Passion of a Junkie

It's a Jeep thing

Traffic four lanes wide and easily ten cars deep, all cars idling at the busiest intersection in town. My son strapped in to his car seat sipping his juice rocking with his daddy to Diamond Eyes by Shinedown. As we wait for the light to turn green on the way to see his grandparents we share nothing with these folks around us other than that we are waiting for the light to turn green. There sitting right in front of us though is a White base black soft top Jeep Wrangler, with two youngsters (age of not yet rebelling against the folks but filled with free thought) in the back seat. As I glance back from smiling at Lil Man, I see the frantic wave of these two youngsters hands through the back plastic window. Their gleaming smiles ear to ear, so enthusiastic at the simplest of gestures that they want to participate in. I throw my version of the wave back at them as the light turns green and follow them through. They turn off to hit the mall and with a pass I throw a nod and a sign of mutual appreciation for the love of a life style to the driver, who graciously throws one back my way. The Jeep Wave, a simple gesture and like we say "Its a Jeep thing, you wouldn't understand."

As with most of my passions, I'm not alone nor unique in my infatuations/appreciations/addictions, and in no way am I the biggest self proclaiming lover of my passion.  I am however fanatical about them to a point where I feel others just don't understand where I'm coming from. Whether its my appreciation for my Jeep, My infatuation with being a Tennessee Squire and all things JD, My addiction to college football and The Ohio State University, or my passion for EMS, you just not understood unless you live the life.

EMS is more than just a job; Its a life style. EMS is more than being an ambulance driver, an ER taxi, or band-aid buggie; Its about being professionals trained in life saving treatments and care of our clients. EMS is more than traumas, chest pains, or "bull shit" nursing home runs; its caring for any disease, any injury, any time or any place. EMS is more than a stepping stone of Emergency services; its the future of the public safety system.

Be Safe
Ambulance Junkie

Lemon Gator-Aid

I have to believe its a conspiracy, the fact that it wont sell to the consumer in the stores its pushed off onto the hospital world to get rid of it. Figure its great for a non high fructose corn syrup drink and the fact that several elderly folks with diminished taste buds frequent the hospitals they can easily pass the drinks off as a good source of re-hydration. Unfortunately even the elderly patients know better then to be tricked by this attempt. So what does the hospital do? They pass it onto the EMS room, because those fools will drink anything free when constricted by the confines of high call volume. Its Gator-Aid, but not any Aid, its lemon Aid. I didn't think anyone honestly liked watered down fake lemon flavor'd liquids. That was until I was partnered with English, he loves the stuff. I thinks its just plain odd.

Food for thought: L&D

Here's a question for you; Upon pulling into the ambulance parking space at the hospital with an active MI that you will be going straight to the Cath lab (a person having a heart attack going to the procedure table, for the lay people) would you take off the defibrillator pads, the electrodes and discontinue any IV's you had established? I mean figuring that your at the hospital and even though you had to go up a few stories in the building to get to the Cath lab you were already in the hospital, so everything is ok and the patient cant obviously get any worse on you. Right?

So than why is it that same mentality is applied to OB calls? Why is it so common place to forget to take the OB kit with us into the hospital when we take the patient in active labor to L&D?

The last place I'd want to play catch is in an elevator with no mitts!

Be Safe
Ambulance Junkie

Can you tell me where these go?

Sitting around the station I was reminded of a great story that was encountered in a foreign hospital on a rare bring home transfer. Stubs and my self had traveled two and a half hours to get to the sending facility, which we have dropped off to before. Its a hospital that dwarfs our three local shops combined, but of course its a level one Trauma center, Burn center, a Pediatric center, Cancer specialist, Heart specialist, and they even have a few actual Tim Horton/Dunkin Donut shops and a Cold Stone Creamery in house.

So with a hospital this big its easy to get lost, infact its real easy to get lost. They employ St. Benards to rome the halls in search for lost visitors. Information kioask every thousand yards to keep folks on track, and its highly suggested you travel in groups larger than three as a standard safety procedure. Colored lines stripe the corridor floors to lead you to the associated unit, whether it be Blue for the lab, Red for the ER, Green for Oncology, Black for Radiology or even White with blue polka dots for Cold Stone.

We had a general idea of where we were heading and with stretcher in tow we headed in for our adventure. Waiting for an elevator we gazed upon a very lost and confused young lady, looking lost but to proud to admit it. Looking at the signs she tried to decipher where she was in terms of where she needed to be. Finally asking for help she gave the closest guy a chance with no luck, but behold her savior was about to make him self known.

A lonely deaf gentleman, standing in the wings who had always wanted to be a knight in shining armor saw his chance. He approached this lovely young lady and began trying to help, but unfortunately he was no better than the lot of the folks standing at this busy intersection of the hospital. He led her down one corridor than back and around a corner and back, the whole time explaining how he was a nice guy or still lived with his mother. He finally admitted that he wasn't really sure where she was looking for, whether he didn't understand her fully due to his hearing impairment or just had no clue how to take her to where she was looking we may never know.

Finally going to and from the various locations with her escort the young lady finally asked the question, "where do these Elevators go?" he replied simply "They go Up and Down"

Stubs and I lock eyes and grin, as the elevator doors open and quickly slip in to escape before we cracked up in laughter. As we turned to hit the button for the ninth floor we were surprised to hear the young lady ask us to hit the fifth floor knob. Our joy would have to wait I thought as the doors closed and it began to go up a floor, "Oh No!" the young lady let out "I was hoping for the elevator that goes left to right." As she turned and grinned we reached the fifth floor, and with that she departed. Leaving those remaining in the elevator all with ear to ear smiles.

Be Safe
Ambulance Junkie

A Walk In The Park For Us, Is The Great Unknown

Its dark out and she was woken from a sound sleep by an unfamiliar feeling. An uneasy feeling begins to set in as she gains her baring, readjusting her position in bed she closes her eyes. The sensation does not go away no matter which way she lays. Sitting up in bed she just cant shake this feeling, the sensation, the pressure as if someone is sitting on her chest. Not like reflux she has had before, but a feeling scary enough to call for help. 


The 3am call for chest pain is a walk in the park for most, but for the 65 year old female who has never experienced this feeling a day in her life its not just a walk in the park. Its the change of a life time, its scary, its not normal, its new and unfamiliar. We in EMS assess, treat, reassess, repeat; its what makes good providers. What makes better providers is the ability to ease and calm by voice, the ones who reassure the patients through the process of our skill set. Informing our customer of the next step we will take, the multiple things that will be going on all at once all around her.


Not including the frequent flyers, EMS typically knows a lot more than the average person of what goes on in the Emergency room in the first few moments of the ambulance's arrival. Its simply a matter that we get exposed to the initial greeting and assessments of the patient by the ER staff, the annoying wait times for a room, the feeling of udder avoidance by staff, or the paparazzi like attention patients get. As with anything repetitive it begins to be ingrained with in or such common place for us ambulance folks we don't bat an eye at the process. We have become use to it, or if your still a wet tag you'll get use to it and understand everything that goes on and even what to expect from the staff, depending on your patient .


The ones who don't understand are our patients, who already are scared for calling over their personal emergency. We have talked them through what we will do but have we talked them through what will happen?


Recently I have been complimented by coworkers and recent patients on my inclusion of what will occur once the rig stops and the off loading begins. I find it odd that it may not be common place for providers to share their gained knowledge and continue to ease our customer through the transition into the hospital. I'm no expert of what will happen step by step but I know that the process in my region is strangely similar to our first few minutes with a patient. 


So if you know that there is a chance of waiting for a room let the customer know that you'll be with them waiting and they wont just be moved into a chair and avoided. If you know their injury or illness is considered minor and that they will be placed in triage inform them of how that process works. If you know that the customers condition is one that will gain the ER's entire attention tell them of how many people will be swarming around them. 


After all its the least we can do for our customers to help them through the transition.


Be Safe
Ambulance Junkie

Lessons from Jury Duty?

Why is it that its said to be a privilege to serve but no one really wants to do it, well other than retired folks who's soaps are reruns. Maybe its that it seems to come at the most inopportune times, or maybe its the slow drawn out process just to be initiated into the realm of juror that is rather a pain in the ass.

If you have never gotten the "opportunity" to be called for Jury duty is interesting, and nothing like Law and Order makes it out to be. Don't get me wrong because even though it is time consuming, it was insightful into the process involved. Its similar to what I'd imagine the military draft was like only on a civilian aspect. Being randomly (though I'm convinced that because I voted in the last high profile election it threw flags up as still being an active member of society) selected by mail a few weeks before of my required attendance. Sure you can get excused but than you still need to show the next time, so you cant really get out of it. Upon your arrival you realize that you are one of a lucky few 120+ members of the community to be reviewed and given the chance to be scrutinized by a judge and lawyers.

Now it got me thinking, what if EMS worked the same way the courts did? Your in a motor vehicle crash, and are in need of care but you had to wait close to a year until a group of knowledgeable folks question a perspective gathering of 120 people who have randomly been selected just to weed through them and reduce down to 12 people. Now that would all have to occur before you even had the chance to be assessed or the evidence of mechanism of injury reviewed. Than once that group has been whittled down from 120 to 12 those same said knowledgeable folks than present the information to the group of 12 who make a decision of if you've really been in a Motor Vehicle Crash before they pass their verdict of to the Judge.

OK,OK,OK I know a little far fetched, right? Obviously there is no way legally let alone ethically this would be a reality. My only point is that in EMS we strive to make things better, but let us not forget they can always be worse.

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

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

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

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

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

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

A Mid Fall's Night

The sun has set some time ago,

The night before last,
And all through county not a call was being placed, not even an "I've fallen" 

Ambulance plugged in, wheels ready to roll, hopes of a stroke emergency will soon be here.
EMS providers comfy are all snug in their seats.

Thoughts of diabetics and traumas of past were dancing through medics heads. 

Suddenly with out much warning, came a tap tap tap at the window. 

Waking the snoring dispatcher in such a startle. 

Getting up from my desk, eyes filled with joy, I head to dispatch to see what was the matter.

The glow from the neon light shows us what the noise had been.
Could it be, A patient in need?

A call for help? maybe it is an assault? 

Or maybe a chest pain

But no, it is none of these
Twas a drunk cold urban nomad slurring as he speech.
"Its Nisss un.....warmth and conthy."
Looking for a warm place to stay no doubt on this chilly fall night.
The aroma of booze lingered off his breath
Before we had a moment to think the door opened again
In came the officer to escort our late night visitor away to his sleigh
"I'll take him" he said with a jolly chuckle
With a spring in his step, and away with his catch
"Sorry to disturb you and have a good night"

Be Safe
Ambulance Junkie

The Boy Next Door

You would think that one of the safest places on earth would be living next door to the ambulance station.  I don't mean in the rhetorical sense of next door either, literally twenty feet away, building to building. No matter how close the help was, it wouldn't have made the difference. He never reached out, He must have known we were here. He saw the ambulance's parked in the lot underneath his window. I'm Sure he saw the glow of the lights at night as we backed in the garage. Surely he heard the echoing of the sirens while he watched television. 

Did he not know that there is always some one here? Did he not know that we are well versed in assisting people in need? Depression is a disease like any other. Why did he not reach out to ask for help? It is not his fault that he felt this way, its not something to be blamed for. Was he under that much stress that it blurred his vision of reality? He left this world in a cold and dismal way, in hope to escape the social confines of this world. 
With the last words he uttered to his mother


I'm Sorry

Be Safe 

Ambulance Junkie

Vegas Series: Meet Mr. Hero

Hanging out in the Centrifuge Bar at MGM in Las Vegas we are enjoying a night out. A bar filled to the brim with people enjoying them selves. Drinks in hand, Fly boy, Nerf Herder, and myself are comfortably set up against the wall people watching, life is good. Our other two former comrades, use to the crowded bar scene, work their way to the bar strategically near an unsuspecting group of ladies. M.S and Fidney anti up to the bar and buy two shots, enjoying them selves Fidney sets his eyes on his target.

Now maybe as outside observers, we could see the pack mentality, the configuration of these woman and the devotion to one in particular. A Petite blonde, the center of attention and the inevitable item of affection to Fidney. Making eye contact he strikes up a conversation, and buys the young lass a drink, on account of celebrating. Though he never really knows what the celebration is all about, and doesn't bother asking.

The rounds of drinks pass and we take notice of M.S with a shit eating grin on his face. We see the ladies look on in disbelief which quickly turns to horror. Fidney continues to ramble on in an animated fashion, arms flailing, head weaving side to side. Quickly M.S leaves his post as wing man and heads to us as to disassociate him self with Fidney. M.S weaves a tale of Fidney's feeble attempt to impress the ladies he was surrounded by. Mr. Hero's, as M.S renamed him, exploits of life as a medic in the big apple, include tales of dying baby's, being shot at, and saving those sworn to protect the people of NY. These are all in a days work for this man. By the looks of the ladies, what went from a casual interest, irrefutably changes to disbelief. With the bar tenders jumping on the bar to do a dance grabbing Fidney's attention in mid sentence these opportunistic ladies simultaneously finish their Cosmo's and beat feet.

Slightly dismayed Fidney heads to the rest of us and talks a big game. We let him chat on and on ever knowing the glorious ball of fire he was shot down in. We continue our adventures of the night and to this day we know Fidney as the man to drive an entire Bachelorette party from a bar, in Sin City.

Moral of this story guys: Never over play the hero card.

Be Safe

Ambulance Junkie

An EMT's take on not Needing more Medics.

Recently fellow bloggers have put forth a topic of discussion that I feel I would weigh in on. Medic 999 posed the question of  "Do we really need Paramedics on ambulances?", which caused a well thought out response,   "We don't need more Medics"  from 510 Medic.

Both Bloggers are Paramedics and offer, in my opinion, a surprising response. They both seem to say that more medics is not the solution to an overwhelming problem in EMS. There is no need to have a Paramedic on every single ambulance let alone two. In fact I am willing to argue that the common place of having Medics on every single rig has lead to a decline in patient care and a Medic's overall ability. 

Now don't get on your soap box and assume I'm saying that Medics abilities are poor, or we don't need medics. One the contrary my dear reader, I am merely making reference to my comment on 510 Medic's blog, which was:

"I agree totally, I feel it is leading to a downward spiral of our providers. EMT’s who may not get the experience from the BLS truck, may not be as experienced with the “basics”. EMT’s only riding on ALS trucks then feel the need to advance them selves in order to get more patient contact and more experience. Thus becoming Paramedics, and with declining con-ed budget’s, are still not being as experienced as their predecessors. These newly carded Paramedics who have a lack of the “basics” typically turn out to be poorer providers. "

By this I refer to the idea that EMT's are rushing them selves into a Medic class before having confidence in their own ability or exposure to really bad patients. EMT's see Medics doing more skills, being paid more, and being the "life saver". They do not get a sound fundamental skill set that they can rely on through their career in EMS by rushing their advancement. These providers are then welcomed into a world of diminishing providers by being thrown into the captains chair by being cleared. The expectation of a systematic transition to gain and hone the much needed street skills is pushed aside to the need for a warm body to fill a schedule hole. The response to the negligence of clearing a provider before they are ready? They can make up needed skills in the continuous education training that is expected of all providers and catch up on their need. Sounds great, and almost reasonable right? Except we enter the new age of declining education budgets and fewer instructors. Now the much needed continuous education isn't being offered or being set aside for a later date. Now the new medics have to rely on their experience and their fundamental skill set. When all else fails they can rely on the basics after all right?

So if you have followed along, you may have picked up on the criticism systematic failure that faces EMS. 

"I’m not saying we need to triple the BLS trucks on the road but rather put weight on the experience gained for our EMT’s in a BLS setting. As with any performance overhaul its typically a good idea to start at the bottom/beginning."

I think we need to understand and credit that there is an enormous amount of applicable skills that can be learned in the Basic ambulance arena. By putting weight on this experience, EMS will only benefit with strengthening our base structuring and ultimately our future Medics.

Be Safe
Ambulance Junkie

What does OH, NC & MD have in common?

Ohio, North Carolina, and Maryland  all had crashes involving ambulance's this month thus far. With all of these being in the news lately and it has caused me to do some reflection on my own driving. Whether its due to youth, our inexperience, the inability to handle the adrenaline, or other motorist faults, we are at risk. A constant risk of Motor Vehicle Crashes, some of which have ended with fatalities of civilians and EMS providers.

Emergency Medical Services unfortunately involves the use of Ambulances. Ambulance's which are on every city street, rural road, state route and interstate highway. Roadways which are occupied by various other forms of vehicles. Vehicles have a molecular attraction to each other, much like moths to a flame. Being in the ambulance is possibly the most dangerous yet consistent part of our jobs. Yet I dare say that it is the most overlooked when it comes to safety, not necessarily by the industry but by the providers.

There are new safety features and innovations when it comes to patient compartment restraints, new ideology for paint schemes including the American's introduction (and acceptance) to the chevron. Emergency vehicles are being equipped with the same safety features many new age passenger vehicles have. Along with the addition of Opticom's to give us the right of way at intersections, are all valiant attempts for safety. This way of thinking excludes what I'd argue is the biggest factor of the accidents, the Human Factor.

As the articles have shown, some times EMS is the human factor, sometimes the populous is the human factor and sometimes in the case of training an inexperienced individual its multiple human factors. Now there is little we can do to fix the populous other than public service announcements and the hope it sinks in. On the other hand we can strive for better self control and a stronger diligence towards the inexperienced while training them. The need for repetitive assessments of current practices and skills would go a long way. A strong need to re-mediate any and all practices we may not have a full remembrance about. This is not a supervisory or managerial assessment but rather the responsibility of each individual to protect each other. Self assessments and continual application of safety concepts would go a long way

A few remediation points hopefully to spark self awareness: 
1. Never drive above the posted speed limits going to or returning from an incident. 
Now this by far is the hardest for me to do. Though I understand the thought behind it. There are posted speed limits set forth by the state as to the operator of a vehicle to know at which speed he can safely operate at. Safe operation includes such factors as population, road size and road conditions.  I find it hard to travel the speed limit because I rarely do in my personal vehicle.


2. Wear a Seat Belt.
This goes for both while in the front of the vehicle or passenger compartment while vehicle is in motion. Though not directly related to the concept of this piece a good point to make anyway. 


3. Stop and Clear all traffic controlled intersections.
If being in the ambulance is potentially the most dangerous part of the job, it being in emergency transit and entering an intersection is death defying! The factors involved in a safe intersection transition are numerous and readily relies on others. Stopping and making sure all traffic is stopped before you enter the intersection is imperative to life.


Now in no way is this a fix all to this months crashes. Nor do I intend to place any form of blame, rather I hope I get you to think of how to make yourself safer on the next run you make. After all, Your life and others depend on it. 


Be Safe
Ambulance Junkie

Addition to my Digital Imprint

I'm sure it has already been coined but I haven't yet found an actually definition. So, I have to go by my opinion of the meaning and concept. So here we go, 


Digital Imprint: Your individual and distinctive influence of self or brand though the various outlets available on the internet. For Example Web Page's, Social Media outlets (Facebook, Twitter, LinkedIn) and/or Blogs. 


Like the term? Yes? No? 
It is fashioned after the idea of a Carbon footprint.


Anyway's I have added to my Digital Imprint in hopes to extend my slight influence and input on this ever changing world.


You may have noticed the Like button on the upper right hand column of the blog. Which I hope, is linked to the new Facebook Fan page for the Blog. It will soon also be added to the Digital Imprint page of the blog. 


I hope you find time to click the Like button and share the Fan page and ultimately the Blog with your various EMS networks and friends.


If not its OK, Because the true trason behind this Blog is so my son knows the kind of Father he has.


Be Safe
Ambulance Junkie

Vegas Series: The Prologue

"Vegas?" I jokingly pondered.

"Yeah it'd be fun" says Fly Boy. "think of it as a Man'cation"
"Wait...Vegas? like Las Vegas? Sin City?"
"Ya!! End of this month" Fly Boy burst out in excitement.
"Vegas" I say with confidence

 I hadn't really consider the proposition as usual, it was more the off the wall idea we entertained. This time was different though, it felt right. Why not? I thought, and as simple as that, we began to get excited. A trip away from the grind of work, away from this east coast existence. Fly Boy, Nerf Herder, and myself meeting up in NYC with Fidney and flying out to Sin City to hook up with M.S who now lived in Henderson. The five of us reuniting for the first time in a couple of years. We weren't age old friends, but we had all developed and honed our EMS skills together for a time. While we were traveling so far we'd of course take the time to head to Yosemite through Death Valley to flex our need for the out doors. See some sites, place some bets, and Fly Boy could even see his Grizzly bear he was so obsessed with.

It was a trip of a life time, and in all honesty it was the best thing to ever happen to me besides my bride and my son. It was just one of those moments that I was fully capable of letting go of control and decided to just go with the flow. The last time I truly did that was when I began dating the girl that became the love of my life, who is now the Mrs. Who, by the way was the ultimate decision

The antics we are known for carried over into our Man'cation and lead to some rather precarious moments. Whether in the NYC, aboard the air plane, in Las Vegas or Yosemite National Park we were never far from a laugh.

I hope you enjoy this sliver into my life outside of EMS.

Be Safe
Ambulance Junkie