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…
Conversations
One of the best parts of this job is the conversations you can have with your patients, but not yesterday. Every patient I had yesterday had dementia or was incapable of coherent verbal speech. An old lady from a nursing home trips on a curb at the supermarket. Her friend says she is more disoriented…
Richter Scale
Precepting has been going well. My preceptee has a knack for us getting calls – no cardiac arrests yet, but a steady diet of low grade ALS calls – chest pains, COPD, hypoglycemia, broken hips, pneumonias, syncopes. For the most part, I just sit back and watch her. I might draw up a saline lock…
Pain Control
My new preceptee is doing great. On most calls I am a complete invisible man, just sitting back and watching her work. If I offer anything, it is usually just a small trick of the trade. Since she is only part-time, we only work together a couple times a week so I am still doing…
Bleach
The house is dim and smells like a dead person. Dusty, unmopped wooden floors, filthy curtains, overflowing garbage in the kitchen. The patient is down the hall in a bedroom. Old man living with his two sons, or rather two sons living with their old man because what the old man is doing really isn’t…
Random Comments
Random Comments at the ER this Week “I’m the only nurse for 30 patients so its going to be awhile.” “No! No! I just got four new patients. I cannot take another. I’m calling her back. She’s going to have to put him some place else. We’re full here! No! No! No!” “We don’t do…
Ghost Blood
A medic who used to work for us a decade ago died the other day. He hadn’t yet turned fifty. He worked as a medic for many years, but then got hurt and had to find other work. He’d had some hardships and hadn’t been particularly healthy of late. We weren’t close, but when I…
Wine Coolers
The call was for a drunk. We were updated that he was seizing, but he wasn’t when we got there. His wife said he’d been drinking vodka for a week and she wanted him to go to detox. I put in an IV lock, checked his ETCO2 which was 35 and his sugar which was…
Obsession?
“Are you going to give me back my husband’s medicine list?” the woman asks. “No,” the medic says, deadpan. “I have a collection of them at home. Boxes actually. Overflowing. I particuarly like these — the little booklets with flowers on the cover. They are the Van Goughs of my collection. I’m seeing a psychiatrist…