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....