end, and I just had that sensation that something bad was going to happen. I satiated myself saying, because the roads were bad, I was in fear of our multi ton sled was going to tip over and entrap us all, turning the box of the ambulance into a large oven in which to roast me. (Thank you ambulance safety films from EMT class)
When we got to the location, it was a nice little house set a ways back from the road. I carried in the jump bag and monitor, while Byron carried the oxygen tank. This was my first chest pain call, so I ran over the particulars with Byron, figuring out what I'd need to get for him while still in the house. As we walked in, we were met by no less than twenty family members ranging in age from at most eight, up to our patient, who was in her late sixties. Byron let me ask the fun questions and do documentation while he took vitals. Our conversation went something like this.
"So, Ma'am, do you have any pain anywhere?"
"Not really, I just feel like I have heart burn. I get it after I eat strawberries, and I had a chocolate covered one a little bit ago. My son-in-law got nervous and called 911 to get the ambulance drivers to come out and check on me..."
"Not dizzy or light headed?"
"No."
"Sounds good..."
I turned and looked at Byron, a smile on my face. He showed me the monitor and asked me if I felt if they were in the normal range. Everything looked perfect to me. Looking back on it (I still have the strip after all these years) the strip showed the prettiest Normal sinus rhythm. Byron took over and started asking the more medic oriented questions, and everything was in line for a refusal. I started taking information, and I got to the part about past medical history. The patient stated that she had "sugar" and Byron asked me to take a blood sugar.
Now, I have never done it before on a live patient before this. I knew how to, but had never done it in practice. I knelt down, swabbed my site, and I stuck her finger. The minute I did, she went into convulsions with God awful snoring noises coming from her throat. The first thing I did, like any self respecting EMT would, was I stood up, cleared my throat and stated so that EVERYONE in the Eastern Hemisphere could hear:
"I swear to GOD I didn't do it!!! I just stuck her finger is all!!!"
And I screamed like a bitch. Not a loud one, I just punctuated the end of my sentance with a girly little squeel. Yeah, true picture of professionalism and decorum here.
Byron and Matt both took control while Jason ran out to the ambulance to call in for backup. We got her on the floor, and the first thing we all did was look over at the screaching monitor. What replaced the most perfect Normal Sinus Rhythm ever was the even straighter looking Asystole. I mean it was a complete laser trace.
Remember me saying I had never worked an arrest before?
I was told to get on the chest and start CPR. What they failed to say in EMT school was that, ribs will break when you do CPR. That first hard push, I felt the ribs break...and there I went squeeling like a bitch...again. We worked her, and hard. Drugs were flying every where. She had IVs in places I didn't know you could do one. After the perfect application of ACLS, while doing a pulse check, I felt something. It was very small, very light, but I felt it; it was a pulse.
The womans' eyes opened very slowly, and she blinked a few times, then she began vomiting...everywhere.
Did I forget to mention I'm a sympathy vomiter as well? At that time, even someone spitting could make the purge rise in my throat.
We had her in the ambulance by now, and we rolled her, on the back board, on her left side. I was sitting in the airway seat, my feet firmly planted on the floor. With one good heave, she proceeded to redecorate the inside of my boots. I had on these crazy boots that the tops weren't flush against my leg. They had a little gap in them, and that was all that was needed for her to fill my boot to the brim. Amazingly, I managed to not throw up. I talked to this woman the whole way to the ER.
We talked about her kids, her grand kids, her pets...anything I could think of to keep her talking. It became rhythmic. With the pitch and sway of the truck, Byron calling in the report, Matt driving...well...he was driving like he was trying to qualify, and Jason trying not to puke in the back because of motion sickness, these two little voices were playing a duet with each other.
"Ma'am...stay awake, please! Uh, tell me 'bout your kids."
"I have three, the oldest is..." and she'd trail off, going back into Lala land. I had her face cupped between my hands, and as she'd trail off, I'd hurridly speak to her, my voice rising a bit.
"No no no! Come on now, wake up for me!"
"Oh! *quietly* I'm so sorry dear, where was I?"
And that's how it played out. I can't tell you how long the trip was, I don't remember. To me, it was just the two of us. I couldn't tell you what else anyone did after she woke up. She was my whole world then. Every once in a while, Byron would throw me a bone, gently cheering me on for talking to her. I didn't know at the time, but that had the same theraputic value as doing all the ALS crap. In that moment I proved just how important BLS was. I may not have been pushing drugs or interpreting rhythms, but I was helping.
When we got to the ER, I remember standing just at the entrance to the room they put her in. The flurry of activity was incredible; doctors spewing out commands and everyone followed them. It was an organized symphony, and even though all I did was play the Triangle a few measures back for a few beats, I still had my part.
I will always remember the round of thanks we got from the family and even the patient. I felt odd, knowing I was getting the same kudos that everyone else was getting, when all I did was talk to the patient. After returning to base, I cornered Byron in the ambulance garage while he was restocking the truck.
"Hey. Why didn't you tell them that I wasn't involved. I mean, all I did was let her puke in my shoe and talked to her. You, Matt, and even Jason did all the hard work..."
"Hand me that saline, will you?" He gestured to the bag of saline on the stretcher. I handed it to him obediantly, waiting for an answer.
"Kari, what did they teach you in EMT class...about the difference between EMT's and Medics?"
"Uhm...you guys get to do IV's, push drugs, save lives, you know, the good stuff. EMT's drive the truck and are just over trained stretcher-fetchers."
He shook his head and closed the drug box. What he said next impacted my career, and I preach the same message to any EMT I've ever worked with who doubted themselves as having any impact on a patient.
"That is the function of your job. Yes, I do the drugs and all that other crap, but you deal with the bigger problem. I can push all the drugs I want, but if the patient doesn't feel that everything is going to be okay, it almost turns into a self-fulling prophecy. You sat there, through everything, and made the patient believe that she was going to be okay. I watched her smile at you every time you told her it would be okay. The bit where you talked about playing with her grandson in a week or so was brilliant. You gave her that drive, that focus that there was going to be a tomorrow, and you were going to help her get there."
I know I had the dumb dog look on my face as I went to change the portable oxygen tank. What could I say to that?
"Also, look at my patch, what does it say?"
"Emergency Medical Technician...Paramedic..."
"Exactly. What does yours say?"
"Emergency Medical Technician..."
"Exactly. I am an EMT-Paramedic...my EMT skills, the BLS stuff, always comes before the ALS crap. I can push all the drugs I want, but if the basic stuff...the Airway, the Breathing, and the Circulation are left behind, nothing I do ALS will fix that. You kept the BVM going even though I could've shoved a lump of coal up your ass and you could've produced a diamond on demand. When she started yacking, you helped roll her over and then suctioned it out. If she would've aspirated, I would've been dealing with a mess. You were on the compressions for the CPR for a while. If the blood ain't goin' around in a circle, the drugs can't get to the heart."
He double checked the regulator, making sure it was on tight before putting it back in the sleeve.
"Just because you didn't do the IV doesn't mean you didn't help save that life. Just because you don't have those nine little red letters doesn't mean you deserve less credit. You did great, especially since it was your first time. Now, let's go reheat dinner, and I'll show you how to write a tripsheet."
I grinned happily. I could honestly say I saved a life, and on Valentine's Day, no less. As I started to go back in the crew room, I found the strip from the monitor, the code summary showing every rhythm change. I handed it to Byron.
"Hey, you dropped this..."
"I don't need it. Why don't you keep it and use it for your project?"
"Really?"
"Sure, why not? By the way, Happy Valentine's Day, and thanks for everything. I couldn'tve done it without you..."
*************************
Eight years later, I still feel all warm and fuzzy when I think about that night. The patient made it, fortunately, and as far as I know she's still alive and kicking, playing with her grandson. I've had many cardiac arrests since then, some with me as Medic, others as an EMT. I've saved as many as I've lost, but nothing can compare to that first save. That night, I was bitten by the bug, the EMS bug. It was barely six months into my life as an EMT, but I draw on that strenght I had then.
I hope the EMT's I have worked with over the years know that, even though I had my nine little letters on my patch, I respected them with everything I had. I was there once. I was where you are or were; a fledgling EMT who wanted nothing more than to make my mark on the world. You made your mark on my world at least. I thank you from the bottom of my heart.
Have a good one, and Be Safe!
Unpacking and Day Dreaming
So, I finished upacking my room. I still had some errant boxes floating around from the move, and I opened one ealier that just had the label MISC. on it. Mind you, when we all decided to move, we began packing oh, about, three months before the move, so there were a lot of things that were packed and forgotten about.
As I lifted out old blue uniform shirts and Con-Ed certificates, I found a black, dusty holster with my very first pair of Trauma Shears and yes, they were hot pink.
I pulled them out and I did what any self respecting Paramedic with a pair of Trauma Shears would do when they are not currently surrounded by accident victims in need of being made naked in a hurry; I cut a penny. As I did, I thought back to some of the calls that I had used my trusty shears on.
The one that seems to be the first call I think of is the first car accident I ever went on. That, followed by my first Cardiac Arrest. Then, I reflect on the day that I retired them, to never be used on a patient again...and that's when the tears begin to flow.
I promise, I'll get into some story telling soon, so that you can understand where I'm coming from. Where I get the ability to plan dinner while looking at a 3 week old decomp, or can tell someone that they have just a minor Boo-Boo while their foot is barely hanging onto the rest of their leg from their own drunken stupidity (both are true stories). I promise, I'm not some jaded individual who thinks life sucks and that Natural Selection is a blessing. I just firmly believe that someone needs to pour just a bit more chlorine in the shallow end of the gene pool that my more...interesting patients have come from.
Well, now that I've led you on long enough, I'll tickle your fancy some more. Hopefully in the next post, I can get off my soap box and delve into some good stories. Feedback is always appreciated!
Have a good one, and Be Safe!
As I lifted out old blue uniform shirts and Con-Ed certificates, I found a black, dusty holster with my very first pair of Trauma Shears and yes, they were hot pink.
I pulled them out and I did what any self respecting Paramedic with a pair of Trauma Shears would do when they are not currently surrounded by accident victims in need of being made naked in a hurry; I cut a penny. As I did, I thought back to some of the calls that I had used my trusty shears on.
The one that seems to be the first call I think of is the first car accident I ever went on. That, followed by my first Cardiac Arrest. Then, I reflect on the day that I retired them, to never be used on a patient again...and that's when the tears begin to flow.
I promise, I'll get into some story telling soon, so that you can understand where I'm coming from. Where I get the ability to plan dinner while looking at a 3 week old decomp, or can tell someone that they have just a minor Boo-Boo while their foot is barely hanging onto the rest of their leg from their own drunken stupidity (both are true stories). I promise, I'm not some jaded individual who thinks life sucks and that Natural Selection is a blessing. I just firmly believe that someone needs to pour just a bit more chlorine in the shallow end of the gene pool that my more...interesting patients have come from.
Well, now that I've led you on long enough, I'll tickle your fancy some more. Hopefully in the next post, I can get off my soap box and delve into some good stories. Feedback is always appreciated!
Have a good one, and Be Safe!
I am so not in Kansas anymore
I've landed somewhere so bizzare and strange, I just had to write about it. For those that don't know, they call me Medic Trommashere. Yes, I turned a piece of medical equipment into a pseudonym because Lord knows, in a few months, I'll have some crazy Tromma Junkie pounding on my bedroom window for a few minutes of my time (or a pissed off former supervisor/co-worker who could read through me trying to hide who I am and what happened until the statute of limitations is up)
A bit about me. I am a 20-something Paramedic who moved from the land of quick ground transports and a hospital on every blessed corner to...well...not. When I was told that my trauma patients would have to be flown in to the nearest hospital, I about cried. Back home, I never thought about calling for "a bird" because, well, I had a total transport time of less than 2o minutes running red lights and woo-woos.
My next favorite question that I get to answer is this: Why did you get into this job?
Honestly, many things happened in my life to put me here. I watched way too much Rescue 911 for my own well being. I couldn'tve been any older than eight when I first started watching. Secondly, at 14, my father collapsed in our kitchen after a new medication he was on caused a bad reaction. My mother was in a sheer panic, babbling incoherantly, and I got to get on the phone with 911.
After explaining to the 911 Dispatcher what was going on, she promptly hung up. No pre-arrival instructions, no, "everything is going to be okay", nothing. Just, "Turn your porch light on and the ambulance driver will be there shortly." The first person who showed was a police officer. His idea of helping was...drum roll please...to move the kitchen table and then go back out the front door. Once again, I am left alone with my incoherant mother, my father who is currently breathing slower than a snail's pace, and me.
When the medics did show up, it was as if God Himself had come down and saved the day. The Medics and EMT's acted with such professionalism that I wanted to do the same. One consoled my mother while the others set about helping my father. My mom made me ride in the ambulance because I had seen my father fall and knew how he was acting just prior to the fall.
At 14, I thought the EMT's and Medics were just sooo cool! I even told my mom that, because the Medics said that everything was going to be okay, it was going to be. Fortunately, they were right. After that, I had been officially bitten by the EMS Bug. I signed up for the first class I could, and lets just say that the goings on in that class can span several posts, and it will when I do them.
Now at 24, the Medics are still as cool as they were back then, even though I have ascended to their rank. I still hold those who taught me through my younger years in high esteem; my friends and colleauges who get a chance to run with me outside of my steady partner ask me where I learned some of my tricks, and I don't have many that I can't attribute to a former Paramedic partner.
As for why I'm not in Kansas any more, long story. Mostly, I was itching to move laterally in my chosen profession. Where I came from, that just didn't happen. Politics played a heavy hand in EMS back home. Boards of Directors were filled with Husbands, Wives, Fathers, Mothers, Children (both legitimate and not) and signifigant others (Whether the wives/husbands knew anything about them was a different story to be told.)
Mutual Aid contracts were fueled by who was drinking buddies with whom, who had slept with who, and just who liked who. I listened to Priority 1 calls be fielded out to services over 10 minutes away (if traffic/road construction wasn't going on which never happened on my side of paradise), while my truck sat in stone throwing distance from the call, just because that week, the owners of company A and B had a great time at the bar that weekend.
Moving up in the company was also something that just couldn't happen. I am one of those people who will always be a "blue shirt" (or minion, take your pick), not because I don't want to be in a leadership position, but because I enjoy working on the trucks. It seems as if when someone ascends to the role of supervisor (or "white shirt"), they, for some reason, decide that they've had enough with truck time, and are happy to sit around the station and annoy the hell out of their minions...ahem...co-workers.
That is not to say that I haven't gained the qualifications to do some of the lower ranking supervisory positions like Con-Ed coordinator, or ALS Coordinator, hell, even BLS Coordinator, I just wasn't in the "in crowd" (see also: drinking/sleeping buddies with the boss).
The straw that broke the camels' back was when I and 2 other co-workers who had been with the company for years, had been unceremoniously put in charge after the death of the station cheif. For the next three weeks, we worked hard to keep the station together, keeping employees from killing each other and the trucks on the road. At the end of that time, we were told that other employees, who had started with the company AFTER the Cheif's untimely demise, were the ones in charge. Three weeks of hard work were undone in a matter of minutes.
The ones in charge did not like the former cheif, and they did their best to get rid of those who did. I got screwed in ways I didn't know was physically possible. For a while, I contemplated getting completely out of the field. Why did I want to be a part of something that could turn people on each other like rabid animals? I felt like I was in a profession that condoned eating its own young. Fair play and cohesiveness were outlawed, it was all about back stabbing and trying to get dirt on whomever you could so that you could take it up the chain and maybe get a promotion. Good works didn't reward you, but playing dirty could make you a star.
After an especially horrific incident, I up and left. I'll admit, I went off like a firecracker when I found out what happened, and I up and left, but I felt like I had all the explination I needed. Loyalty to the company was no longer in style. I needed to play dirty to keep playing the game, and I wasn't about to do that.
I had decided about 6-8 months prior that it was time to move. I had a sit down with those closest to me and within a matter of a few days, it was decided. We needed, for the sake of keeping our sanity, to leave the state and start anew. Then came, as a sign from God that this was supposed to happen, the job opportunity of a life time. I couldn'tve designed a better job, so I jumped on that bandwagon, and rode it south, to where I reside now. I left a lot of good friends and better partners back home in search of EMS Nirvana, and well, lets just say that...this is close enough for government work.
In closing, I'd just like to say, thanks for sticking with me. I know I can get long winded, but hey, this is my blog and I'll do whatever the hell I want to with it. I plan on throwing in some field stories, some old, some new, some in between, and just general life stories. I'm sure the layout of the page is going to change more often than a frat boy changes girlfriends, so hold in there with me while I try to make up my mind...then again, it's the female peroggative to change it at a moments' notice.
Have a good one, and Be Safe!
A bit about me. I am a 20-something Paramedic who moved from the land of quick ground transports and a hospital on every blessed corner to...well...not. When I was told that my trauma patients would have to be flown in to the nearest hospital, I about cried. Back home, I never thought about calling for "a bird" because, well, I had a total transport time of less than 2o minutes running red lights and woo-woos.
My next favorite question that I get to answer is this: Why did you get into this job?
Honestly, many things happened in my life to put me here. I watched way too much Rescue 911 for my own well being. I couldn'tve been any older than eight when I first started watching. Secondly, at 14, my father collapsed in our kitchen after a new medication he was on caused a bad reaction. My mother was in a sheer panic, babbling incoherantly, and I got to get on the phone with 911.
After explaining to the 911 Dispatcher what was going on, she promptly hung up. No pre-arrival instructions, no, "everything is going to be okay", nothing. Just, "Turn your porch light on and the ambulance driver will be there shortly." The first person who showed was a police officer. His idea of helping was...drum roll please...to move the kitchen table and then go back out the front door. Once again, I am left alone with my incoherant mother, my father who is currently breathing slower than a snail's pace, and me.
When the medics did show up, it was as if God Himself had come down and saved the day. The Medics and EMT's acted with such professionalism that I wanted to do the same. One consoled my mother while the others set about helping my father. My mom made me ride in the ambulance because I had seen my father fall and knew how he was acting just prior to the fall.
At 14, I thought the EMT's and Medics were just sooo cool! I even told my mom that, because the Medics said that everything was going to be okay, it was going to be. Fortunately, they were right. After that, I had been officially bitten by the EMS Bug. I signed up for the first class I could, and lets just say that the goings on in that class can span several posts, and it will when I do them.
Now at 24, the Medics are still as cool as they were back then, even though I have ascended to their rank. I still hold those who taught me through my younger years in high esteem; my friends and colleauges who get a chance to run with me outside of my steady partner ask me where I learned some of my tricks, and I don't have many that I can't attribute to a former Paramedic partner.
As for why I'm not in Kansas any more, long story. Mostly, I was itching to move laterally in my chosen profession. Where I came from, that just didn't happen. Politics played a heavy hand in EMS back home. Boards of Directors were filled with Husbands, Wives, Fathers, Mothers, Children (both legitimate and not) and signifigant others (Whether the wives/husbands knew anything about them was a different story to be told.)
Mutual Aid contracts were fueled by who was drinking buddies with whom, who had slept with who, and just who liked who. I listened to Priority 1 calls be fielded out to services over 10 minutes away (if traffic/road construction wasn't going on which never happened on my side of paradise), while my truck sat in stone throwing distance from the call, just because that week, the owners of company A and B had a great time at the bar that weekend.
Moving up in the company was also something that just couldn't happen. I am one of those people who will always be a "blue shirt" (or minion, take your pick), not because I don't want to be in a leadership position, but because I enjoy working on the trucks. It seems as if when someone ascends to the role of supervisor (or "white shirt"), they, for some reason, decide that they've had enough with truck time, and are happy to sit around the station and annoy the hell out of their minions...ahem...co-workers.
That is not to say that I haven't gained the qualifications to do some of the lower ranking supervisory positions like Con-Ed coordinator, or ALS Coordinator, hell, even BLS Coordinator, I just wasn't in the "in crowd" (see also: drinking/sleeping buddies with the boss).
The straw that broke the camels' back was when I and 2 other co-workers who had been with the company for years, had been unceremoniously put in charge after the death of the station cheif. For the next three weeks, we worked hard to keep the station together, keeping employees from killing each other and the trucks on the road. At the end of that time, we were told that other employees, who had started with the company AFTER the Cheif's untimely demise, were the ones in charge. Three weeks of hard work were undone in a matter of minutes.
The ones in charge did not like the former cheif, and they did their best to get rid of those who did. I got screwed in ways I didn't know was physically possible. For a while, I contemplated getting completely out of the field. Why did I want to be a part of something that could turn people on each other like rabid animals? I felt like I was in a profession that condoned eating its own young. Fair play and cohesiveness were outlawed, it was all about back stabbing and trying to get dirt on whomever you could so that you could take it up the chain and maybe get a promotion. Good works didn't reward you, but playing dirty could make you a star.
After an especially horrific incident, I up and left. I'll admit, I went off like a firecracker when I found out what happened, and I up and left, but I felt like I had all the explination I needed. Loyalty to the company was no longer in style. I needed to play dirty to keep playing the game, and I wasn't about to do that.
I had decided about 6-8 months prior that it was time to move. I had a sit down with those closest to me and within a matter of a few days, it was decided. We needed, for the sake of keeping our sanity, to leave the state and start anew. Then came, as a sign from God that this was supposed to happen, the job opportunity of a life time. I couldn'tve designed a better job, so I jumped on that bandwagon, and rode it south, to where I reside now. I left a lot of good friends and better partners back home in search of EMS Nirvana, and well, lets just say that...this is close enough for government work.
In closing, I'd just like to say, thanks for sticking with me. I know I can get long winded, but hey, this is my blog and I'll do whatever the hell I want to with it. I plan on throwing in some field stories, some old, some new, some in between, and just general life stories. I'm sure the layout of the page is going to change more often than a frat boy changes girlfriends, so hold in there with me while I try to make up my mind...then again, it's the female peroggative to change it at a moments' notice.
Have a good one, and Be Safe!
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