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It’s a Slinky Call!

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I’ve long said that the MPDS dispatch card for “fall” should only require an ALS response if the dispatch information includes the phrase, “off a building.”

Tonight, I was dispatched to a “long fall,” a code of which I’ve never heard before tonight. So I asked dispatch, “Can you define what a ‘long fall’ is?”

Their reply was, “Between 9 and 29 feet. The patient fell down a flight of stairs.”

That fits the definition, I guess, but it poses an interesting philosophical question:

Is a fall down a flight of stairs really a long fall, or is it technically just 15 very short falls in succession?

Musings On A Blog Title

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A little something different for you today, a guest post from a reader, in response to the JEMS Facebook fans who piddle themselves over a blog title, without ever actually reading the blog. Enjoy!

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“A Day in The Life of An Ambulance Driver.”

This is the TITLE of one of the most popular blogs in the EMS community right now, but it seems that there are a lot of people out in the arena of the world wide web who have taken offense, not to the blog, but to the TITLE. So, let’s take a moment and look at a book’s title which, I think applies here.  In researching this idea, I came across a web page entitled “How to Write a Great Book Title,” and thought, just what I was looking for. The first paragraph that I see says, “It’s all in a name. Your book’s title has more than one function. Besides identifying your story, the title of a book has to attract attention and create interest.” Once I read this, I realized that is exactly what the TITLE “A Day in the Life of an Ambulance Driver” does. One knows immediately that this blog is about a day in the life of a person who drives an ambulance and since I am a paramedic, I find it interesting. I showed the title to my sister, who is a beautician, and she could care less; I guess the interest isn’t for everyone.

I’m sure that a some of my interest comes from the fact that, as anyone who has been in EMS for longer than 26 minutes knows, the general public refers to everyone who works in EMS as either a ‘paramedic’ or an ‘ambulance driver.’ Through the years I have tried desperately to get the inbred booger-farmers of the world to realize that my job entails more than just driving an ambulance. But, what they see is you driving up to a house in an ambulance; ergo, you are an ambulance driver. I can tell, just from the title, that this might be a blog that may have some interest to me, even though I personally hate being called an ambulance driver. So I took a chance and read some of this person’s musings. It seems that the crusty, old, limey codger Bill Shakespeare was right, “that which we call a rose by any other name would smell as sweet.”

It didn’t take long to discover that the person writing this blog was a guy, a guy who has a beautiful daughter whom he loves immensely, a guy that shares some of the same interests as I do, and a guy who writes in a tongue-in-check, matter of fact, and somewhat irreverent fashion; I like this guy. Politically correct? Sometimes, maybe; not really.

I read on… His days are like mine, same issues with work, similar ramblings with his partners, interactions with others akin to mine. And wait, there is more… there is also some food for thought, some educational insights, some things that make you go ‘wow’ and others that just make you go “hhmmm.”

That bastard sucked me in with one line; “A Day in the Life of an Ambulance Driver.” I guess the title did what it was supposed to; it attracted attention and created interest. This sneaky guy sucked me into his world and allowed me to laugh with him and at him, and worse, he made me cry along side of him.

All of this because his title drew me in, it sucked me into his blog and, through his writings, I could see parallels between his world and mine. That bastard! But, the reality is, he didn’t ask to enter my world, I asked to join his. He put it out for any and all who desired to join him in his daily goings on. From reading blogs, I have discovered that some try to teach, others to enlighten and some to just plain vent. There is something cathartic about putting pen to paper (at least figuratively) and discussing your trials and tribulations, only to discover that you do not stand alone. Damn this guy yet again, his siren must be sucking me into the vortex of his collective, I must resist the hive!

After discovering all of these things, I noticed people taking shots at this guy and what he choose to title his blog. As I read these comments, they started to remind me of what I had always imagined a blind retard would look like trying to shoot at clay pigeons; nice effort but waaaaay off the mark. I wondered if any of them had ever read what this guy writes. And then I started thinking, if they don’t like the TITLE, why don’t they change the channel? There are way more than thirteen channels of shit on this TV to choose from.

This guy’s TITLE did what it was supposed to. If you don’t like the TITLE, don’t read the blog. If you don’t like the blog, go read one that you do like. This world is full of options; more so now than ever before. If you don’t like what is on your plate, you can get something else or you can scrape off the onions and get to the steak that’s hiding beneath them.

In today’s technologically advanced society, there is a group of people out there who are trying to change EMS for the better. They are doing that through the use of blogs, podcast and other social media outlets. Their goal is to elevate EMS to a level higher than what it is or has been in the past. Unfortunately, many of us are still stuck in our old way; looking for a new forest but damn all these trees.

Let’s give these people a little bit of credit for trying and doing what most of us wish that we could. If you don’t like the book, no problem.  Thanks for browsing, pick another.  The library is full!  Respect is a strange thing; it is never freely given, it can only be earned. But, you have to respect, at least a little, the one who is trying to improve not only his own life but this crazy mixed up thing that we call a profession.

As for me, blog on Ambulance Driver: I’ve read the disclosure, I’ve signed the waiver, I’ve assembled my supplies, and my bags are packed; let’s catch the wind and see where this all will take us. I know it’s going to be a bumpy ride so I’ve got my seat belt fastened. The future begins… here.

For those that are interested, the short article on book titles can be found here:
http://bookpublishing.suite101.com/article.cfm/how_to_find_the_right_book_title

OrdoPM

For You EMS Newbies…

3 comments

Episode 10 is up at Confessions of an EMS Newbie.

Ron and I discuss birthin’ babies (Rule #1: don’t drop them!), medical patient assessment, and the essential books in any paramedic’s reference library.

It’s Confessions of an EMS Newbie, the podcast known to cause cancer in laboratory rats…

… but they listen anyway, because it’s just that damn good.

Sparky.

18 comments

My partner is a constant source of amusement, every shift. The kid is quite possibly the sparkiest EMT ever. And if I could teach him to engage his internal censor when the calls turn out to be less than the fun and excitement he envisioned, he’d be just about perfect.

Tonight, Kelso got the sort of shift he has always wanted: shootings, codes, overdoses, respiratory arrests, grisly trauma… you name it, we’ve had it this shift.

Our first call of the evening was a shooting well out in the sticks, and we wound up flying the patient to the trauma center. The call had everything a little adrenaline junkie needs: two medics and half a dozen firefighters acting out a tightly choreographed resuscitation ballet, and for a change, a patient sick enough that his survival may very well have hinged on speed and the skill of the people treating him. And Kelso was right up in the middle of it getting his hands bloody, a goofy grin plastered on his face.

In other words, one of those calls where all your training actually matters.

The flight medic pushed the paralytics while I got the tube, we decompressed his chest, packaged the guy and hustled him to the bird. When the flight medic asked Kelso to ride in with him, I thought the kid was going to piddle himself.

“Go get in the bird, hero,” I chuckled. “I’ll clean up here and pick you up at the ED in a few minutes.”

I swear, if the kid had a tail, right now it would be wagging hard enough to generate a breeze.

Heeeeyyyy, Nice Veins!

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For you EMS types, there’s a new clinical tip on EMS1.

Remember, ladies, if the paramedic you just met won’t look you in the eyes when he talks, he’s not ogling your boobs.

He’s ogling your neck.

Hemi-Inattention

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Many medics do not realize that the Cincinnati Stroke Scale or Los Angeles Prehospital Stroke Screen are only reliable at identifying a hemispheric stroke. They can usually identify paralysis or weakness on one side of the body or another, but aren’t really geared towards identifying stroke of the brainstem, cerebellum, or intracranial hemorrhage.

To do that, you have to check for limb ataxia, visual field deficits, and deficits in extraocular movements.

But one phenomenon that never ceases to amaze me is non-dominant hemisphere syndrome. For around 85% of the population, the left hemisphere of your brain is the dominant one. Southpaws have a dominant right hemisphere.

And when a right-hander strokes out the right, non-dominant hemisphere of their brain, often the left-sided paralysis is accompanied by a total lack of awareness that anything is wrong.

Weird, that.

I’ve had a couple of patients over the years that I had to force to go to the hospital, so deep was their denial. One sweet little old lady was so certain that nothing was wrong with her that she insisted that the frail, flaccid black arm I was holding up before her eyes was my arm.

The guy I ran just a little while ago wasn’t quite that bad, but it still never fails to weird me out when I have to point out to someone that one entire side of their body has stopped working.

Revolving Door

10 comments

Four times yesterday we transported him. That’s four times he asked someone to call an ambulance.

Four times he was taken to an Emergency Department. And all four times, he left before a doctor could see him.

I knew he was lying the fourth time we picked him up, when he told us the ED staff refused to do anything for him. Yet I loaded him in the rig, and took him back there anyway. I had to.

He has renal insufficiency, hypertension, diabetes, and poor circulation in his extremities. He’s already lost several toes on each foot, and the remaining ones on his left foot are so necrotic that I was genuinely concerned that they’d fall off as I gently wrapped his foot.

He’s also a surly, ill-tempered asshole, which doesn’t make it any easier to treat him. Those of us who try, do so with an air of resignation, any inkling of compassion long since burned away by the futility of caring for someone who absolutely, steadfastly refuses to help himself. He’s been given medication. He’s been offered wound care. He’s been hospitalized.

He doesn’t bathe himself, he doesn’t fill his antibiotic prescriptions, and what prescribed painkillers he doesn’t use himself he sells for alcohol and street drugs. Vicodin tabs fetch a nice premium on the street, after all, and crack is cheaper. Gives a better high, too.

Soon enough, one of those 911 calls will be for him in cardiac arrest, and we’ll try our best to resuscitate him. We may even succeed, despite the doubts that each of us secretly harbor but would never give voice to, that maybe society would be better off if he were dead.

And God help me, I hate him because he makes me ask these questions of myself, makes me wonder how much of my soul I’ve subverted over the years taking care of him and people like him. Will I have anything left for the next guy? I hate him because he makes me suspect that compassion comes in a finite supply, and I fear that I’ve used up too much of mine.

Pundits and policy-makers, people whose understanding of health care has been formulated within the reality-insulating walls of a think-tank, would use him as the perfect example of someone who has fallen through the cracks of the system, and the reason we need universal health care.

Those of us who have had those maggot-infested feet within inches of our faces as we loaded him into the rig, have a different view. We know that, no matter what, some people will. just. not. be. helped.

And he’s not unique.

BB & Guns, now with 100% of your RDA of Ambulance Driver!

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I’ll be chatting with Breda and Bonnie tonight on the BB & Guns show on Blogtalk Radio tonight at 7:00 pm Eastern.

Tune in to listen live, or call in at (347) 215-8643 with your questions!

For You EMS Newbies…

3 comments

… Episode 9 of the Confessions of an EMS Newbie podcast is up.

Ron’s White Cloud Syndrome continues, and we discuss a potentially lucrative career of hiring himself out to overworked EMS preceptors in need of a break.

Other highlights include the ineffectiveness of national and state EMS organizations and why you should join anyway, advanced airway insertion by EMT-Basics, and legitimate reasons to call a helicopter.

It’s Confessions of An EMS Newbie, the only podcast guaranteed to taste great and be less-filling!

Overheard on a sleepy drive to Oklahoma City:

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Matt G: “So anyway, the guy’s an engineer, and he crunched the numbers. And he discovered that, if you believe all this homeopathy stuff and the concentrations they recommend, you wind up with a vat of water with a few lonely molecules of whatever it is you’re diluting in it. You have to be winning-the-lottery lucky to get anything other than a bottle of distilled water.

AD: “So why does he put up with it?”

Matt G: “Oh, he knows it’s bullshit, but his wife is a true believer.”

AD: “So he keeps his mouth shut to preserve peace and harmony in the household?”

Matt G: “Exactly. I’m lucky, myself. My wife is a pretty level-headed sort. If anything, I wish she’d put out more, but I think all husbands wish their wives would be more interested in sex.”

AD: “There’s a homeopathic cure for that, you know. You dilute wedding cake to one part per million in sterile water…”

“I HAVE A GUN!!”

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No, not me. Actually, I have one less gun. It was my gift of one of my .22 rifles to our hostess Christina at the Inaugural North Texas Epic Blogmeet that prompted such an exclamation.

Normally, such an announcement is cause for the sheeple to duck for cover, but amongst our crowd, it garnered only applause and congratulatory shouts.

God, I lurves these people.

Among the blogger luminaries present were Phlegmmy and LawDog, the latter sporting the moustache of fame and legend. Matt G., Johnny and Holly were there, as were Bob and his wonderful wife, Swamp Rabbit (who doesn’t blog but should) and Mrs. Rabbit, Mulligan DoOver, Mike of The Holster Site and his lovely wife, Jennifer, Daniel Scott and his wife, AEPilot Jim, OkieRhio, John the Texaner and…

… crap, I’m sure I’m forgetting somebody.

Much good food was eaten, many guns and holsters were coon-fingered, and an excellent time was had by all.

The following day, there was a planned range day, but that was scuttled by a flat tire on Mike’s car and less-than-hospitable range owners (that one deserves a post of its own), so we spent the day tooling around lake Ray Roberts on my jet ski instead.

Suffice it to say that Christina’s spawn now have the perma-grin, and Mike and Jennifer are calculating how many holsters they need to sell to purchase their own ski. Everyone also got a glimpse of the daredevil assassin that lurks beneath my daughter’s adorable exterior.

Seriously, the kid is fiendish when it comes to slinging people around on an inner tube. I kept having to remind her that 60 mph is a wee bit too fast to be skipping across the waves in anything but a boat.

I followed Jennifer and Mike home to Oklahoma Saturday night to make sure their donut spare tire didn’t leave them stranded on the side of the road. I spent Sunday visiting relatives in Oklahoma City, and awoke in the wee hours of Monday morning to make the 10 hour trek back home. I made it home just in time to wash a uniform, grab a bite to eat, and head to work.

Right now, I’m beat. I’ve spent 24 hours of my weekend off behind the wheel of my truck, and a full day on the lake that left me sore in muscles I didn’t know I had. Still, it was a great trip, and at least work doesn’t require me to sit in a truck for 12 hours while I…

… oh, wait.

Crap.


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