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EMS Taxi



You Call, We Haul



Updated: 2017-09-13T06:16:27.051-04:00

 



The Call For Help

2009-08-15T00:56:12.201-04:00

The radio screams, the phone rings or the pager beeps. No matter how the call for help is received, it will always be answered. Let's face it, this is what we do. We pull ourselves out of bed, chairs, meals, out of our lives to respond to this never ending call for help. They are the nameless, faceless masses that drive passed your rig on the street without a second look, until they need you. At best, we are considered a utility, something to be used when needed then forgotten about.

This is one of the harsh realities we face day to day on this job. We throw out our backs, break bones, dislocate joints and may never, ever be asked if we are okay by the community that we service. How do we get by? How do we get back on the truck one more time? We depend on each other. Sure you can talk to family or friends about these things. But do they really understand what it's like? How we feel when a mother throws her dead child in your arms then spits in your face and curses you off because you were unable to save her child. That very child that she, just a few hours ago, threw down a flight of stairs because he wouldn't stop crying. How could they understand that?

It is in that spirit of helping each other, for being there when one of us fall that has led me to this post. I won't dive into the whole story, there are smarter people that have used better words to discuss this. I will just say that a dear friend of mine, a guest author to this blog and a decent human being has fallen on some hard times. The greatest thing is that, in the age of blogs, Twitter and FaceBook, we are able to connect and help each other even when we're countless miles away.

Please click this link if you are interested in helping one of EMS's brightest members.

Call It As I See It



What a good idea!!

2009-06-17T08:37:19.629-04:00

So in Bangkok, they were finding that a large percentage of expectant mothers weren't making it to the hospital in time, due to horrible traffic conditions. So they formed a special division of the traffic police to deliver babies!!! That's actually a really great idea!!!

What a neat thing to do! (OK, neat...maybe not so much....cool might be a better word)


Special police unit delivers babies in Bangkok traffic jams (video news report)

Enjoy!



8 Comments

2009-06-13T15:17:13.887-04:00

I posted this on my tumblr but I thought y'all might appreciate it too.


Dear Drunk

My name is Katie and I’m a healthcare worker. I take care of people when they’re sick or hurt, I hold their hands when they’re scared, take the extra corners out of their arms when they fall and put band-aids on boo-boos. Sometimes, when someone is really sick, I’ll even breathe for them or keep their heart pumping by pushing on their chest. I’m good like that, see.

While you’re out “enjoying” yourself on a Friday night, I can be found in your local Accident and Emergency department kindly giving up my sleep to look after sick people. In case you were wondering, by the end of my shift last night, I’d been up for 24 hours straight… and the reason, dear drunk, is this.

Before losers like you decided that a good night out ended with lying semi-conscious on the sidewalk with your eyes rolling back in your head, A&E would empty out in the early hours of the morning leaving just the sickest of sick patients in the department. This allowed us poor healthcare workers to have a break, a cup of tea and occasionally a nap. Now, because you’re selfish and stupid, this is not the case.

On a Friday and Saturday night, the majority of patients I see are:

so drunk/high on drugs they collapse in the street and inevitably, someone calls 999. If a person is intoxicated and unable to get home, the ambulance crew must take them to the hospital.
so drunk/high on drugs they walk in front of a car/spaceship/bike/train or fall down. Alcohol masks pain and so ambulance crews, unable to assess the patient properly, bring them to A&E just to be safe.
so drunk/high on drugs they get in to a fight with someone else who is equally intoxicated. Someone hits/stabs/shoots someone else and lo and behold, we have visitors. Its also worth noting that when we try and help them by stitching up their wounds, we’re met with abuse and violence.
If you weren’t so stupid and childish, you wouldn’t drink quite so much. You’d be able to walk out of the club with your shoes and knickers still in place, get a taxi/bus/train home and disappear in to the night. But, piss-head, the concept of moderation is far too advanced for you and your tiny pickled brain so listen up.

When you show up in my A&E, know that you are not my priority. You are not sick or dying, you’re drunk because you chose to be and I’m not interested. Please take a vomit bowl and find a seat out in the waiting room and be quiet. If you don’t want to wait, you’re more than welcome to go home, I don’t want to see you anyway.

When I do finally see you, its only because I have to. Please keep your hands to yourself at all times, I know I’m gorgeous and I’m very flattered but I’m not interested. Do not try and spit at me, swear at me or threaten me either, you’ll just end up thrown out of our nice warm establishment (or even arrested).

I’ll stick a big needle in your arm and dilute the alcohol in your blood just enough to make you sober enough to go home but not enough to relieve that enormous hangover you’ll have tomorrow… or in three days when your body gets done processing the booze.

When you wet yourself or throw up in your hair, don’t expect me to change you or clean you up. You’re a grown up and this is what you chose… If you have to get the tube home at 9am covered in piss and vomit, so be it. Now you know how I feel after a Friday night shift.

If nothing else, when you read about the 8 year old boy who almost died because there were no ambulances to send to him last night, know that it is your fault. The ambulance he so desperately needed was tied up scraping you, the piss soaked drunk, off the street.

Yours

Katie



Manual VS Automatic B/P

2009-06-03T18:37:24.768-04:00

I came across this article on JEMS where a study was done on the differences between a manual and an automatic B/P reading and it reminded me of a conversation I had recently with a paramedic. In my county we use the Lifepak 12, ours are set up to be a BLS and an ALS tool as we can use it for pulse ox, B/P, capnography, Congreve, ECG and 12 lead ECG and as our AED. The paramedic and I were discussing the fact that most providers rely only on the information they obtain through their Lifepak now. We have both witnessed the look of panic on the newer members faces when the Lifepak beeps, alerting them that the pulse ox is not found because they put that on the same arm as the B/P cuff. When I first started I remember working with medics who insisted on at least one manual B/P, when going through my Enhanced class last year I had a few teachers who still felt the same way. Most people in my class rolled their eyes at the thought of taking a manual B/P, including myself, but after reading this article it definitely makes me take a step back.

Since the contributors and readers of this blog cover many states and protocols I figured we could get a good mix of opinions on this subject. So tell us, do you prefer only manual, only automatic, or a mixture of both?

P.S., When doing spell check on EMS related blogs you receive some interesting "suggestions." Instead of "capnography" spell check suggested that I use "pornography." Our Lifepak doesn't provide that, maybe it's an upgrade option?



Getting a little quiet around here!

2009-05-12T14:52:21.228-04:00

Ok, so no one has posted in a while. We need something fun to get it started again!Here's a quiz from facebook that someone just sent me:1. Do you believe people sometimes activate the 911 system just so they have a story to tell thier friends and family?a) Heavens no! Why would someone do that.b) Sometimes, but then again it gives me a good story.c) Absolutely! 2. Have you ever wiped your feet "after coming out of someones home"?a) Oh yeah! I have even thrown them away before getting in the truck. Used their trash can as a matter of fact.b) Sometimes, but that is just the way it goes.c) I would never do something as insulting as that. I am sure they were getting ready to clean up before we got there.3. Have you ever deliberately called a patient the wrong name just for enjoyment?a) Golly gee, no! How disrespectful!b) Only once, and I was sorry.c) No, that would me to inquire what their real name is so I could call them by a different name. Too much effort!4. Have you ever just opened the door to the ambulance, pointed to the cot, said "Sit", and drove to the hospital without saying another word?a) Seriously, people do that? That is an atrocity.b) Every run!c) Only if they have trouble hearing or language impaired.5. Have you ever provoked a patient to antagonize the police just so you can watch them get tazed?a) You are kidding, right?b) No, I render care to enough peole who have been tazed. I don't need to create more work.c) Hell yes! I don't care who you are that's some funny shit! 6. Have you ever prompted a faking trauma patient into saying their different parts of their body hurt just so you can cut their $100.00 jeans, $300.00 coat, and $75.00 shirt off their lying ass body?a) Who prompts? Just start cutting! Hold them down if necessary. Lying pieces of sh*t!b) OMG! Who does this? That is horrible.c) No, why make more work for yourself. 7. Do you think EMS should be able to issue cab vouchers?a) No! Obviously if they called 911, they need help.b) In some cases this would be appropriate.c) Why can't dispatchers just fax them out and save me the trouble? 8. Have you ever told a patient the voices in their head actually would prefer they stay home and not call again?a) Yes, yes I have and I will not apoligize for it.b) No, easier to haul them in than to come back in two hours.c) I would never knownly mess with a person's psychosis. 9. Have you ever "accidently/deliberately" broke something each time you go to a frequent flyer's house?a) Too much paperwork.b) I am not even going to dignify this question with an answer!c) Judge & Punish, baby! Lets get it on! 10. Have you ever made a patient cry from a well deserved EMS-Come-To-Jesus talk?a) No, easier to just haul them to the ER.b) I hate this test! You people are horrible!c) I have tears on the fender of the squad where most dweebs put storks wow.....some of these questions are pretty far out there. Deliberatly breaking something in a house? Egging on psych calls? And what exactly is a EMS-Come to Jesus talk?? [...]



dealing with the drama

2009-03-03T17:36:15.915-05:00

As with any group of people you always have a certain level of drama or politics going on, I've always believed that I could go to any fire department or rescue squad in the country and find basically the same kinds of people. There are roles to be filled and while the names and faces may change deep down it's all the same. You can always find the know it all, the rookies, the ones who have been there done that, the ones that haven't been there or done that but feel that they know it all, the overachiever, the one who overextends them self and the ones who majored in trouble stirring in college.

Over the years of moving up the ranks from the "wet behind the ears rookie" to "in charge of more things than I can even remember on a good day" I have learned the two step shuffle that is required to survive. It's a tough step to learn, you have to know how to talk to this person and that person without upsetting them or sometimes, stooping to their level. Sometimes it is exhausting. Scratch that, most of the time it is exhausting. You can only please so many people per day and my quota sometimes fills up by 9am. (and believe me, I am NOT a morning person) For the past few years my two stepping hasn't been all that bad but we had a major shift in operational officers a few months ago and I feel like I am stuck in one of those horrible techno dance clubs where the songs supposedly change but you can't tell where one ends and the next one begins. (and you can only chant "only 9 more months, only 9 more months, only 9 more months" so many times before your significant other starts to look at you funny)

What I have never understood is why some of the trouble stirrers spend so much time upsetting people. I am in a volunteer organization, we're not collecting a paycheck to be here every day so WHY do they come by, normally at the worst times, to spread lies and rumors? Why not find something that truly interests them? I am told that obviously stirring up trouble IS what interests them but I can't wrap my mind around that. Maybe the problem is I can't shove my head that far up my butt?

Tell me your department has these people and please tell me I am not crazy since I can't understand their game.



EMS at the scene of Jett Travolta's death

2009-01-23T21:22:11.853-05:00

Did anyone else see this article?
An EMT from the scene tells all....

The fact that this EMT was exploiting this family and their grief was bad enough. I don't know the HIPPA laws in the Bahamas, but morally, trying to make yourself famous by talking about a 16 year old's death is just repugnant. I don't care who the family is.

But I let it slip from my memory, only to read this today:
A paramedic from the scene of Jett Travolta's death is being charged with extortion

If you read the articles, it's two different folks from the crew. Which means at least two people from the crew that day were just ready and eager to tell their tale, and grab their 15 minutes of fame.

Any decent EMT or paramedic would never seek to exploit their patients or their pain, even if it isn't against the law to talk about what you saw or did.

It's just wrong...and it's got me bugged about it.

Anyone else?



You're Very Welcome.

2009-01-20T22:49:10.390-05:00

It's a rule in EMS... It's a self preservation kind of rule. Eat when you get the opportunity. You don't know when you'll get your next chance. So it was with that in mind that I was quickly consuming some very cold Chinese food. Chinese that I had stupidly ordered three hours prior thinking that it might be a slow night. Hey, I was new. Two bites into my meal the phone rang. I shoved the styrofoam takeout container aside and picked up the phone sitting a few feet away, "26's," I answered, looking longingly towards my shrimp lo mein. I really need to look into a cooler and cold meals. The bright and intelligent although occasionally directionally challenged dispatcher answered, "Code three run for the county at the Local Marina." The local marina. 12 miles and four stations separated us. "Okay we're heading out." I shoved my dinner into the dorm fridge and we made our way to the truck. A quick phone call to a Medic who worked in the station that should have been responding to this run revealed that there was a major regatta going on at the marina. Hundreds of people were out on the water drinking and partying. I got the distinct feeling one or both of us were going to get puked on. ********** The ride over was uneventful... Well, as uneventful as a Code three response through 12 miles of city traffic could be. PD was driving, I was the look out. He would roll up to an intersection, and we would both scan the roads to make sure that it was clear before proceeding. I didn't know what the nature of the call was that we were speeding across town for, in Toledo they don't give us that information. It could be a popped pimple, it could be a femur fx. As a BLS truck, dispatch was typically pretty good at not sending us to ALS runs, but the truth is, you never know. We pulled into the park that lead to the marina. Assorted revelers were stumbling along the narrow road we were driving on. The sun was setting fast, we were losing light, and there was scant street lighting provided along the road we were on. We continued creeping along the path until we saw the flashing red lights of the BRT (Big Red Truck, typically the engine TFD sends to the scene). I jumped out of the truck and met my partner at the back doors. Our patient was nowhere to be found. TFD was there, FF's sat on the bumper of the truck. The Medics were presumably with the patient. No one knew where anyone was. It was like the hand wasn't communicating with the brain. Nothing new there, sadly. We radio'd the County in an attempt to locate someone, anyone, who could tell us why we just put our lives and the lives of the people on the roads we drove on for 20 minutes for a patient and Medics who couldn't be found. Before the County could give us an answer, we found them. Two TPD officers, two TFD Medics, and our patient. It was a brawl, folks. Four vs. one very unhappy (and vocal about it) boater. It's never good when it's four versus one and you can't tell who's winning. And of course he would be my patient. PD began to sprint over to help the LEO's and the Medics. The patient was a pretty imposing guy, towering over most of the guys trying to take him down. PD was as equally imposing. I followed him for a few feet before he yelled at me, "Epi, stay back. Stay back!" I stopped where I was. PD had been around the block more than a few times, and I trusted him. He hadn't let me down yet, and until he did... well, I wasn't going to argue with him. I watched from twenty feet away while the now five men wrestled him into submission. Good God. The patient was screaming to anyone who would listen that he did not "want to go to jail or to the hospital". He was just fine, thank you very much. The fact that he was bleeding from the head and nose didn't mean much to him. Nor did the fact that according to bystanders, he had fallen face first on to a dock afte[...]



Update

2009-01-17T22:39:13.950-05:00

Wow, haven't posted anything in some time. I think the last time I had posted, I was scared because of my new job. Well, here I am almost two months later and I LOVE it! I defiantly should have listened to everyone when they said "You'll be just fine."

Today I had another long 12 hour shift. I woke up just feeling like it was going to be a fun day (note the sarcasm). My first 4 hours were uneventful. Got the rig check done as well as the daily chores around our building. Than around noonish, that damn call phone went off. We were sent to a house only a couple of blocks away for an asthma attack. En route, that asthma attack got upgraded to unresponsive. Instead of my heart dropping, like it always had done on calls, I just started to use my brain and think about everything that could go wrong on the call, and what I would need to make sure it didn't go wrong. So I grabbed our big green bag, full of airways, gauze, stethoscope, bp cuff's, cravats etc. I also grabbed the defib, you know.. just in case.

My partner had to move the ambulance closer to the house, so I ventured into the house with the police officer who must have hauled ass to the scene when he heard "unresponsive." Of course little me had to walk up to the second level of the house with our heavy green bag as well as the defib. Instantly I heard a little girl screaming her head off and other kids and 2 adults running crazy around the VERY messy house. They yelled for me to hurry up that he wasn't breathing.

If its one thing I remembered, always look cool calm and collected, even if deep down your not. The second you show fear or uncertainty in your face, your pt's family members will instantly freak. I saw our pt laying on the ground. Of course he was a very big guy so I had a feeling getting him to our ambulance would not be an easy task.

I asked, or rather demanded all the family leave the room. I felt bad, but the room was a mess. Mattresses everywhere, as well as other random crap. I checked for a carotid pulse and to be honest, my heart was pounding and I couldn't tell if it was me or the pt lol. My parter felt a pulse so we held off on the AED. I took out our BVM, hooked it up to the 02 and began to bag our pt.

To make a very long story short, it took 3 other squad members as well as two police officers to carry this man to our ambulance. ALS were in the rig waiting for us and the guy went into cardiac arrest shortly after. I ended up being the one to do chest compressions as we took our pt to the ER. ALS put on their AED, and today was the very first time I heard the AED say, "Shock advised." It was an awesome experience, although my pt probably doesn't agree.

With all the HIPPA laws now, EMS workers can't call the hospital to check up on a pt. I know that when you bring a code into the hospital, you defiantly wish you could see if the pt lived or died. Sometimes all you need to know is your pt survived. It's good to know your hard work paid off.



A new Facebook Cause you gotta check out.

2009-01-11T19:19:28.039-05:00

I just got sucked into the vortex that is Facebook, and today got invited to join the cause "Did you seriously dial 911 for this"

In less than a week, there are over 3,000 members, and more every minute!!!!

With all our posts about how frustrated folks are about these kinds of calls, I thought some of you all would be interested. If you want a laugh, and you have a Facebook account, go check out the cause. Some of the stories are so ridiculous that you can't stop laughing!!!!



New Year, New Job(s)?

2009-01-06T09:26:34.997-05:00

Well, I found out on December 1 that I'd be laid off from my full time job. The joy of working for a corporate EMS provider. They decided we weren't going to be profitable in 2009. The swooped in and shut down our operation. December 31 was the last day. December 30 into December 31 was my last shift. I spent the morning of the 31 at the bar with coworkers who also worked night turn. We figured it was a fitting end.

So, as it stands now, I only work 12 days for the rest of the month of January. My part time jobs are all I have, while I sit and also collect severance from the big giant. I'm getting paid more to do less, currently. Sounds like a win-win to me!



To train or not to train...

2008-12-31T08:51:56.190-05:00

You would think this would be a simple and straight forward answer, but it really isn't. I am an EMT-IV Tech, one step above being EMT-Basic, and I am the training officer for our department. You may be thinking 'Yeah? So what?' as I am, but there are others on my department that are having a fit over it. See, I am not the highest level of care on our department. We have one in class for I-99, two paramedics and one RN/EMT-P. The thought is that these people have more to offer as a training officer than I. While I don't dispute the fact that they do in fact have more knowledge and training than I, I don't think it disqualifies me for the position I hold. There is nothing that says that I can't call in other resources to do a training that is beyond my skill/knowledge level and trust me I intend to do just that.

I'm not really sure what I'm trying to get at here so please feel free to chime in and either school my sorry behind or jump on the bandwagon. I'll even scootch over a bit to make room for ya.



Happy Holidays

2008-12-28T09:01:50.783-05:00

Seeing as it has been a few weeks since anyone has posted, just thought I'd wish everyone Happy Holidays and a safe New Year.



Lessons learned...

2008-12-15T14:05:52.460-05:00

Some people love to train rookies, others hate to do it. My station decided to make me training officer since I always seemed to inherit the rookies so I spend a lot of my rotations training new members or members that just got their EMT certification. Last week's lesson was that even experienced people can make mistakes. Actually it was a two part lesson, the second part is titled "THIS is why I always yell at you to wear your seat belt!" While responding to a call in one of our response cars we had a little mishap that was almost a big mishap and would have turned our crew into our very own mass casualty incident. Everyone was okay and there was no major damage but it really showed them that mistakes happen and the best thing you can do is learn from them and move on. And always wear your seat belt! I joked with the member who was at the station and witnessed the incident that I had planned it all out as a training exercise...for some reason he didn't believe me.

The kicker is this incident happened a few days before the 4Th anniversary of our heavy rescue being involved in an accident while responding to a call. The driver, who is my brother, and the passenger were both injured but thankfully survived. One witness of the accident ran up to help and said "oh my God, you ARE alive. I don't know how." I'm sure that was very comforting for the crew to hear but then again, you don't expect to see a fire truck rolling down the interstate. No charges were pressed as it was caused by black ice but that was a heck of a reminder to our local departments that while we're here to help others we have to remember that we aren't invincible. That's the reason for my post today, we all get complacent and sometimes just have to be reminded that our safety comes first.



Only A Matter Of Time

2008-12-05T17:30:07.680-05:00

Answered a first aid call a little while ago, and people just amaze me. Here's a woman that abuses the 9-1-1 system. I've had her as a patient twice in the past week. The first time, she wasn't too bad. But this time.. she was a different person. Bitching and complaining the ENTIRE length of the call. Didn't want to sit on the stair chair, didn't want to climb one small step, didn't want to do this.. Christ. It's challenging trying to be polite and kind to someone who is being nothing but disrespectful and ungrateful, but luckily I managed. It's sad when you go to give report to the RN and she looks at the report and recognizes the name. Long story short, she's at the hospital getting help for whatever her complaint is this time. Probably only a matter of time before she picks up the phone and dials 9-1-1 again though.



Battle for the ERs

2008-11-30T22:05:20.727-05:00

"The funniest thing I ever heard a nurse say was that Paramedics don't belong in triage. "I am not anti-nurse, but I would like to explore the subject of Paramedics in the ER. Why do nurses run the ER? What is an ER? Emergency Rooms are used to assess newly arriving patients and determine if they need to be admitted to the hospital, or can be treated and sent home. Emergency Room Doctors are equipped to handle a myriad of diseases and trauma, temporarily, until proper long term care can be established. An ER is not meant to be a long term care facility. The idea is get them in and get them out, or admit them. Everybody knows the saying, "Greet them, Treat them, Street them." What is a nurse? The very definition of nursing is to care for in a long term manner, as in to nurse back to health. That is why you see nurses in Hospice and NURSING HOMES!!! What is a Paramedic? A paramedic was created to provide short term care to sick and injured people until they could be cared for, long term, by a doctor or nurse. They specialize in triage and transport. So I ask again, why are nurses running the ERs?Paramedics have taken over the role of the house-calling doctor. No, I'm not calling us doctors, but we do go to people's houses and treat what we can while we transport to the hospital. We work under an extension of a Medical Directors license as put forth by the Medical Control Office's Protocols. Where I am from, we do not need to call online medical direction for anything, unless we just need advice. I am seeing more and more Paramedics being utilized in the ERs around here, but only under the descretion of the nurses. They are treated as techs. Nurses cannot intubate, do surgical airways, or many other things that Paramedics can do, so why are we taking a role that limits our abilities? Wouldn't it make more sense to place Paramedics in the nurses place, to work alongside of the ER doctors and actually help them treat and care for the patients seen in the ER? I know nurses do that same thing, but not like a Paramedic would be able to. Regardless of how you feel about Paramedics and nurses, the end result should be to the patients benefit, and by having a person who can intubate and do many other things that a nurse cannot, the patient would definately benefit. I'm not saying that nurses need to leave the hospital, but they should have a bigger role on the floors, where long term care is needed. There is a nursing shortage ater all, that would help alleviate the nursing shortage, as well as the Paramedic shortage. Paramedics working in the ERs would get paid much more than street medics (they traditionally have), which would lure more people to the field. It would be a trickle efect.So why isn't this going to happen? Nursing Union! They have been here longer, took control of the ER long ago, and won't give it up, even if it means that the patient doesn't get the benefit. I'm not saying there aren't nurses out there that cannot intubate, do sugical airways, and whatever else, but they aren't trained that way. They have to take extra classes and whatnot to get the experience. Paramedics are trained that way from the go, and we specialize in short term medical care, like TRIAGE!! When was the last time a nurse intubated as opposed to a Paramedic? When was the last time nurses were put in charge of Triage at a mass casualty incident? I am sure there will be nurses that say, I have, or I do, or I do all the time. They are the exceptions, not the norm. The only way Paramedics will start to win the Battle for the Ers is with higher education. Everything with us starts with more education. I [...]



Happy Thanksgiving

2008-11-27T19:57:12.260-05:00

Happy Thanksgiving everyone!



You did what?? And why??

2008-11-26T11:41:33.085-05:00

In following up on the sentiment expressed in the previous post about EMS' "taxi runs," here's one of my stories. I spent a while looking for the PERFECT one, but after realizing I had SO MANY (unfortunately), I decided to just close my eyes, point my finger, and pick THAT one...



We were en route back to the station from the hospital when EOC dispatched us TO OUR STATION for a “walk-in” having an “unknown problem.” If you’re not versed in this, a “walk-in” is just what it says- someone who “walks-in” or “drives up” to the station for “help.” This particular station I was at for that shift seems to have more than it’s fair share of “walk-ins” for some reason. We were only about a mile away when we got the call.

So we get there and find the fire department sitting in the truck bay with this woman in her 30s. According to her, she had been at home sitting at her computer when she spun around in the chair to get up and became dizzy. Then she threw up…ONE TIME. Now she wants to go to the hospital. Her husband rides in the front of the ambulance with us to the hospital. Know what I did? I took her blood pressure. I took her pulse. I got her O2 sat. I asked her about her medications and allergies. I called the hospital. That was IT. It took me about 3 minutes.

Alright first of all, why do you “need” to go to the hospital because you’ve thrown up ONCE? I’ve spent all day throwing up and feeling lousy, and I didn’t call 911. Never even THOUGHT about doing it. Second of all, if you drove- well actually your husband drove you- from your home to the fire station, WHY couldn’t you just keep on driving to the hospital yourself? I didn’t do anything life-saving for you in the ambulance. I didn’t do ANYTHING for you. A “ride” to the hospital is $400 via our ambulance. Then we charge $8.50 per mile from wherever we pick you up. It’s 15 miles from the fire station we were at to the hospital. You do the math.

The other thing I don’t get- which I didn’t actually think about until later- is what was the point in this woman’s husband riding WITH US? Now someone has to waste the time and gas to come get you both then take you back to get your car and…I just can’t see any point in all this.



Biggest Pet Peeve

2008-11-26T00:21:02.256-05:00

No doubt, my biggest pet peeve in EMS is the taxi runs we do. It has been on my mind a lot lately, between the Men's Health article, and some issues we are having at the firehouse. Go to any state in this great union, to any firehouse, and any medic can give you ten examples in the last year of such runs. Why is this such a problem? Ask any child: When do you call for an ambulance? Most likely they will answer: When there is an emergency. Yet, the parents of those kids call for some extremely stupid reasons. If 7-year-olds can figure it out, why not 30-year-olds?

We see abuse of EMS from all walks of life, regardless of race or socio-economic class. Regardless of insurance status. Even regardless of transportation status, and by that I mean the patient is completely ambulatory, stable, not a damn thing wrong, and six family members all with cars are home and able to drive.Over the last few years I have heard many excuses as to why the ambulance was called.
-Going by ambulance will get me seen faster (not true, not true)
-I don't have insurance (this ride isn't free)
-I don't have any other way to get there (OK, I can kind of see that)
-I don't have a regular doctor (huh?)
-Because I want pain meds (I don't think so)
-Because I wanted to (can't argue with that logic)

I have transported stubbed toes, hurt pinkies, and fevers of 99 degrees. I have also transported a 22-year-old who drank one beer and the parents freaked out, a scratched knuckle, and someone who needed inner reflection. I am sure all of you reading have similar stories. I even had a chronic caller, 3 times a day from the same pay phone. He would call and say he was dizzy and he needed to go to the hospital. 3 times a day. I would think that would be an abuse of 911, punishable by law, but PD told us there was nothing they could do. Once, when we were with him, a 3-year-old girl was hit by a car in our district. She had to wait 5 minutes longer for help to arrive. When we explained this to him, his reply was "Oh well. When I call, you have to come." I had no response to that. He had me there.

We educate the public on fire prevention. We educate the public on fire safety. We educate elementary students on E.D.I.T.H., stop, drop, and roll, and stay low and go. We educate on everything fire related. Thanks to all of this public education, fires are down. What about EMS? EMS makes up 85% of FD calls (depending where you live). Why do we not educate on EMS? Sure, we put on CPR and AED classes. But why is it so taboo for us to educate on what is an emergency? When it's OK to use an ambulance? There has to be a solution to this problem. Unfortunately I don't see it coming anytime soon.



Just another day at the office

2008-11-25T17:42:45.817-05:00

I've worked in the ER long enough to feel confident in what I do. I can do that 12 lead ECG with my eyes closed, I can get the IV first time and draw blood without bruising my poor unsuspecting patient. I *can* do it. I do do it... and most of all, I enjoy it. Well, at least until the end of last week. I think the universe decided I was getting too big for my boots and knocked me clean out of them.

Without going in to enormous amounts of detail, towards the end of my shift, we had a 30 something year old lady come to us with chest pain. She had a significant family history (both parents died of MIs before 40) and her ECG showed huge ST elevation. Oh and before I forget - she was 38 weeks pregnant... and she coded.

So, skipping over the gory bits (for my sanity as well as yours), there was a very quick and dirty c-section in the ER, not an OR with dad watching. Mom didn't make it but the baby is going to leave the NICU tomorrow morning.

I didn't know that pregnancy increases the risk of the patient aspirating and that I needed to apply cricoid pressure. I didn't know that my hand position for chest compressions should be moved up the sternum or that the uterus needed to be displaced. I didn't know, I didn't know, I didn't know...

I've learned a lot from it and in that respect, I'm grateful for the experience. I just wish I hadn't been left feeling like I've failed... but I guess thats the price you pay for for all the great stuff being in medicine gives you the chance to take part in.



Party Paramedics

2008-11-21T13:11:03.449-05:00

Just got my JEMS email, and in there was this fascinating article about "party medics" and the concept of having EMS staff on hand at college parties.




One has to wonder, though, what kind of message it sends.


Does it simply accept that "college kids will be college kids" and offer a measure of protection for that mentality or does it show a level of acceptance for potentially illegal behavior?


Working part time for a small university's Public Safety department, I've seen the best and the worst of college students, and their choices. We very recently created our own EMS club, and are in the tentative stages of trying to figure out what roles they can play on our campus, without major liability on the university's part.


Does this university's insurance policy cover the "party medics"? Are they affiliated with the school itself? How are they funded?


And does anyone else see this as a lawsuit waiting to happen?



Advice Anyone?

2008-11-19T16:14:49.467-05:00

Hello everyone. I was recently laid off from my job due to a budget cut. There, I was a Security Guard/EMT, but if you ask me, I was more of a secretary than anything else lol. I thankfully found a new job, but this time as a paid EMT. I'm a member of a volunteer first aid squad in my town but to go from volunteer to paid, well that's just a HUGE jump, at least in my eyes.

I joined the squad in my town a couple of years ago for reasons I'm not even sure of. Our squad, along with many other volunteer squads were struggling and dying for EMT's, so taking the EMT course was just kind of the next step. I wish I had some meaningful reason as to why I became an EMT but sorry guys, I don't.

Although I did well in the class and passed everything with flying colors, to this day I swear up and down that I shouldn't have even passed any of the tests and even the state test. My new job obviously will entail answering emergency calls and I feel like I'm no where near ready. I try to answer as many calls with my squad and even sign up for more than one duty crew night a week. Sometimes up to four. I feel like the effort is defiantly there but the lack of call volume and certainly the lack of confidence defiantly doesn't help my situation.

I will hopefully be starting at my new job next month and will have to either get over my fears and suck it up or be jobless. I know this blog was originally started has a place for EMS workers to tell their stories but I come to this blog looking for advice. With that.. advice anyone?

(Yes, I did do a similar post a month or so ago.. but did I mention I REALLY need advice?)



Meltdown

2008-11-14T20:48:06.944-05:00

Protecting its citizens from harm is the noblest of government functions, the very core of a successful republic. Providing that protection is the purpose of organizing and maintaining our government. But who do we turn to when our fellow citizens turn against us? A pregnant female with a toothache called 911 from a housing project at six AM. She had been up all night, unable to sleep. An advanced life support vehicle was sent to her home and took her to the emergency room. Innocent enough, one of hundreds of EMS calls fielded by the Providence Fire Department every day. Most rational persons would have a difficult time defining the majority of these calls “emergencies.” Had the Emergency Medical Technicians refused to transport her, instead of being commended for using common sense and reason, would be reprimanded for failing to address the needs of the patient. It matters not that an entire section of the city was left unprotected during the time this patient was transported; time when true emergencies could, and often do happen. The patient was catered to, no complaint filed, and the department’s goal of “covering your ass” was met.Our EMS System is in chaos, patients are allowed to call and request transportation to the hospital for any reason whatsoever and an advanced life support vehicle will be sent, damn the cost to the taxpayer. Most responsible people wouldn’t dream of tying up a valuable resource because they needed a ride or wanted to get into the emergency room faster. Responsible citizens are being bullied by the minority who think government is at their beck and call.Is this society’s problem? Is there a law that protects the rest of us from such unscrupulous drains on our resources? No, there is not. Perhaps it is time to consider the possibility. We pay for a service. That service is rendered useless when it is unavailable. The CYA policy is an insult to those providing EMS service, and those who founded this country and the generations who fought and died for our independence. The time has come for us to learn how to say no!For years the 911 system has been overburdened with calls for non-emergency reasons. Because of fear of litigation anybody who calls for assistance for any reason will get help at their door within minutes; unless all resources are otherwise utilized. In that event, the people requesting transportation will have to wait a little longer. Some people die waiting, and that is the result of ineffective leadership. It happens. It could happen to any one of us. In Providence, there is a severe shortage of advanced life support vehicles. Or is there? Six rescue units handle approximately thirty-thousand calls for emergency medical aid each year, and the number is growing. The need for additional resources is well known, and blatantly ignored by the Mayor’s office and the Fire Department administration. But is this crisis truly a crisis? Or is it merely the personification of a much larger problem plaguing our society, the insistence of many Americans to have government cater to their every whim? When will we have had enough, and simply say, NO MORE!Because of the very real fear that a responsible person may not call for help in time of crisis we as a society are catering to an unscrupulous bunch who will exploit any option that is available. A mentality exists where government services represent an unlimited pie waiting be devoured, and only a fool would hesitate to get their piece. O[...]



Some Days Are Good

2008-11-09T17:32:48.609-05:00

As with life, in this job you have to take the bad with the good. The first call we had this morning was routine. Man fell down, woman gets scared and calls 911 thinking he's having a CVA (Stroke). We arrive and find that he just tripped and all is well but still want to go to the ER just in case.

About an hour after that, we get a call for the unknown medical call. Now nine times out of 10 these calls turn out to be nothing. Just a tag that the dispatcher gives a run when they don't know what the complaint is. We arrived on scene and was greeted by the PD officer who reported that our patient was in bed and breathing shallow. As we proceeded towards the bedroom, I asked the daughter when the last time anyone saw her was. She replied that the checked on her a few times last night but didn't see her until about 30 minutes ago. At that point she wasn't responding to anyone.

Hearing that, we increased our pace to the bedroom. We soon found our patient. We found her doing very little actually. No shallow breathing, no heartbeat, no response to pain. Her lifeless body cold to the touch. Giving my partner a look, we asked the family to leave and informed dispatch to send an ALS intercept our way.

Once the family left the room the CPR began. I have always thought that the most effective scene for a heart disease commercial would be to show an actual CPR scene. The indignity, the blood, the sound of cracking sternums not to mention the far off stare that the patient has. Yes, all of this would definitely open a few eyes because it wasn't like it seemed on TV.

With ALS enroute, the patient packaged and the D-fib advising no shock, we carried our patient outside. Passed the waiting family, passed the eyes of the curious onlookers who had begun to congregate. Out onto the stretcher and into the bus.

After ALS set up and was ready to go, we proceeded to the ER. But during the trip, something happened. Something that very rarely happened. After the third Epi was on board, a heartbeat could be felt! No that can't be right?! Her age, the history of heart disease and the fact that she was just in the ER yesterday for chest pain all pointed to her not making it.

Yet here is was, a pulse! Soon the monitor confirmed it, she had a rhythm! The rest of the trip was spent maintaining her airway and respiratory rate. Turning her over to the ER staff with a heartbeat was really a great feeling.

Now in this game, CPR saves are a few and far between. Some days you get them and some you don't. It's yet another cold hard lesson of life. But today we actually did it! We actually saved a life. It wasn't a drunk frequent flier or a BS taxi ride to the hospital. We actually made a difference in someone's life!

Yes, these moments are truly a few and far between. So when they come, enjoy them, learn from them, for they won't last forever.



Wait

2008-11-05T08:17:37.376-05:00

She stripped off the non-rebreather, reached deep, turned her head my way and coughed. Not a polite little clear your throat cough, rather a full on clean out the lungs job. I looked out the rear window of the rescue and focused on the car that was tailing us. Her boyfriend.

"Cover your mouth!"

Years of training and experience reduced to scolding a petulant patient with the audacity to call 911 for a free ride to the hospital. What possesses people to call? Do they think they will "get in faster?"

I walked her past the ambulance triage, through the treatment area and into the waiting room.

Cough in my truck? Not today.