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…
"Funky Troubling Looking" — Right Bundle Branch Block and MI
As I mentioned in a recent post, we have a process for instituting a STEMI alert to, in consultation with an ED doctor, activate the cath lab prehospitally based on clinical assessment and a 12-Lead ECG. The coordinator at the hospital that I transport most of my patients to told me so far EMS is…
That Narcan Shit
What follows first is fiction: “482. Lawrence Street. 2nd Floor, unknown on a one. PD on the way. Advise when you get there.” We were around the corner having just cleared Hartford Hospital. “Shouldn’t we wait for the cops?” I said, as Troy grabbed his house bag and monitor from the side door. “No, it’s shift…
Nursing Home Codes
I did another nursing home code this weekend. We have five nursing homes in our town. Two are very nice and are the final stop in larger retirement communities where residents start off in the own cottages or apartments, move to their own rooms and then go to skilled care before they pass on. The…
Two Jobs: Good and Bad
I’m back at work today on the ambulance after four days working the desk job, reading run forms, working on education presentations, and entering trauma data. There are good and bad things about each job. Here’s a brief run down. Desk job: The Good – I can sleep until 7 in the morning. I don’t…
My Hall of Fame
Every now and then I marvel at how far EMS has come, I did three calls on Sunday that had they happened fifteen years ago would have gone quite differently. The first was a CHFer. Obese woman, filled up with rales, felt like she was suffocating with the nonrebreather on her. I strapped on the…
Hip Fractures (2) and Dr. Welby
So I have been talking to many people about this hip fracture issue and it is quite a dilemma. I want to change the dispatch protocols to send ALS to fall with hip pain. They don’t have to go lights and sirens. They can go “cold,” but they should at least be on the way….