I took a city shift yesterday. I try to work at least two city shifts a week, but the last couple weeks I’ve been busy with my triathlon training, plus it’s been harder to pick up overtime shifts lately. I get my 40 hours in the suburbs, but city overtime time is scarce. It’s a…
Pain
We’re on our way back from the hospital when we get sent non-priority to a motor vehicle accident for shoulder pain. The accident happened awhile ago, but one of the patients has decided they want to go to the hospital now so we are being sent. The police direct us to our patient — a…
Blue Sky
A long procession of cars, many with their windows whitewashed “RIP Hector” line both sides of the narrow road deep in the cemetery. I kneel on the lush grass. Family and friends dressed in black suits and dresses press against me as I try to calm the young woman who thrashes about and cries out…
MedicCast – Running Cardiac Arrests
Tuesday night (Tuesday, July 10, 2007) at 10:00 P.M. EST Jamie Davis will be hosting MedicCast Live an internet call-in show “Running the Code: CPR oversight and team leadership” discussing managing cardiac arrests and other difficult calls. MedicCast MedicCast Live Visit Talkshoe.com to register for free and get a pin number to login. Talkshoe.com The…
New Medic
Congratulations to Baby Medic on completing his precepting. He is out there now on his own doing some good. I look forward to his fresh, insight posts.
Listening
Listening. It seems like such a simple thing, but we’re all so busy. I had a patient the other day — an old man who has been losing weight and growing weak. He had his esophagus removed 10 years ago and has had problems ever since — diarrhea, loss of appetite. Now almost ninety, he…
“Street Cred” for EMS Physicians
I read an interesting article on Jems.com this week called “Street Cred” for EMS Physicians written by Sabina Braithwaite, an emergency physician (and paramedic) from Charlottesville, Virginia. She asks an interesting question about whether the relationship between paramedics and their medical directors is affected by the medical director’s experience or lack of experience with the prehospital environment. She asks: What…
Compelling Reasons
At our regional medical advisory committee’s meeting last week I listed a number of issues I wanted us to address when we reconvened in the fall, including changing our state’s DNR regulations to enable paramedics to accept a family’s verbal wishes not to initiate resuscitation in a patient with a terminal condition in cardiac arrest….
Triathlon
Last October I got the crazy idea* in my head that I could be a triathlete, meaning I could enter and finish one of those swim, bike and run distance races. I read an article in Men’s Health called: Anyone Can Be a Triathlete. And I met a nurse on one of my Dominican trips…
No IV
Yesterday was my last day riding with my preceptee. She rides with the chief paramedic on Friday to get cut loose. She will do great. She was a pleasure to precept. We were still checking out our equipment when we were sent for a difficulty breathing. It was an area of one of the towns…
How Doctors Think
Giving a verbal report at the hospital is an art form. You want to be able to tell a story clearly and with brevity and nuance so you can accurately convey the issues the patient presents. You want to encapsulate the entirety of your physical exam, history, treatment and thirty minutes spent with the patient…
Nut Allergy – Sneezing
There are certain calls you get that usually turn out to be nothing — baby choking, person slumped over wheel of car, fall with severe bleeding. In fact, just about every call you get, usually turns out to be nothing much. That’s good. Over time it is a great calmer. I usually say to myself,…
Katherine Howell – Frantic
I just finished reading* a great EMS-police crime/thriller written by Katherine Howell, a former Australian “ambulance officer.” One of the main characters is a woman paramedic, the other is a female detective. The paramedic’s husband, a police officer, gets shot and their baby is kidnapped. From that point on it is a nonstop rush to…
Yankees Fan
Circus atmosphere:Yankees come up big, top Red Sox in series opener Connecticut is divided in a diagonal line between Red Sox and Yankees territory. The Red Sox rule the North Eastern section, the Yankees the South Western. There is much intermixing, however, and the center of the state (where I live) is up for grabs….
No Chest Compressions
File under: Something New Every Day The group home patient with a history of mental retardation was found unresponsive in his wheel chair. The small frail man has significant kifofis. His body is flaccid and he cannot even hold his head up. The quick story is he was found that way this morning. Normally he…
Slither
We are called to a nursing home for a lift assist. I have never done a straight lift assist in a nursing home before, so I am a little puzzled. Isn’t this something that nursing homes are supposed to do themselves? The short, squat nurse demands to know why we have brought in our stretcher,…
Good Folk
One of my EMS heroes is Thom Dick, the author of People Care, and a regular contributor to both JEMS and Emergency Medical Services. He has an interesting column in the April Jems called “Spring-Man: What are your jittery patients going to do next?” The gist of the article is to be quiet, to listen, and be nonadversarial. Don’t try to…
CPAP
This morning we had a call for a 70 year old man with dsypnea and found him guppy-breathing with a BP of 210/100, HR – 144, skin ice cool and clammy, unable to get a SAT, ETCO2 of 50, RR of 32. Wheezes and crackles in lungs. Upright CO2 wave form. He was sitting on…
A Tip
Instead of writing about one of my calls – I haven’t had much to write about lately — I’m going to write about a call a medic I know did a few weeks ago. In addition to being a good story, it is instructive. The call comes in as a syncope. A basic crew responds…
Miscellaneous
I like it when my preceptee beats me to work. It shows good work ethic. And I’m almost always 15 minutes early. *** There is a pro and con article in one of this month’s emergency medical services magazines about cell phone use on the job. I hate it when my partner’s phone goes off…