We are called to a nursing home for a lift assist. I have never done a straight lift assist in a nursing home before, so I am a little puzzled. Isn’t this something that nursing homes are supposed to do themselves? The short, squat nurse demands to know why we have brought in our stretcher,…
Category: ems-topics
Good Folk
One of my EMS heroes is Thom Dick, the author of People Care, and a regular contributor to both JEMS and Emergency Medical Services. He has an interesting column in the April Jems called “Spring-Man: What are your jittery patients going to do next?” The gist of the article is to be quiet, to listen, and be nonadversarial. Don’t try to…
CPAP
This morning we had a call for a 70 year old man with dsypnea and found him guppy-breathing with a BP of 210/100, HR – 144, skin ice cool and clammy, unable to get a SAT, ETCO2 of 50, RR of 32. Wheezes and crackles in lungs. Upright CO2 wave form. He was sitting on…
A Tip
Instead of writing about one of my calls – I haven’t had much to write about lately — I’m going to write about a call a medic I know did a few weeks ago. In addition to being a good story, it is instructive. The call comes in as a syncope. A basic crew responds…
Miscellaneous
I like it when my preceptee beats me to work. It shows good work ethic. And I’m almost always 15 minutes early. *** There is a pro and con article in one of this month’s emergency medical services magazines about cell phone use on the job. I hate it when my partner’s phone goes off…
Pain Control
My new preceptee is doing great. On most calls I am a complete invisible man, just sitting back and watching her work. If I offer anything, it is usually just a small trick of the trade. Since she is only part-time, we only work together a couple times a week so I am still doing…
Bleach
The house is dim and smells like a dead person. Dusty, unmopped wooden floors, filthy curtains, overflowing garbage in the kitchen. The patient is down the hall in a bedroom. Old man living with his two sons, or rather two sons living with their old man because what the old man is doing really isn’t…
Random Comments
Random Comments at the ER this Week “I’m the only nurse for 30 patients so its going to be awhile.” “No! No! I just got four new patients. I cannot take another. I’m calling her back. She’s going to have to put him some place else. We’re full here! No! No! No!” “We don’t do…
Wine Coolers
The call was for a drunk. We were updated that he was seizing, but he wasn’t when we got there. His wife said he’d been drinking vodka for a week and she wanted him to go to detox. I put in an IV lock, checked his ETCO2 which was 35 and his sugar which was…
Obsession?
“Are you going to give me back my husband’s medicine list?” the woman asks. “No,” the medic says, deadpan. “I have a collection of them at home. Boxes actually. Overflowing. I particuarly like these — the little booklets with flowers on the cover. They are the Van Goughs of my collection. I’m seeing a psychiatrist…
Load and Go/Stay and Play/Load and Go Stay and Play
Stay and Play or Load and Go? I had many interesting comments on this issue following a brief discussion of a call in my post on scene management called An Unappreciated Skill. While my style is always evolving, these are my current thoughts on the continual question. *** First off, my goal is to arrive at…
EMT to Medic School
My post on Tuesday generated quite a number of comments centering around the issue of EMTs going right from EMT class to medic school. Here are my thoughts on it: When I started you had to have at least a year of field experience before they would even consider you for admission to medic school….
An Underappreciated Skill
What makes a great EMT or a great paramedic? I’ll start of with some common and easy answers –compassion, impressive medical knowledge, outstanding airway and IV skills, cool head under crisis. I could go on. While this would clearly make a great subject for another post, what I want to talk about today is a…
Class in America
We went to a doctor’s office for an unknown. The secretary led us to an exam room where a man in his sixties sat in a wheelchair, his chin on his chest,eyes closed, looking very tired. He had a huge distended abdomen and a hint of a yellow tinge to his skin. His wife was…
EMS Haiku
Eric from the EMS Haiku site has just posted his trip report from the JEMS EMS Today conference. Like his blog, it is a good read. His post gives a good feel for what the conference is like, complete with educational session recaps and photos of interesting products. Add his site to your bookmarks.
The Other Side
I had just left the locker room at the fitness center and was standing at the information desk when a man ran out of the men’s room and said, “Somebody call 911, he’s having a heart attack!” Now I hate these situations. I am in “plainclothes.” I am anonymous, yet I carry a card that…
King Sugar
It’s been my week for diabetics. Actually where I work, as I’ve written before, is a diabetic town. Some towns are trauma towns or heroin towns. I work the streets of a diabetic town. Lots of African-Americans and Jamaican-Americans with diabetes. I’m constantly going into dark cluttered homes or into nursing homes for the unresponsive….
EJ
Unresponsive in the waiting room of a large medical clinic. The woman is a GCS of 3 – no response at all. The staff thought she was sleeping, and then after walking by her multiple times, they finally noticed she was awfully pale and clammy. They checked her sugar. It was ten. I notice what…
A Nap
Got called to a nursing home for an unresponsive, found an obese woman laying across the bed, snoring respirations. Nurse says patient has been nodding off all morning, and won’t respond to her at all. Plus her SAts are low. This is not like her. Deep sternal rub opens her eyes, but then she shuts…
Bloggers and PodCasters
The night before I left Baltimore, I met up with some bloggers and podcasters at a local sportsbar. It was great to put faces with people. The meeting was organized by Eric Augustus of EMS Haiku and Dan White of Paramedic Blog. Dan works for alliance medical and is the man behind the AllMed AVC…