Well, for the last month now we have been using electronic run forms. For the most part, I like them. I like most being able to type out an extended narrative, instead of trying to scribble it all into a confined space. (I know you could always attach a supplemental page, but I rarely did.)…
Author: medicscribe
Out of Time
Difficulty breathing at the nursing home. The officer who arrives on scene tells us to keep coming lights and sirens. The room in the nursing home is sparse. The patient, a large man in a hospital johnny, is pale and diaphoretic with a low grade fever and edema in his abdomen and extremities. His eyes…
Sha La Lala Lala, Live For Today
Elderly man. Alzheimers. DNR. No history of seizures. Had a witnessed seizure at the nursing home. Started with his eyes twitching, progressed to a full gran mal. Now the patient who is normally verbal, isn’t saying anything, and has snoring respirations. His pressure is 200/110. I stick an oral airway in after a slight gag,…
Run Forms
A fundamental tenet of the street medic is that you do not criticize another medic if you were not there on the call yourself. Countless times I have had people come to me and tell me what so and so medic did on a call and can I believe how stupid they were. But most…
Straps
I may have mentioned recently that I started a new part-time job. I’m an EMS coordinator at a local hospital. I’m still keeping my full-time medic job, only I won’t be working so much overtime. I haven’t written yet about the new job — I need to think more about the proper way to write…
Standing Orders and Consistency
A young doctor I know, who used to be a street paramedic, says the reason paramedics have standing orders is because no two doctors can agree on anything so they let the medics decide based on written guidelines. Otherwise there would be chaos. Where I work I transport patients to any of eight hospitals, but…
Solo Again
Yesterday my preceptee didn’t come to work. He told me he might not come in. That was okay because he is pretty much done. We’re just waiting for the hospital coordinator (who officially cuts him loose) to come back from vacation and sign the paperwork. The truth is it was great being the medic again….
My ETA/ The Triage Zone
You call in for orders and medical control asks “What’s your ETA?” That’s an interesting question. There are several answers. I am fifteen minutes from the hospital grounds. I am eighteen minutes from my back door opening. I am twenty minutes from arriving at the triage desk. I am anywhere from twenty-five to fifty minutes…
Summer Report
I apologize for no posts for a week. It’s summertime after all. I have been busy playing with my seven-month-old baby girl, staying up watching the Olympics, while channel-surfing to the Red Sox games (including their epic 19-17 win over the Rangers), and celebrating my fiftieth birthday by running my first triathlon of the year…
Drips, Slow Pushes
I was watching my preceptee give Zofran the other day and I thought that he gave it a little too fast. I didn’t have the stop watch on him, but I was looking for maybe 30 seconds to a minute for the small 4 mg in 2cc injection, and what I saw was about ten…
Family
Sometimes it takes back-to-back calls to help you understand lessons you might not otherwise have thought about. There are family members on scene of most of all calls and they often ask if they can ride along with us. In most cases, we are not traveling to the hospital lights and sirens so we might…
Overtime
When I started working as a precepting medic in 1995, I was making (I believe) $12 an hour, which may have gone up to $14 when I was cut loose six weeks later. I worked three 12’s and was often held after crew change, but never to the point of going over 40 hours for…
Day-to-Day EMS
You punch in. You check your equipment. You get your calls. You respond. 83-year-old female fell, head lac. 6-year-old boy, history of seizures, had a seizure. 63-year-old man with abdominal pain. 74-year old with fever. 59-year old man with syncope. 23-year-old driver with neck pain from rear-end MVA. You do your assessments, get your histories,…
When Are You a Competent Medic?
I recently received the following question in the comment section: At 10:31 PM, DavisEmt said… This is going to sound stupid:But I don’t really have anyone I trust to ask. How do you know when you are a competent medic, because I know every call isn’t going to run perfect, but I’ve been a medic…
The Grapes of Wrath
We hear the cops go out for a minor motor vehicle up on the mountain, and then twenty minutes later we get called up there for neck and back pain. The accident doesn’t look like much as we get there. One vehicle rear-ended the other, but I start to get a little nervous when I…
Advice to a New Preceptee
A year ago I wrote a post called Letter to a New Preceptee, offering reassurance to a new paramedic. Today I am supplementing that with “Advice to a New Preceptee.” Note: This letter is not directed to anyone in particular, but rather meant for preceptees in general. *** Dear Preceptee, I have been precepting new paramedics…
Trauma Room: The Sequel
When recently (seven weeks ago) we saw certain of our heroes, the trauma team, in the Trauma Room, I had just unveiled an item of interest for them: “I give my report in the trauma room. I feel bad to say so but I feel almost like a celebrity chef unveiling a master dish when…
Trauma Room: The Sequel
When recently (seven weeks ago) we saw certain of our heroes, the trauma team, in the Trauma Room, I had just unveiled an item of interest for them: “I give my report in the trauma room. I feel bad to say so but I feel almost like a celebrity chef unveiling a master dish when I finally…
You know You’re a Paramedic When…
At the movies you find yourself noticing the veins in movie stars arms as much as their looks. At youth sporting events you are the only person who does not rise from his seat when a youngster bangs his knee and falls to the ground crying. Yet you still applaud heartily when the youth finally…
Democracy in Action
We’ve been having a big union battle where I work that has pretty evenly divided the company. In the first election, the current union, Local 1199, garnered 81 votes, the challenging union, NEMSA, garnered 71, and 16 people voted no union. Since there was no clear majority, there is a run-off election held today between…