60-year-old female (a frequent flyer know to us) with low temp this am (87.6 –Shouldn’t they have maybe taken it twice to see if that was really what they got?) and low blood sugar(given 2 mg glucagon by nursing staff at 6 AM), now this afternoon (5 PM) has high blood sugar (400) and a…
Crash
I’m in the back, helping my preceptee with an IV. I repositon the catheter to get a blood flow, and then pull out the needle, occluding the vein with my left hand while I reach for the saline lock. All of a sudden we are decelerating and I start sliding to my right, and I…
Snow
The snow is coming down in near white out conditions. At one point we lose the road the snow bank kicking up snow that completely obliterates our view through the windshield. We arrive at a townhouse apartment complex where we have been called for an unresponsive diabetic. Carrying our blue house bag, heart monitor, and…
You Never Know
We’re called for chest pain at the court house. We question whether it is a case of “Jailitis.” We find the patient sitting in the lobby on a bench surrounded by marshals and firefighters. It is a young man – twenty-five. My first reaction is he is a prisoner, but then I realize he is…
Suffering in the World
We are sent to a detox center for a diabetic. We find a sixty-year old Puerto Rican with a blood sugar over 600, although he has no complaint. He has come to the center to kick his heroin habit. But first now he will have to go to the ER to get his sugar under…
Grand Central Station
I walk through the ER. There are beds in the hallway. I step aside as a tech pushes a portable X-Ray machine past. I call a greeting to a nurse who steps out of a room carrying an IV tray. In another room a doctor intubates an extremely large patient. The intercom pages a cleaning…
ECG Changes
It’s pouring rain and we get called for anxiety. 40 year old female sits in her kitchen holding her chest saying it feels heavy. We ask if she has been under stress and she says, “You don’t want to know.” But she has never felt a pressure like this before and she says it feels…
Carolina Tall Tale
I’m working on the computer when we get the call. I am in fact in the middle of downloading a program. Bad timing. There is no way I can wait for the download to finish. I decide to just minimize the window amd leave it at that. Only when we are on the way to…
Out! — I Mean Safe! — Legacy of an Ear
A number of years ago, one of our ambulances was involved in an MVA. The EMT in the back went flying forward and banged his head against the cabinets and sliced his ear against a sharp edge. When he regained conciousness, his ear was just hanging there. Shortly after, he recieved (I believe) a prosthetic…
Good as New
An old woman in a group home slips and hits her knee. She mutters “I broke my leg, I broke my leg” so her aides call us. We find her sitting on the floor. I ask her how she is. She mutters, “broke my leg, broke my leg.” But she didn’t break her leg. There…
Call 911
Ruby has been taking care of old Mrs. Johnson for seven years. This afternoon she finds Mrs. Johnson has been a little too quiet, even for a 93-year old. And she just won’t wake up. Her skin is cool, and she doesn’t respond to the throat rub that the doctor taught Ruby to do whenever…
Paramedic Journal: A Year on the Streets
A year ago I started another EMS blog, called Paramedic Journal: A Year on the Streets.It was my intention to only record “a year” of being a medic, so anyone interested in knowing what the day to day life of a medic was like could have a reference. In Paramedic Journal the entries are rougher…
Courteous
We get sent for an EDP (emotionally disturbed person). The cop meets us outside and says it is an old lady with Alzheimers. She took the trash out in her nightgown even though the trash doesn’t get picked up today. This has happened before — the woman wandering the neighborhood in her nightgown. Her husband…
Pastry
The call is for severe bleeding. It turns out to be a burst abscess in a teenage male, who three weeks ago tore his hamstring. He bled internally , but the blood wasn’t reabsorbed by the body and an abscess started to grow. He was scheduled to have surgery to remove the undrained blood. At…
Christmas
Last night I watched Scrooged, the Bill Murray version of a Christmas Carrol, where Murray is the bah humbug head of a big TV network. Bill Murray is a very funny actor, and Scrooged always chokes me up at the end, when the little mute kid speaks for the first time and says “God Bless…
Imagine
I rarely follow up with my patients. If they are in the ED when I come back with a new patient, I will stop in and see how thay are doing. Or I might ask a nurse or a doctor what was the deal with a certain recent patient from earlier in the day or…
Alone
A sixty year old woman who lives alone feels her throat begining to swell. This is not the first time it has happened — she has a history of angioedema — so she knows what to do. She takes her closest epi-pen (She has ten scattered about the house) and injects herself with the lifesaving…
A Blanket
It is during the tail end of a snow storm that has left ten inches in six hours. We are on the way back from the hospital after a call where we had to wade through deep drifts to get to a patient’s farmhouse. The roads are barely plowed. We get called for a 93-year…
People Care
If you are looking to get someone in EMS a great Christmas present, here is the book for them or for yourself: People Care: Career-Friendly Practices for Professional Caregivers Thom Dick is the author of Street Talk, a book of essays that came out about the time I was in EMT school in 1989. It…
New AHA CPR and ECG Guidelines
I’m like a kid before Christmas waiting for the new AHA CPR and ECC guidelines to come out. For almost a year I have been following the evidence sheets posted on the Heart Association web site, and nearly everyday in November checked the site for the new guidelines to be posted. When they finally came…