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: Fidney's Surprise!

We were all boarding the plane and preparing to fly out of Vegas that morning. All taking our respective seats, I in the back quarter of the plane, isle seat with Nerf Herder the opposite isle side one row back. Fly Boy a row in front of me with his window seat and Fidney, likely still hung over, four rows up center seat. We were all muttering amongst our selfs of the fact that Las Vegas could be swallowed by the desert and we wouldn't care at all.

The welcome passengers greeting comes over the Jet Blue speaker system, along with notice of free movies extended to us all today due to a passenger having gum stuck on her seat. The Pilot, who likely was a former Red Bull aerial acrobatic pilot, tells of likely catching a great tail wind from the jet stream and cutting flight time down dramatically. Every passenger settling in for the trip to JFK. When suddenly from the quite comes a boisterous groan of disbelief.

"OH SHIT!" I hear, along with the rest of the plane.
"WHAT The Fuck" coming from a few rows up.
"I do not remember ordering that" Don't let it be him I remember thinking.
"THREE HUNDRED DOLLARS!" Comes exploding from the center seat four rows in front of me.
"Oh shit" I whisper through the seats to Fly Boy, ducking my head out of sight. I hear the faint giggling of Nerf Herder a row back.
"Think Fidney found the receipts" Fly Boy poses towards me as he slouches in his seat.
"I think so" replying as I glance over my shoulder at Nerf Herder who has assumed the proverbial airline's crashing position.
"A HUNDRED FIFTY!!" causing us to smirk and peak over the seats up in Fidney's general location.
"I did not order all this, No way in hell. Fly Boy what is this all about?"
"Um..." Fly Boy studder's "She really liked Appletini's?"
"She? Thirteen Dollar martini's Fly Boy!"
"NO, Actually they were Appletini's, and She really liked them" Not a valid argument from Fly Boy but a sarcastic and valiant effort.
"I don't remember ordering all of this for you guys last night?" a dumb founded Fidney says
"Well you didn't technically, Tatiana was not going to let us, But Ambulance Junkie kinda charmed her into it." Fly Boy jest's.
"Hey!" I utter "N.H and M.S helped too, I'm not only to blame here"
"Wait, Wait, Wait, Who's Tatiana?" Fidney wonders.
"Our Lounge Server from last night" We all chuckle.

As Fidney danced him self frantic last night, We had all been enjoying our lounge singer and being the life of the party. We had realized that Fidney had opened a tab, intended for himself, on our table. With a little sweet talking and over whelming peer pressure we had convinced out super nice Russian Lounge server to bring a round of drinks for the lot of us. Our group of five quickly included a group of three ladies we made small talk with. One of which was a mid forty's female who's father was the first Battalion chief of a major west coast metropolitan area. Needless to say our conversation was strongly centered around Fire and EMS. Our conversation continued and so did the rounds of drinks, including the Appletini's for the Chiefs daughter.

Fidney ever unknowing the booze which did flow thanks to him, well until he had to rummage through his pockets on the flight that is.

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

A chance encounter

He sits waiting but for who he doesn't know.

I sit finishing up my chart from the last run.

He looks at the passing faces with confusion and concern.

I look at my fellow workers and strike up a conversation.

He wants to call out for help but is afraid.

I get the call for help and head for the scene.

He meets an officer and he answers "I cant move along" wiith an embarassed feeling.

I meet the officer who admits he thought he was just another vagrant.

He tries to stand but he can not.

I tell him not to stand, though he still attempts.

He doesn't know what to make of me

I don't know what to make of him.

He says he can do it on his own.

I say let us help.

He feels young at heart, he looks old and aged. The sun has blemished his skin, the wind has hardened his face. His wrinkles chissled in his face's granite fasade, His eyes blueish grey screaming out in pain and anguish. Time has washed all the color from his hair and beard leaving it white. His hands, rough as sand paper and cold as ice, his fingers jaggedly contorting inwards with lose of dexterity. This urban nomads right foot externally rotated from years of abuse to his body, his left leg bent.

He wears layers of clothes because he has no place to keep them, his boots tied up with rope. He has spent years on the street. Made it through heat waves and blizzards, droughts and floods, and has received hand outs and has been made a fool of. He is an old weathered man to stubborn to know when to give in to the help that surrounds him. Or maybe He feels to much pride to accept from those who offer assistance.

Not knowing what its like to be him, He knows not what it is to be me. There is something that connects us on this day, we are both fighting to keep him safe.

Be Safe

Ambulance Junkie

Off on Vacation

Realizing I have never spent more than 4 days off in a row with my son since he's been born, I am going to spend 11 days with him and the Mrs of course.

I am off to the area know as New England.

I shall return,

after a much needed family vacation.

What Would I teach Lizzie?

-The Handover-EMS Blog Carnival Aug. Submission-

So your proficient in your skills, able to back board with the best of them. Fully capable of putting on a traction splint, vacuum splint and can sling and swath a shoulder. You've studied all the acronyms needed, DCAP-BTLS, PERRL, SAMPLE, and have a solid understanding of their use as it pertains to the patient.

You have a sound understanding that majority of calls will fall in the "grey realm". You'll have some black & white calls laid before you, but over all you'll have an unproportional amount of grey calls. Understanding that once on the streets the clinical decision making is in your hands. You do not solely rely on your initial education, rather the trends in EMS you have been continually researching and the Con Ed classes participated in.

When all else fails Lizzie, you know when to call for help. People become afraid to show weakness in this line of work, but don't be. The simple fact is the nature of the beast that is medicine is ever changing and progressing. It is impossible to be on the cutting edge of every single change in EMS, but hopefully some one else may have the knowledge where you haven't gotten to yet. We must never forget that we are serving for one single reason, and that is to do whats best by the patient. Sometimes that means to ask for help, but you know that already.

Solid fundamentals, capable clinical decision making skills, and the ability to admit to one's self that you need help. That pretty much covers the whole lot of attributes a newly carded EMT will need for the field, and you have them.

So what do I hope I've taught Lizzie? Keep your sense of humor girl! This Career/Stepping stone/Hobby/Calling surrounds us with people having the worst day of their life potentially. We are always in the thick of their crisis, and are the ones they have summoned to help. That is a lot of pressure on an individual, to be the sole saver of life, the Grand Puba of help. the Sultan of Assistance. In order to maintain our sanity we have to be able to keep our sense of humor. Humor is really just a matter of perspective after all. When in the appropriate times it lightens our moods and gives us that little extra to make it another call.

But I'm sure you already knew that Lizzie, you were always a great student.

Be Safe
Ambulance Junkie

The Girl

She has walked this side walk hundreds of times before, but never quite like this. She is a young girl, only six years of age, a cute girl, innocent and sweet. She walks this sidewalk gazing upon it as though she's never seen it before. She feels lost and alone as she walks this side walk she has hundreds of times before.

She walks with a small suitcase beside her then she waits to cross the street. She seems to be alone, as she carries her suit case next to her in the cross walk. She disappears from view as she passes in front of my rig. She reappears pulling her Hello Kitty luggage, she walks with her small suitcase beside her.

She's not alone, for she holds her teddy by its arm. She stops on the curb and sets her luggage down. She tucks her teddy into her arm and looks around her, unsure of what to do next. She looks infront of her but does not know where to go or who to ask. She's not alone, she has her Teddy she holds tucked in her arm.

I know she's run away from home, but I dont know her reason why. I can't sit by and wait to understand her reason. I have an obligation to help this child, even if she doesn't know she needs help. There is some one missing their child. I know she's run away from home, doesn't matter the reason why.

A wake up and a wasp

I wake up and stretch, glancing over my shoulder peering at the bed side stand looking for the clock. Rubbing my eyes I can barely believe the red numbers laid out in front of me. 16:10 I read, "Crap!" I exclaim "I got half an hour before I need to leave for work." Throwing the covers off and swinging my legs over the edge of the bed I sit up. "Hi moo moo, Hi A-bay" I rattle off to my dogs on a maddened dash to the the shower. Five minutes flat I'm out and then I get changed in my uniform. Stumbling down stairs I head for the sliding door out to the back yard still tightening my belt. I let my dogs out and off I am to preparing the pup's evening food bowls.

I then wonder what on earth I'm going to fix for dinner. Grabbing a corn muffin out of the microwave to munch on it while throwing a few south western style egg rolls in the oven and also grabbing a few cucumbers to cut up. Eureka, PB&J I determine as I'm sliding the back door open to let the pups in for grub. Glancing at the clock I realize its only 16:25.

I jet over to the radio to turn on some classic rock while I begin to unload the dishwasher, placing all the cleaned items on the counter top. Being spastic I begin to peel and cut the cucumbers and toss them in a Tupperware bowl with seasoning of salt and pepper and a tablespoon of Mayo. Closing the lid I give it a few gentle flips and place it in my lunch box. Grabbing bread and jelly from the fridge and peanut butter from the cabinet I slather together two PB&J sandwiches and put them in zip lock baggies. Back to the dishes I finish putting them away, and grab my egg rolls from the oven. Toss it all in my lunch box and throw my boots on in the living room, Time check 16:35.

Rushing back in the kitchen I wash the dishes I created and place them on the drying rack. Running up stairs I call for my boxer Gracie to go in her kennel. In she goes and I stumble back down to pick up my lunch box and grab the kitchen garbage bag to take it to the curb. Head to the front door I grab Jeep keys and pull the door shut behind me. I grab two garbage cans and take them to the curb, jump in my Jeep and off I go. Time 16:40

Right on time I think, now I can enjoy my two and a half mile ride into work. Windows down, music jamming I am physically and mentally prepared for the night ahead. Suddenly a ticklish and unexpected sensation on my arm. Startled I look over and see a Wasp has landed on my forearm braced against the passenger head rest. Shivers run down my spine and I flail my arm violently in hopes to dislodge this creature of nature.

Unaware of my surroundings I have begun drifting towards a row of parked cars. Screaming like a school girl because of the wasp I notice my course and make a quick  yet over-corrective action. Realizing the Wasp has fallen from my arm I look frantically over my body for it. Glancing back on the road I swerve correcting my course yet again. Coming to a red light I have time to gain my composure. I catch my breath and notice the Wasp fly out the window, good rid dens I think and turn my attention back to the road.

No sooner have I regained my composure do I notice a spider drop down in my field of view. "Odd, what is a spider dangling from outside my wind shield?" I mutter to my self when I realize this nasty horrific beast of a spider is actually between me and my wind shield.

Surprisingly I made it to work on time that day, though there was one less spider living in the world upon my arrival. Time check 16:46

Be Safe
Ambulance Junkie

The story of a Druggie

She enters the room seeing the site before her. The curtains pulled shut with only the slightest streak of sun light comeing through. A man lays before her in his own filth, no doubt over dosed on today's black bag special. Shes not afraid, she just goes to work. On the table bag sits emptied and the spoon covered in the residue of the druggies fix. The smoldering wick of a tea lite candle sits ideally by. She prepares the site, cleaning it in a circular motion working out from the center. She has her supplies laid out in front of her, at an easy reachable distance. She wraps the rubber tournique around the arm, ties off the tourniquet in the middle of the bicep and quickly slaps the AC vein a few times in hopes it pops up. Its tiny and tattered, but it'll have to do even though its been used several times before. She picks up her needle and syringe her partner had already prepared. Flicking the syringe to make sure the air is out, she places the setup in her teeth and caressed the vein with her index finger. She hopes that it wont roll or vanish when she sticks it, for she needs this site to be usable. Placing the needle up against the skin, she is ready for it all to come together. Steady and with slight pressure the needle advances tearing a hole in the skin, piercing through with a familiar pain. In the vein unnaturally sits a cold and lifeless piece of manufactured metal, its as though she can taste her sucess. A thumb overs the end of the syringe she begins to push slowly, forcing the fix through the body, a mental escape from the hell in which she lives. Trying to kill the pain she slips away, to a place she feels free. The drug rushes through her veins, coursing through her body leaving her numb. The needle drops to the floor, the tourniquet still attached, she feels nothing. She stumbles from the table completely strung out, she experiences the world in her to familar way. She crashes to the floor just like the one before. Her future is unknown.

Be Safe

Ambulance Junkie

The Glorious Life

EMS is not the highest paid career choice there is by any means. I mean Children aren't lining up on career day to see the Paramedic thinking "Wow, I bet he drives a Lexus and has a twelve bedroom mansion." No the thought of saving lives and being involved in the Emergency is what brings the kids, that and the lights and sirens. We make sacrifices in life constantly, though it seems EMS is a bit more often.

My Wife and I have done alright for ourselves, both in under paid professions, we own rather than rent and are able to provide for our son. That being said, I have made changes in these economic times to be more fiscally responsible. Packing my dinner rather than buying out, drinking from the stations water cooler, and enjoying being home bodies for entertainment. Its not ideal but it makes life easier on us, and reduces our stress.

Now I'm not blogging for sympathy, or bragging rights, that's not my style. So there is comedic twist to this blog...dun, dun, dun...foreshadowing? But I digress.

 I am not afraid to be, as my wife would say, cheap; though I think of it as Fiscally responsible. I go through the couch cushions at the station to find loose change in attempts to scrounge up enough to purchase the item of my desire. After a few weeks I use this said change to treat myself on day four to a soda. Which today was that day, That day where my hard earned work of flipping cushions and combating the creatures of the couch paid off. Three weeks to find enough change to buy an ice cold, thirst quenching, caffeine enthralling Mountain Dew. What a brilliant, magnificent, splendid, resplendent, splendiferous, illustrious, redoubtable day this was going to be!

Much as I enjoy cake and fried foods, I love my Dew. The day I get to purchase my Dew from the vending machine is what I can only relate to as Christmas when I was younger. I wasn't even going to wait for a while before the purchasing and inevitable consumption began. As soon as I clocked in, I headed straight for the back of the ambulance bays, my eyes locked on the light emanating through the stiff plastic logo of the soda incubator. Oh sweet luscious mana of heaven, I thought upon reaching the towering machine. I glance over my shoulders to make sure we're alone and stretch out my arms embracing it in a long, yet surprisingly satisfying hug. Getting lost in the moment I realize I have the correct amount of currency to release this locked liquid crack. Digging through my pockets, I throw unneeded items aside, gloves, spare pens, my junk drive all just to grab the loose change sitting with in its depths.

In my palm sits the key to happiness, I begin to slide my change in the slot of the machine. A quarter followed by another, followed by a few dimes. All was going great until this stationary bipolar vending machine turned on me. Clank I hear as a dime falls down the return shoot. I grab and reinsert. Clank I hear as it falls again. Temperamental piece of crap I think as I try a nickel. Clank, Clank, Clank as it spits out Sixty of the dollar ten it had already been given. The tiny LED marquee reading, Balance: 0.00, "What the hell" I exclaimed "Worthless piece of...Rotten, no good son of a....." Locked within the belly of this beast sits my hard earned, some one else's misplaced, change.

The fit of rage that ensued is not appropriate for all readers. I ended up losing to an inanimate object, out smarted at a game I obviously had no idea we were playing, by a soda machine.

Like the title implies, Ain't this The Glorious Life.

                                                           Be Safe

Ambulance Junkie

A Black and White or a Grey Affair??

"Everyone thinks when they get out of the academy, everything is black and white.  Well you know what? It isn't.  We live in the gray." Southland. 

There is no amount of training or schooling that will prepare you for the gritty realization of life on the streets. There is the obvious right thing to do and the obvious wrong thing to do, but that only covers the extreme polar ends. What do you do the rest of the time? What would you do in the moment when none of your training and none of your schooling seems applicable? The moment you enter the Grey Zone?

Your presented with a Frequent Flyer drunk, we all know the one, you pull up on scene and know his Name, DOB, SSN, Medical Hx, his wife's name, and their pet cat named Fluffy. He's a block away from his apartment, and is shit faced. He left the bar the block back and has been fighting the ever ominous force known as gravity the entire time. A good Samaritan saw him fall while driving and called 911, though never felt the need to stop and help him.

So Black and White would say a male Intoxicated fallen is a transport to the ER, right? He has consumed alcohol and thus not allowed to refuse medical aide and transport because he has a mind altering drug on board. He is adamant in not going to the ER, and it will be a struggle the entire ride in to keep him relaxed and on your stretcher.

Grey would say that he was heading home, He's a block away, and he needs to sleep this off. Yes he is drunk but if he shows no signs of trauma after a full assessment and is capable of appropriately answering person, place, time and thing than he has the right to refuse Medical aide and transport. You can't take a man against his will and you know his non driving wife is home awaiting his eventual arrival.

So what do we do? In this exact situation it comes down to your way of thinking, which I have done both:

Black&White- You get your Malnourished Morgan Freeman look alike patient and sit him on the stretcher. He banters on about being taken against his will as you put his lap and leg belts on. He emanates enough booze out of his pores for you to inhale a contact buzz. You wrestle to keep him on the stretcher and avoid his misguided attempts at a punch. You use all EMS Mind tricks to distract him and take his attention off his disgruntlement.

Grey- I've signed off my local drunk and given him a courtesy ride home. Walking him to his door and helping him to his front door where he lets himself in. Seeing his worn and weathered wife looking with shame and embarrassment of the spectacle he must have caused from with in the house. We bid our patient ado, and reassure the wife that bringing him home was no problem and it'd save them some money from the ER bill. No doubt leaving the patient to crash on his couch and sleeping off his alcoholic induced life style.

No one prepares us for the split second decisions having to be made on the streets. No one prepares you for the second guessing you'll do the moment the call is over. EMS is Black and White except for when its grey. EMS is truly a conundrum.

No matter your decision, use you clinical assessments and sound medical judgment and stick by it; but always be able to learn from your mistakes.

Be Safe
Ambulance Junkie

My Promise to my Son

The first time you smiled, I was Working.

The first time you Laughed, I was Working.

The first time you learned to sit up, I was Working.

The first time you crawled, I was Working.

Your mother will tell me of your wonderful accomplishments, I am proud!

Though I am saddened, I will never let you know.

I will never let your mother know.

This is my burden to bare, and no one else's.

Please don't think this is how your life will be.

I'll be there for you my son.

I won't miss your games, I won't miss your awards, I won't miss your growing up.

I know what that was like and I won't make the same mistake.

That is my Promise to my Son

Dry Chem + Ambulance Cab = A Day Off

It had all the story lines of a comedy plot with the classic punch lines and gags of a Charlie Chaplin movie. The scene is set, the parking lot of a busy service station, the afternoon of a mild winter's day. Our heroes sit in the front seat of their ambulance...and action:

My partner and I have the same routine once on post, the every day chatter entails in the rig over what we did this weekend. The music playing in the back ground we joke and laugh amusing our selves over various happenings at work and hear say about the unionizing neighboring department. We head inside to grab an early morning coffee and discuss whether its to early to grab a cup of Wendy's chilly or not. Exiting from the service station we tromp through the slush and gusty wind and hunker back in our warm ambulance. All the time never thinking about the mischievous happenings that are effectively occurring at that very moment.

Unknown to us the plastic seal on the fire extinguisher is to the point of total failure. It at any moment has enough disintegration through its plastic being to break apart setting in motion the days events. The continuous  vibration of the old 98 Ford will ultimately bounce the broken seal tag off the extinguisher and onto the ground. The said vibrations will rattle enough to dance the pin out of the dry chem, and set up this devilish plot.

We continue to chatter to each other and a few hours have passed. The Pin now on the verge of falling out and clanking will no doubt alert us to the unsafe extinguisher standing between us. As the pin falls it lands on the only towel in a five foot radius thus not making a noise, and not warning us.

Reaching back to his bag my medic goes to grab his novel to read. the bag having shifted just enough out of reach during the mornings drive. He has to stretch and with his finger tips grabbing at his bag just out of reach. in order to get a little extra leverage my Medic has rested his opposite elbow on the handle of the extinguisher. The same said extinguisher that we unknowingly possessed with a faulty seal tag. The planets have aligned in favor of the events about to happen, and set in motion to a point of no return.

With the slightest of pressure on the handle he is able to stick his finger on the bag with the tiniest of traction, pulling towards him he shifts his weight. The transfer of weight from his reaching grasp to his steadying arm creates enough energy to drive the handle down on the extinguisher releasing dry chem agent into the air. With out missing a beat my partners shifting weight triggers him to become off balanced and falling between the seats. Kicking up the dry chem on the rigs floor. As he falls his legs stretching out shoving his boots towards any solid mass in attempts of bracing him in his new stance strikes the the GPS unit mounted on the dash dislodging it. In his follow through with his boot he strikes the speed dial of the heat vent kicking it to high. The vent intakes near the dog house floor suck the low lying dry chem in allowing it to vanish from site momentarily.

Laughing at each other we do not realize what is about to happen. The vent sounding as if its clogged draws our attention to the outlets. We stop laughing just in time for the evil twist of Karma, *PUFF* as it fills the entire cab with dry chem. My medic laying on the floor no less than two feet from me vanishes in a fine white cloud within our rig, the air becomes thick and unbearable. Coughing ensues with intermittently laughing over our situation. We stumble out of our rig coughing and dry heaving from the dust that has no doubt filled out lungs. Suppressing the cough we assure each other of our safety. Then burst out in laughter which begins the cycle of coughing once more.

We call OOS and proceed to drive back with windows open and our heads hanging out. At the station we explain to the D.O the events of the day while uncontrollably shivering and coughing. We are told to head to be medically cleared at the ER. Once doing so we return to be advised the truck will be in need of a interior servicing and vent work cleaning. With no other trucks available for use that day, we are given the rest of the day off with pay.

It seems as though Karma had its intentions all along.

Be Safe
Ambulance Junkie