I want to compliment myself because I took a vow quite awhile back that I would stop whining about all the bad things in this job, and I think I have done a pretty good job of it lately. When you start letting things like lengthy triage waits and pompous health care providers (whether hospital,…
Just a Paramedic
Baby Medic asks in his most recent post Routine about the frustrations of the mundane in EMS: I would like to know how those who have been doing this job for a long time are able to withstand the mundane. Do they no longer live for the exciting calls? Are they content to relax in…
The Asshole
I‘ve been called an “Asshole” by a patient two days running now. I guess I have to reluctantly plead guilty in the first instance. The second, I’m not ready to admit it yet. Here’s how the calls went down. *** The first was for a diabetic, altered level of consciousness. 40-year-old man lying in bed…
Trauma Room
I’ve been bringing quite a number of patients to the trauma room lately. You get hurt in a routine motor vehicle accident, you end up in a regular room in the ED or probably even more likely, a bed in the hallway until they can clear your c-spine, get you off the backboard and send…
The Future of Intubation
I recently taught the bougie station at an airway class for ED physicians. While there I got to sit in on an excellent airway lecture and play with some of the other airway devices in the hospital’s difficult airway cart. There was a vendor there from King Systems helping demonstrate a new product of theirs…
The Church Lady and the Ambulance Attendant
The woman heard a pop as (twisting) she tried to help her (stumbling) mother out of her wheelchair and into the church pew. The pop came from the woman’s knee and she crumpled in pain. She screamed again as we tried to pivot her on her good leg onto our stretcher. The entire congregation turned…
Celtics Fan
The Boston Celtics are back in the championship hunt. As a kid, I was a huge Celtics fan. I watched them on our small black and white TV and then I’d go out in the driveway and dribble around and shoot against the hoop my father had nailed over the garage door. I pretended I…
Multi-Leads
I was asked a question about using Lead III in the post below about 3rd degree Heart Block. While the strip says “III,” it is actually something called “S5,” which I neglected to label. “S5” is done by putting the left leg (red) lead in the fifth intercostal space just to the right of the…
3rd Degree Heart Block
I had an interesting strip the other day. We were called to a physician’s office for an abnormal ECG. The EMD dispatch sent us “hot.” But the prearrival instructions indicated no immediate emergency. Patient was alert talking with good color, no pain and no shortness of breath. And as it usually turns out at a…
Ripe Bananas
The old man with Alzheimer’s who used to stand out by the road and watch the traffic go by isn’t there this morning as we pass. He hasn’t been out there for awhile. Ahead there’s a For Sale sign in the yard of the now vacant split-level ranch where for a time we used to…
24s and Snipers
The President was in town the other day. The first I found out about it was seeing a string of police cars and sawhorses by the side of the road. My partner mentioned she’d heard he was coming to speak at one of the local schools. As soon as we passed (headed South into the…
Cutting Clothes
We all carry trauma shears. Of all the tools, a medic has to carry, I would say there are only three — a pen, a stethoscope and trauma shears that are essentials. I wear my stethoscope around my neck, my pen or pens in various shirt and or pants pockets, and I carry my trauma…
Fund for Injured EMTs
I receieved an update on the condition of the EMT who lost her arm in a recent crash, as well as her partner, who also suffered serious injuries. JKosprey writes: “I am a regular partner of both EMTs involved in that horrible accident. Seems to me there wasn’t much that could have been done to…
Comments and Follow Ups
I wanted to thank everyone who has posted comments. I always read them and have learned a lot from many of them. I want to use this post to followup on comments and some recent entries. *** I particularly want to thank the commentator who brought up the tidbit that Nitro spray (NitroLingual) doesn’t have…
Equipment? (Brain) Malfunction
It doesn’t happen often, but every once and while, there we go again. *** Where I work in the contract town, we have three ambulances that all look pretty much the same. Box Type. Red stripe along the side. AMBULANCE written on it. We have four medics (but only one on at a time). Every…
The Tree
The husband awakes to an empty bedroom. He reads the note his wife has left him on the kitchen table and then goes out into the backyard and finds her in the backyard at the edge of the woods, hanging from the big tree. When we arrive, an officer in the driveway tells us they…
Black Flies
I just finished reading a new EMS novel called Black Fliesby Shannon Burke, who also wrote Safelight. The novel is about a young paramedic in Harlem who, trying to fit in, falls under the influence of some seriously burned out medics. Black Fliesis a much better read than Burke’s first book, which while well-written, seemed…
Faces of Life and Death
Earlier this week I did a cardiac arrest at a nursing home. I arrived to find an elderly patient apniec and pulseless. The patient was quite large and had a lifeless face with a small amount of facial hair that made it difficult to ascertain gender. The nursing home staff had last seen her (she…
Minimally Interrupted CPR
There is another new study out (published in the March 12 Journal of the American Medical Association that may change the way we do CPR, continuing the emphasis on “Minimally Interrupted CPR.” Minimally Interrupted Cardiac Resuscitation for Out-of-Hospital Cardiac Arrest Here the jist of the protocol: This novel approach, aimed at maximizing cerebral perfusion, involves:…
Zen Masters and Gizmos
I’ve been precepting a new part-time intermediate. He needs 15 IV starts in the field. He may have five or so. (We only work together once a week.) He doesn’t quite have the hang of it yet. I tell him not to worry about missing because when you miss you learn what not to do…