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…
Category: EMS in City
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…
Shock
The call is for difficulty breathing at a nursing home. A nurse meets us at the curb – a bad sign. “You have to get him out of here quick!” she says. “We can’t get his SATs above 60.” Another nurse meets us at the door. “This way,” she says and starts walking speedily ahead…
A Day in the City
I took a city shift yesterday. I try to work at least two city shifts a week, but the last couple weeks I’ve been busy with my triathlon training, plus it’s been harder to pick up overtime shifts lately. I get my 40 hours in the suburbs, but city overtime time is scarce. It’s a…
Conversations
One of the best parts of this job is the conversations you can have with your patients, but not yesterday. Every patient I had yesterday had dementia or was incapable of coherent verbal speech. An old lady from a nursing home trips on a curb at the supermarket. Her friend says she is more disoriented…
Richter Scale
Precepting has been going well. My preceptee has a knack for us getting calls – no cardiac arrests yet, but a steady diet of low grade ALS calls – chest pains, COPD, hypoglycemia, broken hips, pneumonias, syncopes. For the most part, I just sit back and watch her. I might draw up a saline lock…
Ghost Blood
A medic who used to work for us a decade ago died the other day. He hadn’t yet turned fifty. He worked as a medic for many years, but then got hurt and had to find other work. He’d had some hardships and hadn’t been particularly healthy of late. We weren’t close, but when I…
You Aren’t Talking to Me
There is a scene in Apocalypse Nowwhere the Martin Sheen character shows up at an outpost base that is under fire by enemy forces and has been every night for months. He walks through the chaos looking for someone to report to. He asks a soldier who’s in charge and the flustered man says, “I thought…
A Cigarette
The mental health team meets us outside. “We should wait for the police,” the clinician says. “She’s a big woman. When we went back up there she had a knife near her that wasn’t there the first time we were up with her. She’s very anxious today. When she’s off her meds, she can be…
New Boots
A couple weeks ago I noticed the soles were starting to peel away from my boots. I tried to ignore it at first. I was in denial. I didn’t want to admit that the end was near. I spend some time surfing the internet looking at new boots, thinking I should have some on hand…
Acknowledge. but Don’t Accept
A reader asked me to comment on the following article. Public Safety Personnel Work Through Danger Here is the most relevant passage: A few years ago, in a discussion among several of us who do critical incident stress debriefings, we talked about the difference between acknowledging and meekly accepting danger as part of one’s career. It wasn’t long…
Not a Bad Thing
Not a Bad Thing The state was here inspecting our ambulances. Everything was in order except all the pedi ET tubes in the airway kit were expired as were all the replacement pedi-tubes in the supply room. 2.5, 3.0, 3.5, 4.0, 4.5, 5.0, 5.5 – all expired. I didn’t even know tubes had expiration dates, but…
Sick
Working sick. It happens all the time in EMS. Why? In EMS you get exposed to so much, its hard to make it through a winter without getting whacked by at least one bout that would put a salaried worker in bed with a thermometer in their mouth and a water bottle on their chest….
Arms
Nearly every day a stranger’s arm rests on my knee. I roll their sleeve up and strap a tourniquet around their arm just above the elbow. I usually have already eyeballed their hands for veins. Is this going to be an easy stick? Or am I going to work for it? While their arms rest…
State of the Union
10 calls today starting with two minutes after the moment I laid my head down after checking my gear. I’m on my fourth different crew of the day and I admit I am getting cranky. The goal is to reach a zen-like state where you can do each call 100% with full attention and senses…
A Tale of Two Codes
The Chain of Survival After finishing my paperwork I come out of the ER and sit in the front seat of the ambulance. My partner, who is in the back putting linen away, says, “About five minutes ago they sent an ambulance up to Pilson Way for a call where they are doing CPR.” “We should…
Helpless
A week ago I responded to a fall, a little eighty-year-old lady with failing balance, tripped and fell on the bedroom carpet. She was laying on her right side and couldn’t get up, she said. Her right arm was at an odd angle, but when I repositioned her arm, she had full range of motion….
DNRs
Speaking of…. Called for difficulty breathing to a nursing home. Second time in same day called to the same nursing home for same complaint, had same nurse, asked the same question. What is the patient’s norm? The nurse shrugs and turns to an aide who says, she don’t speak, but she converse. Does she have…
Hole in the Windshield
Past midnight. A giant of a man stands by the open door of his twisted Buick blinded by the lights of the fire truck. He is bare-chested, blood streaming from his severely lacerated head. There is a hole in the windshield the size of a basketball. “I don’t need a collar,” he says, ripping off…
Stay Awake
Buy stock in ambulance companies. There is no way around it. There will always be ambulance transports. Talk all you want about treat and release. It’s not going to happen. Here are the problems. Liability. No body wants to take it. Plus people seem to like ambulance rides. There is a certain cachet about them….