Monday, June 27, 2005

Hot, Hot, Hot

If the weather in your area is as bad as it is in my area please pay attention:

1) Plenty of fluids. Remember if you are thirsty you are already at least 4% dehydrated.

2) Light clothes reflect heat, dark colors draw it. If your company supports a summer uniform, be sure to wear it instead of your darker color duty gear.

3) SUNBLOCK. Even if you think you "bronze" nicely. Melenoma is a killer that doesnt leave many warning signs. 2 sunburns that cause blisters TRIPLES your chances for skin cancer.

4) Limit your exposure outside. Work smart not hard. Use an extra crew for a difficult move. Dont OVER exert yourself, because in this heat it can be a killer for us slightly pudgy people.

This is the 10th straight day over 95 degrees with no rain. The wheat is ruined, the corn is not going to ear out right and field fires are rampant.

Those of you that support a fire department MAKE SURE you carry lots and lots of cool water and towels to rehab your guys. Remember that if it's 95 degrees outside your guys are 120+ in their SCBA and VERY, VERY hot inside a structure fire. Responders in hazmat suits will be good for 15 minutes TOPS. Rotate your crews and keep them well hydrated.

Take care guys.


Wednesday, June 22, 2005

War is Expensive!

You never really realize how much a war costs you until you see it broken down. You can check it out HERE
I started out supporting our war effort in full. I thought we should have turned that place into a sheet of glass and then planted an American Flag out there and made it one big roller rink for our children to play on. I wanted revenge for 911 and I wanted Saddam to pay for not following the rules and guidelines set forth by the first gulf war.

However, looking at the situation now I cant help asking myself: "Why are we still there?"

Their new leadership is in place, they have their own police force and their economy is starting to support it's self. So how much is enough?



Monday, June 20, 2005

Kids and their mouths.

What is it about teenagers that prevents them from using proper language?

This morning I was given several complaints about my Explorers. It would seem that they are using some improper language. Now, let me be the first to say that I'm an EMT and my mouth can get pretty bad when I'm in the station house, but about 6 months ago I started guarding what I say so I would not look like a hypocrite when I told the Explorers they their language was unacceptable. Trying to lead by example so to speak.

They (explorers) would not even consider swearing around me, my coworkers or a patient, but I can't seem to impress upon them that they need to watch their language EVERYWHERE.

My boss got a couple phone calls about inappropriate language and of course he calls me and tells me that I need to address it. I exploded! My knee jerk reaction was to punish them all military style, hoping that this punishment would force them to police themselves a little better. I even considered canceling the next 4 meetings (month) to drive the point home that this will not be tolerated. My boss told me that it might be a "bit" too extreme.

So now I don't know. I have until their meeting tomorrow night to figure out what I'm going to do. If anyone has any input I would welcome all comments.


Sunday, June 19, 2005

In Memory of Amanda

June 19th 1976 my sister Amanda's Birthday. She passed away at the age of 27 almost 2 years ago.

Even though we were 2000 miles away from each other there was not a day that went by that I didn't think of her. Not a day goes by since her death that I don't realize that there are HORRIBLE problems with our health care system.

Amanda died because of a poor medical system. Amanda leaves 3 children without a mother because the medical system failed her. Doctors failed her, nurses failed her and yes, EMS failed her.

My sister Amanda was mentally ill. She was diagnosed with depression, bi-polar disorder and she was prone to fits of rage as well.

Amanda also had some physical problems. She suffered from seizures as a result of severe beatings she received from a man and she struggled with her weight on a daily basis.

These things could have been easily fixed and my sister Amanda would still be with us today on her 29th birthday if it were not for the fact that she was "POOR" and had no medical insurance except for the welfare system.

A cool autumn day and the leaves were falling, Amanda doesn't feel right so she calls 911 with the complaint of an aura. EMS arrives and provides almost ZERO care. No O2, No IV, No monitor. Transports her in the jump seat to a level 1 trauma center (it's the closest ER). Amanda arrives and tell the triage nurse that she is seeing halos around objects and her head hurts badly. Her BP is elevated as well as her heart rate.

Amanda sits in the triage are for 3 hours and is finally sent to a treatment room. The doctor walks in who barely speaks any English. Amanda tries to tell him what she has told the triage nurse. She is not certain he understand her. The doctor reviews the file and sends her home with some BP meds and a script for toradol. No tests because no insurance! No blood work because no insurance and she is not taken seriously because she has an extensive history of mental illness.

This situation repeats it's self at least 3 times over the period of 9 months and then it gets worse. Amanda starts having seizures and goes to the hospital almost weekly. Basically the same thing happens. She is not dying at the moment so she waits a long time to be seen and then is sent home after minimal or no testing to determine the actual cause of her problems. The mental illness' are reviewed in her chart, maybe some different medications are prescribed and off she goes again. Home to 3 babies with seizures and severe headaches.

About a year goes by and I hear from my sister a couple times. It's always the same thing. I ask her if she has seen a specialist and she tells me she cant afford it and her medical card doesn't cover it. I try to help her as much as I can, but with 4 kids of my own an ex-wife and a new girl-friend my funds are streched pretty thin. I urge her to continue trying to get help and she states that she will try.

I'm sound asleep one morning at 5am and my phone rings. It's my mother informing me that my sister is dead. Shortly after I receive another phone call from Amanda's husband telling me that she did not wake up this morning. I'm stunned, I'm angry, I'm confused! She is only 27 I tell myself. There must be some mistake! No way "MY" sister is dead.

Over the next weeks I place phone call after phone call to the doctors and EMS services. I receive no replies. I finally got through to the ME and demand an autopsy. She stated that there would be one since Amanda was so young. The findings later stated that Amanda had built up scar tissue in her head as a result of her beatings and that is what caused the seizure that ended her life while she slept.

No CT scan was ever done because Amanda was poor and she had a history of mental illness. EVERYONE ASSUMED she was lying! They all assumed she was making it up! Well as it happens they were DEAD wrong.

You see guys, in the good 'ol USA you can be poor and get EXCELLENT medical attention. In the good 'ol USA you can be "Crazy" and get EXCELLENT medical attention. BUT, you can't be poor and crazy. That gets you a one way ticket to the triage room and a quick bounce on your ass out of the ER with little or no treatment.

How many time have you run on a patient with an extensive psyche history that you KNEW were not going to pay the bill? How many times were you cussing under your breath that this was a "bullshit" run. How many times did you joke about it to your co-workers or maybe even made a few off color jokes to the ED staff as you walked a psyche in?

Well my baby sister Amanda is dead. She had 3 beautiful children. And that aint no joke.

Think about her the next time your pissed about having to take a "psyche" or "No Pay". That person is someone's son or daughter, brother or sister, mother or father and they deserve the same medical care you would give any sane person. They deserve the same care you would give any one with "High Pay" insurance.


The Basic EMT "Big Lie"

Ok, I'm back now. After months of not posting and my mental health continuously declining I feel that it's best that I start writing on a regular basis again. I just have to force myself into remembering that I can NOT say whatever I want to say. We all remember what happened with that the last time. I certainly don't want a repeat of that. Nor do I want to end up like this person.

If you are new to blogging let me fill you in on a few things. NEVER, EVER post ANY pictures of yourself. Either in uniform or not. Never post pictures of your company or their property unless you have their WRITTEN signed approval. Never mention ANY names or ANY places that can even remotely be linked back to you or your company.

Most people would never post any of these things out of malice. Most people just want to vent and have a little fun with the blogging community, but you have to understand that as you write more and more often you lose track of what you might have said. As you mood changes you might step over the line of what is acceptable by your company. This can and most certainly WILL lead to termination of your position with them.

I got lucky. I did not lose my job, but after I reviewed all the facts I realized that I could have been in much more trouble. Be smart guys, venting is fine, but do it in such a manner that your not going to put yourself in the soupline.


On to today's thoughts. The Basic EMT "Big Lie"

It's been quite awhile since I was a basic EMT, but I can still remember going to class with this big stupid grin on my face and really cramming the books.

I was going to be a HERO, I was going to be the guy that came in the nick of time and cured the full arrest, stopped the seizure and pulled the drowning baby from the bathtub. That was going to be me and my Basic EMS Classes and Instructor made me feel that way. IT WAS ONE BIG LIE.

Ask yourself. Are you going to work for a private service or a public service?

If your going to work for the public odds are your either a volunteer or a driver. Paid public service in most areas are going to have and Medic or Advanced in the back of the truck. As a volunteer you might get to work a bit more but check you scope of practice for your area and you'll find that your going to do just a little more than your adverage Red Cross person.

Now here is where the "Big Lie" starts. No EMS instructors tell their students what private EMS is like. In some areas private EMS companies run all the 911, but in most areas private EMS does either "Hand-Offs" or "Transports" Your basic EMTs in school are not properly informed as to what awaits them in the job market! Lets examine them:

1) Handoffs - Quite simply put; a public responding EMS service such as the fire department responds to a scene. They determine that there is a need for ambulance transport to the hospital, but there is nothing life threatening. They call a private service to do the transport. That is a perfect example of a "Hand-Off"

2) Transport - Sometimes referred to as a "tote". This is the private service bread and butter. It is also a very important part of EMS, but instructors fail to tell new basic EMTs that this is NOT lights and sirens and rush, rush, rush. Your going to be taking grandma to her doctors apt. Today because she can not sit for long periods of time. Get used to it, it makes up about 75% of all private service EMS runs.

As a basic EMT in a private company you can look forward to long hours with a pay scale of somewhere in the 16-22,000 a year range depending on where your working. You can expect to turn your lights and sirens on about 3 times a year (if your not on a 911 rig). You can expect to do anywhere for 6-10 runs in a 12 hour shift and have about 40 pages of paperwork to complete before you go home. You can expect to be under appreciated by every ER doctor you meet and frowned on by all Public EMS employees. Now that's the truth, but there is also another side! Read on before you start flaming me.

As a basic EMT in a private company you can look forward to taking your "regular" patients who know your name and are always happy to see you. You can expect to be a counselor to people with terminally ill family members. You can plan on being requested by patients in facilities that have grown to only trust you and your partner. You have the freedom to do things "Just Because". You can make your rounds though the nursing home checking on all of "your" patients keeping track of their progress with the staff. You can cry with a family on their loss. You are free to feel the joy of watching someone walk after the powers that be said they never would again. You get to see so many sides of medicine, and 10 times as many sides of the human race. This is where you are fortunate. You make a difference in these people's lives everyday and most of the time you never know it.

So instructors, start leveling with your basic EMT students. Those that want to actually make a difference in people's lives will respect you all the more, and those that are the glory hounds will silently drop from your classes and you are probably better off without them.