I had a patient a few days ago who I found very annoying. She was a woman in her late sixties with cold and flu symptoms. What was annoying to me was she refused to speak in anything but a whisper. I can’t hear you, I would say. But she would keep whispering. I asked…
Author: medicscribe
Does EMS Need to Call 911
I am a big fan of Men’s Health magazine. I often read it in the ambulance. I also get emails from them almost every day with workout, diet and other fitness tips. Today I clicked on an article called How to Break Through a Rut: Reach the Next Level. A sidebar on the page happened to catch my…
Damsels in Distress
I grew up reading books like King Arthur and His Knights. Thus when I was a young boy watching EmergencyI imagined a paramedic as a sort of knight errant rescuing people in distress. The job of a paramedic seemed like noble work with the added reward of being thanked by rescued damsels – whether the rescue was saving…
I Almost Died Today
I almost died today. As we approached the intersection I looked up and I saw my death coming at me. It was a large box truck. I quickly calculated that at its rate of speed eastbound on Park and at our rate of speed southbound on Broad, there was going to be collision. The box…
You Don’t Have to Put on Your Red Lights
The hot line rings. Two-thirty in the morning. The dispatcher says, 80 Dorchester. That’s all. Just the address. That’s all we need to know. Calvin. I don’t work the nights as much as the other guys, but I know Calvin. We take our time getting up. Take a leak. Walk out to the ambulance. Drive…
Rusty
My preceptee got cut loose so I am back at work having to carry my own gear again. My rhythm is a little off, but I think I’ll get it back soon enough. Not much interesting so far – just the meat and potatoes of EMS in this town. 1) An old man with pneumonia…
Ethical Question
Baby Medic just posted about doing three codes in two days. He includes this snippet: Thirty-nine years old, the family said, and they thought she was alive this morning but they couldn’t be sure. Someone thought they heard her get up and make coffee. “The lady deserves a chance at that age,” the doctor said…
Precepting
Today is the last day my latest preceptee will be with me. Tomorrow he rides with our chief paramedic, who if all goes well will formally approve his being “cut loose” to be a paramedic on his own. My preceptee has been with me for nine weeks and has been, by all standards, “a shit…
Billing
My paramedic preceptor told me many years ago, “You’re a paramedic, billing isn’t your job. A patient doesn’t want to be asked their social security number when they’re having a heart attack.” Consequently, I didn’t pay too much attention to the back of my run forms. Sometimes I’d turn them in with the backs blank…
Hair
If you are a football fan, have you noticed lately how many more players sport dreadlocks under their helmets. You watch the player on the team you are rooting against run with the ball and you can’t help but think, someone ought to grab that guy by his hair and tackle him. That would be…
Not a Scratch on Her
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…
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…
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,…
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…
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…