I promised more columns on enhanced BLS, but I have instead been silent for the last two weeks as I have struggled to come to a clear understanding of the issue. The most successful commentators all stake out clear positions (whether they believe them or not). But I continue to struggle with this one. Just…
Gathering of the Eagles
If there was any place I could be this weekend, besides sitting here at home playing with my five-year old daughter (and working the ambulance tomorrow), it would be in Dallas for the annual “Gathering of the Eagles” conference.
Inventory (DOA)
King of the World
I work Sunday, Monday and Tuesday, 12-hour city shifts. I took the day off today (Tuesday) to go to the monthly regional EMS meetings for my clinical coordinator job that fall on the 2nd Tuesday of every month. I was excited for the meeting because we were going to be voting of our new spinal…
Homemade Soup
I am conflicted. I am having doubts about some of the benefits of medicine. Let me be more specific. In our state, we are told to advise a patient at least three times to go with us to the hospital before we can accept a refusal of care against medical advice (AMA). (For legal purposes…
Risk Assessment
This post is inspired by a book I am reading – Antifragile: Things That Gain from Disorder by Nassim Nicholas Taleb. In this fascinating book Taleb discusses risk. Take this example which I am modifying from his book: Would you get on an airplane if there was only a 5 percent chance that the plane would crash?…
First Night
Brothers and sisters, carry those lights in your heart, and spread their warmth into every house you enter, every patient you comfort, every life you touch.
Sandy Hook
In the nursing home, Mrs. Brown sits in her wheelchair, two feet from the television in her darkened room. The blue hues illuminate her face. Our stretcher rolls past in the hallway. Each door is open. The story on every channel. In stillness, they watch. We are still young, the children call to them. Craddle…
Pink Sneakers
She has become a regular. She calls early Sunday morning. “923, respond for the abdominal pain.” The dispatcher gives the street and apartment number. It’s always her. We have stopped bringing the gear in. We just wheel the stretcher in and leave it in the hallway, and then walk up the three flights of the…
NTG and the Hero medic
My favorite stories are when medics talk about great medics from their past. The stories can be made up, exaggerated or true, but with telling they achieve the status of folklore and the medics in them are our Paul Bunyans and Davy Crockets, our Supermen and our Columbos (the great TV detective played by Peter…
It Depends
Here is a question that I recently considered. If you have a critical patient who you are worried may crash, when do you do the IV? At the patient’s side, on scene in the ambulance, or en route to the hospital? The key is that you need to have the IV when you need it….
Christian Schmeck
Christian Schmeck passed away a few days ago at 59. I saw his obituary posted in the EMS room at a local hospital. I suspect most of the newer EMTs who saw it didn’t know who he was. I first met Chris over twenty years ago when I worked at the state health department. He…
How EMS is Like Baseball (But With Better Food)
I think EMS is a lot like baseball. It can be fairly slow-paced (boring, if you prefer), but it has its moments of excitement. You have your days when you don’t even remember the calls you did they were so routine. Like in baseball, you can stand around all game in the outfield waiting for…
The Wheelchair
The call is for an unresponsive in a wheelchair on a street corner in front of a social services agency. A woman who works at the agency flags us down. She says she has a man in a wheelchair who is unresponsive. She does not know him. He is not a client there. She says…
What I Carry
A reader (Lucus) queried me about what I carry on my when I am on duty: I have a stethoscope around my neck. In my right shirt pocket, I have four small blank index cards. In my left pocket I have a pen, a pack of gum, and my I-phone. I have trauma shears on…
Everyday EMS Athlete
There is a profile of me over at Greg Friese’s Everyday EMS Athletes, a feature of Everydayemstips.com.
EMS Changes
The number one treatment change in EMS in the last twenty years is the increased emphasis on painmanagement and comfort care. Albert Schweitzer said, “Pain is a more terrible lord of mankind than death himself…. We must all die. But that I can save him from days of torture, that is what I feel as…
Annual Cold Report
Decreased
I pride myself on my assessment skills, my finely tuned senses — the ability to see, hear, touch, smell, taste, and whatever the sixth sense is – I do that one well too. But lately, I must confess I have been having some issues with the hearing. I auscultate the patient’s lungs and hear nothing….
Backing In
I was in a parking garage over the weekend when my exit was held up by a woman in a SUV who took about five minutes to make all he turns necessary to back into a parking space. I was thinking why not just drive in straight? Why do you have to be parked for…