Monday, October 12, 2009

Trauma...

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.

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.

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.

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.

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.

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.

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.

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.

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.

Just remember, it's TV! Not reality!

BRM

Thursday, May 21, 2009

Another Great Read....

...and very educational too.

Prehospital 12 Lead ECG

Enjoy...

BRM

Vindicated...

Ran into a bit of trouble a while ago. All over a damn refusal...

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.

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.

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.

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. Bullshit 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.

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.

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.

So now I am fully vindicated...

BRM

Tuesday, May 19, 2009

Great Reads...

Two new blogs I recently happened upon. They've been around a while, but I'm...well...a little slow..

Pink, Warm and Dry


Paramedicine 101

Friday, May 15, 2009

Transferred...

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.

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.

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.

Anyways....I reckon that's enough bitching for the time being...Till next time..

BRM

Wednesday, May 6, 2009

One of My Very Own...

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.

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.

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.

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?

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.

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.

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.

So..with all that in mind, I got some more work to do....

BRM

Friday, January 30, 2009

25,000....

25,000 visitors and counting. YeeHaa!!!

Wednesday, January 28, 2009

On Learning...

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.

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.

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.

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.

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.

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.

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.

BRM

Friday, January 2, 2009

Ice...

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.

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 early. Then I left for work early. So I wouldn't have to rush, and so I could go slower and be more careful.

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?

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.

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?

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.

BRM