Moving

Its finally time to share my news.

I'm packing my things and headed to a new home.

Well the Blog is actually

It will now be at

http://www.ambulancejunkie.com/

I will be forwarding this blog spot address to my new domain in a few days

so you will be able to get to my new place through this site still.

I'm hoping to make things easy for folks who already follow my feed by forwarding that also.

And for any of the Kindle readers I am trying to do the leg work so that also gets a smooth

transition to the new site.

Its still a work in progress but it is up and running.

So I hope you continue to follow me to my new home.

As always thank you for your support

Be Safe

Ambulance Junkie

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

Winds of change

Things are changing around the blog, stick with me for updates.

Hope it wont be long now before I can get the details out to ya'll

Packing

The excitement of relentless searching for the object of my affection, looking high and low for items I only use a fraction of my life. The enjoyment of planning my life out in detail to the clothes I will be wearing is like heaven to me. Having to decide how to cram all this stuff into one half of a duffel bag to cut down on packing space is what I dream about at night. That is why I loath the concept of vacation packing. Its also inevitable that I will forget something, this trip alone I forgot a belt for pants, and a coat, time before I forgot my pillow and sunglasses. The joy of packing for me is only dwarfed by the enthusiasm I have towards unpacking. 


Getting back to the grind after vacation is as complicated as getting ready to go on the trip. Nothing is where it was before we left, and getting out the door on time was impossible for my first day back. My ID tags which lay on the counter along with my pens find themselves in drawers. My boots usually sit next to the front door, but when we go on vacation they find themselves in the closet. Let me rephrase this, getting out the door was the easy part but the problem lays with how many times I had to run back in to get something I forgot. I do not mind picking up before leaving for vacation, after all with no one in the house it totally needs to be straightened up.  


It baffles my mind when I have to figure where the correct place for all my gear is, no matter. I grabbed what I needed and obviously am hoping I do not need that what I forgot. I will be ready to go next week, I'm still gearing up this week.


Be Safe
Ambulance Junkie

The 21inch snow storm of 3/7/11

With my son at the folks and the Wife working a double I could focus on the night worry free. It was a lack luster night for calls over all, which was great. A few falls and abdominal pains, a few left overs from public drunkenness day, and not a single motor vehicle accident needing EMS. Most of our time was spent working at the station keeping up with the added duty's the job description never tells you of, shoveling.

Sure we had to shovel, but it was to just keep our rigs capable of getting out of the station, but our tires were the first to tread through the untouched city roads at times. Sure we struggled with how to extricate a resident from their house with a three foot snow berm at the end of the driveway. Over all we felt it was a good night but it was only 2100hrs, and the snow kept falling, so still we shoveled and piled it in mounds, and still it kept falling. We would venture out ever so often, and shovel not knowing where to put the snow that kept falling. Inches at a time we would clear with no end in sight but we encountered a phenomenal display of  Thundersnow. We were all in good spirits, which I credit to my survival of my the trip home.

I sent a courtesy pick up for an employee walking into work, punched out and was meeting my wife to give her a ride up south mountain. The wife's two door car had no chance in making it home, so we had planned to meet at Walgreen's in hopes to park in a cleared lot and carpool home. When I arrived I found a struggling Cavalier in a barren stretch of parking lot smaller than a landing strip in the Peruvian jungle. Questioning our choice, I suggested the Hospital lot within eye sight, Wife agreeing she stepped on the gas and went no where. Physically pushing the cavalier back she got traction and turned it around, only to get stuck as I jumped in the my Wrangler. Moving it the 10 yards closer I jumped out and gave her another push where she again gained traction and was off. Back to the wrangler I head towards the exit of the parking lot rounding the building to see her stuck. Grabbing the tail end with my now frozen hands I give her a shove and off she went leaving me covered in the snowy remains of tire kick back.

Back on city streets I pursue her around the corner to come upon her stuck in a snow bank 20 yards from the very barren parking lot of the hospital. Sliding to a stop I jump out and heave ho, heave ho, oh no shes in there good. One more try and she brakes free, once more leaving me covered in snowy remains of tire kick back. No matter she was in a cleared lot and parked safe, and she jumped in the Jeep.

"Why are you so out of breath and wet?" she innocently asked, "Shut up" I replied with a smile "you know why." Off we went to climb the beast of south mountain. A direct shot from the parking lot up a mile stretch to the base, where a drastic sixty degree incline awaited. The four wheel drive making easy work of the mess that were the roads we ventured on. Rounding a slight bend I see in the distance a sight only to familiar, "Shit" I burst out, to roll up on my courtesy pick up rig wheel deep in a snow bank. After a quick explanation from the crew it was agreed upon that they were stuck and it was time to push. Freeing the rig from the snow bank we still had to battle with the absence of traction and an up hill battle to get them out. A few more shoves and the gracious assistance of a county plow truck and the rig was buried with a three foot snow berm and in need of a tow.

Back in the wrangler we ascended leaving the crew to wait, climbing we followed the evil plow hoping to pass him as he stopped. A block from our road we made our move as he sat idling as if to taunt us. With out warning he continued forward blocking my pass and pushing a five foot jeep impassible wall through my roads intersection with out a second thought. Unable to make it the final few hundreds yards to the homestead we were forced to slide back down the mountain, passing the still stuck rig and ventured back to work to plan out our next adventure.

Luckily a few hours of waiting around the station we ventured back out and had no issues as the town had enough time to clean up and let me in front of my house. An hour later of snow blowing I was able to finally pull the Jeep into my drive way.

Be Safe
Ambulance Junkie

Staffing Dynamics; A tale as old as time

Since the beginning of all conceivable time it has been wondered what is the best way to staff an ambulance. It has been debated amongst the paper pushers, Emergency Managers, Director's, Board Officials, Supervisors, and Preparedness experts. Though no single perfect solution had ever been forged from these discussions.


So what is best for the system as a whole? Double Medic rigs, Medic/Basic trucks, Double Basic with ALS Fly car, Medic with Driver only, or Double Basic's with hospital being ALS? Frankly how do you even debate when the idea of Best is so foreign also. Best for patients, Best for sustainability, Best for retention, Best for profit margin?  Obviously we have to do whats in the best interest for the patient, but if we can not retain staff how does this benifit patients? If we can not afford to be paid and stay in business how does that benifit patients? When the idea of whats best for the patient is so abstract and different from system to system how can we possibly define how to best serve the system with out being with in the system?

As usual I have gone on a bit of a tangant so; Locally the career shops run Medic/Basic or Medic/Driver only rigs as the standard. Occasionally Double Medic trucks as the staffing allows, though its not the set precedent regionally. The majority of the volunteer world has what they can get, mostly who shows up to the call, which would lend to a lot of Basic only trucks. 


Now obviously I don't intend to have the all mighty answer that will change the world of EMS staffing dynamics as we know it. I realize that it really is system dependent on what works for your area. If you hoped for a large volunteer base to staff Basic rigs in hopes to only rely on paid ALS Fly cars you'd have to plan for the increase death rate due to poor volunteer turn out in my system. Though if this works for your system I applaud your community and believe that you turn out much stronger and more confident basic providers than other systems.


The way I see it, the use of Double Medic trucks have the ability to demoralizing providers over time with a constant barrage of patients who do not require advanced interventions. It allows the poison to seep in and self questioning of why am I a paramedic if I only do BLS calls. This along with the lack of exposure for Basic providers will create weaker providers by not exposing them to calls. Inevitably decreasing our future recruitment by excluding those who want a bit of exposure to see if its for them.

Use of Medic/Basic trucks allows a proper assessment by a medic and transport by a basic if warrented. Which seems to be an excellent idea for doing whats best for a patient. On the other hand having a Medic right there is a bit of a crutch for a Basic provider. Knowing that a ALS assessment occured and it must be a BLS call can lead to weaker providers. Can these folks handle being with no medic as a safety net?

Use of Basic only rigs where as the hospital acts as closest ALS leads to a rapid mentality. Everything is a load and go situation, everything is hurried in fear of the patient crashing. In the unlikley occurance of an ALS assist can they calm themselves and revert from the load and go mentality of rushed care.

 Use of double Basic rigs with ALS fly car of course strengthens the Basic providers skill set but they also get engrained with the crutch mentality knowing that ALS is coming. Can they handle themselves in a system overload situation? Where they must transport to the hospital due to all fly cars being tied up is unseen.

So as I knew I wasnt going to have a solution, rather just open up discussion and set forth my opinion. When it comes down to it, it really is system dependant and there is no real solution that fits everyone. Though I'm sure you all knew that.

Be Safe
Ambulance Junkie

First Responders Network

EMS Today is over,

but thanks to some great folks and their insight,

they have shared some great video's with us

from Baltimore.

First Responders Network You Tube Channel

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.

Embrace the Machines?

So I'm finishing up a call cleaning the stretcher in the ER and I go to restock equipment and supplies used. For us locally the Trauma hospital has an automated dispensing machine known as the McKesson. It works rather simply, plug in your user ID along with password and then with use of the touch screen interface you select your needed supplies. Than it dispenses drawers and cabinet doors to allow access to your goodies. It replaces the logic of grabbing out of a large storage area or bothering a busy nurse with a medial task, with pure automation.

My only problem in this embrace of automation? The fact that when you have only 4 Atrovent's left in the machine it does not require you to count the remaining quantity. 

OK so whats the problem with that? Its that when there is 30 albuterols the very next to administer that it requires a count to confirm the correct number of remaining stock!

Be Safe
Ambulance Junkie

Good Bye Old Friend

We've been together for so long it seems, since before I lived on my own. I can still remember the day I meet you. All the fond memories I have with you, the things we have shared, the nights we spent together keeping each other company. 

-----Click-------

Laughing through the good times, Crying at the losses we have had, and always willing to share the ever changing world events knowing we have seen history together. All of that has been amazing to know I have someone out there that has always been there for me. You my friend have stimulated my sense of exploration along with my ever need for comedic relief. Even from the times we seemed to grow apart, with my job and my growing relationship with the girl, we always knew we'd stay together through it all. 

----Click-----      -----Click-----

Ugh.....I told you from the start that even with me moving on to the new unknowns you'd be there through it all. I didn't lie, you where there when I moved out of my folks. You were there when we got our own place, and than when we had a home. You were their when my son was born, and I figured you'd be there for the rest of life. Lately though I feel that its less and less a sure thing, you seem to be loosing the battle within and I'm not sure how much more I can take this with our friendship.

----Click-----   ----Click-----   ----Click-----   -----Click-----

Come on!....Frankly you've become very unreliable lately and being as busy as I am with life you seem less of a good fit. It'd be different if I felt you were trying but you take the longest time to get yourself going and your always blacking out. I don't have time for these shenanigans, I don't have time to wait, you ever try waiting around with an infant? 

I'm sorry TV but you're being replaced.

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

I try not to be Political

I'm not claiming I know everything thats going on, and I don't expect you to agree, but 

You know what grinds my gears? Wisconsin

I try not to be involved in politics, because the system is broken and it wont make a bit of difference who is in charge until we fix the system. With that being said, I have to say how disgusted I am in Wisconsin and their strife. I mean we all need to take a stand with them! These public employees are being asked to pay for a whopping 20% of health care premiums, that with instituting radical ideology of merit based pay! How dare they! I mean why reward only the ones who work hard? Rather they must continue to pay everyone the same regardless of how much or how little work they do, after all thats only fair.

Ok a little sarcasm there, but I don't feel your strife folks. I'm not sorry you have a great retirement and haven't had to pay your fair share of health benefits.  Why don't I feel your struggle? When I began my career, there was no retirement plan in place, fortunately now there is and I feel lucky to have one. The cost of private sector health care is paid for completely by those who own the insurance. I know, crazy 100% of the cost of health insurance is paid for by the employee. Did I mention that the cost of private health care for a small business is also through the roof? I'm sorry your being asked to suffer a burden by paying 20% of the cost, but frankly you have a job and have never cried over being paid to much.

I also don't agree that your job performance isn't based on how hard you work. I believe that the harder you work the more productive you are. The more productive you are the more productive the company is. The more productive the company is, the more revenue it will generate. Thus (theoretically) the better they compensate those who were productive.

Welcome to the new America, gas is $4+, health care is expensive, Taxes are astronomical, Unemployment is record breaking and the Republicans are just as bad as the Democrats.

Be Safe
Ambulance Junkie

Logistics

Logistics is a thing of beauty
its the wife bringing food to the station
and being able to arrange the drop off on a scene of a call.

Secretly and covertly placing the goods within the ambulance and
slipping into the night.
With out ever knowing that she was even there.

She knows how the system works, understands the dimensions
and is able to operate cohesively with its
less than predictable nature

All with out waking the sleeping child in the car
or breaking a sweat

Help!
I think I married a Ninja! 

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

I'm out of places to look.

I give up! I am through, its impossible and I admit defeat! I am not a quitter but damn it I'm finished. I have searched all over and am out of places left to look for it. Impossible to rationalize that there are only so many places to look, and yet each and every one of them has yielded no success. 

Its only four rooms, all the cabinets are locked up, the stair ways are blocked off and the closets closed. No Open windows or doors and no holes in the floors or walls. Every last conceivable location looked over with a fine tooth comb.

 Still no success!

The only one who possibly knows where the object of my affection may be isn't talking. Or at least isn't talking in any rational form, rather just babbling along. Sure he has the dexterity to hold and "throw" but not the stature to place it atop any object. So its hard to imagine where he has put it.

I have to admit my little man has bested me at hiding the remote control,

8 weekends in a row!