Monday, May 29, 2006

I See You.

Would it kill you to leave a comment from time to time? Ya you! You reading this... That comment thing at the bottom... I know your there.. I can see you and my hit counter keeps growing, so I know your there. Your lack of comment posting unfortunately means only 2 things to me. #1 You agree with 100% everything I have to say, Zer0 your a genius and I have nothing to add.. Or #2 You think the blog is horrible and would not lower your standards to the point of actually replying to my blather... Come on, I can take it.. I got broad shoulders


National Health Care

Ok I was playing WoW (World of Warcraft) today and chatting with a few of my online buddies and the topic of National Health Care came up. I know this is hot topic for a lot of people so I'm going to try and approach it delicately. Ok, who am I kidding I never approach anything delicately.

Question: Why doesn't the USA have National Health Care? Answer: Greed.

that's right folks, the people on the upper end of the health care spectrum make way too much money to ever consider endorsing a National system. While the people on the lower end of the spectrum i.e. ME, make very little money and would welcome a standard wage across the board.

National Health Care also does some pretty drastic things like (gasp) makes sure everyone gets equal treatment regardless of income bracket, provides medications to those who can't afford it. Ya, that's right Granny can get her blood pressure meds and not have to eat cat food for a month to afford it! If you need a transplant you get it... Even if you cant pay for a single penny of the procedure or follow up care. Sure you may be on a list for awhile, but you'll get the same shot everyone else gets. You'll get the same meds, not ones dumbed down or generics.. The SAME.

National Health Care also generally runs the ambulance services. Do you think that any owner of a private ambulance service wants to turn over control to the government? Let me think a second . . . Uh, no. There is way too much money in private health care, whether it is ambulance service or privately owned hospitals. Doctors in most areas of the US are private contractors. Look on the walls of most any ER! The doctors don't work for the hospital you are being treated at. The hospitals hire these contractors or contractor groups. National Health Care would put all of these people under one banner. It would regulate pay across the board for quality of service. If you were a year 1 doctor with XX certification you would make the exact same coin as another year 1 doctor with the same certification.

As it stands now hospitals are set up very differerntly by the JACO standard. Then you have Trauma hospitals, level 1,2,3. Wouldn't it be easier and better for the patients if the doctors with the greatest expertise were placed in the hospitals where they were needed most... Regardless of where they were located?

wouldn't it be nice to know that if you called for an ambulance in a "bad" part of town that you would get an ambulance in a timely manner?

Sound off guys, I wanna know your input.


Sunday, May 28, 2006

The Amazing Mouth Mime

It's funny how you never really think about things until you are in the back of an ambulance. Today I had a patient that appeared to say or "mouth" my words as I was saying them. It almost appeared as if he were trying to complete my sentences for me under his breath.

I don't know if I found this act to be rude or slightly un-nerving. I certainly don't think he was doing it on purpose. He didn't appear to be hard of hearing.

As I sit and reflect on it, this isn't the first time I have noticed this behavior, which leads me to believe that it might be some sort of illness not defined by age or ailment. Thinking back I can recall at least 4 other times that has happened. Two males and two females, ages range from mid 20's to mid 60's.

Anyone have any information on this?


Thursday, May 25, 2006

Secondary Drowning

Now, I have been an EMT for a good many years, this makes me feel very ignorant.

You ever hear of a condition called Secondary Drowning? No? Me either. Leave it up to my English counterpart Tom at Random Acts of Reality to point it out.

Those damn Brits know their business I'll tell ya!


'Tis the season for severe weather. Don't worry though, no matter what mother nature brings you, rest assured that you will be in the squad 50 miles from the station. You will be rocking back and forth like crazy and fearing that you will die in a pile of wreckage that used to be an ambulance.

Returning a patient to an ECF (nursing home) today I noticed nurses scrambling through halls squawking about a "tornado watch". They had every aide go into patient rooms and inform them of the situation and close the patients window drapes. I found this very interesting and being the person that I am, I stopped an aide I the hall and asked what was up. The aide replied to me in a very un-concerned voice... "Nurses have been informed that there is a tornado watch for the next few hours" I said: "Ya, so what's the business with closing the drapes?" He looks down the hall to be sure he wouldn't be over heard by said nurses. "I have no idea man, we used to have to cloths pin them together too, but someone stole the cloths pins. I guess they think the drapes will protect the residents from breaking glass and stuff " I found his remarks interesting to say the least and when were we're comfortably outside of the facility and back in the truck I looked to my partner and told her that they probably close the drapes so the old folks don't stare outside at the impending doom in the form of a funnel cloud. If all it takes are a few yards of fabric and some cloths pins to protect a person from a tornado, sign me up for home economics.

For those of you that may not be as familiar with emergency language during severe weather season I have broke it down barney style for you. I'm sure everyone can relate to a fart.

I'm eating all the wrong foods at all the wrong times, I don't exercise as much as I should and I'm stressed to the maximum load allowable without medication. This is Fart Season.

I'm sitting in the truck and we are on our third run. I haven't been able to take my morning constitutional this AM and I'm not very happy about it. I'm awake earlier than I want to be awake and all this bouncing around has got me a bit on the uncomfortable side. I know that it will be at least 30 minutes before I get back to the station. This is a Fart Watch. Conditions are right for massive gas, but nothing noticed yet.

The 4th run comes in and it's a doosey. I have to crawl under a car and try and extricate a 16 year old kid from some wreckage that used to be his car. I have the family screaming at me, the police would like information on the patient, my partner is pressing me like crazy to get this kid out so we can scream to the hospital. I get back to the station, sit down on the couch and take off my boots. The next thing you should be concerned about is.... This is a FART WARNING. Some mild soiling of the pants has already happened and there is sure to be more.


Boom.... KA-BOOM

Well, as many of you know I'm the commander for a special division of where I work and from time to time we get the opportunity to attend new and interesting classes.

One of those classes is IRTB or "Incident response to Terrorist Bombing". Un fortunately for me I wont be able to attend this one due to scheduling conflicts and the fact that I still have a 2 day class to teach for about 20 of our employees on WMD and I haven't gotten that totally prepared yet. BUT, BUT, B U T.. If you get the chance to take this class please drop me a line and fill me in on all the particulars. It is held in New Mexico at New Mexico Tech.

The government pays for most of your expenses, including travel, food, lodging and rental car, all you would really have to provide would be some free time and willingness to learn about bombs. According the the paperwork I received you will be building and detonating explosives and studying the effect they have on different materials.

Keep in mind though, to a dog, you will smell like Osama after this class. Take pictures of the class, bring your paperwork as a carry on, have your certificate handy... These things might make your wait in security a little less stressing and keep good 'ol Johnny from cramming a finger up your butt and digging for C-4.


Tuesday, May 23, 2006

Protocol VS. Scope of Practice

Here is something for you to wrap your head around.

You are called to transport Joe a 67 year old cancer pt to his radiation appointment.
The skinny on Joe is.

Throat Cancer
120 lbs
6' 3"
BP 110/70
Pulse 100
SP02 93% with trach o2 mask set at 4 lpm.
Non-communicative, has trach, requires frequent suctioning.

The catch to this senerio is your a basic crew and according to your company protocol you are not allowed to trach suction. Your "state" guidelines say you can, but your company protocol does not have a provision for it.

You are 20 minutes into your transport and Joe starts to grab at his trach site and he appears to be turning blue. You immediately contact your dispatcher and ask for an ALS intercept and head for the closest facility that can handle Joe.

Joe is breathing on his own, but it's very noisy and you can hear obvious obstructions with his airway. A yankur suction device is not doing the trick. Joe's SPO2 drops into the 80's, you are 15 minutes out of a hospital and your intercept is at least 10 minutes away.

The question I have for you is. Do you suction Joe as you have been trained by your state? This would go completely against your companies policy. Do you wait for your intercept and hope for the best?

You decide.


New Look

I revamped the look of the blog today. Kind of an "Out with the old, in with the new" type of thing. I'm even considering adding another author or two to the writing so that the content wil be fresher than it has been lately. Give me a few days and I'll have the page counter back and all my links restored to their former glory.


Monday, May 22, 2006

Comment Spam

It's late and rarely do I ever make more than 1 post in a 24 hour period but this is pissing me off.

You know, we blog as a sort of diary. It lets us get things off our chest and share with others who might be able to help with a kind word or a well deserved atta boy.

This business of spamming a bloggers comment box is complete horseshit. I spent the better part of 2 hours de-turding all the bogus comments on my board by people trying to sell me viagra or an online degree I can get in as little as 6 weeks with 900 dollars.

A blogger's face lights up when they see that they have a new board comment. To log in and see that it's just some bogus spam really brings me down.

I have turned on word verification on my comments... Sorry to everyone who wants to post a comment, because of a few asshats you now have to type the little word in the box to post.


Grown Men Dont Cry

Ya! Sorry!

I know I havent written in forever. I honestly intend to write about once a week, something just comes up and I dont have the time or more pressing issues are before me.

I was talking to friend online about EMS today and it inspired me to fire up blogger and give it a whirl.

Things are much the same here, kids, job, bills, more bills... did I mention bills?

I got to thinking today about how desensitized we EMS providers get to violence and death. We like to laugh and joke, but seriously, have you ever taken the time to really reflect on the amount of suffering you see on a daily basis?

My father passed away about a month ago and it never hit me. I was sad, and I wanted to cry for my sons who were without a grandpa, but I never even thought about crying for myself... after all, GROWN MEN DONT CRY. I stayed strong for my boys, and I stayed strong for all the family that was there. Every one hugged me and said how sorry they were. Some were crying, some were not. I never even considered it, at least not in the sense a child would cry for the loss of a father.

We see death and violence on a daily basis.. we come back to the station and turn on the television and watch more while the crew fires up the BBQ and cooks lunch... we never give it a second thought. Sure a child hurt will rattle our cage, and the senseless death of a teenager by their own hand will disturb us, but when someone of "adult" age dies.. no matter what the cause, it's all in a days work. I'm thinking maybe this is wrong.

Maybe we dont push CISD enough (Critical Incident Strees Debriefing). Maybe because GROWN MEN DONT CRY, we dont press the issue of much needed mind flushing.

I think next week, when things calm dawn a bit with the kids and job and home life I might find a quiet place to cry for my dad, maybe in the garage where we used to work together so often. I dont want to go much longer without mourning the loss of a loved one. Come to think of it maybe I'll find time to cry the next time anyone loses a loved one, maybe that will remind me that even though it's all in a days work for me...lives are still shattered and some grown men cry.