R. Adams Cowley, the founder of Maryland’s well-known Shock Trauma hospital in downtown Baltimore, famously said: “There is a golden hour between life and death. If you are critically injured you have less than 60 minutes to survive. You might not die right then; it may be three days or two weeks later — but…
Trauma
Tonight is the premiere of another new EMS oriented TV series — Trauma — which is on at 9:00 PM EST on NBC. At that hour I will likely be reading “Brown Bear, Brown Bear What do you See?” and “Good Night, Moon” to my twenty-month-old daughter in hopes that she will finally close her…
Elmo’s Song
I’ve written recently above the new advances that have made our care and lives easier: Stretchers going from two man to one man to now power-operated. Airway adjuncts like bougies, LMAs, and of course capnography. Life Pack 5s to Life Pack 10s to LifePack 12 with 12-leads. EZ-IOs. I discovered another one just the other…
Incredibly Nimble
We were sent today for a lady too dizzy to get out of bed. There were elaborate instructions given about where the key was in the garage. We searched for about fifteen minutes with no luck. It was dark in there and dusty and there were mouse traps everywhere. We saw two neighbors come over…
Learn Something Every Day
50-year-old woman recent heart surgery to replace a valve. Visiting nurse says the patient is bradycardic. The officer tells me the patient doesn’t look very good. I find the woman laying on the couch with a nonrebreather on. She says she doesn’t have any pain, but doesn’t feel well, and vomited a couple hours ago….
Work
I came into work yesterday morning and as I always do, switched ambulances. We have three rigs here, and each of the four regular medics are assigned their own (two share one). Every six months or so we switch assignments. Right now I have my own ambulance, but it is the oldest one. Very rough…
Till I One Day Vanish
I work in a diabetic town. There is one particular section of lower middle class homes along the avenue that runs north out of the city that seems to be diabetic central. Many of the older residents came to the United States from Jamaica, and while they continue to enjoy their home cuisine — jerk…
Beach Ball Bellies
Woman collapsed on the roadside CPR in progress. We arrive and when I get out of the ambulance, I can barely see the woman’s face her stomach is so large — it looks like a beach ball and getting bigger with each squeeze by the first responder of the bag valve mask. “I think the…
Micellaneous
A rainy day at work. I’m sitting at the computer and trying to get caught up on email, bills, scheduling, and maybe even this blog. Here’s a couple of recent tidbits. This morning a first occurred. I occasionally hit my head at work — most often on the overhanging bright lights above ER beds, and…
Paramedic Block
I have had trouble posting lately. I go through phases with the job and with the blog and am in one now. The reason I started writing about EMS in the first place was to capture the human side — the view of life and people the job provides. To a lessor extent I like…
A Profession
Over the past year we had pretty prolonged and at times nasty debate over whether to change unions, which we ended up doing. While I wasn’t happy with the previous union’s representation( they in fact screwed me on the one issue I needed them to grieve for me), having sat in on the last contract…
Florida
My brother and I went to Florida for this past weekend to see our father. I left on Friday and came back on Monday. My father had a back operation in December, and while he didn’t want us to come see him then, he finally agreed, now that he is up and walking around, to…
Empty Shoe
“How much morphine?!” the nurse asks. I see across the room in the faces of the ten staff gathered around looks ranging from shock to disbelief to not certain they heard right. “Seventeen,” my preceptee says. Again some looks, understandably. 17 milligrams of morphine is a lot, but after all we are in the trauma…
An EMS Mark Twain
Stephen “Kelley” Grayson’s book “Life, Death and Everything in Between” has been rewritten and published in hardcover by Kaplan Books as “En Route: A Paramedic’s Stories of Life, Death, and Everything in Between.” The book covers Grayson’s long career from day one EMT rookie to established paramedic. It is told in short chapters that are…
12-Lead ECG in ROSC
The other day I heard a story of an ED doctor geting angry at the paramedics who had brought in a cardiac arrest who the medics had had gotten pulses back on in the field. The doctor was angry because after he had done a 12-lead on the patient in the ED, he’d discovered the…
Something to Ponder
I have been working at my clinical coordinator job for over six months now, and while I miss being on the ambulance during my desk job days (I still do 40 hours a week in 3 nondesk job days as a field medic), I am enjoying some aspects of the job — particularly the patient…
Dust
Cardiac arrest. Old frail man in his 80’s in a hospital bed. Wife was talking to him, and then after awhile noticed he had stopped talking back, not that he ever said much in the first place. We put him down on the floor. He was warm and limber, but asystole in three leads. I…
Sky
Something really nice happened today. I was in the supply closet, putting away our latest shipment, when my partner came in and said someone was here to see me. I walked out through the bay and into the main area and there was a man and a woman in maybe their late forties. The woman…
Granddaughters
My father recently had major surgery on his back that required him, at age 75, to spend ten days recovering in a rehab facility. Rehab facility is, of course, the modern code name for a nursing home. His first night there, still feeling the effects of the anesthesia two days post op, and doped up…
Tahiti
The old man was upstairs in the room in this farmhouse in which he was born. His granddaughter explained that he had Alzheimer’s and would not go easily. She said he had stopped eating and drinking. In the past, they had always been able to get him to eat and drink when he had been…