I haven’t worked since Tuesday. No open shifts, which is rare. I guess a lot of part-timers are home from school and looking to make some Christmas or school money. They get priority on the open shifts. I’ve been spending the week driving my girlfriend’s kids around. I’ve been carrying my pager with me hoping…
The Sealed Envelope
The last post on interfacility transfers sparked quite a number of comments, including several on the “sealed envelope” which plagues us. For those not in EMS, the sealed envelope is what the nurse hands you containing the patient’s medical records. Sometimes “Confidential” is written on it. Sometimes they hand you the sealed envelope “for the…
Interfacility Transfers, DNRs, Choices
I recently recieved an email from Jamie Davis, The Pod Medic, about a dilemna one of his listeners faced on a recent call. Here is the story he recieved: This happened to me last month and I’ve been asking around trying to get other people’s opinions about what they would have done, so let me…
DNRs
Speaking of…. Called for difficulty breathing to a nursing home. Second time in same day called to the same nursing home for same complaint, had same nurse, asked the same question. What is the patient’s norm? The nurse shrugs and turns to an aide who says, she don’t speak, but she converse. Does she have…
Back
Back from vacation. It will be the last one for quite awhile. I sort of overdid it this year with travel. The only reason I went this time was I had some tickets I had to use or they would expire this month. Vacation is great, but there are always difficult decisions to make. Do…
No Work Today
I feel like I am unemployed. Everyday I check the pager. No shifts. Years ago when I lived in the Midwest and was a day laborer, I used to go down to the work office every morning. When things were good it was unloading trucks, roofing, or working in an plant – making frozen fast…
Listening
We get called to a nursing home for abdominal pain and possible kidney or gallstones. We find an 88 year old man, alert and oriented, in no pain. The nurse explains he had an unresponsive episode earlier in the day. They did an ultrasound which revealed he had an Abdominal Aortic Aneurysm, multiple gallstones and…
Johnny Tops
I always put a fresh hospital Johnny (gown) on my stretcher along with a clean sheet, bath blanket and towel. If I am going to do a 12-lead ECG, run a bag of fluid or even just do a good torso exam, I like to get the patient out of their tee-shirt, button down shirt…
Postscript
It’s funny in EMS how you can get talking about something, and then something similar happens. You talk about a bad motorcycle accident or messy GI bleed code and then that’s what you get sent for. Why we were just talking about… It’s really just random chance. How many times do people use the Q-word…
Hole in the Windshield
Past midnight. A giant of a man stands by the open door of his twisted Buick blinded by the lights of the fire truck. He is bare-chested, blood streaming from his severely lacerated head. There is a hole in the windshield the size of a basketball. “I don’t need a collar,” he says, ripping off…
Stay Awake
Buy stock in ambulance companies. There is no way around it. There will always be ambulance transports. Talk all you want about treat and release. It’s not going to happen. Here are the problems. Liability. No body wants to take it. Plus people seem to like ambulance rides. There is a certain cachet about them….
Hit Me With Your Best Shot
My left deltoid is killing me. I can hardly lift my arm up. I got a flu shot last night. Needles don’t bother me. I took the PPD like a pro. The little tuberculin syringe into the right forearm. I hardly felt it. Then the nurse pulled out the flu shot needle. I wasn’t even…
The Edge of the World
It’s a cold rainy evening. We’ve been doing nothing but soaking wet drunks and third floor carry downs of heavy women. Dispatch pages us with a transfer from a local hospital to a town about thirty minutes away. I don’t like transfers except on cold rainy days. They beat doing MVAs in the rain, they…
Medical Priority Dispatch
I have written in the recent past about my frustrations with Medical Priority Dispatch (MPD), as well as the recent research that has been published pointing out its failings. The posts include Troublesome, Unformed Idea, Fair Enough and Dispatchers. Bryan E. Bledsoe, DO, FACEP, who has made a name for himself debunking EMS myths in…
Changing Season
People were out raking today or in many cases using their high-powered blowers to clear their lawns of the orange and red leaves still falling from the trees. They didn’t have those blowers when I was a kid. I’m lucky though, I have a small yard now and don’t get many leaves. The ones that…
Freedom
He is a young barrel-chested man in his thirties with a thick Russian accent. The cops found him asleep in his car outside his apartment building. They have ordered him to the hospital to sober up. “I love you,” he says to the burly officer. “Okay, fine, buddy,” the officer says. “Just go with them…
No Lash Marks
A patient with Alzheimer’s and an unsteady gait falls and has a small bruise on her nose. The doctor wants her evaluated even though there doesn’t seem to be anything wrong. A 21 year old woman at a minimum wage assembly plant feels dizzy and has a headache – a common complaint at this plant….
Routine
Routine. Routine. Routine. Twice in just a couple weeks I have been saved by routine. Here’s what happened this time. First, a little background. The first responders in one of the towns I work in have decided they will no longer respond to lift assists without injury. It was argued to the high-ups that well,…
What Harm?
Four more chapters of the novel Mortal Men are posted at the following site: Mortal Men *** It’s been a typical day in the suburbs. A nursing home rectal bleed, an elderly man from home with pneumonia, a lady with hypertension and a nose bleed, and a call from our most frequent flyer — Hazel,…
Understand
Understand The call is for a sudden death; mother took her last breaths according to the son, and does not wish to be resuscitated. They send us in a non-emergency mode. I tell my partner we should probably be going lights and sirens until we know what is going on. He radios dispatch and they…