tag:blogger.com,1999:blog-9872270956773599312024-03-14T08:21:46.466-04:00Blue Ridge MedicBlue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.comBlogger82125tag:blogger.com,1999:blog-987227095677359931.post-79590668292066353522012-03-17T08:51:00.002-04:002012-03-17T09:00:30.481-04:00Undecided...<span class="Apple-style-span" style="font-family:'times new roman';font-size:130%;"> Just got home from my last shift. Last night I sat down and re-read everything that I had written in the past. Now I sit here with my iPad in front of me wondering where to begin. I honestly don't have a clue. So much has happened in the last two years it's rather daunting when I stop to thnk about it. I also took the opportunity to look over my reading list of other bloggers. It seems that I'm not the only one who's been MIA, several others have stopped writing as well. Be that as it may, I wish them well in their endevours.</span><div><span class="Apple-style-span" style="font-family:'times new roman';font-size:130%;"><br /></span></div><div><span class="Apple-style-span" style="font-family:'times new roman';font-size:130%;"> Over the past 2 years I've seen a lot of changes, both in myself and in EMS. Personally, my daughter was born, I've gotten divorced, met someone else and fallen in love again, gained hopefully a little wisdom in both of those areas but by no means am I an expert in either. Professionally, I'd have to say the same. The fundamentls havent changed but ive seen two total protocol changes, lots of meds have left and new ones hace taken their place and the same with equipment. I'm considered a senior medic now with my service, only 3 others on my shift have more time in. I'm still teaching and I still love it. I've found a definite calling in being an instructor. It seems as though I'm fairly decent at it, if you take the students and staff comments and add in pass rates. I've also participated in 2 state and regional paramedic competitions, I'll be writing about those experiences later on. </span></div><div><span class="Apple-style-span" style="font-family:'times new roman';font-size:130%;"><br /></span></div><div><span class="Apple-style-span" style="font-family:'times new roman';font-size:130%;"> All in all, I feel like I've hit my stride in life. Sure, there are still quite a few things on my list of stuff I want to accomplish, but I'm a little more patient now and all things come to those who wait, or sonthy say. Till next time...</span></div><div><span class="Apple-style-span" style="font-family:'times new roman';font-size:130%;"><br /></span></div><div><span class="Apple-style-span" style="font-family:'times new roman';font-size:130%;">BRM</span></div>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com8tag:blogger.com,1999:blog-987227095677359931.post-32054284391589368572012-03-17T00:16:00.004-04:002012-03-17T01:06:20.276-04:00Long time coming<span class="Apple-style-span" style="font-family:'times new roman';font-size:130%;">Wow, it's been a long time since I've even taken a look at this blog. For whatever reason I've been thinking about it for the last few days. So today I read through all of my old posts and had a little reflection time. Thinking about all that has happened in the past few years. I reckon I might try this writing thing again and see how it goes. </span><div><span class="Apple-style-span" style="font-family:'times new roman';font-size:130%;"><br /></span></div><div><span class="Apple-style-span" style="font-family:'times new roman';font-size:130%;">BRM</span></div>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com3tag:blogger.com,1999:blog-987227095677359931.post-35291458372990259152009-10-12T21:39:00.002-04:002009-10-12T22:11:42.610-04:00Trauma...<span style="font-family:times new roman;font-size:130%;">OK, I know I haven't posted in forever but I got to put my two cents in on this new show "Trauma." I've been reading other posts, websites and NBC's site and this show is getting a lot of shit. I don't understand what the problem is.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Yea, OK it's not exactly realistic. Every episode so far is packed with some kind of MCI and you got medics doing outlandish stuff that most people in this job never see or do. But guess what? It IS TV! What show on the air is true to life? Do you think anyone would actually tune in to see a crew doing granny totes, sick calls and dialysis runs for an hour? Hell no they wouldn't. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Now, what about other TV shows out there that are emergency or medical based like Rescue Me, ER and House? Does anyone think that everything that happened on ER was true to life? I saw false intubations, doctors defib asystole and many other things. Yet, that show went on forever and was critically acclaimed.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">How about Rescue Me? I love that show and I've been a fireman for 15 years. Yet it portrays us in a completely negative way. That show is nothing but drinking, drugs, screwing, adultery, abusing, murdering, lying and cheating with a few fires thrown in for good measure and it has been on the air for several years.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">And House? I love that show too, never miss an episode. But does the public think that every doctor is like House? Does the public or anyone for that matter think that medical professionals act that way in the hospital? I would have to say no, they realize that it is TV.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">The next beef I have is with people wishing there would be a new "Emergency" with ole Johnny and Roy or their comparing Trauma to Emergency. Have any of these people actually seen Emergency? Johnny and Roy were always going to some major wreck, heart attack, something blowing up or falling in. Granted, I wasn't around back then, but my dad was and he said that was bullshit back then just like it is today. So stop comparing everything to Emergency.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Another one that most people love was Mother, Jugs and Speed. I agree it was a great movie, but what happened in that one? An EMT accused of having dealings with drugs, another that smoked weed and the star drinking while driving on shift. Plus sex in the back of the rig, yet people loved that movie. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">One other show that still comes on Discovery was "Paramedics." A reality show based on us. Even they just showed the juicy stuff, and very little of routine day to day.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I just don't get it. I'm kinda glad that we finally got a show of our own. They cancelled the last one "Saved." I wish people would shut the hell up so maybe this would might stick around for more than one season. There are a ton of cop shows and very few fire or EMS shows. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Just remember, it's TV! Not reality!</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com7tag:blogger.com,1999:blog-987227095677359931.post-8723759002600003592009-05-21T20:11:00.001-04:002009-05-21T20:13:02.599-04:00Another Great Read....<span style="font-size:130%;"><span style="font-family: times new roman;">...and very educational too.</span><br /><br /><a style="font-family: times new roman;" href="http://ems12lead.blogspot.com/">Prehospital 12 Lead ECG</a><br /><br /><span style="font-family: times new roman;">Enjoy...</span><br /><br /><span style="font-family: times new roman;">BRM</span></span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com4tag:blogger.com,1999:blog-987227095677359931.post-83908861106985810962009-05-21T11:59:00.003-04:002009-05-21T12:35:58.854-04:00Vindicated...<span style="font-size:130%;"><span style="font-family: times new roman;">Ran into a bit of trouble a while ago. All over a damn refusal...</span><br /><br /><span style="font-family: times new roman;">Got a call for a CVA. We get there and this guy ain't having a stroke. All he had was numbness on one side of his leg, which he had a history of. His grand daughter was there, freaking out and she was the one who called us. He didn't want to go, he didn't want her to call 911. So of course he refused. He let us take his vitals and do a stroke screen on him. All were normal. We let him and his granddaughter know that he hadn't been examined by a physician and that we could not tell him definitively that he wasn't having a stroke and that we would be happy to take him to the hospital. He refused all of that. He was obviously competent and he was now informed of his condition. I felt he had every right to refuse further care and transport. So he signed my paper and we left.</span><br /><br /><span style="font-family: times new roman;">About 3 hours later we get called to the local band-aid station for an emergency transport to the big city hospital for a stroke transfer. We get there and it's him. The charge nurse is pissed and she doesn't even give us a report, just points us towards the bed. We walk over and talk to him. The patient has no clue that he is being transferred or why. He said he only came to the hospital to shut his granddaughter up. We load him up and start towards the truck. That's when the nurse grabs my arm and tells me that the patient should have been transported from the scene and she will be making a complaint for further investigation about the situation. My reply was "OK" and we continued to transport.</span><br /><br /><span style="font-family: times new roman;">Later that day the quality assurance guy from our service comes to call on us. He asks what happened, he already had a copy of my report so I told him that it was all there. He wanted to know more, so I pretty much told him the same thing that I had typed. In a round about way, he accused me of selling the refusal or encouraging the patient to refuse. Well that pissed me off and I let him know it. I asked him if he and everyone else in management didn't trust my judgment as a paramedic, then why in the hell was I out there on the road? Why was I able to function as a medic at all if he was going to question everything that I did? He finally left. The next day the charge nurse came to me and apologized for her actions. I accepted and I thought that was that. I was wrong.</span><br /><br /><span style="font-family: times new roman;">Apparently he and the charge nurse are good buddies and he wasn't about to let it go. The next week I was at the office and he calls me into his little corner. He shows me a customer service questionnaire that he says that he sent to the patient about that call. He said that he had made this little form up some time ago but had never sent it to any patient so far. So this would be the first. Well, I start to get pissed all over again, but I managed to keep my cool. I asked him if he was going to start sending these out on a regular basis. He said no. I asked if he was even going to send them out randomly, he said no again. His explanation was that the budget wouldn't allow for it. </span><span style="font-style: italic; font-family: times new roman;">Bullshit</span><span style="font-family: times new roman;"> I thought. So I asked, "This is the only survey that you have ever sent out and the only one you're ever going to send out?" He just looked at me and I just about lost it. I turned to walk out and over my shoulder I said, "This sounds a whole hell of a lot like discrimination to me." I kept walking before he could reply. </span><br /><br /><span style="font-family: times new roman;">I left the office steaming. I felt like this was a fucking head hunt and my head was on the chopping block. I also found out that the patient in question got sent home the same day, actually within a few hours of us taking him there. He wasn't having a stroke. I guessed our Q/A guy found that out and it just pissed him off that much more, since I was right about the patient. But that didn't change the fact that I had pissed off his buddy.</span><br /><br /><span style="font-family: times new roman;">Well a couple of weeks go by and I get an email. It's the survey, apparently the patient had filled it out and sent it back in. It contained an excellent review of my care, on both calls; the refusal and the transport. It even had a handwritten comment saying how good the care was. I think I laughed out loud when I read it. It must have put a burr in his ass to get that back in the mail. </span><br /><br /><span style="font-family: times new roman;">So now I am fully vindicated...</span><br /><br /><span style="font-family: times new roman;">BRM</span></span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com3tag:blogger.com,1999:blog-987227095677359931.post-7695583958325062722009-05-19T00:38:00.002-04:002009-05-19T00:40:46.179-04:00Great Reads...Two new blogs I recently happened upon. They've been around a while, but I'm...well...a little slow..<br /><a href="http://www.pinkwarmdry.com/blog/"><br />Pink, Warm and Dry</a><br /><br /><a href="http://paramedicine101.blogspot.com/">Paramedicine 101</a>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com2tag:blogger.com,1999:blog-987227095677359931.post-35077922634250275162009-05-15T19:13:00.003-04:002009-05-15T19:31:45.679-04:00Transferred...<span style="font-size:130%;"><span style="font-family: times new roman;">In my three short years working for my current employer I have now worked at every station. They call me the shift whore. I am usually the one that has to move around when a Medic is needed to work with an Intermediate or Basic. But now a co-worker has been injured and my semi-permanent station is the farthest from civilization that you can get in our county. It's over an hour to the nearest major hospital from our response area and that's going emergency traffic. </span><br /><br /><span style="font-family: times new roman;">We also get the fewest calls of all the stations. That in itself isn't so bad, I get plenty of time to sleep, work on lesson plans for my teaching, read and stare at the walls. When we do get a call it usually takes about 3 hours to get back to the station.</span><br /><br /><span style="font-family: times new roman;">Yesterday we traveled through 4 different counties, not counting our own and went to 5 different hospitals for a total of 7 calls. Most of them were bullshit, one actually needed to go. That one was a bad breather. Her house was sweltering and her rain-barrel girth and permanent growth in the shape of a cigarette glowing at the end of her fingers certainly didn't help. I wanted to tell her this but didn't, just put her on O2, loaded her up, gave her a few nebs and listened to her talk in a raspy voice for the 78 minute transport.</span><br /><br /><span style="font-family: times new roman;">Anyways....I reckon that's enough bitching for the time being...Till next time..</span><br /><br /><span style="font-family: times new roman;">BRM</span></span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com1tag:blogger.com,1999:blog-987227095677359931.post-41567712031097966412009-05-06T23:02:00.003-04:002009-05-06T23:22:31.569-04:00One of My Very Own...<span style="font-size:130%;"><span style="font-family:times new roman;"> These past few months have seen a couple of my career goals come to light. I finally finished my Level I EMS Instructor. That took almost a year and a half to complete. The other is finally getting my own EMT class. I got a call the other week by the coordinator of the EMS program of the local community college that I have been teaching part-time for. It seemed like he was in a bit of a bind and my name popped up on his radar.</span><br /><span style="font-family:times new roman;"> </span><br /><span style="font-family:times new roman;"> Apparently there was a course scheduled for this summer that didn't have a maximum capacity, or someone forgot to put a cap on it when they did the paperwork before the class began. Well, to make a long story shorter, there was over 40 students that showed up for the first day and no where to put them all. Hence why I got a call.</span><br /><br /><span style="font-family:times new roman;"> I had made it known that I wanted my own class for some time now, whenever the powers that be deemed me experienced enough to handle it own my own. Evidently, that time has now come. So for the last few days I have been running around trying to put a lesson plan together, go through all the presentations and generally getting everything ready.</span><br /><br /><span style="font-family:times new roman;"> The night before the first class I was nervous as hell. At first I couldn't really understand why. I had been teaching for some time now, and I knew that I knew the material. I don't have a problem with standing in front of people and talking. So why was my gut in knots and my hands all sweaty?</span><br /><br /><span style="font-family:times new roman;"> Then it hit me. This one was all mine. Whether the students pass or fail will ultimately rest on my shoulders. Plus, if I am ever to continue on to further goals, like being a training officer or a coordinator of a program, this was the first step. I figured that if I fuck this up, I probably won't get another shot for awhile, if ever.</span><br /><br /><span style="font-family:times new roman;"> Now I know that not all students will pass. The drop-out/ fail-out rate is almost 50% in EMT-Basic courses around here. I have dealt with problem students of many different types and been through many courses on how to deal with various learning styles, etc, etc.</span><br /><br /><span style="font-family:times new roman;"> As far as my teaching style...well...I try to roll with the punches that come and also try to get the information to the students in as many ways possible. That way, hopefully, most if not all will understand the material, pass the test and ultimately become good EMT's. </span><br /><br /><span style="font-family:times new roman;"> So..with all that in mind, I got some more work to do....</span><br /><br /><span style="font-family:times new roman;">BRM</span></span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com2tag:blogger.com,1999:blog-987227095677359931.post-11711206571843116812009-01-30T23:13:00.001-05:002009-01-30T23:14:41.289-05:0025,000....<span style="font-size:130%;"><span style="font-family: times new roman;">25,000 visitors and counting. YeeHaa!!!</span></span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com3tag:blogger.com,1999:blog-987227095677359931.post-24993724210082940532009-01-28T11:35:00.002-05:002009-01-28T11:51:12.542-05:00On Learning...<span style="font-size:130%;"><span style="font-family: times new roman;">I had an instructor who once said that you can learn something from everyone that you come in contact, no matter for how long. I kinda took that to heart and now try to apply it to my work as well. I tell my students the same thing. Every patient that you come into contact with, you can learn a little something if you want to.</span><br /><br /><span style="font-family: times new roman;">Even if it's just a routine doctor's office visit or a dialysis run, you can learn. If not from the person, due to being in a comatose state, then their chart and medical information. I always try to keep this in mind as I go about my job. I think it helps.</span><br /><br /><span style="font-family: times new roman;">The other night we got dispatched for a psych transfer. The address was all too familiar. It was Joe again. Joe is a mentally and physically handicapped, 25 year old who is also deaf. He lives with his mother and grandparents. We go out to their house at least once a month when Joe decides to get angry and either hit one of his caretakers or throw stuff around. Tonight was no different.</span><br /><br /><span style="font-family: times new roman;">You really can't blame the guy. He has the mental capacity of a 6-8 year old. Like any kid with that mentality, he pitches a fit once in a while. The problem is that he is exceptionally strong. I've seen him toss around 2 deputies from his wheelchair when he really gets going. </span><br /><br /><span style="font-family: times new roman;">When we got there the cops had him handcuffed and everyone was sweating. After a while Joe calmed down and stated that he wanted to go to the hospital, so they took the cuffs off. His case worker was there and she basically told him that he was going away for a while, it wasn't going to be just an overnight thing. He seemed to understand and was OK with it. He went about packing his things.</span><br /><br /><span style="font-family: times new roman;">We got him into the truck and I climbed in after him. Knowing how he is, I tried to keep him calm and in a good mood. It seemed to work. For some reason, even though I didn't know how to use sign language, he kinda took to me. He showed me his comic collection that he had brought along and through simple gestures and writing, he told me about the video games he liked. He even taught me a little sign language. I really enjoyed the ride with him. </span><br /><br /><span style="font-family: times new roman;">We got him to the hospital without a problem and got him into his room. He promised to be good to the staff and we left. My partner was just kinda looking at me on the way back. I asked her why. She said that she had never seen anyone be that way with him before. Most people just stay away from him and leave him alone for fear of provoking an attack. I told her that wasn't the way I do things. After all, he is just a big kid.</span><br /><br /><span style="font-family: times new roman;">BRM</span></span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com1tag:blogger.com,1999:blog-987227095677359931.post-62740616635824414032009-01-02T21:39:00.003-05:002009-01-02T22:29:09.036-05:00Ice...<span style="font-family:times new roman;font-size:130%;">I left for work this morning a bit early. So I could take my time. You see, this morning we got our first taste of winter weather. It was sleeting a bit when I left, it was really putting it down by the time I got to the station. Usually it takes me about 20 minutes to get to work, this morning it was more like 35-40. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;"><span style="font-size:130%;">Does this seem complicated? I watched the weather the night before and saw that there was a good chance of bad weather coming in. So I got up and got ready <em>early.</em> Then I left for work <em>early.</em> So I wouldn't have to rush, and so I could go <em>slower</em> and be more <em>careful. </em></span></span><br /><em><span style="font-family:times new roman;font-size:130%;"></span></em><br /><span style="font-family:times new roman;font-size:130%;">Now I know that many people may not have a TV, or watch the weather if they do. But when you get into your vehicle and there is white stuff falling from the sky and there is a whole bunch of this white stuff covering the ground and roads, is it that much of a stretch to begin to think that it may be a slightly dangerous situation?</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Apparently not around here. The really dangerous situation is when you get this white stuff falling from the sky and a human with a 4-wheel drive vehicle and open road in front of them. There were a lot of said people out this morning. We had 7 in 30 minutes just in my area. I have no idea what the total for the county was, but it was a lot.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">People don't seem to realize that, on ice, it doesn't make a difference what type of vehicle you have. To prove this fact, I was once on a military base during the winter. I saw a full sized tank driving along on a cement pad outside of the motor pool. It hit the ice and went sideways and there was nothing the driver could do about it. So if a tank slides on ice, what makes u think your shiny new 4x4 is gonna just drive right on through? </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Luck was with us and everyone else today though. I can't imagine what the monetary cost was for all the damage done, but as far as I know no one was seriously hurt. The other lucky thing was that the schools are still out for Christmas break. I can only imagine what it would have been like with all the kids on the roads this morning.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com4tag:blogger.com,1999:blog-987227095677359931.post-42297301368617782332008-12-16T23:06:00.003-05:002008-12-16T23:45:45.815-05:00No Idea...<span style="font-family:times new roman;font-size:130%;">Had a call last shift and like many calls that I run, I have no idea what was going on...</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">The call was for a respiratory distress on a child. We get to the daycare center where the call was and go inside expecting to see a child in distress. Instead we see a smiling, laughing, playing kid. The workers at the facility said that the little patient had turned blue. Now, when you get a call for respiratory distress call and the people on scene say the patient was blue, you expect the face, or at least the lips and maybe nail beds to be blue right? <em>Wrong</em>. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">They said that the patient's feet were blue, well actually everything from the knee down. I asked if he was having trouble breathing? <em>No</em>. Wheezing? <em>No</em>. Crying? <em>No</em>. Did it seem as though he was in pain? <em>No.</em> Acting different than normal? <em>No</em>. What was he doing before, during and after? <em>Nothing, just playing</em>. Hmmm... So he wasn't acting like there was anything wrong with him at all? <em>No.</em> They just noticed that his legs were blue. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">The patients legs and feet were fine when we got there. The first responders who got there before we did said that the kids feet were a bit cyanotic, but quickly returned to normal. I continue my questioning...</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Any past medical history, medications, allergies? <em>No to all. </em>Last meal and what was it? <em>Lunch, mac-n-cheese and apple juice, same as every Tuesday.</em> Did you change the brand of food, drink anything? <em>No.</em> Any new people, toys, carpet, anything new at all? With a weird look, they answer no to all. Well, I'm completely stumped at this point. Either they don't know this child's complete medical history, or they are hiding something to try to keep themselves out of trouble. The patient is too young to talk to me, so I can't ask him any questions. But my partner has been playing with him and checking him over. She tells me that the kid seems fine, nothing wrong that she can see. Vitals are fine, cap refill is good, lungs sounds good, neuro check is good and he seems to be acting like a kid his age should act.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Then the grandmother shows up and I find out that she is the child's primary caregiver. She tells us that the history is slightly skewed from what we were told. The patient was a preemie, and only 2 pounds when born. But the kid is 16 months old. I ask her if he had any medical problems? <em>No, none at all, his doctor said he was the picture of health. </em>I ask if there was a reason that he was a preemie? She darts her eyes away from me. I tell her that I need to know if I am to make an informed decision about her grandson. She leans in and tells me that the child's mother was a meth addict. I ask her all the same questions that I asked the staff and get the same response. No other history, and nothing new around the child.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I tell her that he seems to be fine now. And that, according to the staff, the child displayed no other symptoms during the episode. I tell her that if it was my child that I would want this to be checked out by a physician, at the very least, his regular doctor. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">She doesn't want him to go to the ED, nor be transported by us. But says that she will call the doctor and see if he can be seen today. She signs the refusal and we leave.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I have no idea what would cause this. My first thought was cardiac. But if it was his heart, I'd think it would have systemic symptoms. At least it would have involved his other extremities, not just his legs. My other thought is maybe a congenital defect that hasn't been found yet. Maybe some kind of peripheral vascular defect in his legs. Maybe it was some sort of arterial spasm. I've never heard of it in a kid, nor just in the legs. But who knows? I'm just a paramedic...</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com1tag:blogger.com,1999:blog-987227095677359931.post-27018929852085200962008-12-01T20:09:00.003-05:002008-12-16T23:51:53.528-05:00When God Make Paramedics...<span style="font-family:times new roman;font-size:130%;">...an oldie, but goodie...<br /><br />When God made paramedics, He was into His sixth day<br />of overtime. An angel appeared and said, "You're doing a lot of fiddling around<br />on this one." God said, "Have you read the specs on this order?<br /><br />A Paramedic has to be able to carry an injured person up a wet, grassy hill in the dark, dodge stray bullets to reach a dying child unarmed, enter homes the health inspector wouldn't touch,<br />and not wrinkle his uniform."<br /><br />"He has to be able to lift three times his own weight. Crawl into wrecked cars with barely enough room to move, and console a grieving mother as he is doing CPR on a baby he knows will never breathe again."<br /><br />"He has to be in top mental condition at all times, running on no sleep, black coffee and half eaten meals, and he has to have six pairs of hands."<br /><br />The angel shook her head slowly and said, "Six pairs of hands...no way."<br />"It's not the hands that are causing me problems," God replied. "It's the three pairs of eyes a medic has to have."<br />"That's on the standard model?" asked the angel.<br /><br />God nodded. "One pair that sees open sores as he's drawing blood,<br />always wondering if the patient is HIV positive." (When he already knows and wishes he'd taken that accounting job) "Another pair here in the side of his head for his partner's safety. And another pair of eyes here in front that can look reassuringly at a bleeding victim and say, "You'll be alright ma'am when he knows it isn't so."<br /><br />"Lord," said the angel, touching His sleeve, "rest and work on this tomorrow."<br />"I can't," God replied.<br />"I already have a model that can talk a 250 pound drunk out from behind a steering wheel<br />without incident and feed a family of five on a private service paycheck."<br /><br />The angel circled the model of the Paramedic very slowly.<br />"Can it think?" she asked.<br /><br />"You bet", God said. "It can tell you the symptoms of 100 illnesses; recite drug calculations in it's sleep; intubate, defibrillate, medicate, and continue CPR nonstop over terrain that any doctor would fear... and it still keeps it's sense of humor."<br /><br />"This medic also has phenomenal personal control. He can deal with a multi-victim trauma, coax a frightened elderly person to unlock their door, comfort a murder victim's family, and then read in the daily paper how Paramedics were unable to locate a house quickly enough, allowing the person to die. A house that had no street sign, no house numbers, no phone to call<br />back."<br /><br />Finally, the angel bent over and ran her finger across the cheek of the Paramedic.<br /><br />"There's a leak," she pronounced.<br /><br />"I told You that You were trying to put too much into this model."<br /><br />"That's not a leak," God replied, "It's a tear."<br /><br />"What's the tear for?" asked the angel.<br /><br />"It's for bottled up emotions, for patients they've tried in vain to save, for commitment to that hope that they will make a difference in a person's chance to survive, for life."<br /><br />"You're a genius!" said the angel.<br /><br />God looked somber.<br /><br />"I DIDN'T PUT IT THERE" He said.<br /><br />Author Unknown<br /><br /><br />BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com4tag:blogger.com,1999:blog-987227095677359931.post-84352033754752726782008-11-24T21:12:00.000-05:002008-11-24T21:13:27.156-05:00Whoo...<a href="http://www.namethatdisease.com" title="Name that disease"><img src="http://www.namethatdisease.com/images/badges/badge-9.gif" width="200" height="100" border="0" alt="NameThatDisease.com" /></a><br />NameThatDisease.com - http://www.namethatdisease.com">Name That Disease<br /><br /><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com3tag:blogger.com,1999:blog-987227095677359931.post-6629696653299008472008-11-24T20:57:00.000-05:002008-11-24T20:58:06.607-05:00Another Article...<span style="font-family:times new roman;font-size:130%;">Here's another article about problems in EMS...</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><a href="http://kob.com/article/stories/S661228.shtml?cat=10134"><span style="font-family:times new roman;font-size:130%;">http://kob.com/article/stories/S661228.shtml?cat=10134</span></a><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com2tag:blogger.com,1999:blog-987227095677359931.post-53788324991174327082008-11-20T20:30:00.002-05:002008-11-20T20:32:54.884-05:00Can 911 Be Saved?...<span style="font-family:times new roman;font-size:130%;">I read this </span><a href="http://www.menshealth.com/cda/article.do?site=MensHealth&channel=health&category=doctors.hospitals&conitem=7933ba9f6197d110VgnVCM20000012281eac____&page=1"><span style="font-family:times new roman;font-size:130%;">article</span></a><span style="font-family:times new roman;font-size:130%;"> on the Men's Health website. Finally some support for EMS...</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com3tag:blogger.com,1999:blog-987227095677359931.post-21441921122581172062008-11-19T12:21:00.002-05:002008-11-19T12:53:48.318-05:00Reasons...<span style="font-family:times new roman;font-size:130%;">I'd bet money that just about everyone in EMS, no matter their level of practice, has been asked why they do what it is they do. And if they have been doing this job for any number of years, they've been asked why or how they have stayed in as long as they have. I was asked the other day by one of my EMT students. I've been asked several times over the years. It seems that my answer changes over time.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Originally it was about the rush. You know what I'm talking about. The feeling you get when the pager goes off. You rush to the rig and tear off with lights blazing and siren wailing. Get to the call and maybe get to do a bunch of cool shit, see someone all fucked up. Then after it's all over you sit back, beat your chest and holler at the moon to let everyone know how stoked you feel.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Don't get me wrong, helping people is a major reason that people, including myself, got into this business. But the rush is equal or greater than the want to help people. If anyone reading this is honest with themselves, I believe that they will agree with me. People may initially get into EMS for helping people, but the rush keeps them coming back.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Now, 13 years have passed since I ran my first call as a spunky teenager. The rush is still there, sometimes. Other times, not so much. At times, I find myself falling asleep while my partner drives us emergency traffic to the call. It's not that I'm burned out, far from it. But like </span><a href="http://ambulancedriverfiles.blogspot.com/2008/10/scorched-earth.html"><span style="font-family:times new roman;font-size:130%;">AD said once</span></a><span style="font-family:times new roman;font-size:130%;">, either you find something to love about EMS, or you get out. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Even before the rush, there was my Dad. He got his paramedic a year before I was born. To say that I grew up in this business is an understatement. My daycare was the EMS station. The ladies that did the billing were like surrogate mothers to me. Hell, I even had my own locker with a blanket and GI JOE's, complete with toy ambulances. Until my Dad left EMS in the late 80's to be a flight medic, I lived at the EMS station; eating, sleeping and helping the guys wash the trucks. (I was the tire washer....)</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">For many years I was in the fire dept and volunteered as a first responder. But my inherent disregard for authority led me to rebel against my Dad and his chosen profession. I have to give it to him though. Even though he loved EMS and medicine in general, he never pushed it on me, he let me make my own decisions as far as my career was concerned. So I never even considered it as a career till about 5 years ago when I finally realized that I couldn't run away from it any longer. Nothing else I did was ever satisfying. I'd learn everything I could and usually excel in whatever it was I was doing. Then I'd hit that wall. Either there was nothing else to learn, or I couldn't advance my position to be able to learn any more for one reason or another.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">So I turned to EMS and I haven't looked back since. In medicine, I found an ever satisfying subject. There is just so much about the human condition that no one person will ever know it all. So I found "it". The thing that could keep me busy for the rest of my life. That's the real reason I'm in EMS. I can never learn it all, there will always be something else to learn.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">The second reason that has came around in the past year or so is teaching. I love to teach. I realise that in the grand scheme of things, I don't know much. But what I have learned, I enjoy passing that knowledge on to others. That's the only thing I can see myself doing other than being a field medic. I would someday like to be a training officer, or maybe over a medic program at a local college.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Those are my reasons for doing this and sticking around....</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com1tag:blogger.com,1999:blog-987227095677359931.post-35065677265299336962008-11-07T07:47:00.003-05:002008-11-07T08:33:40.557-05:00Instincts...<span style="font-family:times new roman;font-size:130%;">Have you ever ran a call that made the hairs on the back of your neck stick up? You know that feeling that something just isn't right? Well, if you ever get those feelings, you need to pay attention. Your mind and body are trying to tell you something...</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">We get dispatched to an obscure address for a respiratory distress. Dispatch tells us that its beside a church, but no other information is available. But if memory serves me right, that church is abandoned. We arrived to find an old pickup sitting next to the church. I can see someone inside the truck. The windows are up, the doors closed and the vehicle isn't running.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I get out of the rig and it hits me. <em>Something isn't right here.</em> For one, if it is a respiratory distress, most people wouldn't be sitting cramped up in a vehicle when its over 70 degrees outside. I would imagine the door would be open to try to get some fresh air. Maybe even sitting with their feet on the ground, tripoding, etc. depending on how bad they were struggling to breath. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I make my way around the back of the truck, keeping a good distance. The windows are tinted so I can't see much inside. But I can see that the person isn't moving. Looking around the scene, there is nothing out of the ordinary. Nothing that would raise my suspicion level. It's the truck, or rather the person in the truck that's got me worried.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I continue to walk around the vehicle towards the drivers side door, keeping my distance. The hairs on the back of my neck starting to raise and someone has dropped a large rock in the pit of my stomach. As I get level with the driver, I can see it's a man. He doesn't seem to be in any respiratory distress from where I'm standing. Plus, he doesn't look at me. It's like I'm not even there. He continues to ignore me as I holler at him, approaching slowly. My partner has sensed my hesitation and is slowly bringing the cot and equipment out of the truck, keeping his eyes on me. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I get to within a few feet of the truck and the driver is still not paying me any attention. I move towards the front, in his line of sight and he still ignores me. I can see that he is alive. I can see him breathing and his eyes blinking. That's enough for me, I holler at my partner and tell him to get on the radio and get the cops here, now. We are right down the street from the sheriffs office, so it shouldn't be long before they get here. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I start to back off, keeping my eyes on the driver, not daring to turn my back. Just then my foot hits something and over I go. I land on my ass and see the rock sticking out of the ground that my heel struck. I hear my partner hollering and I look up. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I see the driver standing outside the vehicle. <em>How the hell did he get out of the truck that fast?</em> He has his hands in the pockets of a jacket that seems a bit too big. I can see his eyes. They seem blank. I don't know how else to say it, it was like the lights were on but no one was home, literally. Because I started talking to him and it made no difference. He was looking at me, but other than that, nothing, no response at all.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">He takes one step towards me and stops. I start backing up, pushing with my hands and the bottoms of my feet. Trying to put distance between the two of us. I see his arms start to move. Then I see a something from a nightmare coming out of the pocket of his jacket. Flat black, metal and dangerous. A gun.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I get to my feet in the blink of an eye as he raises it level with my face. In an instant I am covered in sweat and my heart leaps into overdrive in my chest. It's amazing how big the barrel of a gun looks when it's pointed straight at you. My mind does some quick calculations. I am too far from him to jump at the gun and try to knock it away and there is nothing around me but open ground, so no help there either.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><em><span style="font-family:times new roman;font-size:130%;">This is it, end of the line for you BRM... I close my eyes and a picture of my family jumps before me. I whisper a prayer and hope that it's a clean shot and it doesn't hurt...</span></em><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I open my eyes and he is just looking at me. Then he moves his hand and puts the barrel in his mouth. The report is loud, but not as loud as I would have thought. I feel something wet hit me in the face as he falls to the ground. I can't move. I can't speak. I can feel someone shaking me. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I turn to see my partner is holding me by the shoulders, shaking me and saying something, but I can't hear him. I look back at the guy on the ground. His eyes are still open. The expression hasn't changed, still that blank stare. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Slowly my hearing seems to return and I hear approaching sirens and my partners voice, screaming at me now. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">"I'm OK," I say. I remove his hands and wipe my face. My hand is red. I turn and walk back to the ambulance and sit on the tail board, my expression blank... </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">The entire event took less that 10 minutes.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span><br /><span style="font-family:times new roman;font-size:130%;"></span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com8tag:blogger.com,1999:blog-987227095677359931.post-19489482002808704802008-11-02T22:01:00.004-05:002008-11-19T13:46:33.050-05:00"This ain't basket weaving...<span style="font-family:times new roman;"><span style="font-size:130%;">...these are people's lives you're dealing with."<br /><br />That's a quote from my EMT-Basic instructor. He said it on the first day of class. He was trying to make us understand the gravity of the subject we were about to learn. Since then I've taken this statement to heart and used it in my own classes and with students that I precept.<br /><br />A few days ago I got switched to another station and worked with an Intermediate that was in Medic school. He was a month from graduating. I figured that I wouldn't have to do too much those 2 shifts. He should be able to function pretty much without me. Boy, was I wrong...<br /><br />First call we get is for chest pain. The first mistake he makes is taking the clipboard in with him. Leaving me to get the stretcher and equipment. I follow him into the house to find him writing down basic demographic info on a patient who looks like shit; pale, sweaty, breathing about 30 times a minute and I can hear her gurgling from across the room. He has no equipment, so he hasn't even taken a blood pressure, nor has he asked her anything except her name, social security number, date of birth and phone number. I quickly step in and do a quick assessment and direct the patients son to help me get her on the stretcher.<br /><br />My student/ partner gets the idea and finally helps us wheel her out to the truck, forgetting the monitor and jump bag in the process. Eventually he gets everything back to the truck and starts helping me treat our patient. He wants to give her <span class="blsp-spelling-error" id="SPELLING_ERROR_0">nitro</span> and aspirin before the IV, monitor or even a B/P. I calmly give him the cuff and stethoscope and point to her arm as I get her on some oxygen while asking her all the pertinent questions.<br /><br />Eventually we get all the basics done and I move some leads around to see if that big fat inferior MI has a friend. Sure enough, she's got an associated right sided MI as well. My partner is looking at me as if I just grew a second head as I do all this. I really wanted to have him back here on this one so he could maybe learn a thing or two. But I can't wait, we've been on scene for almost 10 minutes as it is. I just tell him to drive...<br /><br />After the call he just sits there in the drivers seat and asks no questions whatsoever. I'm not sure if he's thinking it over, or he really isn't curious about what I was doing and what was wrong with our patient. When I was in his position, you wouldn't have been able to shut me up for all the questions I would have been asking.<br /><br />I let this go on till we get back to the county line. Then I start asking him questions. Like, what the hell was he thinking not taking anything in with him? Why was he asking demographic questions instead of accessing the patient? etc, etc. As we move on in my questioning I start to quiz him on his drugs. That's when I start to get even more concerned. The boy doesn't even know his basic drugs. Like the dose for aspirin, <span class="blsp-spelling-error" id="SPELLING_ERROR_1">nitro</span>, charcoal and the like. So once we get back to the station we go over every <span class="blsp-spelling-corrected" id="SPELLING_ERROR_2">drug</span> in the box...all 46 of them. I tell him that I'm gonna give him another quiz later that night. Well, he studied some, but retained nothing. Eight hours later, he couldn't remember anything we went over that morning.<br /><br />I get almost <span class="blsp-spelling-corrected" id="SPELLING_ERROR_3">disgusted</span> when he starts to blame his instructor. I tell him that the EMT-Paramedic course is a college level class, taken at a college, this isn't grammar school. You have to take the initiative to learn on your own, to study on your own and to ask for help if you need it. He seems to understand and take what I am saying to heart.<br /><br />The next shift is no better. He still knows nothing of his drugs, <span class="blsp-spelling-error" id="SPELLING_ERROR_4">ACLS</span>, <span class="blsp-spelling-error" id="SPELLING_ERROR_5">ITLS</span>, or even his own <span class="blsp-spelling-corrected" id="SPELLING_ERROR_6">protocols</span>. I'm not sure if I should just give up, help him, or brow beat the hell of out him.... I end up spending the rest of the shift trying to give him a crash course in <span class="blsp-spelling-corrected" id="SPELLING_ERROR_7">pharmacology</span> and patient assessment. I have no idea if it did any good or not. It scares the hell out of me that there is a <span class="blsp-spelling-corrected" id="SPELLING_ERROR_8">possibility</span> that he will eventually be out there on the streets treating patients, maybe even me or my family...<br /><br />I just don't understand some of the students nowadays. Maybe I'm just too hard on them or try to judge them against myself. When I was in class, we had to make at least an 80 on every test and keep an 80% average or we were gone. My thinking on this was...if I make an 80, then statistically I know 80% of the information. What if I need that other 20% to help someone, or what if someone dies that could have been saved because I didn't know that 20%? Now I made 100% on a lot of tests...but not all, not by a long shot. But that made me sit down and study even harder to learn what I had gotten wrong. And even making a 100 doesn't mean that you know all the material.<br /><br />I didn't fuck around in class like many of my other classmates, I didn't make fun of others that were called to the front to do a <span class="blsp-spelling-corrected" id="SPELLING_ERROR_9">mega-code</span> and didn't do the best. I was usually one of the ones that always raised his hand when the class was asked for an answer and I often made the class longer than usual because of my questions. For this I was dubbed "Rescue 911" from some of my classmates. But I didn't care, because I knew that eventually it would be my ass out there with a life possibly on the line.<br /><br />I haven't changed my thinking or reasoning on this subject and I doubt I ever will. Because this ain't basket weaving, these are peoples lives we're dealing with....<br /><br /><span class="blsp-spelling-error" id="SPELLING_ERROR_10">BRM</span></span></span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com2tag:blogger.com,1999:blog-987227095677359931.post-8328764768338752372008-10-17T20:44:00.005-04:002008-11-02T22:00:17.133-05:00Story....<span style="font-family:times new roman;font-size:130%;">I want to share a story with you... This story is about two people. One of them is an 18 year old girl. </span><br /><br /><span style="font-family:times new roman;font-size:130%;">Jessica woke up to the sound of her alarm clock and her mother hollering from down the hall. She didn't feel like it, but she rolled outta bed and planted her feet on the carpet and stretched. The sun was just making its way over the horizon and it promised to be a beautiful day. Jessica made her way to the bathroom and showered, put on clean clothes and sat before her mirror brushing her long dark hair. She paused to put a picture or two in an album that was laying on the table. A project of hers that she had been working on. It was filled with photos of her family, her dog, her friends at school and her boyfriend whom had recently asked her to the prom. She was so excited about it. Her and her girlfriends were planning to go dress shopping today after school.</span><br /><br /><span style="font-family:times new roman;font-size:130%;">She looked up at the clock on the wall and realized that she was gonna be late. She sent a text message to her boyfriend not to look for her before school and another to her friend whom she gave a ride to saying that she was running behind.</span><br /><br /><span style="font-family:times new roman;font-size:130%;">Running downstairs she grabbed her books and her keys, gave a quick kiss to her father reading the paper at the kitchen table and out the door she went. Jessica yanked the door open of her little sports car and jumped in the drivers seat. Off she went with a flash of brake lights at the end of the street....Her parents never saw her alive again.</span><br /><br /><span style="font-family:times new roman;font-size:130%;">Jessica stopped at her best friends house and didn't have to wait long before her friend came running out holding 2 steaming pop tarts wrapped in paper towels. They ate as they went. Jennifer eating and driving and be-bopping to the latest tune on the radio, grinning around her pop tart. She was speeding, but that didn't seem to matter. She knew the road to school well and had lived here all of her short life.</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">A delivery truck loomed in front of her as she navigated around a sharp bend in the road causing her to jam on the brake. Cursing, she pulled to the left to see if she could get around, a car blaring its horn caused her to jerk back into her lane. She knew a short cut to the school was just up ahead. Riding the tail of the truck in front of her, she was mentally counting up the times she had been tardy, knowing her first period teacher would cut her no slack. </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">With her turn just ahead, she could see the road as it cut away from the highway she was currently on. She swerved to the left and accelerated. Too late did she see the full sized pick up coming straight for her. Too late did she hear the sharp intake of breath from the passenger seat. Too late for Jessica...</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I woke up that morning to the sound of the alarm clock ringing its shrill tones to anyone within earshot. I reached over and jammed the snooze button down almost hard enough to break it and rolled over. I lay on my back and stared at the ceiling in the semi-darkness. I rolled outta bed and stretched. I made my way to the kitchen to start the coffee machine and headed for the shower. Drying off after my morning wash I could hear the steady drip-drip of the coffee machine. I sat on the edge of the bed and dressed, making sure my name tag was straight in the mirror and putting the Cross pens my wife gave me for Christmas last year in my shirt pocket. I crept into each of the kids bedrooms and gave each a soft kiss, trying not to wake them, then back to my wife for another kiss and whispering "I Love You", hearing the mumbled return. </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I slung my bag over my shoulder and grabbed my coffee and out the door I went. I sat in my truck for a few minutes, letting it warm up before backing down the drive. I be-bopped to a favorite tune playing from my i-pod as I made my way to the station. Getting there and then completing my morning ritual of checking of the truck, placing things within easy reach where I like them. My partner has taken the day off and a new part-time EMT has taken her place for the day. While we sit around chit chatting the pager goes off...</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">MVA less than five miles from the station. Bystanders on scene state the vehicle is down an embankment, multiple patients, patient status: unknown. I look at my watch and think: school traffic.</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">We jump in the rig and tear out, siren wailing. We arrive on scene in a few short minutes and pull up next to a small red car pointing straight down the embankment, the hood smashed in and </span><span style="font-family:times new roman;font-size:130%;">resting against a tree. My partner had already jumped out of the rig, almost before I got it stopped. I grabbed my turnout coat and the jump bag out of the back and hurry to the edge of the road. My partner is already down the hill at the drivers side. He looks up and I can see the fear in his eyes and he yells "You better get down here."</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I make my way down the 15 foot embankment to the drivers door and look inside. I see a young </span><span style="font-family:times new roman;font-size:130%;">girl, obviously unconscious, her head pinned between the seat and the post of the door. I also see another teen aged looking female in the passenger seat. She looks dazed. I ask her if she is hurt. She says that her leg is hurting and is pinned in the floor board, she can't get it out. I tell her in the most reassuring voice I can muster that its going to be OK, that I am a Paramedic and am here to help.</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I reach in and lay my hand on the chest of the driver, she isn't breathing. I notice that she is also pinned in a very bad way. I can't see anything below her chest, the steering wheel is bent and broken, the dash is pushed all the way over her thighs against her chest. I turn to tell my partner to get the BVM and he is no where in sight. <em>Damn...where the hell did he go?</em> I yank the zippers on the bag and grab the equipment I need and then try to place it on the patient. I cant reach in far enough, because of the way the vehicle is sitting and the mangled portions make it impossible for me to get both hands where I need them. The back window is halfway down, so I take my coat off and throw it over the patients head and grab the top of the back window and jerk. It shatters, sending glass everywhere.</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Now I stick one hand in from the font and the other in from the back, bagging the patient as best as I can. I feel for a pulse in her neck. She has a strong one, but I can tell without having to count that its too slow. I feel my vision starting to narrow, the all to familiar feeling of tunnel vision. Shaking my head, trying to clear it and keep my thoughts and feelings in check, I look around for help. To my astonishment, I see an off duty Medic making his way towards me. He asks me what I need. I say my airway box, extrication equipment, monitor and someone to go to the other side of the car to check on the passenger. He promptly turns and marches back up the hill. Returning in just a few minutes with the familiar red and white box that contains all my airway supplies and several people in tow, I recognise one as another off duty medic in fire dept turn out gear. </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;"><span style="font-size:130%;">They split as they reach the car, the first off duty medic coming to me and the others going to the opposite side of the car. I say we need to intubate this one now and he gets the equipment in order with relative speed. I can't intubate as I normally would, due to how the patient is positioned. So I hand the blade back to him and he sees instantly what I am thinking before I speak. He goes in from the front window, the blade reversed and uses a technique we always called "potato digging" and others call "the tomahawk method". While I reach through the back window with the tube. Working in unison, we manage to position her airway with very little movement of her head and neck. During this I notice something very bad. She has a definite step-off about midway down her neck. <em>Her neck has got to be broken, </em>I think. I peer inside her open mouth and also see that she has braces. For some reason this disturbs me. <em>This is not supposed to happen. I am not supposed to be sticking a tube down someones throat that is still wearing braces. Christ Almighty....</em></span></span><br /><br /><em><span style="font-family:times new roman;font-size:130%;"></span></em><br /><span style="font-family:times new roman;font-size:130%;">The next shock happens as I ask for a little pressure. He responds by pressing down on the front of her neck, the cords pop into view, but with a shocking revelation. I can see the almost gleaming white of the vocal cords. But they are clamped shut. No darkness between them that is my target for the end of the tube. I remember something at that moment that my instructor had told me. I pull back my head slightly and send a hot breath down the tube, while watching the vocal cords. Nothing, no response. I try again. Still nothing. I try to push through them, nope...not working. I pull out and grab the bag again. Thinking, <em>I'm gonna have to trach her.</em> </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">My monitor is laying on the ground and I tell my coworker to get it ready as I check for a pulse. She still has one, and it's slower than before. I can hear the rumble of the equipment as the crew on the other side of the car attempts to pop the door to free the passenger. I can see her face peering out from under the turnout coat that is over her head. Her face is white as a sheet and her mouth stands agape. I realize that she has been watching me attempting to stick a tube down her friends throat and just as quickly realize that there is nothing I can do about it right now. </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">"Is she gonna be OK?", she hollers over the loudness of the spreaders and screaming of metal on metal. </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">"We are doing everything we can", is my return as I mentally reach 5 in my count and slowly squeeze the bag. Knowing full well that I didn't answer her question. Thankfully she doesn't ask again, but I see the tears start streaming down her face.</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I turn my attention back to the driver and my coworker. He has the pads out and is trying to find enough room on the patient to place them. He has her shirt up yet there just isn't enough room to place them properly because of her position and the distortion of the interior of the vehicle. When he is done, the pads are almost touching. I look down to the screen and see the complexes look fairly normal, but way too far apart. I ask for the trach kit with dread. I have never done this before on a patient.</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">He tears away the plastic with hands that are shaking, his dread apparently matching my own. I switch places with him so he can bag and I can cut. I prep the area, and do what up to this point I have only done on a pigs trachea. He attaches the bag and squeezes air into the patient. I listen to lung sounds and they are decent enough that I know I did it right. I step back wiping sweat from my brow and take stock of the scene when I hear a long beep from the monitor at my feet. Looking down I know what I will see...flatline. <em>No, not now, please not now.</em> </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I look over and see that the other crew is having difficulty getting the other patient out, as her left foot is still pinned under the dash. Just then I hear someone shouting at the top of the hill. Something about another patient down the hill on the other side of the road. </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Time seemed to stop. It was decision time. The dreadful decision that I didn't want to make. I take stock of my patient. Probable broken neck, airway compromise for an untold amount of time, asystole, probable multiple internal injuries, etc, etc. I add this up and realize that there is nothing I can do and there are too many others here who need help. I reach down, and hit print on the monitor, tearing off the strip and sticking it in my shirt pocket. </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I grab the radio from my belt and tell dispatch, "Confirm code blue on scene." As I make my way around the car to the other victim.</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">We get her out eventually and get her packaged. She has several scrapes, cuts and bruises, an angulated left wrist and an open fracture to her left ankle. We make it up the hill with her and to my waiting ambulance. </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">There I learn of the other patient and vehicle. It was down an almost 50 foot embankment on the other side of the road. I never even saw it. Another crew had arrived and had gotten him packaged and loaded while I was down the hill with my 2 patients. I also learn the chopper is waiting for us just up the road to take our patient to the nearest trauma center. I finish my assessment, start a couple large bore IV's, splint her leg and wrist as we make our way to the LZ.</span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">We hand off the patient and the bird takes off. I sit on the bumper with my head in my hands. A fireman comes up and offers a smoke which I gladly take. Drawing deep on the cigarette. We start to clean up the back of the truck and I realize my airway box and jump bag on still on scene. We make our way back to the scene and the supervisor advises us that our equipment is in the back of his truck. They are still in the process of getting the dead girl out of the car. </span><br /><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I grab the equipment and take it to my truck. Then grab my camera and return to take a few pictures, careful not to get any shots of the body or license plates. We make our way back to the station. I learn then where my partner went. He had went back to the truck to get the things he thought we would need and while rounding the back of the truck had heard someone yelling. He looked over the embankment and saw the other vehicle and went to help who ever was inside.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">The rest of the shift was uneventful, a few calls, nothing of note. The next morning I came home and printed the pics I had taken from the wreck. Reliving it all over again. Wondering if I had made the right decision. I take the pictures and place them in a photo album that is laying on the table in my office. In it are other photos of wrecks I have run, notes on various calls and interesting 12 leads that I have saved. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I sat looking at it for a long time...remembering...</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com4tag:blogger.com,1999:blog-987227095677359931.post-69175748356995938742008-08-04T19:48:00.006-04:002008-09-18T21:37:54.995-04:00Looking back...I've hit the year mark. One year as a paramedic. Actually that mark came about 4 months ago. But it seems almost like yesterday that I was still going to class and clinicals. Still had the world in my grasp so to speak, at least that's what I thought then. I suppose that to some, well...to most, I am still wet behind the ears and I guess I would have to agree in some aspects.<br /><br /><br /><br />When I got out of school I thought that I was ready to take on the world. I was ready to cure the ill, bring the dead back to life and make little old ladies walk again. I can't help but to laugh at that now. It's intereseting the changes that you go through as you gain experience. It's also interesting the things you forget as time goes by.<br /><br /><br /><br />When I was in and fresh out of class I could spout off just about anything you wanted. Pediatric dose for some off the wall drug? Bam, right there it was, on the front of my mind. Now? Hmm, have to think about it a little first. I used to look down on some medics for not knowing some of those things. Now I see why. I'm not excusing myself or others. It's our job to know these things. But sometime things just kind of fade from memory without constant vigilance.<br /><br /><br /><br />In this past year I've went from a brand new medic to a now FTO. Thats short for field training officer. The training officers for the region that I work in have gotten together and started this program for FTO's. The old precepter program is outdated and none of the 5 services in our region nor the students riding in those counties use it. So a bunch of us from each service have been sent to all kinds of classes on how to teach in the field. A lot of it is very interesting and has helped, but the rest is fairly boring and stuff that we, being students once ourselves, already know. Anyway, I now get students that come to do clinicals on my shift and the new hires when they are doing their orientation rides.<br /><br /><br /><br />I find that I enjoy it though. I have also been teaching for about a year now. I love to teach. In some ways, I like it more than actually running calls. I had an incredible instructor through my Intermediate and Paramedic classes. We learned so much more than what was in the books. I enjoy giving back the little knowledge that I have and the little tricks and things that the more experienced medics have taught me along the way.<br /><br /><br /><br />As far as me being a FTO now, I'm not really sure what to make of it. We've had a lot of turnover recently, as most services around here have. There is also that gap that seems common place in EMS. There are a lot of medics with 15+ years of experience and then a lot with less than 5, with not too many in between. I don't know if I was picked to be in the program because of my competance or just lack of options. Think about it, a medic with only one year of experience is teaching others how to be a medic. Doesn't seem right to me sometimes. It seems like the more experienced people should be the ones teaching. But since it fell in my lap, I do the best I can with what I got. I hope they go away with more than they came with.Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com3tag:blogger.com,1999:blog-987227095677359931.post-6354176605366994822008-07-31T20:15:00.002-04:002008-07-31T20:17:33.580-04:00I'm back...<span style="font-family:times new roman;font-size:130%;">I reckon I'm gonna try this bloggin' thing again. I apologize for the readers that have come back looking for something and finding nothing. I have a lot of excuses, most of them probably not good ones... So I'll spare you...</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com6tag:blogger.com,1999:blog-987227095677359931.post-60908958875939152462008-04-05T22:19:00.003-04:002008-04-05T23:01:40.518-04:00Fight...<span style="font-family:times new roman;font-size:130%;">I hate Narcan. I really, really do....</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">The last two times I have given it, I got puked on for my efforts. This time I got into a fight.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">We got the call for a chest pain that turned into an unconscious while en route. Me and my partner look at each other thinking this is gonna be a code. We get there and it's a whole other story.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">The patient had ingested an unknown amount of alcohol and possibly taken some Vicodin. He was completely unconscious and unresponsive. We get him loaded up and do our thing. All his vitals, 12-lead and blood sugar are normal. Except for his breathing; about 8 times a minute and shallow and his pupils; constricted and nonreactive, everything is normal. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">I decide to give him 0.5 mg of Narcan. A few minutes later nothing was happening so we decided to head to the ED. My partner was standing on the back step talking to a family member when the patient decided to wake up. He immediately began to struggle against the cot straps. I tried to calm him and let him know what was going on. He wasn't hearing any of it. He said that we should have let him die and when asked, he said that he had been trying to kill himself. In my county that is enough, they are then deemed a danger to themselves and they are going to the hospital one way or the other.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">He then wanted to fight. He took a swing at me and caught me on the side of the face and then another on the chest before I could get around to his head to control him. I've been trained on how to subdue people, both medically and non-medically. I read an article in EMS Magazine a few months ago on restraining a patient and got several tips that I used that night. I went straight to the captains chair and laced the fingers of both my hands under the patients chin and pulled back. This pins the patients head to the cot, closes his mouth to inhibit biting and spitting and you are still able to control airway and see the entire patient and keep monitoring. A very good technique as it worked very well, is easy to do and is safe for the patient. I recommend it to anyone that needs it.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">My partner jumped back in and on top of his legs. One of the first responders came in and tried to get his arms and got socked on the jaw for his effort. The patient continued to fight and curse and generally make an ass of himself while we called for the sheriffs department. All this happened in about 30-45 seconds, although it seemed like a lot longer. We got a non-re breather on him and just held him there. The reason for the mask was one to administer O2, which never hurts and another to keep him from spitting. He wasn't yet, but it usually doesn't take them very long to start after they figure out that they can't do anything else.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">We held him until the deputy got there and placed him in custody then cuffed him to the cot. We got his legs strapped with cravats and put the shoulder straps on so he couldn't move his upper body. The patient then got the bright idea that he would choke himself on the V made by the chest strap and the shoulder straps. He wasn't the brightest crayon in the box, but he gave it the all American drunk try. I let him, I was tired of fighting with him and I figured that he would either give up or pass out, I didn't really care which at that point. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Eventually he gave up and he finally calmed down during the transport. Then he started bawling, going on and on about how the world was out to get him and how life generally sucked for him. I didn't feel like it, but I listened to it and tried to calm him further and told him that there were people at the hospital that would like to help if he wanted it.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">We got him to the ED and turned over care with a promise from him that he wouldn't give any of the nurses any trouble. I don't know what happened to him after that, but I have a feeling that I will see him again at some point.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com6tag:blogger.com,1999:blog-987227095677359931.post-88054708981387333552008-04-05T22:01:00.003-04:002008-04-05T22:18:30.276-04:00Glue...<span style="font-family:times new roman;font-size:130%;">This is something that I have heard about several times, but never actually seen myself.... We get the call for a routine eye injury, no other information. We get to the house and find a guy standing at his kitchen sink flushing out his eyes. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">We ask what was going on and find out that he had glued his right eye shut. To make a long story short, he picked up a bottle that he thought was his prescription eye drops and applied it to his eye. He stopped said application when he felt the burning. His teenage daughter had been putting on fake nails with the glue and had set the bottle down on the end-table where her dad, the patient, usually put his drops. To his credit, both bottles had the same color top and were the same size. It was an honest mistake, but one that me and my partner couldn't help but to laugh at. Luckily the patient thought it was just as funny.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">We called the local hospital to ask for assistance in dealing with this matter and the doc on call in the ED gave us some unorthodox advise: rub some Vaseline in his eye. What? Yea, you read it right, put some Vaseline on it. He said that it would remove the super glue.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">So, we did it. We asked the family if they had some and they did and then we did. To every one's amazement, it worked almost instantly. It left a glob of glue on his eyelash and he kinda ripped it off, pulling most of the lashes of with it, but he could see out of his eye.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">We flushed his eye some more and he said that it wasn't burning anymore. Other than a little redness, he was fine. We tried to get him to go to the hospital, but he wouldn't hear of it. He did promise to see his eye doctor the next morning. </span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">Like I said, I've heard about this before, but never actually seen it myself. I did learn something useful though. It's good information for anybody, but especially anyone with kids.</span><br /><span style="font-family:Times New Roman;font-size:130%;"></span><br /><span style="font-family:Times New Roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com2tag:blogger.com,1999:blog-987227095677359931.post-79529063027711875902008-03-17T09:30:00.002-04:002008-03-17T09:36:39.721-04:00Blogger Blues....<span style="font-family:times new roman;font-size:130%;">I apologize to my readers out there who haven't heard from me in quite a while. I guess I've got the blogger blues. I just haven't been running anything worth writing about, or that I haven't written about already. I have 2 calls that are somewhat noteworthy and I will try to jot them down sometime this week. I was out of work for a few weeks due to an injury and I have also been teaching an EMT class for the last month, so I haven't had a lot of time. I know that is no excuse, but there it is. Like I said, I will try to do better in the near future. I thank those who come back looking for something to read and I apologize that you have had to go away empty handed so to speak.</span><br /><span style="font-family:times new roman;font-size:130%;"></span><br /><span style="font-family:times new roman;font-size:130%;">BRM</span>Blue Ridge Medichttp://www.blogger.com/profile/09340913000098413846noreply@blogger.com4