The call is for a rollover, no injuries. Non-priority dispatch. When we arrive we see the car off the road into the bushes. The officer tells us the driver, who is claiming no injuries, is sitting in the police car. As the officer is talking to us, a bystander approaches and interrupts. “When I got…
Author: medicscribe
MRSA Precautions
Methicillin-resistant Staphylococcus aureus (MRSA) This happens all the time. You get called to the nursing home. There is a sign on the patient door that says “Contact Precautions.” The staff tells you you have to wear a mask and a gown to enter, so you put it on. You are told the patient has MRSA…
Mobile
What I like about EMS is you never know where you are going to find yourself. Somedays are pretty boring and routine (nursing home calls and fender benders), but then the next moment, you find yourself in an upside down car, or diving head first through an open window of a locked house, or climbing…
ETCO2 with BVM
In my post of yesterday, I wrote the following: While my preceptee prepared the tube, and our crew did CPR, as an experiment I applied a nasal capnography cannula to the patient to see how well we were ventilating with just CPR and bagging. I have heard it suggested that this is an excellent way…
Thoughts on CPR, Compressions, ETCO2 and Codes
I came back from a week off the other day and was greeted with a cardiac arrest on my first call and then another arrest the next day. Both codes were asystole, although we managed to get pulses back briefly on the second one. I had my preceptee with me on both calls. He got…
Life
Clearing out my garage a few months ago, I came across a fifteen year old notebook in which I wrote down my monthly goals. Be a good man. Read 5 books. Work out regularly. Do 30 pushups in a row. Be a good EMT Get 2 Ivs. It was from a different time, a different life. I…
On the Night You Were Born
I stood by the hospital entrance I thought your mother would drive through so she would see me. It was dark and cold and I had to stomp my feet to keep warm. Then I saw her drive by. She didn’t see me, and as she continued toward the parking garage, I ran after her,…
Internal Debate
I have a new preceptee again, and while we have been busy, most of our ALS calls – even our good ones — have been routine – CVA/TIA, chest pain, asthma, dislocated shoulder, allergic reaction, pneumonia, nausea and vomiting. Lots of IV, 02, monitor with the basic drugs – NTG, Aspirin, albuterol, solumedrol, benadryl, zofran,…
Your Choice
He was on his way out to the car when he slipped on the ice. We find him on his knees, leaning into the open front seat of his car. He says he isn’t hurt, but he needs help getting up. He is a big man. I’m guessing three hundred pounds of dead weight. It…
5 Hour Gap
The call is for a hypoglycemic in the lobby of the nursing home. The nurse tells us the woman sleeping in the chair is an admission from a hospital post cardiac care . They were expecting her five hours earlier, but she has just now showed up in the last ten minutes, apparently by private…
The Motions
I haven’t been writing much lately. I’ve been working a lot, doing lots of calls, but nothing I haven’t done before. I’ve been trying to follow my renewed anti-whine, anti-complaint, try to be an easy going nice guy policy. I’ve had a fair amount of success. It is much less tiring going with the flow…
Four Electrodes
At night I empty my pockets on the dresser. Once a week I clean the dresser top off. Crumpled gloves. ECG strips. Narcotics slips. Med lists scribbled on a notepad. An empty drug or saline vial. Four ECG electrodes stuck together. The call is for the man who can’t be woken up, cold to the…
Rant and Rude Business
I have been thinking about all this rant business, and promised some thoughts on it. I was on the phone the other day trying to get an issue resolved with a telephone person and I was frustrated and trying to get her to understand my dilemma and how it wasn’t my problem, but their problem….
Coming Soon
Why do we rant in EMS? That’s what I want to write about. I want to write about it in a way that is not a rant, and I want to write about it in a way that will help to stop me from ranting because I don’t think it is a particularly attractive quality….
Room
I’ve been doing a serious garage and house cleaning. I do it a couple times a year. I always manage to throw a good bit out, but never quite get control. I’m no pack rat. Paramedics won’t find my rigored body underneath a collapsed stack of yellowed newspapers, but I have stuff. A month ago…
The Gear
I’ve pretty much been a stickler over the years about carrying gear. You get a call — whether its chest pain, a fever, or a fall — you bring all your gear in. Monitor, house bag, 02. You never know. Many years ago, I was working with a partner named Steve. Good partner. We had…
Weak
My plan today was to write a response to Baby Medic’s rant Bad Day — a rant I have had myself on too many a day, week, month and year — but in order to write what I really feel — about the privilege of this job despite all the bullshit — I need not to be…
D'oh
I consider myself on the cutting edge of pain management. I have worked within the state and region to increase the amount of morphine paramedics can give patients on standing order and I am very aggressive with my use of morphine. You have pain, I want to take it away. Instead of screaming with pain,…
Hey, Look at This
The call is for a possible stroke — a fifty-year old cancer patient can’t move her right side. I’m thinking it’s not a stroke. Maybe weakness, maybe a tumor. But it could be a stroke. We’ll see when we get there. The woman is lying in bed. Her eyes look up at me as I…
Nephews
For years I have been on the regional medical advisory council. One of our responsibilities is to come out with the regional paramedic guidelines. It is always very exciting for me to get to use a new guideline for the first time. I think we worked on this for so long, went though many drafts…