Holiday "Break"

From my family to yours

Merry Christmas

I shall return after the New Year, as I will be spending it with
family and celebrating my Lil Mans 1st Birthday.

Please enjoy every thing that is the holiday season
 And thank you for all your support from the bottom of my heart

As Always

Be Safe
Ambulance Junkie

Over Simplified?

While fueling the rig I saw the sign above, which raised a thought. Doesn't the use of a Credit or Debit card negate the "payer" as Cash Customers? So is this sigh really necessary than? Frankly should this over simplification of a concept have to be this redundant within such a small space?

Obviously if we have to have such a sign even exist, which obviously we do, it really needs to be quite large. The individuals it is intended for aren't going to see this misplaced signpost plastered to the steel support beam of the gas station. Rather they need an enormous neon sign on top of the building that asks a simple question and then will answer it for them (No thinking involved): USING CASH? PREPAY. Maybe add additional blinking lights, flashing arrows to point at the glowing neon light pollution. That way Joe Public is drawn to the sigh much like bugs to a light, they'll ask them selves "Am I using cash?...Hmmm...Yes I will have to use cash to buy my gas today, what of it? Oh I understand, I must Prepay"

So that got me thinking about some of the people I've had the pleasure of training over the years. The ones who didn't see the giant neon sign above the stations which read's "You don't know it all, apply within, we teach"  The fresh out of Basic class, who already working their way through the Medic Class with out an ounce of real exposure, new hire. By the time they are getting out of the Medic class they are so full of them selves and how well they have the book knowledge down that a little basic, such as myself, is nothing more than the proverbial "Ambulance Driver"or the "Bitch" to do all the crap calls.

Granted, I may not almost be done with the eighteen months (or less) of schooling that you have under your belt that has taught you how to read cardiac rhythms, given you the "skills" to push drugs, start IV's, or intubate a patient, and given you the ability to read protocols. But I do have a couple of years of experience and more calls under my belt than some agencies have in a year.

So it may be advisable to listen to what I have to say, and don't automatically answer "Ya, I know". If I've picked up on something you're doing incorrect or am attempting to refine your hop-scotch assessments, your incoherent patch reports its because its apparent you don't "know"...Ya Know?

So do not brush off the guy who's "just" a Basic that could be the one to save your ass if you ever get cleared as a Medic. Our Basic's are the best assest you could ever have in your bag of tools. Though you are the one with the eighteen months of education, so you tell me; what should our basic's neon signs say?

Be Safe
Ambulance Junkie

Twelve days of EMS

*On the First day of EMS my dispatcher sent me to
A Smelly Necropolis Rectal Bleed

*On the Second Day of EMS my dispatcher sent me to
Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

*On the Third Day of EMS my dispatcher sent me to
Three Faking Seizures,  Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

*On the Fourth Day of EMS my dispatcher sent me to
Four Frequent Flyers, Three Faking Seizures,  Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

*On the Fifth Day of EMS my dispatcher sent me to
Five Trauma Codes, Four Frequent Flyers, Three Faking Seizures,  Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

*On the Sixth Day of EMS my dispatcher sent me to
Six Month's of Chest Pain's, Five Trauma Codes, Four Frequent Flyers, Three Faking Seizures,  Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

*On the Seventh Day of EMS my dispatcher sent me to
Seven CHF'ers, Six Month's of Chest Pain's, Five Trauma Codes, Four Frequent Flyers, Three Faking Seizures,  Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

*On the Eighth Day of EMS my dispatcher sent me to
Eight Swinging Drunks, Seven CHF'ers, Six Month's of Chest Pain's, Five Trauma Codes, Four Frequent Flyers, Three Faking Seizures,  Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

*On the Ninth Day of EMS my dispatcher sent me to
Nine Needing Narcan, Eight Swinging Drunks, Seven CHF'ers, Six Month's of Chest Pain's, Five Trauma Codes, Four Frequent Flyers, Three Faking Seizures, Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

*On the Tenth day of EMS my dispatcher sent me to
Ten Tooth Aches, Nine Needing Narcan, Eight Swinging Drunks, Seven CHF'ers, Six Month's of Chest Pain's, Five Trauma Codes, Four Frequent Flyers, Three Faking Seizures, Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

*On the Eleventh day of EMS my dispatcher sent me to
Eleven Esophageal Varices, Ten Tooth Aches, Nine Needing Narcan, Eight Swinging Drunks, Seven CHF'ers, Six Month's of Chest Pain's, Five Trauma Codes, Four Frequent Flyers, Three Faking Seizures, Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

*And on the Twelfth day of EMS my dispatcher sent me to
Twelve Febrile Kids! Eleven Esophageal Varices, Ten Tooth Aches, Nine Needing Narcan, Eight Swinging Drunks, Seven CHF'ers, Six Month's of Chest Pain's, Five Trauma Codes, Four Frequent Flyers, Three Faking Seizures, Two Stubbed Toes & A Smelly Necropolis Rectal Bleed

Tis The Season

Dispatch: "Caller advises it's the house on the corner and stated he left the lights on"

I have nothing against holiday cheer, in fact my house is beautifully decorated both in and out. I begin to listen to Christmas music the first work shift after Thanksgiving. I'm not devote about it, it just seems that its only played a short time out of the year so I should enjoy it. I'm not fanatical about Christmas in any way, its not my favorite holiday but I do enjoy it.

It perplexes me though about human nature and how they can put the time and effort into creating the "master piece" as seen above. They then use it to their advantage when having a medical emergency, great! Very creative in fact, I applaud your effort and out of the box thinking. Any other time of the year though they can never turn on a porch light, Shovel thier sidewalks or make sure house numbers are visible (if they even have them). I cant begin to count the number of times that I have had to back down a road with scene lights on just to guess which house is probably the correct scene because you've obviously passed it. Its like a game show half the time, the prize? The Patient!

As long as I am on the subject, know what your address is. If I have to roll up to a 23 Made-up St. one more time this year and its an empty lot, I'm going to think about calling out No Pt found. Rather I take the time to call up to county dispatch advising of the current situation and asking for them to recontact the caller to find out the call is at 32 made-up St. and then I get grief because the Pt's "Dyslexic".

I really do enjoy rolling up with all the flashing lights though, the blinking candy canes, the dancing Santa Claus, The moving deer statues, the twinkling the brightness and the rest of the festive display but can we carry this courtesy through the rest of the year?

Be Safe
Ambulance Junkie

The Boo-Boo Bunny

Thanks to my great mate over at Scaredy Fish 

I'd like to share this helpful trick with you.

All credit is due to Scaredy Fish for bringing this into my everyday skill set.

Now its not original to him but he taught it to me so I give him credit

A matter of fact this Posting is dedicated to him for teaching me it.

(I kinda asked/stole its Blog use prior to his return to Blogging)

The ambulance is a scary and unfamiliar place for people especially children,

so if there was a way to ease their anxiety while preforming simple treatment and care

should we not strive to accomplish it?

There is the natural psychological first aid effect for children towards stuffed characters,

  Kids typically cling to them for comfort during times of distress.

This can typically be used to our advantage

as a great tool to disguise an intervention such as an Ice pack, or Blow by Oxygen.

"Hold the bunny on the boo boo." 

"Make sure you hug the bunny"

Items needed: Standard Hospital Towel

2 or 3inch Tape

a Sharpie or marker.

Ice Pack/ Oxygen Mask

The instructions are simple.

1. Lay the towel out

2. Fold the corners in 

 3. Roll tightly

4. Tape the edge

5. Bend into a U shape

6. Twist the ends to form ears

7. Tape around the base of the ears 

This creates the face and keeps the ears formed

8. Draw your best cute bunny face, remember triangle noses

Smiles are nice, no teeth.

You can put an ice pack in the hole in the belly 

and wrap the body in another towel to create a cold pack they will hold on the injury

Works wonders for holding O2 masks, 

just insert from the bottom of the belly out the back and its instant blow by oxygen.

Be Safe

Ambulance Junkie

One Award I'm Glad I Didn't Win!

 With the ever approaching New Year

I thinks its safe to say

My Wife and I are not in the running

for Worst Parenting Decision 2010

But I'd like you to meet a front runner...

MCKEES ROCKs, Pa. (AP) - Authorities say a 2-year-old girl spent 15 minutes stuck inside a toy crane vending machine in a Pittsburgh-area mall. The girl apparently climbed up the chute into which the coin-operated crane drops prizes. Moon Run Fire Chief Paul Kashmer tells WPXI-TV that the girl didn't seem upset by the ordeal Wednesday night in the food court at the Mall of Robinson, in Robinson Township. 

She was extricated from the machine unharmed

Though it took nearly $9.00 in quarters to get the girl out. 

(yes I stole that from SNL but its funny)

Be Safe

Ambulance Junkie

Coach Now

He is a frail, weak and sickly old man.

Some time has passed, but he still looks the same to me.

He lays in front of me on his hospital bed in the living room

Face sunken in around his eyes and cheeks

Wife holding his hand, daughter at the foot of the bed

Hospice nurse giving us his paperwork and a run down.

Its funny how for years I rode on his bus to places with the rest of his team

Now he rides on my bus with my team

This time instead of to the football field we travel to the hospital

We talk about the years past

We talk about my life

Lastly we talk about football

Coach was a good man

I'm glad I had the chance to tell him how he influenced me

For Coach was in the final minutes of his final game.

He knew he was losing, and wouldn't tie up the score

That night the Ref's blow the final whistle

Game over

 Good Game Couch, Good Game.

Be Safe
Ambulance Junkie

Coach Then

He was a rough, rugged and rotten old man.

Bathed in booze and Cigar smoke

Skin tough as leather

Face wrinkled and weathered from battles in the elements

Eyes cold and grey

A formidable opponent to a high school kid

Making us Bleed, though never laying a hand on us.

Making us sweat until we ran out

Making us suffer at his mere delight

Always on his hill, watching over us

Criticising our every move, our every formation

His voice screaming to get it right

Wrong route; Run The HILL!

Missed the block; Run The HILL!

Fumbled the ball; Run The HILL!

As hard as he was though, he was our Coach

Year after year we returned in early August

To be tortured under his rule.

To young to understand the lessons he was entrusting us with

If I only knew then what I would have learned

Thanks to Coach

Be Safe
Ambulance Junkie

The Handover: Burn out

So after participating in only a few of these Handover's I just realized I've never allowed

those who dont follow other EMS Blogs to get a taste of whats out

there on the Blog-o-sphere.

I hope you'll take a moment to head over the this months Host

and see what the others in the world of EMS 

have to say.

The Handover EMS Blog Carnival

Burn out

Hosted this month by:
Rescue Monkey

Scaredy Fish

I would love to introduce to you the blog of 

Scaredy Fish

A coworker of mine who I can gladly has become a friend.

Which is hard to say in this business.

In this world of Zombie Apocalypse

He'd be in my fox hole.

Be Safe

Ambulance Junkie 

Trauma note taking

We all have different techniques for keeping track of pertinant assessments. Many people have these Tricks of the trade they do with out second thought. I'd like to share one that I find most useful for the trauma call.

I typically scribe on my left glove all my findings from assessments, so I have the info readily available for a patch report to the ER or nurse report. I found scribing this way inauspicious during a trauma call because of all the dirt, grime, blood and various other substances that typically get on gloves. Also during a trauma I am more likely to change gloves and then lose any info I have scribed.

This Scenario is assuming that your rapid initial assessment has determined that the best course of action allows you to remain on scene with your patient. Let me repeat myself, this is not the proverbial "load and go" yet rather you can "Stay and Play" we are talking about. This technique is rather helpful when remembering all those injuries for later on in the call or after all said and done.

Once the Pt is in the rig and you can focus on your primary detailed physical assessment take a roll of 3 inch tape over lapped vertically 2-3 times. Sectioning it into three areas and place on the cabinets along the patient or the wall/ cabinets behind you. The three sections represent the three sections of the body to focus on in a trauma. Head/Neck, Chest/Arms/ABD and Pelvis/Legs. Now every time you find a injury during  your primary assessment you write the findings on the tape, allowing you to re-evaluate systematically on secondary assessments. This technique also lets you take the findings on these sections into the ER for the staff to see and use.

This is an easy skill to get a young provider to do while you preform the assessments. In the case you are with a driver only, you can use them to scribe for you to help out.

By breaking down a trauma assessment from head to toe you have a record of all the DCAP-BTLS (Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, Swelling) for all the Non EMS'ers. This will alleviate forgetting any injuries when documenting or when sharing during a report to a nurse.

Now not to say this couldn't be done during a "load and go" depending on various factors, such as transport times, Multiple providers in the back Ect. During those times more important life saving interventions of course  take presidence.

I'm glad to pass this off to my readers for I was passed onto me from a great mentor. She's no longer on the streets but misses it greatly. I hope this bit of info helps, I know it has for me.

Be Safe
Ambulance Junkie

The Night Terrors

The Handover- Episode 21 "Burnout"
Hosted by Rescue Monkey

I swing my legs out of bed and sit on the edge, taking a deep breath as I sit in the calm of my bedroom at night. I wipe the bead of cold damp sweat from my brow, I have no intention of going back to sleep, so I lay in bed with eyes wide open, glancing into the pitch dark and wonder if its all worth it in the end. 






Is reliving these experiences worth the time and effort of this job? Is being haunted in my sleep worth the pride I get?  Are the choices I've made actually making a difference?  


My first infant death, a result of SIDS, was thanksgiving night. Only a month after being cleared from the New Employee Orientation and forty five minutes till the end of my shift. We got the call from county, a two month old down not breathing, Echo priority. The actual events have become a blur after reliving it so many times but the feeling and sensation is forever imprinted in me.

The guilt lasted a few months, always second guessing what I did, and if I did it well enough. Constantly judging every call I did, second guessing myself after any run I had. Though I was not prepared for the relentless mental bombardment experienced in the silence of sleep. Night after night after night, a restless sleep in which I felt stuck in the call and even more helpless than during the call. The night terrors have never really went away though. Reliving the calls over and over again feeling that there should have been more I could have done. Feeling that young innocent life slip through my fingers again. I thought the terrors were just going to last for a few days, which became weeks, then months later and now years later. Tonight was a repeat my first terror ever experienced, not surprised seeing it was on this night that it happened. It's the call that now makes me get up in the middle of the night to check on my son six years later, just to make sure.

Pulling up on scene my medic tells me not to run, always walk because there is no time to treat me too. I'm frozen in time. Before we even get to the front door, a fire medic comes out holding what looks like a baby doll in his arms. Small, lifeless and grey, a peanut of an infant, limp on his forearm. I turn to return to the rig and suddenly I'm in the back of the rig. My Medic yells to get us to Trauma One as fast, but safe, as I could. The rig begins to roll but I feel as if still in the back and I'm supposed to be driving. Terror fills my heart, I feel cold and all my training I can not recall.

Now no matter how fast you get to the hospital it wont feel fast enough. No matter how much your told you did all you could, it doesn't sink in. No matter how much time passes I still think of the identical twin who will never know their sibling. Never able to keep secrets with, never able to stay up late at night, never able to celebrate the holiday season.

If I'm lucky I wont have another terror for a week maybe two. Unfortunately its usually not the case, typically they are only days apart. My only relief is that the terrors rarely repeat them selves on consecutive occurrences.

Tomorrow begins like any other day, with me putting my boots on one at a time. The terrors wont get the best of me, I can't let it. Not everyone has the ability to take that step towards a limp child being carried your way, and because I can, I'm needed. Because of this fortunate or unfortunate ability to burden the life and death challenges I have no other solution than to continue, I just hope that maybe next time it will be different.

I have felt the pain of Burnout, I have felt the darkness and utter frustration which has chained me down into a deep depression. The constant self doubt, the constant questioning, the constant fear. The only way to over come it? The only way I've gotten back to the job I love? Taken that first step. Whether that step is debriefing, talking with crew mates, or time to over come it just needs to be taken. The first step is of most importance, and is for the individual to decide.

For me the First step was literally putting my boots on and taking that step back into the station.

I hope this will help someone Take that first step.

Be Safe
Ambulance Junkie

Happy Thanksgiving!!

To all sacrificing their Thanksgiving to serve the community

Thank you!

The Thanksgiving song!

By Adam Sandler

Any Questions?

It's not a hard concept, but maybe I'm wrong. After all it's not nice to assume these days.

It was however, spelled out right in front of you.

With at least five printed signs, 

posted in an area no bigger than two square feet

at all different height levels.

you even had to 

MOVE A SIGN OFF THE BOTTLE TO USE IT

......but

maybe the system that was enacted failed you

and 

maybe we didn't do enough to 

explain what it was about.

So

The Oxygen Bottles..........Do Not Use

Questions feel free to ask, I'd be happy to explain it to you some more.

A Knife called Envy

As we turned the corner the cop cruiser whipped around in front of us and flashed his directional bar light as if to say follow me. We knew it was going to be a legitimate trauma, as the cruiser turned the corner and pulled up on scene we were fifty yards behind rolling up to the cruiser when he jet further down as if to say there he is boys do your thing. My door opened as I called out on scene fighting through radio traffic, throwing my glasses on the dash I approach the screams and agony through a driving rain. In front of me stands a burdened woman in complete suffering. Drenched either from rain or her sorrowful tears the young woman weeps in misery. This early twenty's white female stands unable to control her frantic shaking. At my feet lays her man, my patient, with his legs over a guard rail and a bystander holding a towel on his shirtless torso. He's Limp and becoming ashen in front of my eyes, he's my age and laying in a puddle. Turning his head ever so slightly with his last gasp for air. Its as though I feel every drop of rain falling as time slows down. I remove the towel and see a non sucking chest wound just left of the sternum and one just under his left arm pit. The on lookers circling like vultures with their beady eyes gazing on my crew. A Sergeant from the Police approaches me and asks what I need, I gaze up through the driving rain and yell over the approaching sirens that I need these scavengers roosting on the railings and side walks gone. I stand to see my medic rounding the corner of the rig with his monitor in hand and the newbie in tow with the drug bag. I jump back to the rig and inform my medic in passing the locations of wounds. Grabbing the radio with my wet gloved hands I call out in an apathetic tone, "County and Control from Medic Two; Advise Trauma Two we have a traumatic arrest with two to three stab wounds to the chest; will advise once in route." I walk to the rear compartment of the rig to grab out the back board and collar bag, throwing them closer to the patient. Its no lie to say I felt no sorrow for this gang banger, though I still had a job to do. I grab the intabation kit from the inside cabinet and proceed back towards my medic. Opening the intabation kit and drug bag I prepare for a quick and systematic approach to the call.

Various other units have been arriving on scene from the Fire medics to the detectives. The street looking like a block party with rave lights bouncing off the buildings. The officers stringing the DO NOT ENTER yellow tape around the scene and various people receiving shiny linked bracelets There is no blood exiting the wounds, even if there were the driving rain would have washed it off his cold limp body. We are joined by two of the Fire Medics I would trust with my child's life, One an RN and the other an EMS instructor. The two of them and my medic use a tag team approach. My Medic Intabating, squatting in the puddle as to not get his pants soaked. The Nurse Medic throwing a large bore IV in the left AC, and the instructor Medic preparing the IO gun in the rig. I toss the prefilled Epi and Atropine to the RN medic and take the drug bag to the rig where I hang another thousand bag. I know only first round med's will be given before they move out of this rain, its cold dark and damp on the street. They secure to the body to the back board and throw it on the stretcher, wheeling it to the rig. Inside five providers pile and I close them in. Jumping in the drivers seat I put the rig in drive, kick the emergency lights on and head to Trauma Two. Just twelve minutes have elapsed since the initial dispatch.

I realize five additional occupants may seem like a little much but I wasn't wasting time to weed any out. We were only a few blocks from the highway on ramp which we jump on to head a village over. Slow and steady I proceed only topping out at 60mph. I have precious cargo, a back full of standing providers working there ass's off to save this man. Regardless of his social or economic background he is our patient and he will have every chance to survive we can give him. Slowing for the exit I hear the boys in the back quickly consult each other over the diminishing lung sounds. A Chest decompression is in order, preformed and quickly realize a shock is to follow. Pulling the rig over to a shoulder, I hear "3,2,1, Clear" and accelerate the rig back up to speed we are minutes away from Trauma two.

Arriving we hand off to the ER. having gotten him back momentarily we were hopeful. Only for all that hard work to come up short. Later we find out this was all over a girl...Not a good reason to loose a young life.

Be Safe
Ambulance Junkie

Hero's

When the public has a problem they call for us.

This is be a gratifying feeling,

knowing we can fix anything that may be their 

emergency or problem.

Compelling many in our field to get an immortal mindset, so to speak, one which says we are invincible to the confines of this earth. An inner voice that says we can handle any thing ourselves or with the strength of our Brother/Sister hood. 

After all

We are the ones who save the day!

but....

I'm not Invincible

I'm not Immortal

I'm not a Hero

and definitely

I'm not above the confines of this world

So who do I turn to?

Be Safe

Ambulance Junkie

Slums

Its not the first time, nor the last time that we'll be on this street. It was the worst road in the city, I stand corrected, the worst in the county for a long long time. Then it became to run down even for the gang bangers to be in. The rats and even the roaches have been moving out in the past few months. We've rolled down the ave on a weekly basis before, now its just for an entirely different reason. Before it was gun shots and stabbings, beatings and rapes, despair and death.  Now these shells of building blocks are filled with the poorest of the poor who call for pink eye, slivers and a running nose. We roll down the street for our Alpha call to see the children of the block not riding bikes or skate boards, but rolling around in shopping carts. No baseballs and bats just sticks and rocks in an emptied burnt out lot but one thing is not lost on me, the smiles on their faces. We roll up on what we think is the house by our guess because there are no numbers labeling the homes. Not even sure this shambled hut is occupied as we call on scene, with its boarded up windows and cardboard covered doorways we exit the rig. The city has even given up on this area, the road is more like gravel than asphalt, the side walk a huddled mass of existence. We walk down the stairs to the porch which is lower by at least ten feet than the street. The sound of exiting cars on the off ramp that butts up to the back of the hut. The only knowledge of life being in this place is a faint light coming from behind the tattered black plastic bag used as a wind deterrent. Inside I try not to pass judgment, but heating a home with your stove? I mean there has to be a better way to live than this. Walking my patient out I feel I should wipe my feet before I exit the homestead, feeling I wouldn't want to dirty the environment.

In the rig I know that no matter the complaint, its an emergency to my patient. No matter the ability to pay, this patient deserves the best care that I can provide. No matter my opinion of her hygiene level, or lack of, she is my client and deserves my all.

Be Safe
Ambulance Junkie

Social Media

Social Media back in the head lines!

Though it is the current "IN" thing to push boundaries in and will be the topic of debate for more years to come. Its another instance of some one posted something they shouldn't have and then got in trouble. Now some one's crying because they have to face consequences for their actions! I personally find it ridiculous that people use Social Media as a public medium for complaining....that's what phone calls are still used for!!  

For those who are interested about what on earth I'm talking about,here are the post from the Journal of EMS website pertaining to our topic.The links: Think before you post,  Feds rule EMT facebook firing Illegal

But for all those to lazy to read it all let me break it down for you.

An Ambulance Agency in Connecticut (AMR to be specific) has allegedly fired an employee "wrongfully" after said employee posted disparaging remarks about her Supervisor on a social media outlet (Facebook) along with over other complaints about her work.

National Labor Relations Board (NLRB) has ruled that the firing to be wrongful and illegal. Now there seems to be some discrepancy over why it was considered illegal. From what I took from it was that due to AMR being a Unionized work force, there has to be a Union representative for all disciplinary hearings and the termination decisions. Which seems to be where AMR is in the wrong here, there was no disciplinary hearing and thus no representative present before termination. The talk over the social media aspect is gaining all the attention and focus about it being a ground breaking decision. The NLRB does protect the rights of employees, and this protection allows for the ability to talk to fellow coworkers about your concerns and gripes towards management both in and out of work. Where it is less clear is the social media outlet, does it count for a protected form of complaining? I guess NLRB thinks yes, but I pose a few questions to consider.

1. Was the said employees Facebook privacy setting set to public or private? This is important to know because if it was more than "friends" that she was venting to then it could stain the reputation of the company.

2. What was said about the supervisor, and was slanderous? Now you don't have to like your supervisors, nor do you have to agree with or like their appointment to the position. But you can not speak or publish verbally abusive statements effecting ones reputation. Obviously if it was slanderous then the NLRB would not cover their freedom of speech in this aspect.

Though after I learned of what was reportedly said I see no reason not to fire the said employee.

The NY Times reported that the posting to Facebook was: "Love how the company allows a 17 to become a supervisor"—17 is the company lingo for a psychiatric patient  

Now I'm no lawyer type, and never passed the Bar exam, but this seems to be slanderous. On a possible public forum to call your supervisor a Psychiatric patient, granted the lingo "17" may not be world wide known as this, but it spreads a poor reputation on the supervisor and company, thus is slanderous.

Definition of Slander: a false,malicious statement (spoken or published), especially one which is injurious to a person's reputation. I see no way in which it doesn't fit the definition.

I am sure this is not the last we will hear about AMR or their employee, and there will be some fall out from this situation. I'm not sure that this will be ground breaking by any means for the realm of social media and the work place.  What I can assure you is that this will happen again and when it does some Blogger will shed light on the situation....and take a few fun jabs at the problem.

By the way all complaints can be made to the Ambulance Junkie's Blog Fan page on Facebook. Cause it seems appropriate! 

Be Safe

Ambulance Junkie

Thoughts

A few random thought's as of late

The one thing that has always boggled my mind in EMS 

has been the idea that when you pick up the phone and dial

911 to get an Ambulance there is a high chance that

you will get a provider well under the age of twenty five.

Ice Hockey is a great sport, but I'd like to take it up a notch 

by adding sharks under the ice.

If your driving a Rascal scooter and are drinking scotch

can you be pulled over for a DUI?

What if team mascots weren't actually people in costumes?

I Miss You...

Is the "Case of the Monday's" an actual diagnosis

If video killed the radio star, then what killed the video star? Reality TV?

What would Reminiscing about Reminiscing be like?

Why does All State insurance have a disclaimer 

about not being available in all states?

Why do people always come in from the cold and complain

that its cold out, it is winter after all, its supposed to be!

Be Safe

Ambulance Junkie

An Infants Insight: Barriers

When all seems so unclear and uncertain, I looked at him and he didn't have a care in the world. He just looked out and stared at his puppies. The puppies so far away from him with an invisible barrier that prevented him from getting any closer.

He couldn't possibly comprehend the barrier set before him or even why it was so intent on keeping him from his puppies. All he knew was that it stopped him from going any further.

He stood there and pounded his little hand on the glass. Striking it with what he could muster. Yet to no avail he could not get through this barrier. He looked high then sat and looked low. He crawled to the right and back to the left. It was incomprehensible to this little man as to why he was unable to get to the puppies he loved so much.

As I watched him from my hidden vantage point (on top of the kitchen island out of view) I saw him sit down pick up his letter magnet from the fridge and try to hand it to the dogs who were now near the said invisible barrier. With no success in his actions I expect him to move on to other things or get frustrated and become upset. What I saw not only melted my heart but enlightened my mind.

This Little Guy, My Son, put his hand against the invisible barrier and "touched" the Boxer's nose. He than sat and began to babble on to the Boxer and patiently sat there waiting while the Boxer sat and watched the little guy.

The smile on The Little Guy's face when I opened the glass door to let the pup's in was priceless. The Boxer came in and went straight to The Little Guy and he laughed and grabbed onto the boxer to give her a hug. At which time I had to intervene to prevent an open mouth being licked by a dogs tongue.

It may be I'm getting "Soft" in my old age, or that I'm more sensible to how I really feel. I've likely also way over read the insight this event gave me but I share what I got from this event.

Life isn't about what you can't have or what you can't get to, its about the joyful moments. There will always be invisible barriers between us and what we want. There may even be physical barriers, But the fact of the matter is we can't allow that to keep us from happiness. Sometimes we have to strike out at the barriers in hopes they come down, realizing that the barrier is to strong or even metaphorical we continue. Sometimes we must find alternative ways around the barriers seeing none or even unable to comprehend the size of said barrier we have to take a step back. Sometimes we need to make the best of what our current situation and wait with promise of what will come.

When we find our way past the barrier we must embrace with open arms the figure of our obsession. With joy and happiness we will understand completely that our struggle was worth it

And.....Then Dad will step in and prevent the dog from licking our open mouth :-)

Be Safe
Ambulance Junkie

Gone Hunting

The early morning fog begins to burn off as the groups anticipation dies down. Settled into the weeds and shadows they sit and wait. The echoing of quacks from down around the bend travel up to the waiting ambush. The sun begins to break over the horizon and the group knows that the gaggle would soon be on the move. The calling between the members of the gaggle can be heard clearly now as the flock moves up along the river. Hands shaking with jitters as the unsuspecting victim approaches from the north. With target in site, the order is given.

Take Them!  

Guns drawn from along side

Target in the cross hair

Bang

Bang

Bang

And with down feathers floating though the air, the success of the ambush is known. 

The flock scatters through the side yards and the hunters head for their cars and dart away. 

The injured Goose brushing its self off takes flight only grazed in the opposite direction. 

Near the river in the middle of the street lays an unintended target. A young Duck fatally wounded, only 16 years of age on his way home from choir practice. Still dressed in his slacks and dress shirt wearing his down feather winter coat.

Only now with a 9mm hole left in it and no future thanks to an early morning ambush.

Be Safe

Ambulance Junkie

Ambulance Junkie's Blog now in Kindle Store

For any of you Techies out there that may be interested. 

The Ambulance Junkies Blog is now in

Amazon's Kindle Store.

I know, not really a huge deal but its all part of the changes/additions coming in November.

Kindle Store Badge will be located on the right hand column
and under the My Digital Imprint Page.

FYI: I don't set the price!
and it is a monthly subscription
but

Auto Sync's the blog with your Kindle.

I promise more's to come in November.

Vegas Series: Don't leave a man behind.

I still remember it like yesterday.

"Hi there" Fly boy uttered while taking a share of the glistening bar top set before him.
"I'm married" the reply from a lone woman sipping her drink of choice through a stir straw. Now she was an attractive lass, but no means had the right to be so persnickety. After all last I check it was nothing more than a greeting to make small talk by.
"Thats good cause I have a Fiancée, besides all I said was Hi" Fly Boy responded.

As simple as that the conversation began and the acquaintance was made, all sitting near the bar we chatted about nothing and everything it seemed. Until the young lass had to break it off because she had to work.
"Come over by the tree and take up refuge while I work" she invited. Dumb founded the conversation continued as she had to explain to us that it wasn't and actual tree we were going to.
"Like an imaginary tree? or like a magical one?" was uttered, neither to be exact. Being in the Paris Casino, it was mocked up like the base of the Eiffel Tower, park benches, fake cobble side walks, Merchant carts, and of course Metal trees. One of these fair trees was the landmark we were set to find to see our newly acquainted friend work. Though we really didn't know what she did, but honestly didn't care because of course what happens in Vegas stays in Vegas.

As some in our party staggered, we found our way to what was a lounge and our Lass standing up front with a band of guys preparing to take the stage. An honest to god lounge singer had invited us to watch her, what an honor. We settled in and prepared for what turned out to be a long night of singing, dancing and antics. "This first song is dedicated to my new friends, Fly Boy and his guys" she announced, The music started and we cheered.

"I love myself; I want you to love me

When I feel down; I want you above me

I search myself; I want you to find me

I forget myself; I want you to remind me"

Blondie's I Touch My Self, the minutes had turned to hours, our group of five guys had now included a group of ladies we had befriended. One who was getting hitched that coming weekend and her friend who liked Appletini's. While Nerf Herder and Fidney wore out the dance floor reenacting the Charlie Brown Christmas dance, the rest of us were thirsty. Convincing our lovely drink server Tatiana to continue our tab on Fidney's card, Which of course included free drinks being handed out to perfect strangers walking by the lounge. 

As the night progressed, a slightly inebriated Fly Boy walked the young bride to be and her friend back to their hotel room. In his mind set Paris at night was a dangerous place, Fidney had no doubt chased some tail to the other end of the casino and as for M.S, Nerf Herder and I, we were playing a game of hide and seek. More like me trying to find the two drunks through rows of slot machines. Unknowing it at the time I was searching, N.H was being kicked by a security guard threatening to be thrown out if he didn't stay awake. I knew it was time to call it a night. Finding M.S I told him to form a conga line with me and N.H, Calling Fly Boy I had to navigate him from the Hotel portion back to the casino. This being no easy task, seeing I didn't comprehend that there was a hotel at this casino. Finally finding Fly Boy, we discussed our option and noticed the swagger of Fidney with a lady under each arm heading for the bar once more. Fly Boy headed for him to continue the night of fun, "We don't leave a man behind F.B." I shout as I lose sight of him. To my surprise from around a slot machine reappears F.B sprinting back to us. "No Man left behind, AHHHH" Fly Boy with imaginary mortars and bullets speeding by in his mind, reminiscent of any memorable War Movie. "If N.H needs to get out of here then we go" Fly boy states, "* hiccup* agreed, but what about Fidney?" M.S says. "Bro's before Hoes, He made his own bed" I say "Agreed" in unison each chimed with N.H moaning in the background.

We head off to find a taxi back to Henderson, with drunken directions to the cab driver, finally arriving at the apartment complex, I fireman carry N.H who was way to drunk to be walking his ass the 500 yards to the front door. Fly Boy and M.S in tow doing their drunk renditions of songs and dance.

Our last night in Vegas went off with out a hitch. Tomorrow we return to the city that never sleeps!

But Fidney has our tickets and he's lost in Vegas!

Be Safe
Ambulance Junkie

The Manor

Through the cold dark air the melody of the hustle and bustle begins to fade as time begins to slow to a more simple pace. A stately manor illuminated in the soft flickering glow of amber lights. Casting shadows to the street below, the silhouette's of the flames weave an insightful tale only to be consumed by the night itself. A peaceful breeze has set in from the west wind, with only a faint rustling of the fall leaves speaking with undertones of sorrow and grief.

The doorway is simple, yet elegant, opened as to reveal a glimpse into the life of this most distinguished guest. Entering, the magnitude begins to set in though not a word is spoken. Pillars adorn the entry with masterpieces of the past hung inbetween, a testament to there own wealth and success not lost to those who pass. Draped in white and left as pristine as humanly possible the furniture is not for comfort rather a serene place to pull ones self together.

Up the staircase reveals the master corridor in which this story takes refuge. An elegant yet simple expanse of walls, tile, paint and closed doors is set forth. The design relays comfort and compassion though only implied and never intended. Sconce's adorn each of  the ten solid oak paneled doors. The eleventh door cracked open at the end, with the faintest of light drawing you closer.

The solitary marching boots of the changing guard echo's from down the marble hallway. The soft and methodical tik-tok of hymn's can be heard from the room. Drawing ever closer, the aroma of burning incense lingers in the air as the remnants of the dancing smoke spirits escape into the darkness and to their eternal resting place. Never knowing anything more then to innocently dance on the ever wisp of air they will never struggle with the pressures of this world.

The door opening with out hesitation to reveal the red velvet carpet adorned with rose pedals. Pedals from days past which gleamed in the warmth of a summers day, discarded now along with the thoughts of yesterday. Skirting the carpet, set two by two, stand gold pedestal's as an image of strength and set with white candles on top. Each free willed flame dancing in the chill of the air, ever unable to stand still, they toss onto themselves, breaking into itself and trying to jump off the wick but never able to leave the constraints of their simple existence.

Two by two they are set forth leading the path up to the royal chest circumscribed with the bounty of the memories of yesterday and thoughts of the tomorrows never to be. The shined Mahogany wood top half closed half open. The inside inlaid with dark blue velvet, him in his Easter's best, Peaceful, At Rest from the fight he had endured. A single rose embraced in his hands.

She stands as if carved from stone, slender, motionless and reserved. Her back to those who came before her, who were now seated and had paid their respect's. They all knew him but not like her, not this way, Not like she knew him. She had never gotten the chance to really tell him how she felt and time slipped away. She had always meant to let him know but she got caught up in the enjoyment of their interactions. A chance to tell him how much she liked him had slipped away, leaving nothing but a tear in her eye.

He had always told her with a smile that "It was only Fair-well not good bye, Because Good-bye was forever and he'd see her tomorrow" But not this time, it really was Good-bye, the boy she had fallen in love with, the boy she batted her eye's at, the boy who's sheer thought would make her smile......was gone.

Standing there in line it seemed so simple now, to have just told him how she felt. The life they'd have, the children, the memories, the happiness. Now just a distant memory laid forth in front of her. He had always been that boy she fell in love with.

She stood in front of him silent and still as to not be overcome with the emotions of the life changing event. He was handsome as she knew he would be, dressed in his best with the joyous smile gracing his lips. The guy she had felt so strongly for was now so innocently waiting for her to join him. With a kiss on his lips and  wedding bells in the background they pledged their vows to each other in this very site fifty four years ago.

She reached out to touch his hand like so many times before, to gain the comfort and assurance she truly needed. Her fingers drawn over each and every wrinkle of his skin without recognition of who she was, a cold and empty understanding lost in his past. She waited for the response that would never be returned as the fear set in of all the unknowns. Now truly alone in this world without the man who was her strength, she would now have to make the decisions alone for he could no longer help. He was only a shell, once his mind had gone, but she did her best to take care of him before she too became to old and fragile to provide for him.

As she bowed her head over her husband, the boy, the guy, the man she loved, the tears began to run. Down her cheeks through the air and onto his chest as they had for years. As she weeped she longed for his embrace to comfort her and to mend her breaking heart as he had done so many times before. She felt his strong hand, heard his assuring voice comforting her. "It was only Fair-well not good bye, Because Good-bye was forever and she'd join him tomorrow"

Bringing a smile to her face, she kissed him and uttered it was a date.

Bell's Palsy

Oh Me Oh My! Would you look at that! Bell's Palsy, I got's it, don't want it, and truly hope its nothing worse!





























What is Bell's Palsy?
Well it is the dysfunction of the 7th Cranial nerve also known as the Facial nerve. While the true cause is unknown for Bell's Palsy, it is is believed to be the inflammation of the Facial nerve as it enters through a small opening beneath the ear. This then seems to compress the nerve and effectively inhibit it from functioning. It is typically associated with a viral infection and can be seen with Upper Respiratory Infections.

How does Bell's Palsy Present?
Well of course every one is different, and presentation also will be different. It presents much like I think a stroke could, Facial paralysis of one side with abnormal smile, inability to raise eye brows evenly and the inability to blink the affected sides eye spontaneously. As for me though it started with a generalized numbness of the left side of my face. It felt as though I had facial swelling around my eye along with pressure behind my left eye, though no trauma had been incurred. I felt that my face was bloated with increasing tingling but it would come and go. I began to notice that I had a metallic taste in my mouth and food tasted strange, actually it lacked taste all together. I shrugged it off thinking it was all associated with my lack of sleep from taking care of my ill Son. Late Thursday night I noticed that I had total tingling sensation on the left side of my face, along with the feeling like I had just been given Novocaine on the left side of my upper jaw.

When did you realize something was wrong?
Let me tell you drinking from a straw (which is invokes childhood joy in me) was impossible! I mean the simple act of a proper seal and suctioning of liquid through a plastic tube felt like 11th grade Chemistry chapter on Organic Chemistry all over again. I mean my son has mastered the dynamics of ratio control needed to suck juice up a straw and I was having extreme difficulties with it. This is when I became scarred but tried so hard to not let on to my Wife. I knew something was wrong, I went upstairs to the bathroom and looked into a mirror for the first time that evening. I took a long hard look at my face wondering what could be wrong. I smiled as to laugh it off and tell myself it was in my head. That's when I realized that my smile was exactly like that in the picture on Wikipedia. I went back down stairs and pointed it out to my wife, I even had my wife preform a modified Cincinnati stroke scale on me much like I would preform to a patient who had a similar complaint in the field. I doubted I was having a stroke simply because my affected area was only in my face and had no other coordination issues of the arms or legs or increase of confusion. I felt confident that I was going to live and still thought it would get better if I got a good nights sleep. It was suggested by my wife about Bell's Palsy just as we fell asleep, who has seen it in her line of work with the elderly.

Course of action?
Well in my case, I woke up Friday morning and found to still be having the symptoms. So I headed to the walk-in, where I was diagnosed and given a course of Steroids and Anti-Viral medication's. A follow up with my Primary Doctor was scheduled a few days later. Now much of the literature I have been reading has conflicting ideas as to the proper course of treatment whether or not the Anti-Viral's are effective. There is even a stance that with out any treatment the affects will begin to return to normal all by itself. Much of the reading has said a return can be expected in a months time. I'm no doctor and am not to familiar with Bell's Palsy to begin with and trust the course of treatment currently.

Insight for EMS
Its sudden onset is startling and can present much like a stroke, working your patients anxiety up. Slurred speech, drooping facial features, drooling and abnormal smile will be noted though no further motor defecates are seen. This can still be the beginning of a stroke and by no means an all inclusive assumption whether or not it is Bell's Palsy versus a stroke. Bell's Palsy is only a diagnosis of exclusion, meaning that after all other possibilities have been ruled out can its diagnosis be made. Further insight into the case will be needed but in the field its best to apply our base knowledge and work up the patient. The condition is not overly "popular" but in no means rare, effecting roughly 20 in 100,000 or 40,000 people annually in the US. So the instance of seeing it in the field will be limited and often miss treated. Though this is not a bad thing, by all means play it safe and assume that it is a stroke until proven other wise. The reverse side is you assume its Bell's Palsy and found to be a stroke or other neurological problem.

As for me?
I am awaiting my secondary follow up with my primary MD to see where I stand and what, if any, the continual course of treatment will be. In this case, time is what is important to reduce the inflammation of the facial nerve. If no significant change is seen in another two weeks or approaching 3 weeks of onset further testing will be done to determine the extent of whats going on. So as long as I do not see any changes for the worse I will sit and wait.

Be Safe
Ambulance Junkie