Merry Christmas

Congratulations! You are the lucky owner of the Model ZVZ156 Vangplotz High-Digenation Wide-Scringe Framulator, Series 7000, with fernillated quick-response Worzel™ and 20,000 zurlebytes of scringe-view quorms. Follow these simple instructions and soon you will enjoy untold hours of pleasure.

IMPORTANT: Begin by lifting out the plune-wrapped section marked "Lithinode Distrillitor" and refer to the blue-colored picrochit-regulator intensity chart on the side. If the chart has the fuchsia-colored code BRZ3434, your unit requires an AC4(x2z3) power influrger. Extract the influrger pack from the distrillitor's surge-protection splange and check the code. If you have an AC5(x3z4) influrger instead of an AC4(x2z3) model, or if the intensity chart is colored burnt orange instead of blue, then call your local Vangplotz "Speedy Geek"™ home service provider at 1-800-UONHOLD. (WARNING: If the intensity chart is colored silver with pink stripes, then your distrillitor must be activated in person by a Vangplotz lithinode technician within 48 to 72 hours. Vangplotz service centers are conveniently located in the Yellow Dog, Ala., industrial campus and the six-story Grendel Mall-City in Frozen Badger, N.D.)

Next, lift out the tray marked "Tools" and check the inclusions against the following list:

• One 7 3/4-inch extenulator
• Two packages of 3/4-inch fribbets
• Four packages of 1 1/2-inch fribbets
• One six-jointed revolving spangler
• One Spurgel-head grommel
• Six fandles
• One swigel-headed flonge
• One multi-pronged grallup
• One soft-COR elasticized squiller

Unpack the main components: Scringe, MO-DOR qualblanz scrambler, disk-o-later insertion whindler, zagenator, gridger board, Wooflang biceptor, varnicle inhibitor, Worzel™.

Remove plune-wrapping from the scringe. Using the 7 3/4-inch extenulator, calibrate the number of inches spanning the scringe-gripper aperture on the MO-DOR scrambler. The ZVZ156 scringe must have a 14 7/8-inch aperture to successfully interflex with the MO-DOR picrochits. If the aperture exceeds 14 7/8 inches, insert and turn the soft-COR elasticized squiller. Upon completion proceed to:

STEP 1:

First, insert the lithinode distrillitor pack into the scringe under the panel marked Varnicle Reflexelator Chamber. A flinged graffler at the bottom of the chamber will connect the distrillitor to the varnicle. Next, lower the scringe into the MO-DOR scringe-gripper aperture using the swigel-headed flonge to secure it onto the varnicle nodes, which conduct 20-zilihurtz magnifiers to the varnicles. Use the multipronged grallup to secure the pink wooplers to the orange varnicle nodes and the four triple-pronged green wires to the varnicle inhibitor. WARNING: Even one woopler-varnicle node misconnection will cause xurls to disrupt the scringe-view quorms once the framulator is plugged in.

STEP 2:

On the gridger board, align the zagenator, whindler and biceptor units 2.725 inches apart, calibrating the distance with the extenulator. Place the gridger board on top of the units and secure with 1 1/2-inch fribbets using the revolving spangler. Stabilize the units by installing fandles using 1 1/2-inch fribbets.

Go carefully; this is a narrow space: Attach the Spurgel-head grommel onto the wronchle prong of the multi-pronged grallup and position it directly over a fribbet.

Next, extend the revolving spangler to the fourth joint, attach the bludgger head and release the sping-grip. With your left hand, carefully lower the spangler and clamp the sping-grip around the grommel handle while turning the spangler speed valve to "rapid" with your right, and pressing the oscillator button with your other hand.

THIS CONCLUDES PART 1

The EMS Oath

Getting ready for Christmas, buying more stuff than my boys could possibly use in all of 2008 just because I'm an over-compensating daddy. There is so much of their lives I miss in the course of performing my job. I sacrifice because I never want them to have to sacrifice. I miss out because I want them to grow up being proud of their daddy and what he does.

I want to remind all of you of an Oath I took. Now, not every EMT takes this Oath, but the ones that are serious about the job will, and they will live by it.

EMT Oath

Be it pledged as an Emergency Medical Technician, I will honor the physical and judicial laws of God and man. I will follow that regimen which, according to my ability and judgment, I consider for the benefit of patients and abstain from whatever is deleterious and mischievous, nor shall I suggest any such counsel.

Into whatever homes I enter, I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law.

I shall also share my medical knowledge with those who may benefit from what I have learned. I will serve unselfishly and continuously in order to help make a better world for all mankind.

While I continue to keep this oath unviolated, may it be granted to me to enjoy life, and the practice of the art, respected by all men, in all times. Should I trespass or violate this oath, may the reverse be my lot.

So help me God.

Let me tell you, there is nothing glorious about telling a mother her 6 week old baby is dead. There is no glory in having a drunk throw up on you or a crack head trying to stab you for your narc bag. You do this job because you love it, you live it. Save the glory for someone who needs it. Hug an EMT today! That we can appreciate!

12 Days of Christmas as seen by EMS

On the First day of Christmas, my Dispatcher gave to me...
Grandma who fell and hurt her knee...

On the Second Day of Christmas, my dispatcher gave to me...
2 MG of Narcan for the out of work person who wants to end it all by
taking her Husband's pain pills and won't tell me what she took and is feeling
suicidal....
and grandma who fell and hurt her knee.

On the Third day of Christmas, my dispatcher gave to me....
Three stacked shocks for the 88 year old man who instead of paying the
neighbor kid 5 bucks to shovel his driveway, decided to do it himself
and have the big one in the driveway...
2 Mg of Narcan for the psycho chick trying to off herself...
and grandma who fell and hurt her knee..

On the Fourth day of Christmas, my dispatcher gave to me....
4 AM in the morning I have to go to the nursing home because someone has
had the flu for like 16 years and all of a sudden needs to go to the
hospital....NOW,...
3 Stacked shocks for the full arrested popsicle,
2 MG of Narcan for Morphine eating Momma...
and Grandma who fell and hurt her knee....

On the Fifth day of Christmas, my dispatcher gave to me...
Five minutes to eat.....
4 AM shuttle call,
3 stacked shocks,
2 MG of Narcan,
and Grandma who fell and hurt her knee....

On the Sixth Day of Christmas, my dispatcher gave to me....
Six run reports behind because the computer guy can't fix the system...
5 Minutes to eat!!!!!!!!!!
4 AM Shuttle,
3 zaps to the chest,
gonna have a stomach pumped,
and grandma who fell and hurt her knee...

On the Seventh day of Christmas, my dispatcher gave to me...Seven car
pile up while everyone was trying to beat the light so they can get into Wal
Mart the day after Thanksgiving thinking there is only 4 dancing Elmo Dolls...
6 reports behind...
5 minutes to eat.......
4 AM is way to early,
3 stacked shocks,
2 of Narcan Pushed,
and grandma who fell and hurt her knee....

On the Eighth day of Christmas, my dispatcher gave to me....Eight
flights of steps to walk up to get the 400 pound person who is having shortness of
breath since LAST Christmas and can't walk...oh, and of course, the
elevator doesn't work...
7 cars a crunching,
6 reports a writing,
5 minutes to eat.
4 AM shuttle,
CPR in progress,
2 MG of Narcan,
and grandma who fell and hurt her knee...

On the ninth day of Christmas, my dispatcher gave to me Nine blankets
needed to cover up grandpa because he is freezing and we aren't even out of the
house yet but thinks he will get pneumonia and die for all of the 10
seconds we are outside...
8 flights of stairs,
should have stayed home and bought it off of Ebay,
6 reports I'm writing...
5 minutes to eat.....
What the Hell time is it,
should have paid the kid,
2 MG of Narcan,
and grandma who fell and hurt her knee.

On the Tenth Day of Christmas, my dispatcher gave to me...
Ten Minutes till I can get a bed in the ER because the nurses are busy
figuring out who is going to lunch next....
9 blankets needed,
Hope fire department is coming,
7 cars a crunching,
6 reports I need to write,
5 minutes to eat...
Can't you wait till morning,
stick a fork in him, he's done,
Man I hope she shuts up...
and grandma who fell and hurt her knee.

On the Eleventh day of Christmas, my dispatcher gave to me....
Eleven times I tried to get the heat to work in the back of the truck
and maintainence won't take the truck in...
10 minutes waiting,
9 blankets needed,
8 flights of steps to climb,
Hope you have Progressive,
Give me a new ink pen...
5 minutes to eat....
4 AM is early,
3 Leads all show he's dead,
2 MG won't touch her..
and grandma who fell and hurt her knee...

On the Twelth day of Christmas, my dispatcher gave to me...
a 12 Gague IV needle that I put into the drunk 19 year old who tried to
swing at me...
it's really freezing,
Hope you choke on your sandwich,
9 blankets for grandpa,
How did you get up here in the first place,
man your husband is gonna be pissed,
6 reports STILL down...
5 minutes to eat...
Better than taking them back,
Hope I recorded the code,
Man, just pass out already...
and grandma who fell and hit her knee...

(Author Unknown)

Managing Mentals Minus Meds

Ya, so I was playing with how many M's I could get in a single headline, but the topic remains. You need to know how to deal with these patients and stop crying for a medic intercept.

Step 1, remain calm. Don't freak out when you get the call for the 47 year old man who is threatening homicide and has attacked a nurse. Things are never like they seem. You don't know ANYTHING about this patient yet, don't build a picture without a patient. Hide restraints at the head of your cot, just in case.

Step 2, talk to your patient BEFORE you talk to the charge nurse. If possible. Your patient might be nutso, but he/she does have feelings and if they can see you avoid them to talk to the nurse this will just perpetuate the fact that they think someone is out to get them. Introduce yourself, ask them what is bothering them, and LISTEN. Don't act like some know-it-all and just nod and make excuses to leave. Listen intently, no matter how long it takes. This is your patient and you need to treat them the same way you would treat any other patient. Don't be an ass. Most of the time this is a simple problem of the patient not caring for a nurse or an aid. Even thought hey have a history of mental illness they are still people and they get their feelings hurt too. Talk to your patient, not at them.

Step 3, "Ask" your patient to get on the cot. DO NOT place them on the cot unless you absolutely have to. I mean you have NO OTHER options. These patients have needs too and if you move to immediately restrain them your going to have problems. You will take a reasonable stable nut and turn them into a raging psycho. Not really how you want to spend the next hour in transport. Do it the easy way, don't be stubborn, don't try and be super EMT.

Step 4, Respect your patient, and let them talk to you during transport. Get involved with their care. Don't play into any crazy fantasies, but don't belittle them for their comments either. Acknowledge what they have said, and gently steer them out of their manic thoughts to more positive conversations. Keep it light, like favorite foods, animals, music etc.. Don't try to provoke the manic behavior, don't be stupid. These patients are time bombs and you need to know what the fuse looks like. Be careful.

Ok if you have followed these basic rules and you still have one that is intent on removing your head for you there are several things you can do to restrain the patient or to defuse the situation without the use of meds. Don't yell and scream. Calm is the key. Tell your partner to pull over and assist you. 4 point restrain the patient with whatever your company uses as a approved restraint. DOCUMENT, DOCUMENT, DOCUMENT!

If they are still wildly flipping out, you can use a sheet to restrain their middle. If you do this right, there will be almost no way for the patient to remove themselves and hurt you. The key to all of this is to remain calm and perform these procedures with muscle memory. I strongly suggest lots of practice with the biggest guy you have at your station.

If you have tried ALL of this, then call for your intercept, but know that by the time the medic arrives, your patient will most likely acting like a perfect angel making you look silly. No matter how many times you tell the medic "He/She wasn't like this 10 minutes ago" they will not believe you and you'll have some explaining to do back in the barn.

Good Luck, you can do it!

Rarely do I post reader comments to the main article, but this guy had some damn good points.


FireResQGuru said...

Great advice! I agree with everything you said.

Might I also add 1) Never underestimate your patient. The 90 pound chick can be just as dangerous as the 400 pound guy in the right set of circumstances.

2) If they are suicidal vs. homicidal, be sure to address their issues. Just asking them if they want to hurt themselves or others is NOT enough. you need to get a feel for what they are thinking and why they are acting that way. Try to empathize (not sympathize) with them to make that calm connection you were talking about.

3) Be nice. You said calm, which is great advice, but be nice. I don't care if it's your 14th patient of the night in a 10 hour shift - You need to be nice. you really do get further with a nut case by being nice, but not condescending. I yield my soap box....

Medics.. Does it get better?

Paramedic school is killing me. I don't mean the course work or anything, my class average is in the high 90's. I'm talking about the time commitment.

Work 80-100 hours a week. Class room 10 hours a week, then as many clinical hours you can cram in there. Plus the fact that I'm a single daddy with 2 children! It just seems to be "too much" at times.

There is a light at the end of the tunnel though, we will be done in May. May doesn't seem that far away now.

Things are still good at work. For those of you who don't know I got a promotion about a year ago, thats primarily why I haven't been writing as much as I used to. There is just so much to get done in a day's time that I rarely have the time to just sit and reflect on runs like I used to do. It seems as soon as I get the run completed we turn around and run on another one. My down time is just used now to complete paperwork, and try to sleep while I can.

Some of you have sent e-mails asking about my "love life"... HEHHEHE....

Well I have never been one to "kiss and tell" but lets just say that I have met someone but it will be some time before we can be together. She is wonderful, so I'll wait. Now enough e-mails about stuff like that. This is supposed to be primarily an EMS blog... no need to digress.

So now it's time for a little game. Please observe the following scenario and leave a comment if you are so inclined:

You are doing clinical rounds in the ER. A call comes in from a local squad and the report is as follows. "We are en route to your facility with a 20 year old female. Pt is complaining of severe abdominal pain 8/10. Pt was seen at a neighboring ER 2 days prior for same symptoms, given Cipro with a diagnoses of UTI. Pt has taken 1. Vitals are P-120 R-26 BP 148/88 SPO2 98% on room air. Pt is guarding abdomen . ETA to you 8 minutes.

On arrival pt writhing in pain, Vitals established WNL, nursed asked for urine sample. Urine cloudy with lots of floaters.

What do you think? (Besides the obvious)

Take care guys. I'll write more as soon as time permits.

What is it about the loss of a child that tears open our soul?

I mean, I've been on thousands of calls and seen many many people lose their life, and I notice something odd. No matter how many adults die I might feel bad for a couple hours but then I completely forget about them. The fade away into my memory banks and I have to read the old report to refresh my mind with the circumstances.

However, when I close my eyes I can remember every child I ever lost. I can see their faces and remember almost everything about the way they were found, what we did and even how everyone around me looked. I have instant recall about every one of those.

They haunt me. I'm a big strong guy, I should be tougher than this right? Well, I guess I'm just a fucking wuss. I can't deal. I hate the fact we couldn't do anything. I feel helpless, I feel out of control. It all happens in the span of 45 seconds. Every negative emotion you can have just floods to your head and makes your heart pound. Your hands get sweaty, you start thinking about your own children. You have to look up with a tear in your eye and say: "I'm sorry, there is nothing we can do, you child has passed"

The cops wont do it, and most of the time the family doesn't want to hear from a cop, they want to hear from the guys in the ambulance. They want some answers! You just don't have them and even if you did, you wouldn't tell them. Thats the doctors job.

I caved today. I completely shut down. We realized she was dead and I asked my partner if he could tell the mother. I just couldn't do it this time. I'm usually so strong. I usually have it all in control. Not this time. I felt so helpless.

I just want it all to go away. I don't think I can deal with another dead child. Each time I feel part of my humanity slipping away. They are not my children, but I can't help feeling the loss of the parents and siblings. My heart aches for them. I just want to fucking scream. IT'S NOT FUCKING FAIR GOD! KILL THE BASTARDS THAT DESERVE IT, LEAVE THE DAMN BABIES ALONE!!

enough for today.

Author Unknown

I ran across something a few years back that I would like to share with you folks.


AN EMT / FIREMAN'S Life
It may take you two minutes to read this, but if you do not take the time to read this you are one of the people this post is talking about.
You stay up for 16 hours
He's been up for 48 straight
_________________________
You take a warm shower to help you wake up.
The rain in the middle of the interstate keeps him awake.
__________________________
You complain of a "headache", and call in sick.
He's chilled to the bone, hasn't eaten all day, has the flu, and then runs out to another call
__________________________
You drink your coffee on your way to the mall.
He pumps on a five years olds chest on the way to the hospital.
__________________________
You make sure your cell phone is in your pocket.
He makes sure his cardiac monitor is working.
__________________________
You talk trash about your "buddies" that aren't with you.
He watches his buddy fall through four floors.
__________________________
You walk down the beach, staring at all the pretty girls.
He walks down the highway looking for the motorcyclist's missing limb.
_________________________
You complain about how hot it is.
He wears fifty pounds of gear in the middle of July and drags a body out of 1600 degree flames.
__________________________
You go out to lunch, and complain because the restaurant got your order wrong.
He hasn't seen a meal since last shift when he ate breakfast.
__________________________
Your maid makes your bed and washes your clothes.
He's worn the same stinking, wet, grungy clothes for the past 24 hours....no time for a shower.
__________________________
You go to the mall and get your hair redone.
He holds the hair of some college girl while she's puking in the back of the ambulance.
__________________________
You're angry because your class ran 5 minutes over.
His shift ended 2 hours ago and he's on for another 24 hours at a station thirty miles away.
__________________________
You call your girlfriend and set a date for tonight.
He calls his girlfriend to tell her he made it back alive....then
leaves abruptly for another call
__________________________
You yell and scream at the ambulance that just past you because they slowed you down.
He's in the back of the ambulance, going to cut somebody out of their car only to find out that they're dead and their daughter is barely alive.
__________________________
You roll your eyes as a baby cries.
He cries as he hears his new born cry in the hospital.... he was taking a drunk teenager in when his boy was born.
__________________________
You criticize your fire department and say they're never there quick enough anyways.
He blows the air horn while the person in front of them refuses to move while talking on their cell phone and doing their makeup.
__________________________
You hear the jokes about fallen firefighters and say the y should have known better.
He feels the floor give way while he's carrying an old lady from her bedroom and tosses her on to the hard floor and falls into the unknown.
__________________________
You see the bright lights when you go by.
He sees the broken bodies lying around the car.
__________________________
You are asked to go to the store by your parents. You don't.
He looks into buying a bullet proof vest because he's been shot at trying to save the shooting victims life.
__________________________
You stay at home and watch TV.
He takes his spare time to wash the wagon, restock the ambulance and maybe call his mother to tell her not to worry, he'll be home the next night
__________________________
You crawl into your soft bed, with down pillows, and get comfortable.
He tries to sleep on his spring board bed but keeps getting woken up by the gong and bell, ahh, one hour of sleep, it should do till tomorrow night.
__________________________
You sit there and judge him, saying the that its a waste of money to have them around.
Garbage truck workers make more than he does, but it's not for the money, it's for the people who don't appreciate what he does.


Kinda says it all, don' ya think?

Mortality

It's going to happen. No matter how hard you try.
If you're in this business for any length of time you will start to feel your own mortality.
You will start asking yourself questions and considering the outcome of your own demise. What will my family do, how will I be remembered? Will people grieve for me? How will my affairs be taken care of? What will be come of my possessions, will everything go to my sons as I wished?

I sit an think of these things sometimes and I guess I'm scared of dying. I know the world would continue spinning after I'm gone, but I guess I'm such a control freak that I don't think I would like the way it spins.

Would my boys be raised the way I want them raised? Would they eventually start calling their step-dad "daddy"? I'm daddy god-damn it! I don't want them calling someone else daddy.

I tell my children I love them everyday, most of the time I tell them 2-3 times a day, does it mean anything to them? I let them know that they are the most important thing in the world to me and that NOTHING except God is more important and nothing ever will be.

I usually get the reply "Love you too Dad". I don't know if they really understand that they are my entire life. The entire reason I do what I do.

I go on calls and I see people that take their children for granted, or use them as a source of income. It sickens me. I can't even wrap my head around the fact that people literally kill their children, starve them, beat them, neglect them. Why? How in Gads name is this possible? Is there something broken in their head? They must me broken, I can't imagine any sane person doing such a thing to their flesh and blood.

Ahh, maybe it's just me getting old, or maybe I need to consider meds. I don't know anymore. I do know that I have things to do, places to go, people to see, and I'm not looking forward to cashing in my chips anytime soon. I just wish i could go a month without seeing someone dead while at work. Just one month to reset my head or something.

Your Kidding Right?

I opened up my comments section and found this:

Anonymous said...

Hey,

I am looking to become an EMT, I finished classes, and I just have to take the national registry exam. Trouble is, I smoke marijuana and I dont really want to stop unless I need to. Are there drug tests for EMT-Bs?

Thanks.

Are you fucking kidding me? I hardly know where to start responding to something like this, you have left me 90% speechless. Lucky for you that I still have 10% to work with.

As an EMT you are asking the public to trust you. You are asking them to put an unimaginable amount of faith in your ability to help them on the worst (or one of) day of their life.

Many days, you direct the difference between life and death. Your actions or inactions determine the outcome of some pretty nasty situations. You need to have the ability to think clearly, unobstructed by any drug illegal or legal.

I can't tell you how disappointed I am that you even went to school for EMS. Your a fucking idiot. You wasted your money and you wasted the instructors time. You took such a wonderful opportunity and squandered it because you can't lay off the wacky tabacky.

If you would have started your comment with "I Used to smoke dope, but then I went to EMT school" I would have had no problem, but you blatantly say that you don't want to quit. You disgust me, you are the lowest form of snake-shit on the planet.

Oh and to answer your question. Yes, they do drug test.

Today I declare WAR!

Today I declare war on the world for not making everything perfect for me.
Today I declare war on my job for not making everything easy on me.
Today I declare war on my girlfriend, she is now my ex-girlfriend.
Today I declare war on my kids for being kids and loving unconditionally.
Today I declare war on my house for constantly needing repair.
Today I declare war on my bank for not lending me any money.
Today I declare war on my family for never being there for me.
Today I declare war on my friends for always making me look at the bright side of things.

Today I declare war on myself for setting my expectations too high.
Today I declare war on myself for being 34 and still optimistic.
Today I declare war on myself for not giving my children more attention
Today I declare war on myself for being so belligerent.
Today I declare war on myself for expecting too much out of life.
Today I declare war on myself for being so fucking co-dependent.
Today I declare war on myself for feeling guilty about hard decisions.
Today I declare war on myself for stressing over the small things in life.
Today I declare war on myself for missing the wonderment of just being alive.


Sorry guys, I had to vent. Shit is falling apart around here and I'm in a mad dash to set things right again. It's like trying to crawl out of a hole, you get so far and then WHAMO you slide down again. I'm nothing if not persistent though. I'll get there and my experiences will strengthen my resolve. The bad things that have happened to me over the course of the last 4 years will serve to remind me why I should never trust ANYONE except my sons and my friends.

Z

Whew..!

Thanks for all your e-mails and chats. No I'm not dead. I'm in paramedic school. So I guess thats pretty close to dead.

Many changes in my little area of private EMS. I was promoted, so now I have to at least pretend to be a good boy.

The runs have really been more of the same lately. Either that or I'm so busy with school and home that the really interesting stuff just doesn't interest me anymore.

I will post more later, just wanted to drop a quick line to let you all know I was still around.