The Other Side of Ems

Partners

2011-03-16T05:04:00.000-07:00

It's been awhile. I'm not sure if I have returned to vent or to actually try and express some of the frustration I have been feeling lately. No matter I guess; I'm here now.

You ever stop to notice that it's not just the patients that you make a difference (or indifference) with in your day to day dealings? I mean, we like to think that we are in this job to preserve life but in the end we also leave a considerable mark on those around us. Some of them are patients, some are not.

Partners

One way or the other if you work with someone long enough there is a transference of both attitude and personality (not to mention skill level) between you and your partner. I have written many a blog post about grizzled old paramedics that I have learned a trick or two from. It wasn't until a few months ago that my wife pointed out to me that I WAS in fact a grizzled old paramedic now.

I guess it just crept up on me. I never saw it coming, then one day WHAMO....shit.... you've been doing this a long time. What stories are people telling about you? How did you affect the lives of the people around you? What did someone learn from you? What legacy are you leaving to the NEW group of practitioners?

One person comes to mind when I think about how I might have influenced a younger, less experienced EMT. You know me I never name names, just not polite.

I got this guy as a partner straight from his basic program, he was young, eager to learn and a cracker jack basic. Many times I had to reel him back in on things, but at the end of the day we saw pretty much eye-to-eye on most calls. He would ask questions when he needed answers and I'd do my best to answer them or at least point him in the right direction for answers. It wasn't long before he decided to go to intermediate school, it seemed almost effortless for him. He had a question or two from time to time but in the end he did very well and his experience on the truck gave him a good foundation to build upon his basic education.

After he got his intermediate card he immediately stepped up his game. There was very little coaching from me. He did very well under his scope and knew most of my scope as well. We were able to work seamlessly in the back of the truck. People would often comment about that fact that we would almost never speak to each other during a critical call. Talking to the patient was important to us, but getting the job done didn't require any delays. We had worked together for almost 2 years and we KNEW what each of us were going to do. Conversation with anyone but the patient was unnecessary.

I could see his mind growing past his scope though and it wasn't long before he was in medic school. This time around his training was more difficult for him, but he always asked questions when he didn't know and he pushed right along to graduation day. I was so proud of him when he walked in and passed registry. 3 years had passed and I watched this young EMT really refine his art. It almost like a father watching his son graduate college. I suppose I felt just as much a sense of accomplishment as he did. It wasn't just that HE made it... It felt more like WE made it.

A couple months later staffing changes forced us on to different trucks. A month after that he never showed up for work again. 30 days later he went to work for another company. I felt betrayed. I felt like I had invested so much to have him just walk away without even so much as saying goodbye (not to mention 2 weeks notice). The rumor mill was spreading that he didn't like the people he was reassigned with and he wanted his own truck. Well, I guess he got it.

So I fumed over this for 4 months. I was always polite when I saw him out with the other company but I never stopped to have much of a word with him. I don't know if I was more angry about the switch to another company or just the fact that he left at all.

I ran across his profile on Facebook. Just for old times sake I start poking through some of his pictures then I noticed his favorite quotation.... It was something I had told him over and over during his time riding with me.

I made an impact on him, and in the end I guess thats all that matters. We all move on in one way or the other, it sucks, but it's life.

Death a collection of scars.

2009-12-27T14:10:00.000-08:00

It's a fact of life, that life ends. From the moment we are born we begin the process of dying, it's not a mystery and it is not avoidable. You are born, you live, and you die and along the way you give and get a few scars.

I can run on a DOA of a senior and not even batt an eyelash. It's so common place that you have to remember to be sullen and mournful while in the presence of the family. I guess my brain justifies it as "They had a good long life." To tell you the truth I'd be hard pressed to remember the name or even location of the call. I'd have to read my report to refresh my memory, but it leaves a small scar on me.

With that said, while you're all thinking I'm some cold heartless bastard, I can remember the name, age and face of every person I ever came across DOA or worked in vain that was under 70. I don't know why 70 is the magic number for me, it just seems to work out that way. It's not like someone dying at 71 is any less a tragedy, but my brain just doesn't process it the same way.

The others haunt me sometimes. I'll dream of them and wake up in a cold sweat. I'll close my eyes and vividly recall every single action I took on the scene. I'll hear and feel the screams and sorrow of the family. My heart will start racing again just as if it were that day. I can't escape them and honestly I don't think I want to. They keep me centered, oddly enough. The ones that we lose can teach us much more about ourselves than the ones we save. Can you remember the last 20 patients you "saved" (treated, etc..)? I can't, but I can remember all the ones I lost. I know what I did, how I felt, how the patient presented. I can recall all of my treatment and could probably tell you pretty close to 100 percent on how I wrote the report. The same goes for the DOA's. I can tell you how the house looked, how we determined death, who I called, who was there from the family and who arrived later and pretty much what time they got there. The scars from these calls run deeper.

Then there is my personal nemesis, the 30 somethings. I'm a 30something and when one of them buys the farm I can't shake it for months. Probably some sense of self preservation or something but it scares the hell out of me when someone my age punches their ticket. I have shit to do, I'm not ready to check out, but whenever a 30 something dies I always think "That could have been me". So then my brain goes into "justification mode". I try to find a reason that person died: drug use, poor driver, no seat-belt, alcohol, bad genetics, non-compliance with prescribed meds. Really, anything I can try to explain why this person died. It's all just a ploy though, when your number is up....your number is up. These scars are noticeable.

Kids are the worst. I imagine they are for everyone in this profession. Let me be clear, it's not the absence of life in the child that damages me the most. It's the sound of a parents weeping, like their soul is being ripped from their chest. There is no worse sound in the world than a mother or father crying over the loss of a child. It will burn it's self into your consciousness and sub-consciousness and you will never remove it. No amount of therapy or booze will help, don't bother with it. Maybe you would have to be a parent to understand. These are deep vicious scars that are ragged and ugly.

Death scars us all, no matter how tough you are.

Paramedics are a collection of scars. Cherish them all, they once were a life and will continue to live on through you.

Where to start...?

2009-11-12T05:32:00.000-08:00

Sorry, it's been awhile since I have posted. Things have become crazy in my life and I was also introduced to facebook.

In June I got married to a wonderful gal and was promoted to station captain. Things took a bit to smooth out around the station but we are running like a well oiled machine now. Private EMS is still private EMS.. it has it's ups and downs, you just hold on for the ride and make the best of every situation and every call.

A few months ago they restructured the emergency room. They replaced all the ER technicians with paramedics and I picked up a part-time job there too. I must say that I find that very enjoyable. On the squad you get to be a paramedic 5-6 times a day; but in the ER you get to function as a paramedic for 12 hours in a row. It's a great way to keep your skills polished and learn a lot of new tricks from the ER docs.

I'm still teaching EMS too, so some weeks I work over 120 hours. I feel it's worth it. I'm trying to save as much money as I can now so I can relax later.

Balancing work time with family time is always challenging but I'm doing the best I can.

Stay safe out there guys!

It shouldn't be easy...

2009-06-16T06:20:00.000-07:00

My next few comments may be a bit sensitive. I apologize in advance for them, but they are my true feelings and in the spirit of open discussion I will post them now. They are not pointing fingers at anyone. They are general remarks.

Do not be a "Bare Minimum" provider. Do not be a "Fast Food" provider. Do not be a "Good Enough EMT"
We have already dumbed the system down quite a bit from what it was 10 years ago. Many of my friends who have been medics much longer than I spoke of a text for Paramedics titled "You the ER Physician". We made it easier so more people would do it. I think that was a mistake.

We have cut too much already, we have made the system and the testing easier for people to pass and as a result of this we have some pretty crappy providers on the road. This is also one of the reasons we cant get better reimbursement as a health care profession. It's also a reason why we are not taken as seriously as we should be.

Not everyone should be an EMT. Volunteer or not, some people just do not have the aptitude for the work, they don't work well under pressure etc. All we accomplish by making the system easier is a type of EMT that you wouldn't want attending to your loved one. You can teach ANYONE to pass registry, but the cold hard truth of the matter is not everyone should. There is a big difference between book knowledge and actual working knowledge.

I don't care what your level is. A solid understanding of the human body and how it works is essential to being a good provider. Yes, there are areas you can stress and areas you can gloss over but all of these areas are very important to the rounded knowledge of a "Good" clinician. You can skate with "Just Enough" to pass the class and still get your card; but honestly, is that the type of EMT you want treating you?

*My Disclaimer*

The preceding post was not a reply to anyone. If you take offense to it your most likely one of the people I'm talking about. If you skin is actually that thin, find new work.

Ass Whoopin' Needed

2009-05-28T05:09:00.000-07:00

YOU HAVE GOT TO SEE THIS http://www.youtube.com/watch?v=Gkaq9o_qe1M

By Carlos Miller
An Oklahoma State Trooper pulled over an ambulance on its way to the hospital Sunday, resulting in the police officer placing a chokehold on a paramedic as a patient lingered in the back.

It was all caught on video by the patient’s son, who was following in another car.
The officer was apparently upset that the ambulance did not yield for him.
However, it is evident that the ambulance had a real emergency on its hands, unlike the cop, who had been speeding towards some incident he was able to resolve in minutes, enabling him to refocus his attention on the ambulance.

The incident marks the second time this year that a police officer pulled a vehicle over as it was clearly on its way to a hospital for an emergency.
Paramedics say they were rushing a woman to the hospital who had suffered heat exhaustion when they noticed the trooper traveling at a high rate of speed behind them. They say the trooper had its emergency lights on but had its sirens off.
The driver of the ambulance did not notice the trooper until it got right behind him. He pulled over allowing it to pass. Through his microphone, the officer allegedly said, “You should consider checking your rearview mirrors.” The driver of the ambulance said he responded by lifting his hands in bewilderment.

Three blocks later, the trooper was seen pulling out of a side street - apparently having addressed his emergency or having picked up a female passenger - and pulled the ambulance over.

At first, paramedics thought the woman in the passenger side was having an emergency.
According to the paramedic’s transport incident report: The officer got out of his vehicle in a state of rage. He approached my partner and yelled, “Get your ass back here. I am giving you a ticket for failure to yield.” He also added, “What do you mean flipping me off?”

The trooper wanted to cite the driver of the ambulance but the other paramedic insisted on driving the patient to the hospital first, then allowing the driver to be cited.
The trooper then told the second paramedic that he was under arrest for obstruction and attempted to grab the paramedic’s arm. But the paramedic reminded him that it was a felony to assault a paramedic in the line of duty, especially when he needs to transport a patient to the hospital. They struggled briefly before the paramedic was able to hop in the back of the ambulance to tend to the patient.

By that time, another trooper had pulled up and started banging on the side of the ambulance, telling the paramedic that he was under arrest for assault. The paramedic stepped out of the vehicle and another struggle ensued - this one caught on tape - which resulted in a cop grabbing the paramedic in a vise-like-grip around his neck.

The officers finally allowed the paramedics to transport the patient to the hospital where they planned to arrest the paramedic. But then they finally got smart and contacted the district attorney, who insisted on reviewing the evidence before filing charges.
Police say they have their own version of the truth that was recorded by their dashboard cam. Of course they are refusing to release it.

At one point in the hospital, the trooper told the paramedic that he was so enraged about the perceived “flipping off” gesture that he considered pulling his gun out and using deadly force, according to the paramedic’s transport report.

Clearly this cop was WAAAAAYYYY over the line here and needs to evaluate his position within the scope of things. He would be better suited serveing fries at McDonalds.

I can tell you one thing for sure, he and I would be meeting off duty to "discuss" how he treated me.

If your in this business....

2009-05-21T08:41:00.000-07:00

I started catching up on the comments of this blog today. Lots of people I never got a chance to respond to over the years. In the course of doing that I re-read a lot of my old posts and noticed that I used the phrase: "If your in this business any length of time" quite a few times. It struck me as odd at first that those were he only words repeated often. Then I came to the following conclusion. IT FITS.

If your in this business for any length of time you will...
notice that your call volume increases sharply and proportionately to the las time you took a piss.

If your in the business for any length of time you will...
get screamed at for taking too long to get there, even though no one moved out of your way.

If your in this business for any length of time you will...
know what it feels like to wear the same underwear for 48 or more hours.

If your in this business for any length of time you will...
know the pain of a complete stranger crying on your shoulder.

If your in this business for any length of time you will...
feel wracked with sadness over telling a parent their child is dead

If your in this business for any length of time you will...
eat from every single fast food restaurant in your area.

If your in this business for any length of time you will...
miss your children's plays and sporting events, not to mention special evenings with your spouse. You will cancel and re-schedule appoints almost monthly.

If your in this business for any length of time you will...
respond to find a friend or family member seriously injured or deceased and your the only truck available.

If your in this business for any length of time you will...
see a near complete turnover at your station, leaving you feeling alone and with strangers.

If your in this business for any length of time you will...
see new EMTs burn out and fade away even before their carrer starts, due to one bad run.

If your in this business for any length of time you will...
witness the miracle of life and the sadness of death all within 24 hours.

If your in this business for any length of time you will...
find your boots fit differently at the end of the day because your feet are swollen from all the walking.

If your in this business for any length of time you will...
learn to eat when you can and never miss a chance to take a leak.

If your in this business for any length of time you will...
know the difference between: mostly dead, almost dead and dead.

If your in this business for any length of time you will...
opt to work when your sick and save your PTO for "Important" things.

If your in this business for any length of time you will...
learn from someone everyday and teach others without knowing you did it.

If your in this business for any length of time you will...
be constantly reminded to lift correctly, but still lift incorrectly and suffer back bain almost 50% of the time.

If your in this business for any length of time you will...
ruin at least 2-3 perfectly good relationships, but replace them with stronger bonds than you ever thought possible.

If your in this business for any length of time you will...
notice that most nurses don't even listen to your report.

If your in this business for any length of time you will...
see at least 10 patients more than 10 times each per year. They will start calling you "friend"

If your in this business for any length of time you will...
stare blankly when someone approaches you in the mall rattling off a call you were on that helped them. You will struggle to remember the details.

If your in this business for any length of time you will...
measure your payment in the smiles you recieve from little old ladies, they know someone cares. (JS)

If your in this business for any length of time you will...
sit behind your computer and write lists of shit that occured to you...

There are literally hundreds more I think of day to day but forget to add here. Please leave a comment and I'll keep editing this post until we have covered as many as we can think of. I need to start carrying a tape recorder, lol.

Take care guys, stay safe out there.

EMTs, the OTHER health care professionals

2009-05-20T01:55:00.001-07:00

EMS is the lowest paid of all health care professionals, but before you go to your boss and complain lets look at why this is the case.

1) Personal appearance: Although some of you take great pride in how you look, others look like they have just rolled out of bed 24/7. Stains on their un-tucked shirts, grossly overweight with a 5 O' Clock shadow at 8am. I don't care if your full time or a volunteer you can always take the time to look your best. A simple jumpsuit, hat and can of deodorant by your bed will solve almost all of these issues.

2) Attitude: I can't tell you the number of times I have ran across EMTs who are bad mouthing either the company they work for or the patient they just had because it was inconveniencing them in some way at that particular moment. Shape up, suck it up and do your job. There is always McDonalds if this line of work is too rough on ya.

3) Conduct: If you want to go out on a Friday night and raise hell DONT WEAR AN EMS SHIRT. No one care about your macho ass! Your making all of us look bad when you swill liquor and boast about how many lives you saved today. Grow up. People judge the entire profession on the things they see. Perception is everything.

4) Reimbursement: You are getting a lower wage because the reimbursement rate by the feds or state (Medicare, Medicaid) is garbage. We need a better lobby in Congress and State Departments to get things improved.

5) DOT: Department of Transportation. This is a joke, there is no way in this day and age that EMS should be under anything but the State Board of Nursing. There has to be a department more qualified to oversee us than the DOT. These is a huge disconnect between EMS and other health care professionals and until we bring all of them together on the same issues there will always be problems.

Ya, it's early in the AM and I just got back from a run...I am ranting a bit, deal with it.
It is EMS week, you can be happy about that. The one time during the year that people feel they are obligated to show us even the smallest amount of respect and graditude. We get a trinket from the local hospital and a free meal. They pass out some awards and pat you on the back and tell you GREAT JOB!

Wouldn't you rather have it that way year round? Wouldn't you rather have a living wage and the respect of all of your healthcare peers daily?

Stand up for yourself. Demand change both within yourself, your peers and the system!
Show respect and you will receive respect.

They presented me with the award for "Provider of the Year" today. I was proud and sad at the same time. We all deserve that award, not everyone can do what we do, but until every single one of us is willing to stand up for what we believe in and force a change in ourselves and our situations we will always be "other health care professionals"

G'night

My Boys.

2009-04-13T06:37:00.001-07:00

Few things in this world come even close to the joy I feel when I look into the eyes of my sons. They are the whole reason I do what I do, and the driving force behind my absolute need to succeed. I want them to have the things I never did. I want them to feel secure and know that no matter what life throws at them Daddy will be a constant and home is safe.

Last night someone took part of that innocence from them. Someone violated their home and stole their property.

3 motorcycles, 1 quad and a go-cart all stolen under the cover of darkness by a coward.

Sounds like a lot but it really isn't. My bike was the only thing of real value. A 2003 V-Star that was 2 months from being paid off. It's insured so I'm not really mad at all about that. They found it about a mile away wrecked in a ditch. The sheriff has it now trying to get prints I presume.

What infuriates me is the things that belong to my sons. They were second-hand and pieced together with duct tape and coat hangers in places but they were one of the true joys of their summertime. We spent many hours in the shop welding and tacking broken parts back together. We searched Ebay for parts and rummaged through junkyards for repairs. The time spent with my sons on these projects were as good as gold to me.

I had to work overtime for 6 months to pay for those motorcycles. I gave them to them on their birthdays. They were so excited they could hardly stand still. Some bastard or group of bastards has taken that away from them. They robbed them of the joy of being a child. They robbed me of the satisfaction of seeing them zoom around the yard smiling like crazy.

As a medic we are supposed to preserve life. We are supposed to help those in need no matter the circumstances. Right now I don't feel like the helping type. My sole wish is that I could find those responsible for this just about 20 minutes before the Sheriff does. I wouldn't ever condone killing anyone, but I'd like to give them a taste of the pain my sons feel before they get the pain of a pounding in the ass in prison. I'd like a little "Dad Justice" first.

I was trying to explain to my oldest child (10 years old) what had happened. He looked down sad and simply replied "Well at least they found yours dad, it was the most expensive"

I almost cried. When had he grown up? How did I manage to raise such a good kid? God-bless him for thinking of others before himself... But it's not good enough for me. When I get mine back I'm selling it and buying my boys 2 brand new ones, because I'm a daddy and thats what daddy's do.

To the cowards who stole them. I was ok with you stealing from me, but I'm not ok with you stealing from my children. You are lower than snake shit. You don't rate in anyone's book. Not even your mother loves you, kill yourself and do the world a favor.

Pray to whatever god you worship that I never find you.

Stop, just stop it already!

2009-01-31T06:51:00.000-08:00

Ok. For the last few months I have been hearing a lot of crap about the world coming to an end in 2012 because the Myans stopped making their calendar there.

I think it's bullshit and here is my rational as to why.

The Myans lived from 300-900 AD. They built housing so they had contractors and engineers. They ate so they had farmers etc. They basically had most of the professions we have today right?

So it stands to reason they had teachers and scribes too.

Some poor sap got placed in a hut around 315AD and it was his job to make calendars. As he got older it was further his job to pass off the calendar making to some other non-athletic Myan. Given the average life span of a Myan of lets say, 70 years, that means that from the time they winked into existence around 300AD until the time they winked out of existence around 900 AD we have a span of 600 years.

That means if only 1 Myan was making calendars it took almost 9 of them to do nothing but make calendars for that 600 year period. (Of course you can multiply that number by a factor of 1000 easily as there were probably plenty of calendars)

It is my belief that somewhere down the line they just got tired of adding years. I mean, COME ON! If it were your job to make calendars what year would you say.. "Ok, to hell with it. We don't need to go any further than this!"

Some wrinkly old Myan got to 2012 and said "That looks good, here it is 898AD... Who the FUCK is going to live 1114 more years to even appreciate my work?" "If we happen to make it that far we will just start making calendars again, but this is good enough for now."

Lighten up people.. We are not going to wink out of existence in 2012 just because some Myan got tired of making calendars.

The only thing this serves is to remind ourselves that in EMS there will always be some nutter with a reason to be going crazy. Load up on your Haldol and Versed and start your day guys. There are plenty of nuts out there for all of us.

CCFCCP

Now that takes balls!

2009-01-30T18:09:00.000-08:00

One morning I was called to the emergency room by the head ER nurse. She directed me to a patient who had refused to describe his problem other then to say that he "needed a doctor who took care of men's troubles." The patient, about 40, was pale, febrile, and obviously uncomfortable, and had little to say as he gingerly opened his trousers to expose a bit of angry red and black-and-blue scrotal skin.
After I asked the nurse to leave us, the patient permitted me to remove his trousers, shorts, and two or three yards of foul-smelling, stained gauze wrapped about his scrotum, which was swollen to twice the size of a grapefruit and extremely tender. A jagged zig-zag laceration, oozing pus and blood, extended down the left scrotum.
Amid the matted hair, edematous skin, and various exudates, I saw some half-buried dark linear objects and asked the patient what they were. Several days earlier, he replied, he had injured himself in the machine shop where he worked, and had closed the laceration himself with a heavy-duty stapling gun. The dark objects were one-inch staples of the type used in putting up wallboard.
We x-rayed the patients scrotum to locate the staples; admitting him to the hospital; and gave him tetanus antitoxin, a broad-spectrum antibacterial therapy, and hexachlorophene sitz baths prior to surgery the next morning.
The procedure consisted of exploration and debridement of the left side of the scrotal pouch. Eight rusty staples were retrieved, and the skin edges were trimmed and freshened. The left testis had been avulsed and was missing. The stump of the spermatic cord was recovered at the inguinal canal, debrided, and the vessels ligated properly, though not much of a hematoma was present. Through-and through Penrose drains were sutured loosely in site, and the skin was loosely closed.
Convalescence was uneventful, and before his release from the hospital less then a week later, the patient confided the rest of his story to me.
An unmarried loner, he usually didn't leave the machine shop at lunchtime with his co-workers. Finding himself alone, he had begun the regular practice of masturbating by holding his penis against the canvas drive-belt of a large floor-based piece of running machinery. One day, as he approached orgasm, he lost his concentration and leaned too close to the belt. When his scrotum suddenly became caught between the pulley-wheel and the drive-belt, he was thrown into the air and landed a few feet away. Unaware that he had lost his left testis, and perhaps too stunned to feel much pain, he stapled the wound closed and resumed work.
I can only assume he abandoned this method of self-gratification.
By Dr. William A. Morton, Jr. MD, a retired urologist residing in West Chester, Pennsylvania.

There are angels all around us.

2009-01-28T11:58:00.000-08:00

My truck is back together and so are the other two. I'm tired, I have a laceration to the top of my head and my back hurts like a son of a bitch... but he will live.

As we arrived on scene I saw 4 semi's jack-knifed and about 8 cars piled into them. The snow was pouring down and my partner had a concerned look on his face that I rarely see.

The police approached us and said there was one trapped in the wreckage of a semi. Every one else was just fine. We set off toward this huge pile of twisted metal that looked like a scrap yard and I peered inside the window. I could see the top half of a body in there and my stomach fell. The wreckage was one of the worst I have seen in 15 years and I was just about positive no one could have survived.

There was still a side window intact and I thought I could make entry there, so after we did a quick check for safety hazards I removed the window and started to crawl inside. I heard "Hello, hello... I'm stuck!" By God he was alive... I asked him his name and told him mine and we went to work trying to get him our of the carnage.

Both of his legs were crushed under the engine compartment and the steering wheel was pressed into his belly but he was A&O x 3 hanging upside down by his seat belt.

Within the next few minutes we had a couple firetrucks join us in the extrication and 2 more of my units as well. We took turns holding him up to keep the pressure of his body away from the steering wheel and seat belt. I didn't want to cut the belt yet since it was the only thing holding his upper half in place. If I released the seat belt all of his weight would strain against his lower extremities and I was positive they were in some nasty shape.

Gave him O2 and covered as much of him as we could with blankets. About 30 minutes into it we started placing hot packs in axial areas to keep his temp up. He remained awake and talking most of the time. At one point I told him he was not allowed to pass out without my permission. He laughed a little but I knew he was in some serious pain.

We all took turns holding him up and talking to him. When we were not squished into the cab with him we were outside running the jaws or the sawsall cutting away at the truck and the engine compartment trying to free his legs. He was in there very tight and from what I could see of his legs he was going to need a trauma center.

I called to request a bird, but they were not flying due to the weather, so I called the ER and told them the story and to have a MICU ready to take him to a trauma center after he was stabilized. Our little hospital is damn good, but this guy was going to need a specialist, of this I was sure.

I asked about his family and told him about mine. He has 6 kids.. I said "Buddy, how do you have time to make six babies when you drive truck?" He replied to me "That's all I got time to do man". We laughed about that a little but I could see that it was getting harder and harder to keep him awake. I kept reminding him he did not have my permission to pass out. He would say ok man, ok.

Almost 90 minutes into the extrication we were able to free his legs and pull him out onto a long board. We did the standard immobilization and got him into one of the units. As we were pulling him out his legs were hurting so much he almost passed out. I yelled his name and he promptly replied "I know, I don't have your permission." He then started thanking us. I told him there was still much to do and for him to be strong we would walk this road together.

In the squad we gave him a through once over and controlled the bleeding from his legs. He was in pretty bad shape but there were two legs there and we intended to deliver him to the ER with a good BP and perfusion to those legs.

Started an IV and gave him some morphine for the pain. Worked to realign and get pulses back to those feet with pretty decent results.

On arrival to the ER their trauma team was ready to stabilize and the mobile life was there ready to transport to a level 1 trauma center just as soon as the local guys could get everything under control.

Looking back on it I have to say: Today an angel was riding shotgun with that guy, I have never in 15 years seen an accident that bad have such a positive outcome. This guy will need surgery sure..probably lots of it, but he's alive and doing well when everything there said he should be dead.

Greetings Mr. President.

2009-01-28T05:50:00.001-08:00

We traveled the 500 miles in just over 7 hours. 15 ALS units en route to provide medical support during the 2009 inauguration of President Obama.

The security was very tight and we ended up having several forms of identification we had to carry with us plus FEMA and USSS tags in the windshields of our units. FEMA had also lo-jacked all of our trucks and provided us with 2 cell phones in addition to the 2 phone we were already carrying and 2 radios per truck. It was obvious to everyone that they wanted to maintain contact with us at all times. It was further obvious that they wanted to know where the trucks were.

We started out staging about 12 miles from the DC area, we were not there long before they moved us to a park about 3 miles outside the capitol. The thing is though, in DC during any big public event, it can take you over an hour to travel 2 miles.

We sat at the park for about an hour and then FEMA assigned a DC firefighter to every unit as a spotter. These guys were supposed to know which roads were closed and the quickest ways to get around the capitol area. If you ask the crews, the firefighters were little to no help at all.

Eventually they broke our strike teams up and started assigning our units to DC fire stations. We could hear the traffic on the DC radios and there were literally hundreds of cold related calls within the first couple hours. I heard a couple full arrests come across too. With a crown of over 2.9 million people you had to expect that a few of them would die.

Reports were coming in of ambulances stuck in mobs. They could not respond, as the crowds completely over-took them and surrounded them on all sides. They were using small ATV type carts to get around inside of the venue area with just slightly better results. Some of them would not start and other times the medics on board would have to leave them to go off on foot. When they tried to return to them they couldn't find them. They either were moved of the crowd had just swelled so much they they got disoriented and couldn't find their way back.

My unit got staged at 14th Street and Congress Ave. It was quite a happening place there. I have never in my life seen so many tactical operators in one area. There were officers as far as the eye could see. As far as I could tell there was only 1 more unit in our area and they were sleeping in their truck. Fortunate for them, they were not part of my team, I think I would have had something to say to them.

My team performed exactly as they had been trained, no one missed a beat and everyone was very professional. We even decided that there was not going to be a debrief after this activation because there was really nothing that could have been improved upon. I was very proud of them.

When we got home I got quite a few calls saying things like "Good Job Chief, another activation down with no problems" I was quick to remind them that if not for the ENTIRE team things would have been very different. We have a fantastic group of operators, each one of them makes the team is as good as it is. All I do is gently (well sometimes not gently) steer them in the right direction.

It's good to be home, but now I'm up to my ass in snow...

A New Era

2009-01-20T07:06:00.000-08:00

I didn't vote for him, but I'm willing to give him a chance to excel. I guess only time will tell if this proposed CHANGE is what is best for the country.

We have 15 trucks sitting here in DC as part of a FEMA response team. It's unlikely that we will be utilized but it was a huge honor to be asked to come. Our special operations team made the 8 hour trip and stayed in a hotel a couple nights while all of this was being put together.

We held down a parking lot yesterday, and today we are waiting in the wings. As it gets closer to noon we can hear all of the EMS traffic picking up. Lots of cold related emergencies, a few serious patients but all in all it doesn't seem too busy yet for the amount of people that were here. Just turn on a television and you'll see what I'm talking about.

I'll write more tomorrow, right now were just waiting to be pressed into service and I'm happily surfing the Internet and listening to the traffic.

Cold Weather Musings

2008-12-21T08:40:00.000-08:00

My God is it cold outside today!

My truck is saying 9 degrees and thats not figuring in the 30mph winds that have take the power out all over town. Wind chill -20 or so.

We ran on a few slip and falls yesterday and a couple domestics. Nothing says "Seasons Greetings" like kicking the shit out of your spouse.

My other crew did 2 DOAs in the first 10 hours of the shift and then some various BS runs the rest of it. I hate it when people die near the holidays. You know their family will never look at the seasons the same anymore. They will always equate Christmas with death. Fitting? Maybe, I don't know.

My babies wont be home until Christmas morning. I miss them like hell already, but it's good that they get to spend some time with their mother. I'm a firm believer that little boys should be raised by their fathers (if the father is able) but I'm also a firm believer that no one coddles and preens over a child like their mother. My sons have me all the time to keep their butt in line, and they know I love them but around the holiday season I guess it's ok for them to be pampered by mommy a bit.

The girl and I are getting along very well. This in it's self is news because never before in my 35 years on this planet have I had such an easy going relationship. We both respect each others space and personal differences. We even go so far as to accept each other for who we are. I KNOW, WEIRD HUH??!!??! Now if I could just get her to tell me what she wants for Christmas I'd be all set!

Got a call from one of my guys thats also on a volunteer department, he had a pretty bad run involving a whole family. One of the children died. A parent lifeflighted to a trauma center. He was pretty shook up about it. he would never admit it but I could hear it n his voice.

He asked about the usefulness of CISD meetings. I encouraged him to go, and told him if it wasn't enough to come and see me and we'd talk some more. I've been there, and it sucks. I hope he pulls through without being too screwed up. It's hard to get past those calls.

I'm holed up by the computer trying to keep my hands warm. I have the heat jacked up and Oscar (The bird...The Grouch) is singing his damn fool head off. I can imagine him saying "Hey dumbass, if you cold I'm down right frozen here...help a brother out"

Stay warm guys... hats and gloves on every call. You never know when you'll have to play in this shit for 30 minutes or so.

Seeking Acceptance

2008-12-08T07:58:00.001-08:00

Lately we have been getting a lot of riders on the squads; some are students, others are members of the community who just want to see what EMS is all about.

I wonder about them sometime, what makes them tick? What do they think about our job? Do they respect us?

We have this kid Ben who has been riding with us for a couple weeks. He just finished up basic school and took his NR practicals. Having found out that he passed them he was on cloud nine. I felt happy for him, remembering how I felt years ago when I conquered that obstacle. I told him that the only thing standing in his way now was a few words on a computer screen. He then asked me if I thought he would make a good EMT. I told him the truth "Time will tell Ben, time will tell". I know it's not the answer he wanted but I thought it best not to sugar coat anything for him.

All of that got me thinking about acceptance and how people crave it. I have been overheard saying "I don't give a shit what anyone thinks as long as my patients are taken care of" I know now that is untrue. I do seek acceptance, as much as it displeases me.

At 35 years old I have done more and saw more than most men in their 70's. I have had jobs in every branch of emergency services and finally settled down to be a full time paramedic. I have owned 4 companies, sold 2 of them, lost 1 in a divorce and went belly up with the other. I worked in the family business for years and I even bar tended for awhile.

Through every job and everything I ever did I think I was seeking acceptance in some form or the other. In the beginning I was trying to redeem myself for being such an awful kid. My father would tell me he was proud of me, but I knew he couldn't care less what I did as long as I didn't embarrass him. I worked for his acceptance for 27 years, and he died without ever giving it to me. I'm not sure I will ever be able to come to terms with that.

When my children were born things seemed to switch for me. I'm not sure anymore if I ever wanted anything more than to make my boys proud of their father and what he does. I see children every day in the course of my job who have deadbeat fathers. Fathers who not only don't help support their kids, but are never around either. I never want to be that kind of father. I want my children to say "That is my Dad, he helps people, he's a paramedic"

We all have to have a driving force behind us and in the end I guess it is a matter of seeking acceptance. Whether you are a new EMT looking for acceptance from your peers or a son looking for acceptance from a father it hurts when you don't get that acceptance. It stings like a bitch and there is really nothing that fills that. If your a strong person you will work harder to get that acceptance if you are easily disheartened it will hurt you for quite awhile. Push on, push on and stay your course. In the end you have to accept yourself first.

So I vow today to be more accepting. I will accept people unconditionally and I will reassure them where I can, but make no mistake... I'll still tell them their an idiot when they deserve that too.

Did you expect any less?

An Old Friend.

2008-11-26T05:54:00.000-08:00

If you are in this profession for any length of time you will make some strong bonds with other like minded people. You will learn from them and they will learn from you. You will influence each others lives and never know it happened. We rub off on one another. It's not until years later you realize what an impact they had on your life.

Today I got done with my truck check and wandered upstairs to start the daily paperwork and order supplies for the week when I saw a piece of paper with my name on it tucked under my keyboard. I opened it to find a message from a long lost friend. It listed his name and number and where he was living now with a small note that said "Call Me".

I just sat there for a moment rubbing my head. I thought "No shit, the old guys is still alive!"
I couldn't bring myself to call immediately. I had to basically talk myself into the process. Not because I didn't want to talk to him, not because I was afraid... Because what do you say to someone who unconsciously and unknowingly shaped the clinician you are? How do you tell someone that if not for them, you would be in a very different place right now?

So I sipped on my coffee and tried to rehearse my words before I placed the call. That took all of about 15 minutes and I muttered "Fuck It". I'll just call him.

The phone rang about 4 times and his wife answered it sleepily "Hello?" Shit, it is 8am what the hell was I thinking... Oh well I'm committed now.. "Is Leroy there?"

She heard it was me and her voice changed for a second when she got him on the phone, she remembered me too it would seem.

The first thing out of the old guys mouth was "Hey man, I heard you went to the dark side!" He was referring to me becoming an officer for the company and it brought a smile to my face.

The laughter started then as if it had only been 24 hours since we worked together. We talked about how he was doing and the changes in his life while he inquired about what I was doing now and that he was glad too see I had progressed so far with the company.

We caught up on the children and how they have grown, we discussed dating/being married to younger women and I promptly blamed him for instilling that fancy in my head. It was a light hearted and warm conversation and I enjoyed it very much.

You see, Leroy and I worked together years ago. When he came to work for the company he was at the end of his career and I was at the beginning of mine. He was widely regarded as one of the best paramedics that ever started a line and I was regarded as one of the loudest most obnoxious basic EMTs to ever drive a squad. He was a paramedic instructor and I was defiantly NOT the teachers pet.

I resented him those first few weeks. He was so laid back and mellow, nothing ever got to him and nothing was ever urgent. He would slowly and methodically assess our patients and then make a plan for their treatment. It was far too slow for me.. I wanted the LIGHTS, SIRENS, DRIVE FAST GO GO GO treatment. He was slowing me down.

I don't think I could have been more wrong about anyone. Leroy knew what he was doing, years of experience had proved to him "It's their emergency, not yours". That's just one of the things I learned from him. As I look back through my writing all of these years I realize that Leroy was one of my strongest influences. He taught me a great many things, even if I didn't want to learn them at the time. He was always a reassuring voice in the back of my head when I didn't think I could go any further. Always pushing me forward and forcing me to see the other side of the problem. He forced me to look at things from the patients eyes and not focus on what the book said.

I remember a run we went on in the county once with a 83 year old male that was dizzy and lightheaded. We arrived on scene and the man was flat out refusing to go to the hospital. Leroy hooked him up to the monitor and continued to try and persuade the man to seek medical attention. The man threw us out of the house.

When we got outside we told the fire department to go ahead and leave, we would not be requiring their assistance as the man was refusing care. The patients son was there outside and begging us to do something. Leroy looked at the son and said the following: "Alright sir, I'm going to have to go back in there and tell him like it is. It might sound a little rude but it's the only way I know how to convince him". The Son agreed and Leroy and I went back in. Leroy told the man "Listen buddy, your heart is in trouble. Your going to get up and walk that 4 feet to go poop, your going to sit down, push and die" This convinced the man and we started to load him on the cot when he went into full arrest. We did everything we could to try and bring him back but in the end they pronounced him at the hospital 25 minutes later. I was stunned. Here we did everything by the book. We ran a textbook code and the guy still died. This is where Leroy took me aside and said: "God made paramedics to give him a chance to change his mind" I looked at him in disbelief and he followed it with: "You gotta remember though, he don't always change his mind"

Those words would ring true with me for years following that code and they still are just as true today. I have counseled many new EMTs with the words Leroy said to me that day, and I'm sure I will in the future. Nothing more true has ever been said about why we lose patients in the field. "Your damn right it's not fair" Leroy would say. "If you wanted fair you should have found another job."

I'm glad I reconnected with Leroy, there are still so many things I can learn from him. Now that I see things a bit differently maybe I can take his lessons to heart and use them sooner than later.

In the course of you doing your job and meeting other EMS providers, pay attention. Everyone has something they can teach you if your willing to listen.

Thanks Leroy!

Getting Normal Again

2008-10-03T18:10:00.000-07:00

Trying to resume normal activities after such a long deployment is rough. I got used to the FEMA rule set and the degree of complete chaos involved in responding to a disaster. I got used to the high stress level and constant movement. There are many differences between normal station life and a deployment of that sort. Here are a few things I figured out.

The People.

After working at a station for years you think you know the people you work with. Everyone has dirty laundry that gets aired from time to time and you just kind of take it in stride as part of working in a EMS setting.

You put those same people in a disaster situation where you need to rely on them 24/7 for 30 days and you know what kind of relationships you have really cultured over the years. You want to really get to know someone? Deny them a shower for a week, feed them MREs and keep them up for 22 hours of every day. At the end of your deployment you will know exactly what kind of person they are.

With that said I learned that the people from my area are exactly the same as they are on station. We have put in the time and years to work well together under any circumstances. They performed exactly as I knew they would and their short-comings were exactly where I expected them to be. I played to that a lot and kept them propped up where I needed to and leaned on them when I needed to. I was glad to have them there and I could not have done the job without them.

Now... there were several people that were accepted to go that I knew little to nothing about in the beginning. They all put on an excellent front when they had their face time with me but in the field I could see under currents forming. I could smell dissent and I knew that a few of them were not cut out for this kind of assignment. We would have to do the best we could to keep them all in line. I spoke with my right hand man (sometimes he uses his left) and the safety officer and let them know my concerns. They had also started hearing the bitching and complaining that was done out of earshot from me. We decided that it was just normal stress of being away from their families too long and it would pass.

Well... guess what? We were wrong. Seemed like in our eagerness to get as many people deployed on this mission as we could we wound up getting a few "Complainers" in the mix. Nothing fucks up a good op quite as efficiently as the "Complainer"

One morning during my MRE induced explosion in the porta-john I overheard one of the complainers stating to another complainer (they feed off each other) that if they were assigned one more 911 call they were going to leave the truck, get a plane ticket and fly home. Now, being the asshole that I am, guess who did the next 8 or 9 calls? When they approached me about it several hours later I asked them "Miss your flight?" Needless to say, they knew I had overheard the conversation that morning and they did their best to kiss my ass the rest of the day. I was considering installing turn signals on my BDUs so they would stop running into me. Everyone needs to vent ... Just try not to vent when the Chief is shitting in the porta-john 10 feet away.

Then there was the ones that on day one I thought "They ain't gonna make it" the kind that was red faced and looking lost from the moment we started our 1700 mile journey. You would see them at the gas station stops looking like someone had beat the shit out of them. I was worried that we would need to fly in replacements before we even got to Texas.

Oddly enough, they proved me wrong. As the stress got higher and higher they stepped up and took charge of their situation. It seemed like they might have had something to prove to themselves. When we got home from Gustav they were the first ones that signed up to leave on Ike in less than 24 hours. They will make excellent additions to our team, I'm glad I got the chance to know them.

I know I have been prattling on about nothing for several lines now so I guess in closing this topic let me say that people will surprise you. Give them a chance to piss you off before you lose all hope in their ability to succeed. You might just end up with a new friend.

The Job

Oh my God... the differences are astounding. You would think that the life of a paramedic is exciting but if your not in the field you really have no idea. EMS is essentially many, many hours of intense boredom briefly interrupted by moments of sheer panic. There really isn't that many exciting things that happen day to day. It all becomes pretty mundane in the long run.

On a hurricane deployment things are vastly different. Many, many hours of panic briefly interrupted by moments of sheer exhaustion when you collapse in your unit. That goes on for the first 24-48 hours then your body kind of goes numb and your consciousness slips into auto-pilot. Every single bit of training you have received starts prancing around in your head and you become a machine. Do it, do it again...do it again...stay alert...drink more coffee...be safe...check on your crews... Check...re-check.

Coming back to the station after that was kind of a let down. Nothing was happening fast enough and I found myself bored within a matter of minutes.

The Conclusion

If you get a chance to do it. Do it! We were honored to be there. It was the largest EMS response in United States history and we were all a part of it. We helped as many as we could and we mourned those that we couldn't help. We made friends in most unlikely of places and we measured each other as no one will ever be able to again.

Never Mistake Motion For Action -- Hemingway

Ike was rough.

2008-09-27T08:09:00.001-07:00

So my truck is wrecked ... I'm in a new relationship ... My kids just started a new school ... My lawn needs mowed badly... The house bills are due ... The lawn mower is broken again ... The windows need winterized and my living space is destroyed after I get back from Gustav. So what do I do? Yep, I leave on Ike.

This deployment was a sharp contrast to all of the hurry up and wait of the Gustav deployment. We went to work almost immediately after getting to San Antonio. They shipped a few of the strike teams off to Houston to prepare for Ike's landfall and a few were sent further south as well.

25 units (10 of which were mine) were sent to be the first boots on the ground in Galveston. It was the most coveted assignment there was, we were honored to accept the responsibility.

We arrived about 90 minutes after the storm went through and it looked like we stepped out of the USA and into a third world nation. There was no power, cell coverage, water..NOTHING. We found where the city had set up a temporary shelter and got right to work with 300 or so people waiting to get on a bus to San Antonio.

We set up staging at a local high school and within 120 minutes we had assumed control of Galveston EMS operations. Those guys and gals had been working non-stop for several days now and their station was under water. They needed a break to get shit right and we were the people for the job.

FEMA had set us all up with phones that didn't work, Low-Jack that could not track us, GPS units that worked about 60% of the time and 2 way radios that would reach about 1 mile on a sunny day. So we felt well prepared to step into this hornets nest.

For the first 2 days it was non-stop with 911 calls. We ran a 15 truck rotation to try and get the guys some down time but you were lucky to get 45 minutes of sleep before you were woke up by something. Building collapse, fire, looting, MI, entrapment, diabetic emergencies... all of these things became so common that we didn't even bat an eyelash.

There were several USAR and DMAT teams attached with us as well and eventually we started working together as if we had all know eachother for years. It became normal to see buildings smashed and 50 foot boats just sitting on the top of houses. That chest of drawers on top of the 4 story apartment building was just another thing that seemed to belong.

The dead animals in the street began to bother me after a few days, it was stinking to hell. All of the fish that the storm surge brought in were rotting too, you kinda got used to that.

Profiteering assholes were everywhere. Finally one gas station opened and all of us were in some serious need of tobacco. I went in to buy a log or two of Grizzly mint... The sign on the shelf said 1.90 a can, he charged me 5.00 per can. When I pointed to the sign he replied: "That was before the hurricane sir" Well, it was tobacco not diapers so I didn't make too much of a fuss but I still walked out of there knowing I'd been screwed and there was nothing I could do about it. I paid my 50 bucks... and I had my tobacco.

I could sit and write for the next 5 hours of stories and adventures on Galveston Island and never come close to being able to tell you everything. So if there is something in particular you want to know about just leave a comment and I'll be happy to add another post.

As for now... I'm home. Hurricane Kyle doesn't look like he's going to do much so I can rest easy for a little while. It feels good to be home.

I got a new truck ... Things are going great with my girl ... The lawn is being taken care of ... The kids are doing excellent in school ... The bills are paid ... I bought a new mower ... and I plan on cleaning up my crap on Monday.

Hurricane Season

2008-09-11T06:54:00.000-07:00

I've tried to be better about updating this blog but it always seems as if something interferes with my best intentions.

On the 28th of August our team was deployed to Texas for hurricane relief with Gustav. We got down to the greater San Antonio area and Gustav turned out to be all bust and no balls. That didn't keep FEMA from running our asses off for the better part of 10 days though. Returning patients to nursing facilities and private residences.

We got home last Sunday. All of us were exhausted and glad to be home. My children were missing daddy badly and I'm still culturing this new relationship with a great gal so I had priorities I had to deal with that didn't include a hurricane that caused just about ZERO damage on US soil.

Monday morning rolls around I kiss the girl and then my phone goes off. It's the boss telling me to mobilize the team again and this time add 2 more units so we can have 2 complete strike teams. Looks like hurricane IKE is not playing nice in the sandbox and we are heading back to Texas either that night or the following morning.

I drag my ass away from the girl and get dressed. She agrees to hang out with me for the day so we can at least have some semblance of together time before I'm gone for 10 more days. We hit Walmart so I can buy everything I had neglected to buy for the first trip.. (that was 140 bucks) and then we roll on over to the station so I can see what kind of damage I can cause there.

My guys had everything under control at the station, all there was for me to do was finalize some paperwork and arrange for a few replacement members. Almost everyone who deployed for Gustav wanted to deploy for IKE too... I think it was something about the being paid for 24 hours a day 7 days a week that enticed them... I dunno.

Baby girl borrows my truck so she can scoot out and get a shower... That's where it got interesting.

The station phone rings... they holler for me and tell me it's her. Hmmm... why wouldn't she call my cell phone. I knew something was wrong.

Sure enough she was puttering along minding her own business when WHAMO she got smoked by a laundry truck. Totaled my truck.

A buddy of mine was the responding officer and he called to tell me what had happened.

COP: Hey, where is your insurance card man
Me: Probably at home on my desk.. just use the old one it's the same info
COP: Ok
Me: How is the girl?
COP: She is fine
Me: Ok, that's cool... Can the truck be driven the 2 blocks back to the station
COP: Maybe..ya, I think she said she's taking it to the station. It's in pretty bad shape...
Me: I don't care... at 35 years old it's one hell of a lot easier for me to find a 3000 dollar truck than another 20 year old girlfriend
COP: (laughing) she is fine
Me: Thanks

She gets back to the station a little sore but not complaining of anything major. Her biggest fear is that one of my units would have responded to the call and called me before she had the chance to. I told her it was just the truck... had she wrecked the motorcycle then we might have had an issue.

Meanwhile back in the hurricane deployment stage we are still short 2 units and 3 sets of ALS gear. We don't want to send any basic crews because they are not billed the same as ALS crews. If we send all ALS crews obviously the paycheck is MUCH larger. So I'm in the mad scramble to get everything ready. We only have 24 hours from the time of being activated to get to Texas and check in and it's a LONG run for us.

That night she was heading home and stated that she was going to make a trip to the ER to just get checked out.. her neck was sore and she didn't want to be FUBAR the next morning. I took a couple sleeping pills and forced myself to go to bed early so I'd be ready when the deployment call cam in in the morning. She ended up back at my house later that evening although i couldn't tell you when.. I noticed something soft that smelled nice in the morning and that's the first time I knew she was there.

She heads off to have breakfast with her father and his friends and I head into the station with the rookie and all of our gear. No call yet and everything is set on my end so I decide to face my fears and go have breakfast with her and her Father.

It was not nearly as bad as I had imagined. The conversation was light and everyone was cutting up. They were teasing her pretty bad about wrecking the truck the day prior and my guys were just happy to have me buying them breakfast. We finished our meal barely and my phone rings... Get your team and head for Texas.

We just about kill ourselves getting to Texas in time but here I sit in a parking lot in Houston after being in San Antonio all day yesterday. I know the score now from the Gustav deployment and besides missing baby girl and the boys I'm ok with the world at large.

My guys want to go, they are pumped up on stale biscuits and coffee..they want to work and I keep telling all of them that it takes time. FEMA moves at their own pace and things don't happen on "Paramedic Time"

We are here to help.. waiting on a hurricane that is predicted to be pretty bad. As of right now though we sit and wait. I think I hear the porta-john calling my name. That MRE I ate yesterday is about to be re-visted and I don't think it's going to be plesant.

I'll write more as soon as I can.

Ambulance Ass

2008-08-25T07:31:00.000-07:00

I have a reader who asks about physical fitness in EMS. She is inquiring about what type of work-out we do and how to be able to pass some PT tests.

I think she said she needed to be able to lift 85 pounds 48 inches. I can only assume that would roughly be the weight of the cot while loading it into an ambulance.

Ok, to start at the beginning. If you work in EMS and you don't follow some sort of diet and/or exercise routine you will gain weight. Simple as that. No one escapes it forever. We affectionately call this "Ambulance Ass".

I'm about 5'10" tall and I weigh in at a chubby 216lbs. I was at 240 when I knew I had to do something before my penis disappeared. I gave up Pepsi. Yep, 24 pounds shed in 4 months just by giving up the Pepsi. I also started drinking my coffee black. No cream, no sugar. I mean, COME ON, what do you drink coffee for? It sure ain't the taste.

The biggest problem I saw with my rapid weight gain was the fact that I was eating all the wrong foods at all the wrong times. This is still pretty hard to control given the nature of our work but if you make simple corrections like NEVER EVER eating after 7pm and watching your portion size you can at least hold back the progression while you work out a way to lose some of the extra baggage.

We have one guy at our station that has went completely nuts and lost over 60 pounds in 6 months. He has given up almost everything that tastes good. I think I lack the courage of that convection though. I mean...No Cheese? No Way! Whey protein shakes...water all day and a sensible dinner? I guess I'm just not a sensible guy.

As far as our reader's question goes. "Just Do It" if you are having trouble lifting 85lbs 48 inches...Just do it. Go to one of your volunteer departments and load the cot with a person on it over and over. Do it as many times as you can, remembering to put the stress on your legs and not your back. We have had PLENTY of smaller people build themselves up this way. It would also not hurt to go out to your local Walmart and buy some 2-6lb dumb bells. It doesn't seem like much weight but if you work out with them every day you will see an improvement in your arms and chest.

Everyone who wants to do this job can, it's just a matter of how much effort you want to put into reaching your goal. You'll get there.

As for me. Well I have lost 14 pounds and I'm losing more. I told you earlier how I cut out pop and sugar in my coffee...Well I also started dating a girl quite a bit younger than me. Keeping up with her is aerobic in it's self. I find more time to run around with my children and I try to stay active in the garage and away from the computer. If you sit and do nothing all day, don't be surprised when you develop ambulance ass.

OMG It Changed!

2008-08-22T11:16:00.001-07:00

Yes, we are working with a new look here. The reason is 2 fold really.

#1 I really got tired of looking at the old format. It was boring and not very friendly on the readers eyes.

#2 There are a lot of cool new features that can only be used with a template upgrade, so I figured... Why not?

So far I have added a little tool that tells you important things that happened today in history and a way to search youtube and watch videos right from the sidebar. Type in paramedic in the little box. Some funny stuff there.

If you have any suggestions please drop me a line!

Z

The Pain Of Living.

2008-08-19T05:37:00.000-07:00

In the course of doing our job we see plenty of horrible things. Some things you literally wish you could "Un-See". It's all part of that sacrifice we make to try and force a difference in the outcome of people's lives. The general public should never have to see these things.

An old paramedic once told me "Son, God made EMTs to give him a chance to change his mind but you have to remember that he does not always change his mind". It's those words that help me through the rough calls. What solace does the layperson have in those troubling moments?

I was thinking of this my last shift when we had probably the most horrible motorcycle accident I have ever witnessed.

We were posted across town on a special event when the alarm dropped. Our other unit was about 2 minutes away from the accident and they had an extra crew member so it was not likely myself and my partner would be called. Well, at least that's what I thought as I sat in my lawn chair sipping a cold cola and nibbling on fair food.

They had to have been on scene for about 30 seconds when the second alarm dropped and my partner and I packed up our chairs and raced to the scene.

On arrival I was pretty astounded by the lack of scene control. The road was sufficiently blocked off and there damn sure were plenty of cops there but no one seemed to have a handle on all the gawkers. It was very hard for me to determine who was involved in the accident and who was just standing around.

I send my partner to help the crew working on the motorcycle driver and I proceed to beat the bushes, so to speak, to find any other patients. I turn up empty, the driver of the car was uninjured and in police custody.

Making my way back to the trauma patient I see at least 2 maybe 3 people weeping so hard they can barely stand. As I survey the motorcycle driver I see he is being aggressively worked by my guys so I think I would be most useful trying to calm the bystanders. With the assistance of a couple police officers we get all of them off the road and over to the grass where I can try and answer any questions to the best of my ability.

They were screaming "He's dead, I know he's dead" I replied with the standard: "Everything that can be done is being done" they were not buying it. I knew he was a trauma arrest and his chances were very slim, but how do you tell that to people? You just kind of bite your lip and hope for the best.

Someone had used a whole roll of paper towels trying to stop the blood pouring from this guys face and head. What had been going through their mind when they were doing that? What horrible visions are they having today every time they close their eyes? They pile more and more paper towels on and the blood never stops. Finally EMS arrives and things are moving very quickly for them. It must seem like a nightmare, a painful visage that can not shake even with all of the light of a noon day.

I think I was most concerned with the driver of the car. How would he live with the knowledge of taking a life? The police would not let us near him, but I was worried that he was in shock so I went and talked to the Sargent. He made a few wild hand gestures and I was allowed access to the driver. He was literally destroyed with guilt. He wanted to know if the guy was going to make it. I'm sure you know how I replied: "Everything that can be done is being done".

It was a traumatic arrest and all of us know the odds are greater than 1 in 100,000. The guys worked and worked securing an airway, then stabilized his spine and neck. Into the truck he went and they left. My partner and I were left to collect the equipment from the scene and bag up all the biomass for disposal.

We were told later that he regained his heart beat after a couple rounds of Epi and Atropine in the truck. He was delivered to the ER with a pulse. I was very proud that, the guys were on cloud nine!

6 hours later, when his heart stopped and he was pronounced dead at the trauma center we were all in shock. It's not fair we said. He beat the odds! HE BEAT THE ODDS! How could he die after surviving such a horrible accident? How could God let this happen?

Son, God does not always change his mind.

Z

New plan!

2008-08-15T21:11:00.000-07:00

After going back through all of my posts on the blog I realized that there are a lot of really interesting people that have left comments over they years. I feel kind of crappy only posting once a month or so. I feel like I'm letting people down.

So here is the new plan. I'm going to start posting at least once a week. Every week there will be new content. It's not like I don't have something to say, I just forget. I have made myself a little sign and stuck it above my desk that reads:

"Have you had your blogger therapy this week?"

I encourage all readers to send in comments or things they would like covered. If there is anything on your mind, drop me a line and we'll work through it together. I will supply an email address and put it in the links to the right of the content.

Take Care

Z

To AMA or Not to AMA. This is the question.

2008-08-01T15:40:00.000-07:00

Ok, we have all got those calls at 4am that you just know are bull-shit. You arrive on scene and find lots more drama than trauma. You know they don't have any serious problem... or do you?

Today I had one that was kind of strange as far as possible AMA's go. You see, I don't talk a patient out of going to the hospital ever. I always felt it was my job to talk them into going to the hospital. After all, they did call 911; I would like to think I was there for a reason.

50is woman in a praying position on the floor with arms holding her up against the side of a night table. I stated "Mam, I'm here with EMS, can you tell me if you hurt anywhere?" She replied very slowly: "No I don't hurt but my legs and feet are asleep, I've been down here 3 hours."

After a brief assessment myself, my partner and the FNG helped her to her feet and she could not bear any weight (This lady was 400lbs +). We sat her down on the edge of the bed and began to sort through the laundry list of medications and diagnoses she had. All of which are not really important at this time.

After assessing her again sitting this time I noticed that she was answering everything correctly but it was taking her forever + 1 day to do it. She was incontinent as well... So I'm thinking seizure or stroke right? She is flat out refusing to go to the ER. She states they wont do anything for her. We run baselines and check a sugar... 320. Ouch, that sucks... now I'm thinking DKA or Hyperosmolar NKA (Medic school taught me big words).

The only person there to help her is her 75 year old mother, and there is NO WAY IN HELL she would be able to help her to the bathroom or to get a shower. I call the doctor hoping he will mandate her. No Dice. He told me that if the patient was A&O he wasn't going to mandate her to be brought in.

So here I am with this problem. I know she needs to go, my partner knows she needs to go...hell even the FNG knows she needs to go, but she refuses to go.

Finally I leveled with her. I told her that I was not comfortable with her being by herself and I knew that her mother could not get her cleaned up or even up to go to the bathroom. She nodded. Then I gave her the option of agreeing to go to the hospital with me or I was going to be forced to call the social services officer to place her in protective custody.

After a few minutes of word wrestling and a couple unflattering comments made under her breath she agreed to go.

There really is no moral to this story, but consider what could have happened to her if I would have just happily had her sign the AMA form and left. What would have my responsibility been then?

Food for thought: Have you ever signed off someone only to have it come back and bite you in the ass? Let me know.

Z

It's a TRAP!!!

2008-07-20T18:28:00.000-07:00

What kind of friend would I be if I did not keep all of my avid readers apprised of every single thing I find to be utter bullshit or a blatant attempt to deceive me?

No friend at all that's what kind. So, even though this does not pertain to emergency medicine or emergency services in any way at all; I still feel the need to vent a little and let all of you single guys out there know about the great many traps I've either fell into, or almost fell into over the last 18 months.

It has only been the last month or so that I have started to notice feeling lonely. With that said I dabbled a bit over the last 18 months, but I really started examining the situation over the last 2 weeks or so. I think I have managed to piece it all back together again in my mind; or whats left of it since medic school. CT would show Swiss cheese, I'm sure.

#1 Never date for the sake of dating. You will only end up miserable WITH someone rather than the preferred "Miserable Alone"

#2 Never suggest to your 2 sons that you haven't dated seriously in over a year and a half.

I woke up to my phone ringing. The female on the end said she saw my oldest son at the supermarket with his mother (my ex of course) he said to her "Mam, your very pretty and not wearing a ring.. My dad hasn't dated seriously in over a year. I'm sure he is lonely" The lady who we will call "Lacie" wanted to call me (after getting my number from MY son) and say it was the sweetest way anyone has ever asked her out. I promptly told her that I had not asked her out. After a few seconds of conversation she obviously thought the guy standing behind my ex and my son was ME... it wasn't. I was laughing too hard when I hung up the phone to call the boy and be stern. I waited until he returned from his mothers house the next day and told him if he were to ever set me up again to offer a picture and then call and warn me. He promptly agreed.

#3 Stay away from online dating sites.

Ya they seem "Fun" and "Harmless" but they are not. I tried out Yahoo's service for about 6 months. They were running some special for 60 bucks or so, I figured I'd spend way more than that in a single night at the bar so why not give it a shot.

The first one I got was amazing. She sent a picture and I sent mine. We talked for hours and hours for the first few weeks on Yahoo Instant Messenger. Then one day she offers her phone number and we start talking on the phone. We had so much in common, we had the same likes and dislikes. We had the same view on politics, children, world events etc... This all carried on for about 3 months. Then we decide to meet. On the day before the meeting she calls me and tells me she has a confession. The picture wasn't her. She is 10 years older than me and 17 years older than she told me she was. She is married and has 3 children. Well I have to admit, I was a little stunned. I had never done the online things before and I thought "Gee, I get the real deal right out of the gate...this is AWESOME" Now I know better.

The next few were pretty bad. A few dates, a few disappointments. I had one that was sort of promising but then I realized that she really didn't care for children. Every time I would mention my boys and the fact that they are with me a lot she would say things like "Well you don't ALWAYS have them do you?" It only took 3 times for it to sink into my thick skull and I never returned any of her phone calls after that. My sons are the biggest part of my life. I love them more than anything, they are my best friends. We are a package deal.

#4 Avoid all MOB agent sites! (Mail Order Brides)

Ya so I was feeling a bit lonely one evening and I decided to myself "Self, if you can't meet the right kind of women here... go abroad!" So I start researching meeting women from different countries. All of the websites pitch a good game but when you start peeking under their skirt (so to speak) you get to the hairy mess of it. 99.5% of them are blatant scams. There is no easy or efficient way to sort out the reputable from the scammers anymore. Some sites have BOTH on their pages according to a few articles I read. I spent the better part of 6 hours reading horror stories of men scammed out of THOUSANDS of dollars in the search for love abroad. It was enough to deter me from ever trying to navigate those narrow streets.

#5 Kill all who offer you a blind date.

The phone rings, it's my buddy Chris. First question out of his mouth. "Dude, your still single right?" I affirm reluctently. "Dude, you have got to help a brother out here.. I have this date tonight but she is shy. She will only go out if her BF can come with us" I asked Chris if he could remember ANY of highschool and why I should be forced to play some stupid ass games with his date prospect and her "BF". I further informed him that I was 35 damn years old and he was 36! "Why are you even considering this" I asked. Well, he sent pictures and like the weak bastard I am... I went.

The lady I was set up with was attractive, 5' 5" about 135lbs and brunette. She was a considerable bit younger than me but I could adapt. I'm 35 not 65. She had a wonderful smile and I was starting to feel a little more at ease about this blind date.... Until she spoke.

"Hi man, I'm.... like..... Amber. Whats your name?" "Oh thats right Shelly told me you like.... are an ambulance driver or sumptin right?"

I felt like asking her if I could answer her first question before I addressed the "ambulance driver" question but then I quickly realized it would be to no avail. I start scanning the room for the exits then a brilliant plan comes to me. I excuse myself to the bathroom, call a buddy and cash in a favor.

I got back to the table and sat down. She was babbling on about some idiot on MTV's "The Real World" and how much she lusted over him. I was smiling and nodding. Trying to bide my time.

***Pager Alert*** (Show pager to Amber)

I'm sorry Amber, there has been an industrial accident. I need to get my team mobilized. We will have to do this again. She smiles and looks at me "Can I go?" I told her I was afraid not and got the hell out of there.

She actually called twice. I was unavailable twice as well.

So here I am. At work, praying for a call to come in so I can occupy my mind a little. I'm sitting up in the office typing this while the other guys are down stairs watching reruns of old movies. Most times being alone doesn't bother me. When my boys are home or when I'm busy I hardly ever think about it..... but sometimes, just sometimes I wish I could remember the scent of a woman's hair, or the way she smiles at you when she likes you, or the way you can just be close and not have to say a word.

Sex once in every 12 months wouldn't kill me either. Given my options and my misadventures I think I'll stick with the bar, at least then you know what your getting...or you at least know what the presentation looks like. I don't need a double cheeseburger from Micky D's every night... but just once in awhile I'd at least like to be able to lick the cheese off the wrapper.

night.

I Let Her Die.

2008-07-05T22:44:00.000-07:00

The call comes in early in the morning around 12:30am to take a elderly female back to the nursing home after treatment at the ER for dyspena.

My partner and I arrive to find a 88 year old female with a GCS of about 4 working hard to breathe on 15 lpm by mask. Rate was about 32, SPO2 91%.

We ask the ER doc what O2 he wants her to go back on as the nursing home can only provide 6 lpm by concentrator. The doc then informs us she is hospice care and hands us a newly minted DNR.

We switch her over to a cannula at 6 lpm per the doc and begin the transport.

She makes it about 10 minutes and codes.

As we arrive at the nursing home I leave my partner in the back so I can run in and talk to the charge nurse and try to explain the situation. The charge was just as confused as I was. I guess what we were both wondering is why the ER didn't put her on the cannula and let the dying process happen there?

There are specific protocols for letting a patient die in the ER and there are also protocols for letting them die in a nursing facility under the care of hospice. There are NO DEFINED protocols for allowing them to die in the squad.

It all was very alien to me. My mind knew I had to follow the direction of medical control but my soul was screaming to do something... ANYTHING!

We knew she was going to go. I just didn't want her to go without her family around. I had offered to let them ride in the squad but they chose not to for one reason or another.

I feel sad.
Rest in Peace.

Frustrated!

2008-07-01T19:39:00.001-07:00

I'm still settling into this whole "Paramedic" thing. Trying to find my place in the grand scheme of things. I have made a few very painful realizations over the last few weeks. I'll share a few with you.

#1 Your never as smart as you think you are.

You might have gotten perfect grades in school and you could have been a damn good basic or intermediate but thats no indication of how you will be as a paramedic. You see, you have always been able to secretly think "I'm not the medic, it's not my final decision" When you get that medic card guess what? Yep.. it is your final decision and that scares the bejubus out of you. Take a few deep breaths and let your training and field experience kick in. It's likely you know the solution, you just need to give yourself time to access it.

#2 It's 50/50 now buddy!

I used to get such a kick out of screwing with my medic partners on BLS runs. We would go to a nursing facility for a seemingly routine transport and of course I would be expected to take it since the medic was normally in the back. I would get in and ask a question like "Good afternoon Mam, do you feel like you have any difficulty breathing?" 95% of them would say something to the affirmative and WHAMO.. I would call my partner to take the patient, they are the medic! After getting my card most of the medics I work with now are quick to remind me that it's all 50/50 now unless they feel like getting even for my past shenanigans and stick me with all of them.

#3 Even if it hasn't happened in 10 years, it will now.

Since I have recieved my card I have observed some crazy runs. Stuff you only see once every 5-6 years. Yep, I got the majority of it in my first week. I think it ranked about a 8 on the pucker factor when I was in the back with my first AAA. Prepare for the worst, it's coming.

All of that and the lingering thought that I should probably start dating again at some point. I mean, I'm ok with being single and all but every once in awhile I would like to have some sort of female companionship. No, it's not about sex (although that would be cool too) it more just about the connection to a female that allures me. Plus, women are soft and smell nice. The problem is, I have no idea where to start! I have been so self absorbed for the past 3 years I have kind of lost touch with all the things I SHOULD be doing to put me on the right track to romance. Plus the fact that romance in it's self bores the shit out of me. I prefer REAL conversation with rational people, all the romantic drivel just seems to mask what people are truly thinking.

So I post a couple personals on a couple obscure sites (I shy away from the popular ones) and I get half a dozen or so replies and I notice a trend of BIG women. I have to sit and ask myself "Self, are you only capable of attracting women at 190+ lbs? or is it that those are the only women looking at the personal ads. I certainly hope the latter is true or I'll be single forever. I know I'm a bigger guy, but I'm not obese. I do tend to gravitate toward smaller women but I have nothing against ones with a little meat on their bones either.

So ya, all in all... I'm FRUSTRATED.

Rant off.

Extra Time

2008-06-10T05:32:00.001-07:00

Ok for the last year I've had my life pretty well mapped out for me. Work, School, Study, Rinse and repeat.

My work schedule changed like crazy due to people covering my class time. I never really knew when I was expected to work unless I looked at the schedule the day before. Now that things are back to quasi normal I hardly know what to do. I woke up this morning before my kids did, that was kind of cool. I walked downstairs WITHOUT a textbook and had some coffee WITHOUT looking over notes or drug flashcards, I stumbled out to the back porch to survey the damage of the last storm WITHOUT stressing over an upcoming test.

It only took me about 45 minutes to realize that I needed to fill some time now or I was going to go stark raving bat shit crazy. You just get so used to a mid to high stress level that when it's gone you ALMOST miss it. Note the use of the word almost.

I have to teach at a Basic EMT class tomorrow. I'm pretty excited about that and Wednesday I go back to work but today... Hmmmm.

I think I'll run a new electrical line for my family room AC today so I can watch TV and stay cool at the same time without blowing a breaker.

I think I'll investigate my eve spouts and find out why I'm getting water in my basement.

I think I'll work on the go-cart and get it running.

I think I'll clean up the fire ring and get it ready for a few BBQ's

I think I'll replace the window in the mud room that the storm took out.

I think I'll service the boys' motorcycles and have them ready to ride when they get home.

or.

Maybe I'll just sit and and try to talk myself out of grinning like an idiot. It's really over and I actually pulled it off. At 35 years old I went back to school and became a paramedic.

Still amazes me.

Big Fight!

2008-06-09T17:12:00.000-07:00

I wake up in the morning at 5am. I don't shave. I didn't shave on Saturday and I managed to pass my practicals. So shaving is out for today. My nerves are killing me. I can't eat, just the thought of it makes me want to vomit. Since I didn't shave, getting puke in my beard would be bad.

I go in and kiss my boys. They have sacrificed so much over the last year. Daddy has been gone almost everyday and many events were missed. They miss their Daddy.

I stumble down stairs and turn off the AC, too cold in the house. I grab a Rock Star Energy drink, I know it will make me crash, but the test is only 2.5 hours so I should be done before the big crash happens.

I drive to the shop. The director is kind enough to drive us the 50 miles to our test. He wants to give us every opportunity to be as rested as we can.

The 3 of us don't say a word on the hour drive, we are too consumed with our own thoughts, ambitions, and fears.

As we arrive at the testing center the paranoia kicks in and my stomach starts to tumble. I feel like I'm here to do battle. They WANT to fail me and I will need to fight like hell to even have a chance. I know it's irrational, but thats what I think. I'm a fighter by nature so bring it on, lets get to it. It's either you or me NREMT.

125 questions later I walk out the door wondering how long it will be before I can reschedule. It was a good fight but I think they got me. A cheap shot indeed, but I think they got me. No matter, we'll fight again and things will be very different.

Quiet on the ride home too, I know it will be at least 6 hours before I will know the results of the fight. I was bloody, bruised and tired but I thought I got a few good shots in too. I might not have won, but that bastard would know he was in a fight tomorrow.

Pull into the drive and stumble in the house. Too hot, the AC comes back on. I crawl upstairs exhausted and fall into a coma.

Phone rings. Results are in.

THAT BASTARD GAVE UP! He rolled over and showed me his belly! I may be broken up and bruised but he couldn't continue!

I'm a Paramedic

Medic School Is Over

2008-06-05T09:29:00.000-07:00

Medic School is complete and now the real stress begins. National Registry.

5 Days from today I will find out if I'm a brand new paramedic or if I have fallen short of my goal and need to study up and re-test.

Lord knows I would like to accomplish this on the first time around, but I know many fine paramedics that had to take the test several times.

Then again... I know many crappy paramedics that only took it once.

I don't know how to feel really. One the one hand I'm EXTREMELY happy to be done with school. I have let a lot slide in the last year. On the other hand, I'm about crazy with nerves about this test.

Wish me luck.

Medic School and Clinicals. A Journey Into Hell.

2008-03-27T16:35:00.001-07:00

Greetings all, sorry I haven't posted in awhile. I have been crazy busy. I promise I will be more attentive to this blog as soon as school is over. 10 weeks, 2 days and about 6 hours from now.

Let me start by saying the "school" part of paramedic education is not bad at all. If you have been in the field for any length of time you already have a pretty good idea of whats going on, you just need to learn to do it the "right" way. Or rather, the way that National Registry wants you to do it. If you apply yourself and read your subject matter the course work is really not that difficult.

With that said, clinicals are a bitch. It's not the skills that bother me or even the fact that in the hospital your working out of your element. It's the hours required or number of skills performed. I know some college educated idiot and all his buddies sat down and decided this is what is best for me, but I don't agree. I work between 50 and 90 hours a week. I use my skills on a daily basis and I work with a paramedic. I get absolutely NO CREDIT for this. In order for a clinical hour to count I have to be the 3rd person on the unit and supervised by a preceptor (never mind the fact that my partner is a preceptor). Lord willing, I'll pass my National Registry and then I'm going to start lobbying to do something about it.

Thats right, you all have never known me to be quiet about anything. I think I'll start with a letter to the State and then work my way up to the Feds. There has got to be something we can do for all the students that already have a vast amount of experience in their field. Some sort of testing procedure to PROVE the skills are mastered and can be grandfathered.

Let me give you a little example. I'm an advanced EMT, have been for a good many years, and I'm required to have X amount (whatever the program requires) of I.V. starts for my paramedic education. Oh please! I can start an I.V. in my sleep. I think it's utterly absurd that I have to be tested on something that I have mastered, and PROVED when I took my National Registry for Intermediate. We have got to stand together and call this "Bull-Shit". Don't bitch to your instructors, it's not their fault. They are only following guidelines that are set for them by the Governing State you are in. We need to start at the top and scream that this is shit. Politically of course... You wont get far calling your State EMS Department and using words like "shit". They will most likely just re-educate you to what a dial tone sounds like.

It's been nuts since last May. It started with A&P and then we got August off and medic school started in September. Here we are at the tail end of March and I can see the light at the end of the tunnel. I still have a considerable amount of clinical hours to complete, but I think I have it worked out so Satan only gets 1/2 of my soul.

I'm still a station officer and I feel bad about all the things I'm NOT doing there because I have to study or go to school. I'll get back on track as soon as school is over.

That seems to be the underlying theme with medic school. You are constantly making promises to fix things that you broke during school. I need to eventually find another girl-friend, I went through a messy break-up last July. Medic school wasn't the only reason, but it helped I'm sure. I need to be a better friend, I have lost touch with some really close friends because of school. And lastly but the most important to me. I need to be a full-time daddy again. My boys have suffered the worst of this and I'm tired of sacrificing time with them.

There will be points in your medic education where you just want to throw the book into a burn barrel and say "to hell it it". Don't do it. Close your eyes, take a few deep breaths and work on one issue at a time. If you look at the entire paramedic education picture it's easy to be overwhelmed. Focus on one aspect of it and complete that. Continue doing that until you have it sorted out enough that you can step back and look at your progress.

About a month ago I had enough. I was so close to calling it quits. That night at school the instructor called me into her office for our evaluations and said that based on my test scores she didn't think I would have any trouble with the final exam or the National Registry exam. She told me to keep it up, and then she reminded me I was horribly behind on my clinical hours. Well, I felt better and worse at the same time. Then the next day I went to surgery and managed to complete my clinical requirements there. I felt better and the worst of it was behind me. Push on.... Push on!

We'll chat soon I'm sure, but until then. Do what you do, love what you do and never let anyone call you a fucking "Ambulance Driver".

Merry Christmas

2007-12-26T14:52:00.000-08:00

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

2007-12-06T19:47:00.001-08:00

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

2007-12-06T07:02:00.000-08:00

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

2007-12-03T18:38:00.000-08:00

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?

2007-11-12T09:18:00.000-08:00

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.

2007-08-16T08:29:00.001-07:00

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

2007-07-29T13:05:00.000-07:00

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

2007-07-28T09:23:00.000-07:00

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?

2007-07-16T10:32:00.000-07:00

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!

2007-07-16T10:13:00.000-07:00

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..!

2007-06-21T16:15:00.000-07:00

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.

It's 5am do you know where your ambulance drivers are?

2006-10-08T02:03:00.000-07:00

Ambulance driver. This simple term sets me on fire. I do more than drive an ambulance folks.

To enlighten a few of our readers that do not know what EMS really does please observe the following:

First Aid: You can learn it anywhere, some classes are better than others.

First Aid/CPR: Now your doing something useful, but still, some classes are better than others.

First Responder: This is the entry level of professional rescue, about 2 months of school.

Basic EMT: Step 2 in professional rescue. Some drugs and medications about 6 months of school.

Advanced EMT: (some states call them specialists) Step 3 in a 4 step process. More meds, more proceedures. 6 months school to get your basic then 4-5 more months to get your advanced.

Paramedic: The last step in most pre-hospital care. Advanced Cardiac Care, even more meds and proceedures. At LEAST 12 months of school with many classes being 18 months.

From first responder to paramedic we all drive the freaking ambulance from time to time, but dont call us ambulance drivers.

Z

Emails

2006-08-13T07:11:00.000-07:00

I'm still here guys, thanks for all the emails... Give me a few days, I'll be back at the writing...

Real Life Bites You In The Ass

2006-07-16T05:34:00.000-07:00

**ALL NAMES AND PLACES CHANGED TO PROTECT PRIVACY**

A week ago Saturday I'm at home with my children, the girl is at work. It's about 1pm and I'm settling down for some television while the children are taking their afternoon nap.

My buddy Rick walks into my house and says he needs me to come over to his house with him, someone has locked themselves in his garage and he hears music blaring. Immediately I tell him to call 911 and we'll sort the issue out from there. He calls 911 and they inform him that there are no local police officers on duty he would need to wait 15 minutes or so for the sheriff to arrive. Rick heads home and sends his son over to watch my kids so I can leave. I arrive at Rick's house just as the first Deputy does. The garage windows are all blocked off, you cant see in it anywhere.

The deputy says he is waiting on another deputy before he enters; being a tactical medic I understand fully, but Rick is very upset. He wants to get to the bottom of this, and generally feels a little freaked out. I guess I don't blame him, if it were my garage I would be a bit freaked out too.

While we are waiting for the other deputy to arrive I try to brace Rick for the two possibilities I foresee. I know he and his ex-girlfriend have been on the outs for the better part of 2 years. I know that there is some concern over his visitation of their child, and I know he sought the advice of a lawyer to try and rectify the problem.

Knowing his Ex only two things were possible in my mind; either she was waiting in the garage to kill him or she has killed herself. I relay this information the the deputy, but Rick clearly doesn't want to hear any of this and walks away kind of in a daze.

The other deputy arrives and they discuss how they are going to enter the garage. Eventually they break out the glass in the man door and open it. With guns drawn they yell "SHERIFF'S DEPARTMENT!!" Then one deputy stumbles backwards and yells: "Get EMS!"

From behind the truck where I was standing I reply: "I am EMS". The deputy yells: "She's in the car!" I ask: "Is the scene safe?" The deputy replies "Yes, hurry, she's in the car"

Rick starts for the garage and I quickly yell at him to go across the street and I'll talk to him in a second. He caught a glance of her in the car... I wish he hadn't.

As I rush to the garage I notice the car still running with a garden hose from the exhaust pipe to the drivers window, one of the deputys breaks out the passenger side window and unlocks the door, he leans over and cuts the ignition. As he jumps out of the way I'm yelling for him to open the garage door or we are all gonna be in trouble. I jump in the car and grab her, prepared to pull her out onto the garage floor and work her. As I touched her arm I knew. She had been gone for several hours. Lividity has set in and she was very ridged. No pulse, no respirations.

I exit the garage just as the local squad is pulling up. They go to the patient with a monitor and confirmed what I told them on arrival.

Now, I have been on several calls like this. I would like to believe that I knew what to expect. The truth of the matter though... It's all very different when you know the people involved. It's very hard to maintain a professional distance when the people grieving are your friends.

The first question on everyone's mind was "Where was the little girl?" The deputys checked every inch of the vehicle and were confident in saying that she was not in the car. Rick called the family, informed them of the situation and found out his daughter was with them.

As the sheriff's department was processing the scene they had a lot of questions for everyone. It felt like we were there 100 hours. Rick was still across the street and he had been joined by a friend of ours and eventually my girl-friend showed up there too. They were all doing what they could do to try and keep him calm during the investigation.

The scene was elaborately set up. She had went to great lengths to make sure no one would be able to enter that garage. The windows were blocked, the garage doors were unplugged and she had secured the dead-bolt, which Rick never had a key to.

There was much more, but to tell you the truth I really don't want to have to relive it. I might add more to this post later, but right now it's all still very vivid.

Some times when you think you have seen it all, the EMS gods look down and say: "What about this Mr. Confident?... Deal with this"

Z

Overtime

2006-07-08T08:16:00.000-07:00

Sorry I haven't been real current with the writing lately. We are slammed with OT at work. We have several people on vacation and as it stands we were already down 2 medics and a basic. So basically we are down 5 people. That means one HELL OF A LOT OF OT for the rest of us.

Now, don't get me wrong. In emergency services, most of us like to hover around the 70 hour mark, but 90-100 hours a week is a bit draining.

I put a pool up for the kidos today. Me and a couple buddies spent the better part of 4 hours leveling the ground where it sits. Put the pool up to find out it leans. Crap. Time to drain 2000 gallons of water out and re-level. Poor children might be able to swim by the middle of August.

Playing very little paintball lately, I either cant find the time to play or I can't find the players. So much for shooting your buddy.

Been screwing around with Sony Vegas and Micro(shaft) Movie Maker. I'm toying with the idea of making a realistic video clip about EMS.. Only problem is I have to find enough footage that doesn't infringe on any copyright. If anyone out there has a stock of pics or vids that they wouldn't mind seeing in a video lemme know.

Been teaching a bit lately. Just got done doing a 2 day WMD class for the IAFF. It went ok, could have been better. I just don't understand people sometimes, you give them FREE training and they want to bitch. I got several complaints that the class was too long, then I got several complaints that there was too much information for a class so short. Geees.

Oh well, back to the back yard. I got a pool to wrestle with and kids that at least appreciate me.

Z

A Modern Day Hero is Gone.

2006-07-01T18:37:00.000-07:00

He was never afraid to call it like it was. He was never afraid to get right in your face. He was never afraid to take it to "the man".

You will be missed AcidMan

Z

Private EMS

2006-06-27T18:35:00.000-07:00

Got our ass beat today. Back to back all day.

I start up blogger to bitch, complain and scream about my job in private EMS. However, when I got here and started writing this it occurs to me that I could be in a factory punching out car parts for more money. I could be screaming "Would you like frys with that?" and proabably be making more money... BUT.. what i couldnt do is: Write a blog, read a book, watch television, play video games, eat a sandwich, take a nap, sit in a lawn chair, web surf, or take a lengthly crap. All the while being paid to do it.

My job aint that bad. Sometimes you get the bull, but sometimes you get the horns.

Z

Realisticly Speaking

2006-06-20T12:33:00.000-07:00

If you look at EMS realisticly it's pretty simple. The whole process of Emergency Medicine is simple: You see a problem and you correct it. I like to relate it back to the old BASIC programming days of the TRS-80 and the Commodore C=64.

IF THEN

IF the patient cant breath THEN we check the airway.

Almost every single problem in any given circumstance can be over come with simple logic, remember it is not the EMT's job to "cure" the patient. It's the EMT's job to get them to the doctor alive and as stable as we can. Long term care is left up to the doctors and nurses. It simply is not our problem. The reason I bring this up is because I'm tired of the following:

You arrive to a patients house, they cant breath. The have a history of COPD. A breathing treatment later and some high flow O2 and your on your way to the hospital. Yes I know all about the respitory drive of COPDers, I don't care. It's not my job to worry about the long term care of these patients. At the hospital you are met by a nurse that receives your report and then snatches the non-rebreather off your patient lightning fast. I don't have a problem with them doing this, but I do have a problem with them assuming they know my job and glaring at me as if I have done something wrong.

Sir/ma'am It is your job function to give this patient continuous care, and get them to a point that they can return back to their residence, it was my job to get them to you alive. If their respirtory drive would have magicaly dropped out in the 15 minutes I had the patient, I would have tubed them. I would be doing my job maintaining this patients life and once again you would have to provide for their continuing care.

I WILL NOT deny my patient the O2 they need to sustain their life, because of a "maybe". If I don't give this patient O2 they will die. If I give the patient O2 nd it knocks out their respirtory drive the I will tube them and breath for them, but they wont die.

All I ask is respect the part we EMTs play in the grand scheme of things and we will respect yours. Don't assume because a rule is steadfast for you it's the same for us. Most of the time it's not.

Documentation Evils

2006-06-15T17:00:00.000-07:00

Paper work, paperwork, paperwork, if you didn't write it down, it didn't happen.

They have been preaching this to you since you were in school for your basic card.

I have noticed a few things in my years as an EMT and I think this is a good time to talk to you about a couple of my pet peeves. The "by the book report writer" and the "forecast report writer".

By the book report writer:

This is the guy that can have 40 thousand things go wrong on his scene and when you read his report it's as if he was teaching a class on the proper way to do things. They are marched out step by step in his report perfectly, just as you would see them in the EMS book. Everyone that was on the scene knows it didn't happen the way he wrote it, but none the less it looks pristine.

Come On! We are not stupid, everyone knows that the scene NEVER goes the way the book states, and to make your report look like it did only undermines EMTs everywhere. Tell the truth! A doc would always choose an accurate report of the actions at the scene over a "pretty" fabricated one. Sure you might have done everything you wrote in your report, but it sure as hell didn't happen the way you wrote it.

The Forecast Report:

This type of report writing is very common with non-emergency transport and I have heard of it being utilized a lot. This is the guy who will sit and write his entire report (usually minus the vitals) before he even sees the patient or will write it in the first 10 minutes of patient contact and then just sit in the truck for the rest of the trip. It could be a 1-2 hour trip and his paperwork will be done in the first 10 minutes.

Come On! You cant possibly tell me that there was absolutely no change in the patients status in 1-2 hours, further more you're "guessing" about the patients continued condition during your trip. What if the patient starts complaining of pain that they didn't have when you started transport? What if the patients becomes incontinet or vomits? What if the patient makes comments that you need to document. If your report is already done, I doubt very seriously that anything but a full arrest will get you to rip up your old report and start a new one!

Now that I have vented, lets hear what you have to say!

Z

EMT's the other NOMADS

2006-06-06T13:33:00.000-07:00

Have you ever noticed how EMT's seem to switch job locations frequently? Sure, you have a few lifers that stay in one place, but as a general rule, EMT's of all levels are very nomadic.

They move from place to place and town to town. They have stories that start off like : "When I was a medic in (random town) we did..."

Or

"Back in (Some place else) we..."

I have made many good friends in this business and I've had many good friends leave to persue other oppertunities. Some of the people that they left behind feel deserted or "cheated" on, but I never have. I always figured they did what was best for them and still considered them a friend. Nothing has changed in my eyes except I don't see them often anymore.

As health care providers we have a responsibility to our patients and above that we have greater responsibility to ourselves and our peers. If we let each other down there is no way we can be the professional we need to be for our patients.

My friends are my friends, no matter who they work for. I understand you have your life, all I ask is that you understand I have mine. We are each doing what we need to do, or what we feel is best for us and our families.

Z

HUGE FIRE

2006-06-03T15:55:00.000-07:00

Yesterday we had a huge fire at a manufacturing plant. Our SOG (Special Operations Group) was called in to provide decon of patients and rescue personnel. Our EMS division was called to transport many patients to the area hospitals.

It was our big chance to shine! We have been training and practicing, and practicing and training for 3 years and finally a full scale activation of our SOG.

I'm not going to get into too many details of the disaster, but there is a couple things I wanted to express. First off, we worked exactly as we had trained. Training pays off BIG TIME in the long run. Even members that had never been to any HazMat scene before and only had book work to rely on operated to their specification perfectly. There was no arguing among the team members or with other other departments and there was no ego trips. We were there for the support of the local community under the authorization on the county EMA, and it went beautifully.

It was long though. The activation lasted about 10 hours and during that time we decontaminated many people and even 1 dog. I got to see the EPA in action and those guys are pretty impressive too.

One more note. Our company president was there, and when he first arrived I figured he would go on over to the administration area and chat it up with the other people way out of my pay grade, but then he asked "Where do you need me?" To tell you the truth it blew my doors. He suited up and worked a decon pool for over 5 hours with other crew members. Say what you want about big wigs, but some of them put their money where their mouth is. This guy earned MAJOR respect points with the team. They were talking about it for hours after he had to leave and head back to the office. To tell the truth, I was talking about it too. We all knew he was trained to the operations level, but it was damn impressive to see him voluntarily suit up and join the other guys in the trenches.

For our first major call out I could not have been happier.

Oh Orderly

2006-06-01T15:19:00.000-07:00

I've mentioned before that I work for a private EMS system. We do 911 calls just the same as the city guys, however we also do a lot of medical transports.

For those of you unfamiliar with medical transport it generally involves taking someone who requires medical supervision to the hospital for x-rays or to a doctors appointment, then returning them to their place of residence; whether it be home or a nursing facility.

Today I felt less like an EMT doing a medical transport and more like a hospital orderly. We arrived with our patient who was due for a bone scan, we were told there would be a 10-15 minute wait and could we sit with our patient in the hall. The nurse told us that after our wait we would only be there 15 minutes "tops" she said. Well, we were pretty sure our dispatcher wouldn't want to send us away only to have to call us back in 3o minutes so we waited. And we waited some more.

During this waiting time either myself or my partner were summoned 2-3 times to come into the x-ray room and help move a patient. For the greater good of company PR we happily obliged.

Finally was our patients turn and just like she said "15 minutes tops" BUT, when he was done magically he needed some standard x-rays as well and could we wait in the hall. Now we are getting concerned. It's approaching a hour we have been here and we are sure our dispatcher is getting a bit on the concerned side. Not for our safety, but someone probably has to go somewhere else and we are tied up here.

We receive a page to check in. My partner relays the information to the dispatcher and we sit to wait with our patient again. During this waiting time we were asked to relocated our patient more than 6 times and summoned 2-3 more times to help with other patients. Over an hour passes and FINALLY we get in. The films are taken and we are on our way 2.75 hours after we got there for a 15 minute "tops" appointment.

I guess I'm a little frustrated with the entire health care spectrum. If they really need more help to process patients quicker, maybe they should hire more people. I'm an EMT, not an orderly.

I See You.

2006-05-29T21:03:00.000-07:00

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

2006-05-29T07:39:00.000-07:00

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.

Z

The Amazing Mouth Mime

2006-05-28T19:23:00.000-07:00

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?

Z

Secondary Drowning

2006-05-25T23:29:00.000-07:00

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!

Z

2006-05-25T13:05:00.000-07:00

'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.

Z

Boom.... KA-BOOM

2006-05-25T05:16:00.000-07:00

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.

Z

Protocol VS. Scope of Practice

2006-05-23T18:35:00.000-07:00

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.

Z

New Look

2006-05-23T10:31:00.000-07:00

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.

Z

Comment Spam

2006-05-22T22:10:00.000-07:00

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.

Z

Grown Men Dont Cry

2006-05-22T20:26:00.000-07:00

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.

Z

2005-11-15T08:37:00.000-08:00

Wish You Could Know"

I wish you could know what it is like to search a burning bedroom for trapped children at 3 AM, flames rolling above your head, your palms and knees burning as you crawl, the floor sagging under your weight as the kitchen below you burns.

I wish you could comprehend a wife's horror at 6 in the morning as I check her husband of 40 years for a pulse and find none. I start CPR anyway, hoping to bring him back, knowing intuitively it is too late. But wanting his wife and family to know everything possible was done to try to save his life.

I wish you know the unique smell of burning insulation, the taste of soot-filled mucus, the feeling in intense heat through your turnout gear, the sound of flames crackling, the eeriness of being able to do absolutely nothing in dense smoke-sensations that I've become too familiar with.

I wish you could read my mind as I respond to a building fire "is this a false alarm or a working fire? How is the building constructed? What hazards await me? Is anyone trapped?" Or to call, ""What is wrong with the patient? Is it minor or life-threatening? Is the caller really in distress or is he waiting for us with a 2x4 or a gun?"

I wish you could be in the emergency room as a doctor pronounces dead the beautiful five-year old girl that I have been trying to save during the past 25 minutes. Who will never go on her first date or say the works, "I love you mommy & daddy" again.

I wish you could know the frustration I feel in the cab of the engine, squad car, or my personal vehicle, the driver with his foot pressing down hard on the pedal, my arm tugging again and again at the air horn chain, as you fail to yield the right-of-way at an intersection or in traffic. When you need us however, your first comment upon our arrival will be, "It took you forever to get here!"

I wish you could know my thoughts as I help extricate a girl of teenage years from the remains of her automobile. "What if this was my daughter, sister, my girlfriend, wife or my friend? What were her parent's reactions going to be when they opened the door to find a police officer with hat in hand?"

I wish you could know how it feels to walk in the back door and greet my parents and family, not having the heart to tell them that I nearly did not come back from the last call.

I wish you could know how it feels dispatching officers, firefighters and EMT's out and when we call for them and our heart drops because no one answers back or to hear a bone chilling 9-1-1 call of a child or wife needing assistance.

I wish you could feel the hurt as people verbally, and sometimes physically, abuse us or belittle what I do, or as they express their attitudes of "It will never happen to me".

I wish you could realize the physical, emotional and mental drain or missed meals, lost sleep and forgone social activities, in addition to all the tragedy my eyes have seen.

I wish you could know the brotherhood and self-satisfaction of helping save a life or preserving someone's property, or being able to be there in time of crisis, or creating order from total chaos.

I wish you could understand what it feels like to have a little boy tugging at your arm and asking, "Is Mommy okay?" not even being able to look in his eyes without tears from your own and not knowing what to say. Or to have to hold back a long time friend who watches his buddy having CPR done on him as they take him away in the Medic Unit. You know all along he did not have his seat belt on. A sensation that I have become too familiar with.

Unless you have lived with this kind of life, you will never truly understand or appreciate who I am, we are, or what our job really means to us...I wish you could though.

KEEP SENDING THIS ON. APPRECIATE AND SUPPORT THE LOCAL EMS WORKERS, 9-1-1 DISPATCHERS, FIREFIGHTERS, LAW ENFORCEMENT OFFICERS, AND DOCTORS & NURSES IN YOUR AREA. ONE DAY THEY'LL PROBABLY BE SAVING YOUR PROPERTY OR YOUR OWN LIFE. WHEN YOU SEE THEM COMING WITH LIGHTS FLASHING, MOVE OUT OF THE WAY QUICKLY, THEN PRAY FOR THEM.

--AUTHOR UNKNOWN

Board Troll

2005-07-07T13:19:00.000-07:00

I would not be a good host unless I informed all of you that there are a few blog trolls about on this board.

As a result of people with little minds having nothing better to do than post anoymous comments on my blog I have decided to make the comments section registered users only.

Yes, I fully realize that these trolls can just make fake names and still post. That being said, they will have to work just a little harder to do so. Anything that makes it more difficult for a troll is seen as FINE in my book.

These trolls (well one of them) also works for the spelling police. Please use spell check in all further comment postings. I would hate for any of you to have to deal with a heafty ticket for not using the english language to it's fullest scale.

(lol)

Z

30 Somethings ...

2005-07-03T06:21:00.000-07:00

In the last week the newspaper has sent my head spinning. I don't know why I bother to pick it up anymore.

3 of my highschool classmates have died of heart related problems. All within the same general age of me. I'm freaked out.

I have clothes to buy and funerals to attend. I have hands to hold and a game face to put on.

At work last night I had my partner hook me up to the 12 lead, RSR. Well that's good, but I'm still making an appt. to see my doc. I'm glad I quit smoking last year and I eat more chicken now then beef. It seems like everything I like to do will only make my children be without their father quicker.

I look at the police officers on the street now and many of them are 5 years younger then me. When did I get old? Or when did they get so young?

I am glad that I'm older though, because if I had to wear my pants falling off my ass and constantly hold on tho them as I walk, I'm afraid I wouldn't get much done.

Whats wrong with kids today? No respect, no responsibility?

Ya I know these were some rambling thoughts today... cut me some slack. I'm not doing real well with the 30 somethings dying on me.

Z

Hot, Hot, Hot

2005-06-27T18:14:00.000-07:00

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.

Z

War is Expensive!

2005-06-22T09:01:00.000-07:00

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?

Comments?

Z

Kids and their mouths.

2005-06-20T05:35:00.000-07:00

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.

Z

In Memory of Amanda

2005-06-19T11:25:00.000-07:00

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.

Z

The Basic EMT "Big Lie"

2005-06-19T10:06:00.000-07:00

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.

Z

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.

The SuperBowl

2005-02-08T11:16:00.000-08:00

I know this page is mainly dedicated to EMS stuff but something has not been sitting real well with me since I read this http://tv.yahoo.com/news/eo/20050207/110782500000.html take a look at it and get back with me.
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Ok, now that your back let me ask you this. Why cant people simply turn the channel anymore? Used to be that if you found some offensive that you would get up, put down the cheetos and turn the channel. With the invention of the remote control you could still hold the cheetos and turn the channel.

I really cant believe how people will take time out of their day to log a complaint to the FCC because they were offended over something on television.

Now because of all of this we get lame half-time shows and lamer commercials.

Special thanks to www.fark.com for pointing out the link to me in the first place.

Ups and Downs

2005-01-10T04:46:00.000-08:00

Well it's Monday morning again and I'm back at work. Actually I've put in about 100 hours this week and there have been better weeks, but then again there have been worse ones too.

Yes it has been awhile since I last posted. I dont really know how to explain it except that I get so busy I dont think about the blog much anymore. Ever since the spot of trouble that I got into a few months back the blog really doesnt ride high on my list of things I must get accomplished daily.

BUT, when I dont write I dont feel as good. Go figure!

Things are pretty busy around my neck of the woods, we have been preparing to go get my mother. She lives about 2000 miles from me and I havent seen her in almost 20 years. I guess it's time. The verdict is still out on how that will go, but the girl and I are flying out there at the end of next month and driving my mom and all her stuff back here.... A 30 hour drive with two very talkitive women... I just might not make it back.

Our HazMat group is really starting to form up into something. Yesterday the owner of the company and his wife came to one of our drills and participated. They seemed genuinely interested in the program and that always gives you a boost of confidence. Now, as long as I kep on the straight and narrow I might stay out of the dog-house for awhile.

I've been teaching a lot lately. I dont know what it is about the classroom, but sometimes (just sometimes) I feel more comfortable there than I do on the road. I know that the responsibilities are equally as important, but class work seems to calm me at times.

I know there were a few things I wanted to write about, but at 08Early in the morning my brain is not fully online yet.... I'll let the coffee work and get back with you.

Chronic Dyspena

2004-10-20T10:48:00.000-07:00

Hello all, good to be typing to you again. Here is another case study for your input.

Can't breathe. Consider this:

You are called to an assisted care facility (nursing home) to transport a patient to the local ER for difficulty breathing. When you arrive on scene you are met by the staff that tell you that "Mary" has been having more trouble breathing than usual.

As you approach Mary and try to talk to her she presents as an elderly female in her mid to late 80s with a Hx of COPD and heart failure. The staff tells you that her SP02 has been 89-90 % all week and now she is down to 74-79%. She cant complete even the shortes sentence and is working hard to breath.

You follow your local protocol and take mary to the hospital, providing her O2 and a breathing treatment. On 15lpm of O2 you manage to get her to 93-94% after a breathing treatment. IV established at KVO. Monitor shows sinus tach at 140

About 4 hours later the ER calls you to return Mary to the nursing home. When you arrive you get the report from the nurse and you load Mary into the back of the squad.

Here is the problem. Mary is returning to the nursing home on her standard 2 lpm O2 by cannula. She now has DNR papers. She might have had them before, but they were not presented to you at the nursing home. She tells you that she feels a little better but her heart rate is in the mid 120s and her color is ashen and grey at the hands and arms. She is still breathing with pursed lips and appears to be struggleing very hard to maintain air. SP02 will not come up above 88% at 2lpm.

What are your thoughts? Do you return to the ER and tell them that she is still having trouble? Surely they know, they are releasing her to go back. Do you continue your transport to the nursing home and transfer care to the resident nurse? Surely they will send her back out, because she appears worse now than when she went in. Do you call your supervisor for advise? Do you call your medical control and ask for clarification?

You know she has a DNR, therefor you KNOW what you can and can not do. You KNOW that she wont be able to sustain life long working that hard to draw breathe.

So now it's your turn. What would you do?

Colder Weather

2004-09-30T05:45:00.000-07:00

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.

Well.

2004-09-15T17:49:00.000-07:00

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.

Blog Revision

2004-08-26T07:24:00.000-07:00

Let me explain my removing the blog that used to be here.

I write a blog because I can't afford a mental health professional every time I need to get something off my chest.

I write a blog because it helps me vent to the outside world without venting to my family or my co-workers.

I write a blog to try and inform people of the little things that they miss day to day. Things that might be over looked.

I write a blog to try and get in touch with others that might feel the same way I do.

I have been informed that some of the people in the company I work for did not appreciate the content of my writings. I was told that I needed to remove any and all reference to the company I worked for from my writings.

That would have been extremely difficult. See, my blog was open access. I posted a picture of one of our ambulances and then several other people from our company and explorer post added more pictures. This was a mistake. I'm perfectly able to remove the content that I added, but finding and removing the links other people have posted and editing their comments is just too time consuming. I chose to remove the entire blog.

At no time was there any accurate information posted about patient information. Every name, street, number, hospital ETC was fictitious.

To those people who enjoyed reading and posting to the blog, I apologize.

To any of the people that I work with that might have found the writing inappropriate, I apologize. It will not be repeated.

I posted the pictures because I have an huge amount of pride in the company I work for. I'm proud of the things we have accomplished and the future ahead of us. I posted the picture because I wanted other people to be able to precieve the pride that I was trying to convey. I can only assume that other people posted the pictures they did for similar reasons.

Yes there were some stinging remarks about things that have happened to date. I will not apologize for them. This was my way of dealing with issues that I had to deal with. This was my out in the crazy world of private EMS. I would post my thoughts and be done with them. I would not need to dwell on issues that I had already addressed.

If in the course of my postings some people were offended, it was never intended.