Thursday, September 30, 2004

Colder Weather

The weather is turning here in Ohio. I think we are getting some of the backlash from all the hurricanes down south.

I was in the squad the other day and I think I might have saw the first of many leaves fall on my squad as I was pulling away from a scene where there was a DOA. Kind of strange for that to happen right at that instant and it got me thinking of something I wanted to discuss with you guys.

Has anyone ever "worked" anyone just for the bystanders?

Today's EMS Lesson. Consider this.
You arrive to the scene of a 65 year old male. You origional call was for patient unresponsive not sure if they are breathing.
As you approach the scene you notice several vehicles in the driveway. You enter the home to find a 65 year old male down on the bathroom floor (like this has never happened before). 4 or 5 people are standing around screaming and crying. They yell at you to "DO SOMETHING!" , "Help Him!"
Upon your inital AX you notice dependent lividity and it is apperant to you that this man has been down for awhile. Cardiac monitor reveals "almost" perfect asystole. You could turn the gain up a bit and maybe get what "looks" like fine v-fib.
Suddenly in walks a 16 year old child, presumed to be the pt's grand daughter and she begins to sob uncontrolably.
You are faced with a difficult decision.
In my carrer I have faced this situation a few times. Every time the situation comes up I struggle with it. We have done both. We have worked them and we have called them. It seems that you can never have a preset thing you will do. It seems to me that the decision must be made on a case by case basis. Tell me what you do. Tell me how you deal with the situation.
Fall is comming and with fall comes cooler weather. Be sure to switch your duty gear to a light jacket and be mindful of the rain. Rain will get you sicker and quicker than cold weather alone. Wear a ball cap if your company approves one, and keep heavy rain gear up front with you behind the seat rather than packed away in an outside compartment. Watch the tread on your boots and keep them shined.
The rain always makes a mess out of your professional appearance. Be mindful of your squad, remember the appearance of your squad and your uniform do a lot to put the patient at ease. If you show up dishevled with dirty truck dont be surprised if your patients are less than trusting of you.
Talk to you guys soon.

Wednesday, September 15, 2004


I would like to thank the 70 or so people that have sent me email concerning recent events. You never really know how you touch people until they tell you.

I have enjoyed writing a blog emmensely for the last 2 years, but there comes a time when you have to be real. Here are the things that are real.

1) 4 children under my roof.
2) House Payment
3) Monthly Bills
4) Food
5) Clothing
6) Motorcycle payment
7) Child Care costs (those of you with kids in daycare know EXACTLY what I mean)
8) Ex-Wife
9) Girlfriend (2 of the the kidos are hers)
10) Education expenses

We are pulling all the ends to meet in the middle on 2 EMT's pay along with some side work. This in it's self is not an easy task. It requires at least 10 hous of OT out of each of us a week just we have some "mad" money as well as meeting the bills.

She is trying to finish school for nursing and I am trying to rebuild my reputation within the company I planned to retire from. I plan on going back to school for radiology as well, but I need to get her through school first.

I'm an instructor. I teach all levels of hazmat and WMD through the operations level. I teach various OSHA cources and of course AHA CPR and First Aid. I also teach about 6 FEMA courses along with the state extrication course. Teaching is my passion second only to my children. I love the station atmosphere and I'm equally as comfortable in the classroom as I am in an ambulance running a 911. Lately I have been teaching for various fire departments more than my own company due to the trouble I have been in. Hopefully I will be able to regain the trust they once had in me and teach for my own company more.

The people in EMS make EMS what it is. It's not the paycheck. Everyone of us that do what we do, do it because we love to do it. We like the opertunity to make a difference in the lives that we meet. We like to try and make sense of things that really don't make sense. Yes, we like the lights and sirens... but we like the routine transports just as much.

I do plan on continuing the blog, but I must warn you that I will be monitoring the content and comments section VERY closely. Please respect me and my family and DO NOT POST ANYTHING PERSONAL OR IDENTIFYING. If there is the slightest chance you think your comment might get you or I into trouble... DO NOT POST IT.

The first time this rule is broken, bent or even scratched the comments section will go down permantely and never return. Think before you speak and remember I have a family to feed.

Todays EMS lesson. A thing to consider:

You arrive to an assisted care facility on complaints of shortness of breath. As you approach your patient you notice that they are speaking in full sentences, their color is good and they dont appear to be using accessory muscles to breath.

As you get closer to the patient they seem to magicly develop symptoms, and when you walk away the symptoms seem to disappear again. In the squad the pulse ox said 97-98%

Yes, we have all been there. Consider these things the next time:
1) How old is your patient?
2) How long have they been in the facility?
3) Do they get many visitors?

These things can be gently asked in a routine assessment in the back of the squad.

Many times older people are simply lonely. Their family might not visit them much. Maybe they dont have any family. Maybe they just wanted to get out of their enviroment for a few hours. Maybe they dont get much fresh air or sunshine due to being bed confined.

Dont be mad at these people, try to be comforting. Treat what you were called to treat. A little O2 by cannula at 2-4 lpm, a couple full sets of vitals and MOST OF ALL your conversation and comforting words. Be concerned, be attentive. Remember for the next 20 minutes to an hour this patient should recieve 100% of your attention. That might be all they really wanted.... someone to listen. Be that person. Dont be the cold callous hardass that is annoyed for being called out for what you consider "nothing". It may not be what you were called for but it is definatly "Something".

I'll talk to you guys soon.