I think I am finally getting over my illness, although I am still dragging a bit. Since going most of the winter without being sick, this one has hit me hard. I think I may in fact have been knocked down by one bug and then been dinged by another on top of it. Here’s…
Category: ems-topics
29 Ways To Lift Your Tongue
We can’t use digital cameras on the ambulance, which if you leave aside the patient’s important right to privacy, is a shame because I could really post interesting pictures about this line of work. I was thinking yesterday while trying to spray some nitro under a patient’s tongue about doing a photo montage/art exhibit called…
"I Want the Wide Stretcher"
I had an interesting scenario this weekend that I think could be a harbinger of things to come in EMS. With the growing obesity in the population, ambulance companies have started putting bariatric ambulances on line. The ambulances come equipped with special wide load stretchers that more comfortably accommodate the larger patient. Years ago before…
The Cat that Didn’t Move
The patient — a forty-year-old man — says his back is killing him. He has sciatica. He is on Oxycodone, but his vial is empty and his doctor won’t give him a refill. I look at the vial. It was filled six days ago. You should still have pills left, I say. “You won’t believe…
Whispering Old Ladies, Kleenexes and Placebos
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…
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…
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…
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…
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…
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…
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….
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…