Nov 26, 2010

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

Nov 25, 2010

Happy Thanksgiving!!

To all sacrificing their Thanksgiving to serve the community
Thank you!

The Thanksgiving song!
By Adam Sandler

Nov 24, 2010

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 
maybe the system that was enacted failed you
maybe we didn't do enough to 
explain what it was about.

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

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

Nov 22, 2010

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

Nov 19, 2010


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!

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

Nov 17, 2010


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

Nov 13, 2010

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

Nov 8, 2010


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

Nov 4, 2010

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