30 January 2005

When it Rains, it Pours...Part II

30 January 2005

"When it Rains, it Pours...Part II"

Now...Where were we??

 

In the front seat of the car was a woman, young in age, dressed in business attire sitting almost motionless. Around her was one of those blue plastic bags you get at the grocery store to catch what little she had thrown up.

"Ma'am. Are you okay?" Ken asked.

"I fell down. My head is killing me." She replied.

Ken kept her still and felt for any deformity to the back of her head.  There was a bump there.  It was the size of Kansas. (Okay, maybe not Kansas but it filled Ken's hand...and Ken has decent sized hands.)

Pulling my radio off my belt, I called dispatch to tell them we were out of service again and began to pull immobilization equipment off our truck.

Our patient was very diaphoretic and cooler to the touch than normal. 

Ken grabbed a C-collar  (you know..one of these)

 

I grabbed the backboard, , head blocks,and straps,  and began to get ready to extricate her.

The female that drove in with the patient stated that she was an IDDM (Insulin Dependant Diabetic).

Well, that could play a role into this situation. Hmm...

I ran back to the truck and got the glucometer  and went for the magic test.  Was it the sugar, or was it something else?

Five seconds later, I got my answer.

If it were the sugar, then we could fix that right away, if not, then we have a whole other greater problem.

Her results came back.

Her sugar was 106. Well within normal limits.

Time to kick in the pucker factor.

The patient began to take the collar off and Ken would explain to her that it needed to stay on. This was only part of the problem.

Her Level of Consciousness (LOC) had greatly begain to deteriorate and it was cold outside. Soon, she could start getting hypothermia just by the door being open. (Yes, it was THAT cold.)

Ken tried to pivot her on the cot. She would fight it. Ken would try again. She would fight again.

It was time to take over for her.  Ken and I looked at each other knowing that if we didn't get her in soon, our window of oppurtunity would shrink dramatically.

I grabbed her legs, Ken got her arms, we pulled her out military style and placed her on the board.

She fought a little....then stopped....completely.

Ken checked for a pulse. It was still there but she began to run tachycardia on the monitor.

The signs were beginning to stack against us.

The clock was ticking.

Wheeling her inside, the patient became even less responsive than before. She began to throw up more frequently.

I saw the doctor go in.

I heard him start barking directions...

It didn't sound good.

Ken stayed inside the room to help with the patient. I, so badly, wanted to be in there. But we were all that was left for squads in the city as the other two left on calls.  I had to get the truck back together.

Shortly after, we left and went back to the station. Our curiousity kept getting the best of us as to what was going on with her.

Trying to figure out what we did in our game plan, we heard a helicopter fly over head.

It was .

 They were coming for our patient.

Ken called over to the ER. He got a report, then looked at me.

"Let's go and take a ride" he told me.

I knew where we were going.  I grabbed my coat.

Pulling back into the ER, the doctor there met us explaining what was up with our walk-in patient.

(This is a normal scan of the brain)

 (This is similar to what she had. The arrows point to bleeding in the brain.)

All in all, she had six bleeds going on in her head and needed immediate surgery for it.

A college professor, she was also blind and just couldn't see the ice when she fell. The fall will alter her life for ever.

But wait folks....there's more.

Watching the flight crew leave and carry our patient away, Craig came up to us as we stood in disbelief over the female.

You all better sit down for this.

"You know that chest pain you guys brought in?" Craig asked us.

We both nodded.

"He has a Triple A..he coded twice so far."

Picking up my jaw, I glanced to the other side of the ER to see the code team working behind a closed curtain.

Okay, this was WAY too much now. 

We walked overto the other side to see the team working on our gentleman who, 30 minutes ago, was active and had thought it was gas he was having.  What he REALLY had was WAY more severe.

Ascending Aortic Aneurysm. Roughly, this is when the walls of the major artery leading to the heart, become weak and start to bulge out.  Kinda like a tire. If it burst, your mortailty rate is extremely high.

Peeking in, I could see the patient tubed (intubated) and had no blood pressure.  Surgery was going to be done within the hour as soon as the team arrive.

This, I knew was bad...seeing they never do that surgery here. He was too unstable to leave.

Apparently, the patient's artery burst while on his way to CT scan.

 This is similar to how his artery looked.

As of now, I know he is in ICU and is doing slightly better.

Word of the woman is that she is touch and go.

Ken and I decided to call it quits for the night (no, we aren't allowed to do that.)

But first we got dinner....

After all, that is what our initial quest was.

Here is something to ponder folks. The head injury came in by private car.  This was something VERY serious and potentially, life threatening.  THIS is where you need to call the ambulance.

Yes, I know that we do all kinds of piddly little falls all day long, but this is what we are paid for. This is why we are here. Let US make the decision.

I am not sure that her outcome would be much different had we gotten to her, but we could have definately shaved some time off her golden hour.

Time is crutial.

Call 9-1-1.

Rounding Third and Heading Home,

M-

27 January 2005

When it Rains, it Pours...Part I

27 January 2005

"When it Rains, it Pours...Part I"

Here is a little nugget of useless knowledge for you.

Did you know that there are over 200,000 words in the English language. There are also over 613,000 different combinations of those words.

Hmmm.

Did you also know that half of those words are not in the EMS language. Let me give you some examples:

lunch    (lnch) n.  A meal eaten at midday.

eas·y   (z) adj. eas·i·er, eas·i·est

  1. Capable of being accomplished or acquired with ease; posing no difficulty: an easy victory; an easy problem.
  2. Requiring or exhibiting little effort or endeavor; undemanding

And, of course, my favorite:

sleep     (slp) n.

    1. A natural periodic state of rest for the mind and body, in which the eyes usually close and consciousness is completely or partially lost, so that there is a decrease in bodily movement and responsiveness to external stimuli. During sleep the brain in humans and other mammals undergoes a characteristic cycle of brain-wave activity that includes intervals of dreaming.

There is one more term that has been omitted from our language and is the focus of today's entry.

grad·u·al     (grj-l) adj.

Advancing or progressing by regular or continuous degrees.

 

1912 Hours

Getting down behind some wodden crates, I peeked across the parking structure to see the two men with their rifles circling the area.  The cold rain which started long before I got here had pelted me saturating my clothing and making the surroundings more miserable.  Staying low, I sprinted across the pavement to take cover behind a news van that was abandoned before the incident.  Looking closer, I could see one of the armed men slowly approaching my position. Has he seen me? Does he know that I am here? I wish I had some help.  I knew I was alone.

Then the phone rang.

So I put the game on pause.

"93, XXXX for a 71 year old male with chest pains."

Sam will have to wait.

Oh..meet Sam...

 He works for the NSA.

Here is where I met Sam...

Anyways....

A chest pain. A pretty routine call (final words). We can go, pick up the patient, try to take his pain away, and then get some dinner.

Cruising down the street to the north side of the city, I partook in the beautiful winter folage as the moonlight gliscened off the wintry snow and illuminated the ground creating its own street lamps.  If it weren't for the extreme cold, I think I would marvel in winter for a longer period than it runs.

Pulling down the street, the houses were all well kept and free of debris.  This call was in a middle-upper-class neighborhood and the maintainence of the houses proved that to effect.  This was one of those places where kids play all summer, lining the streets with their bikes. Trees rustle through the breeze, and neighbors stand in the driveways chatting about the day.  This is the type of place that I would love to live in someday. This was Suburbia.

It is easy to find the houses that have patients with chest pains.

One, they are usually the ones with more than 2 cars in the driveway seeing they called their family before us.

And two, (the big indicator) there is a big, red truck parked in the front.

Getting closer, we noticed that the fire guys actually left room for us to back into the driveway. It was rather cold out and the closer we got the patient to the truck, the shorter time they would have to stay outside during thier transit.  I  like to get the patient's where it is warm so they ease their pain and don't have to tolerate the brisk winter wind.

Entering through the front door, I caught a glimpse of birthday cake on the table.  Family was spread throughout the house and children were seen with brand new toys.

In front of us was our patient sitting on the couch.  A pleasant gentleman who, even after almost passing out, wondered what all the fuss about him was about.  Ken began asking questions as to what was going on with him.  The firemen went and got the cot.

Apparently, our patient was feeling some pain that he described as "gas" and felt the need to go to the bathroom...where he almost passed out completely.  A family member caught him, then dialed 9-1-1.

That is where we came in.

"Sir, where is your pain right now?" Ken asked.

"It is in my shoulder blades mainly, it is really not that intense, it just feels like I pulled something. It goes down along my side right here also." He responded, pointing to his left flank area.

With the cot inside, we prepared to get him to the squad.

"Oh, don't you all fuss over me, I can walk to the cot." He said.

Letting him, we got him all belted up and put on the huge, sleeping-bag-like blanket that we carry for the winter months.

Moving him to the squad, his wife came up and tugged me on the coat tail.

"Is it okay if I ride too with you guys. We were here for a borthday party and I don't really drive."

"Of course you can ma'am. I just will have to sit you in the front with me." I told her.

She smiled and was escorted to the truck by one of the firemen where he assisted her up and placed her seatbelt on her.

Putting the patient in the squad, Ken climbed up to start his work-up.  From the front, I can hear the patient joking with Ken as I began small conversation with his spouse.  I pulled out of the driveway and began the trek to the hospital.

It didn't take long to get there and pulling in, I can see that it was one of those days where everyone called 9-1-1.

Opening the doors, I could see a look of sheer discomfort in the patient's face. I could also see that he didn't want his wife to know of the discomfort.

"How ya doing,?" I asked.

"I just felt the pain move down, I think it is just gas. I will be fine." he said grimacing his voice.

We unloaded the patient and transferred him to his room.  It was fortunate we even GOT a room seeing how busy it was.

A little side note here.

  EMH Regional Medical Center (shown here) is our primary receiving hospital and is the second busiest ER in northeast Ohio.  When it gets busy, it gets busy FAST.

Awaiting our patient were Craig and Rich, both paramedics that are staffed by the ER to help with patient care.  The patient moved over to the cot and Ken began to tell Craig what was going on.  The patient sat up trying to get comfortable and then grunted as he said thank you while I wheeled out the cot.

Getting supplies and going out to the truck, Ken and I discussed dinner options eliminating certain types of food due to distance..seeing we were up again.

Loading the cot back into the squad, headlights bounced off the inside of the squad.  Not hearing the diesel rumble of an engine, it was safe to assume that the lights belonged to a private car.

Turning around, a woman jumped out struggling to keep her friend from falling over.

"Do you need a wheelchair?" Ken asked from across the ambulance bay.

"Yes, she has a head injury" The woman proclamed.

Ken looked at me rasing one eye similar to the way The Rock does.

 

Getting a chair, Ken and I went to the car to see what happened and what was needed.

Approaching, the woman told us,

"She fell down the stairs of her house and hit her head."

We got to the car....

I took a big gulp of air.

This didn't look good.

We would need more than a chair....

The clock started......

To Be Continued........

Rounding Third and Heading Home,

M-

 

24 January 2005

The Big Blue Box

24 January 2005

"The Big Blue Box"

Being a paramedic has many different resources at your fingertips.  All which come in handy in the field.

 The defibrilator to help restart your heart.

 Backboards, to keep the spine straight.

 

 endotracheal tube

Even some intubation equipment that helps us make someone breathe.

 

 

 

 

 

 

In all my years in the EMS field, there is one thing that we carry in the truck that still amazes me with each use....

 

 

Dextrose.

 

For those of you who have little insight as to what this actually is or does, I will give you a lay person's description of this drug. 

Diabetes is basically when your body doesn't provide the proper amounts of insulin, which is a natural horomone, regulating the bodies glucose (or sugar). 

(You can click on the link to read more about it)

Many calls we go on for diabetics are that their sugar is low. Normal glucose is from 60-120 mg/dl (miligrams per deciliter).  When I get there, the patients with these complications are way below that. 

The Dextrose (D50 as we call it...50% dextrose in 100% solution) will jump the sugar back up causing, what was once a unresponsive person, to the way they normally would be. Kinda like rising them from the dead. 

I could go on and try to educate you more, but I think I will leave that to the site I posted...and I may comfuse myself even more.

2236 Hours

Finishing the last of my soup, it was all I had left to try to keep me warm.  The remaining carrot that laid at the bottom of the bowl became elusive and just seemed to have a reverse magnetic property to my spoon.  I wasn't going down without a fight. I WILL get that damn veggie or die trying. (I know...a little mello-dramatic). 

Yes, it would be easy to just tip the bowl and sip it up, but I have absolutely NO coordination and it seems like gravity gets just a bit heavier when I do that bring chicken broth down my, once cleaned, uniform.  If I had to, I would break out the big guns...

I would get the fork.

The wind outside howled as the temperature dropped well below zero with the added windchill in effect. 

Remember what the world "Hoth: the Ice World" looked like in Star Wars: The Empire Strikes Back?

 Yeah, when they dressed like that..

This is similar to how it felt in town.  THe thought of even OPENING the bay doors to leave on a call brought a chill to my spine. 

I was already wearing more clothes than Randy from  A Christmas Story

 

and probably wasn't any better off than him either.

It was so cold that the stars in the sky were wearing hats and scarves.

Then...of course....

The phone rang.

"93, you are going to XXX Street for an 84 year old female with low blood sugar."

Backing up a bit, I will review the previous two calls also.

You can click here to add a little travelling music with the calls...and pretty much how we ran.

First call..

In front of the courthouse for a man with low sugar.

On scene..sugar is 28 (remember your limits).  Felt fine (so he said) and said he just needed to eat. Passed our test, signed him off to his boss who drove him to lunch.

Next call.

Low Blood sugar uptown.

Fire Department got a reading of 31.  Male is sweaty and kinda combative and beligerant. (This is normal when sugars get low.)  Held him down, started a line, gave him some D50, sugar came to 287. (High, but body is compensating. Patient became alert, thanked us, refused further care, signed him off and went back to the station.

AndNow....

I think if I could have found anything else to bundle up in, I would have grabbed it.

The squad is rather cold although the bays are heated. The seats are that great vinyl which, in the summer, roasts your ass to your pants, and in the wintertime, becomes so slippery that if you don't wear a seat belt, you will slide right off. You thought Armor-Alling a vinyl seat was bad...

So, here we are. Off to try to do it once again.  The snow was so frozen, that it crunched under the tires. The sound was audible even over the wail of the siren.  The roads were rather empty as the cold had forced a lot of people to stay indoors.  Man, I can't blame them. I wanted to be indoors.  I hope the drugs don't freeze.

Getting there, we parked right behind the big, red fire truck (seeing that is the ONLY place we could park) and grabbed the gear and went inside.  Trying to watch where I go, it was only a matter of time before I fell on my ass once again (oh yeah, I have done it more often than not) and  feel all the blood rush out from under me to warmer parts of my body as I lay stunned on the snowy floor.

Walking inside, I noticed the room being lit only be a single 60 watt bulb in a lamp just right of the couch without a shade uncovered, producing shadows of all the clustered stuff piled on the table. In front of my were the 3 firemen who were on the truck. One grabbing a blood pressure, another to the patient's right getting a blood glucose level and the other on my right obtaining information from the patient's husband.  The room was rather cold and the only heat felt came from the kitchen where the spouse had lit the stove in means to stay warm.

On the couch, in front of me, the patient sat leaning to her right, incoherent and very partially dressed.  Sweat rolled from her skin, yet she was very cool to the touch.  SHe responded only with some verbal stimuli.

I didn't need to wait for the result of the sugar check. I was making my way for the big, blue box.

Ken spiked an IV line for me and I got a tournequet out to occlude the blood flow and start an IV line.

The results were in...her sugar was 25 mg/dl.  This is WAY too low.

Pulling out an 18 gauge needle, I got an immediate flash in her right Antecube (a big vein right at the bed of your arm opposite of the elbow). The line flew and dripped without problem. 

Now....it was time....to give the Big, Blue box.

Hooking up the syringe to the IV med port, I shut off flow to the bag and began the slow, strenuous push of the medicine.

Side note here. Dextrose is not easy to push.  It is not like on TV where after a second, the doctor goes, "Okay, it is in."  The Dextrose itself is very thick and hard to get in. 

Try this. Take a fresh tube of gelled toothpaste. Leave the cap on. Poke a hole in the top of the cap with a sewing needle then try to push all the contents out as fast as you can without stopping. Oh, and refigerate the toothpaste for about two hours so that it is thicker.  Oh yeah, you can only push from the back using ONE thumb and you can't squeeze the middle of the tube.  That is kinda what it is like.

It took me a little over a minute to push the drugs and wait for a response...

And wait...

and wait...

and wait.

And then....

She began to come around as if someone had turned the switch on.

Rechecking her sugar, the new reading  showed a level of 313. High, yes, but that would burn off really soon.

We went from a patient who was drooling at the mouth, not able to talk, to up and yelling at her husband, who, by the way, was being yelled at by the fire department for lighting the stove to keep warm and having that smell of gas imminate through the house. (The furnace worked by the way, he thought he woudl save money this way).

We loaded the patient on up and took her in by her request.

Chatting with her in the back, she was a rather pleasant lady in whom you wished the ride was longer because she was just fun to talk to.

All this was two shifts ago. Yesterday, the squad went back for her...again...

Apparently, this is the fourth time in as many days that she began to frequent the hospital for the same problem.  This is where I shake my head.

There are so many things that still amaze me about my job and so many things that I carry that I take for granted every shift, but am glad that they are there when I need them.

It is a funny thing we do in EMS.  Think, 20 years ago, we would have had no clue as to what to do and the idea of treating in the field and letting them stay home was uncalled for.

The ones that change for the better is thereason I do what I do.

God, you have to love the big, blue box.

Rounding Third and Heading Home,

M-

23 January 2005

The 10K Run

23 January 2005

"The 10K Run"

No, you don't have to tighten your Nike's.

We actually aren't going anywhere.

I, DID, however, reach the 10,000 hit mark, thanks to all of you who read faithfully and keep coming back time after time.

I really do have to thank all of you who take time and stop by my meager little site to take part of not only my day at work, but part of my life too.

I am at work today so tomorrow, I will have a new entry for then.

Thank you all again.

Rounding Third and Heading Home,

M-

19 January 2005

Ticket to Ride

18 January 2005

 

“Ticket to Ride"

 

Looking back at my career and my time that I have spent in this field, I have encountered hundreds and hundreds of people who have requested the services that I help provide.  In a high majority of the calls that I go on, a deep emotion runs including that of compassion and sympathy to their specific needs at the time.  Whether it is creating a better, stable environment for them to be in, or just someone to talk to, having some charity is part of the job, and it is a part that I enjoy offering

 

However…

 

There are certain things, certain people that just set me off and, in essence, waive the sympathetic policy that I have within myself. You see, I have a two and out rule.  I will be nice to you initially. If you get mouthy with me, or act like “Billy Bad-ass”, I will continue to be cordial and show some respect towards you.  If you continue, then the game is on…

 

Some people that I don’t play well with are drunks.  Hey, I didn’t force you to put that alcohol down your throat. I didn’t force you to get too mouthy with a cop. I didn’t force you to do the most stupid thing in the whole entire world and get behind the wheel of a car and operate it…crashing into someone and ruining his or her life.  So, you need my help after you decided to pick a fight with someone that was three times your size and two feet taller than you who knocked you into the next zip code and now you are bleeding but, yet, decided that you will STILL try to play kind of the mountain and get lippy with me.

 

I have nine words for you.

 

“Get in, sit down, shut up, and hang on.”

 

Medical care is secondary.

 

Next, which I think is worse, is the people who create themselves to be a bigger victim than they are for the sole purpose of attention…then try to hold their ground by copping an attitude. 

 

Pfft…please!!!

 

These are the ones where, we in the EMS field, become “bitches and bastards” and a few other choice words

 

With these people, I have absolutely NO tolerance and a needle the size of the Alaskan Pipe Line.

 

These people are the spitters, and punch-throwers. The one who has to have a tantrum just for show.

 

These are the ones that I start VERY large needled IV’s in…just because I can.

 

1537 Hours

 

Today was one of those days where, if you were a penguin, you may have been comfortable. But for all of us who like to maintain a normal body temperature, it was WAY too cold to be outside.  A good movie, some hot chocolate, and perhaps a nice blanket was all I needed to make me a happy camper.

 

Oh, and someone to remove the phone out of the station.

 

RING RING

 

Of  course…

 

“93, I need you to respond to XXXX Drive for a female who cut her wrist and is bleeding.”

 

Well, what did you THINK would happen if you cut it?

 

With winter, comes snow. With snow, comes cold. With cold, comes depression.  It seems like the holiday season has extended and is carrying on well past the new year.

 

Is this a cry for help or is this an attention getter.  In 6 minutes, we will know.

 

The weather was so bad that even at speed limit speeds, it felt as if we were going way too fast.  Going onto the west side of town, we were just around the block from where I used to live. With this, the country setting became more prevalent…so did the blowing snow.  In the snow, people don’t pull over, they just stop. I am sure they will pull over once we slam into the back of them.

 

Here’s a clue…

 

MOVE OVER

Sigh.. okay..I am better now.

 

Getting into the parking lot, I say that the boys in the big, red truck have also shown up to initiate some sort of care.

 

Walking into the living room, a distraught 19 year old female sat on her couch with a look of disgust on her face.  Her mom sat in the background wiping away a tear. Fire was tending to the wound.

 

“What’s going on here?” I asked.

 

“What do you care, I don’t F***ing know you, why the F*** should you bother?” She told me.

 

Stunned, I threw the jump bag down and waived her right for politeness.

 

“Are you trying to harm yourself?” I asked a bit more sternly.

 

“Yep, sure am. I want to die. No one wants me so why the F*** should I bother.” She said in her “matter of fact” voice.

 

“That’s not true” the fire guy tried to be compassionate…I was way past that point.

 

“F*** you, yes it is.” She snapped back.

 

“Hey, Your highness. You don’t need to get shitty with us. We are just trying to do our jobs. We didn’t make you slice your wrist.  Now, get up, stop bitching, and get your shoes on.” I told her already fed up with her.

 

“Why, I ain’t F***ing going anywhere.” She thought she would tell US what to do.

 

“Oh no, dear…you don’t understand. You are OBLIGATED to go. You told us you wanted to kill yourself. You just bought your ticket to ride. Now, you can either stop acting like a three year old and put your shoes on and go voluntarily to the hospital…”

 

“OR WHAT?” she interrupted.

 

“Well, you will put up a fight, the police, here will try to control you, you will struggle with them, they will take you to the ground, you will still struggle with them, they will pepper spray you, you will get to wear their metal bracelets, you STILL go to the hospital, AND you get charged after all of that.”  I informed her.

 

Ken threw her shoes at her (in a nice way) and huffing, she got up and was escorted to the squad. She gave the cops a little attitude as they sat her on the bench seat. What a pain in the ass. I was wondering if I rub Preparation H on her, will she will go away.

 

Looking out the window with a quite chilling look, I told her, “Don’t even think about it. You want to jump, I can see it. Well, I don’t have a parachute so do me a favor, if you jump, do it in another township so I don’t have to get you again.”

 

She didn’t flinch. It was rather scary.

 

Once to the hospital, it was time to go. She didn’t move. I undid her seatbelt. She still decided to stand off.

 

“Okay, here is another choice for you. You can A) get out and walk in on your own, or B) I can hog tie you and put you belly down on the cot and take you in.  I am done playing with you and your “holier than thou” attitude.

 

Fortunately, she picked “A”. Good, I didn’t feel like wrestling. Besides, I am not supposed to do any physical activity for at least 45 minutes after I eat…I may get cramps.

 

Walking her in, I was met by security who took over her escort into the, already busy, ER.

 

I went to register her…then wash my hands…she made me feel disgusting.

 

Folks, I don’t want you to think that I have no feeling and that I treat al my patients with harsh feelings and a below average care. Like I mentioned in the beginning of this, there are certain things that set me off..she was one of them.

 

I hope you all are well and that you are staying safe.  It is cold out there (unless you are in Florida or California where it is wet) so bundle up (or down).

 

Until next time…only 29 days till spring training starts.

 

The clock is ticking.

 

Rounding Third and heading home,

M-

12 January 2005

In A Word....

12 January 2005

"In a Word..."

Whew, what a day at work.  I don't even know what to type about so I will pose the question.

Do you want to know what happened???

NOTHING!!!

Above is a picture I took of the two bracelets that I wear and why I wear them.

 

It was a rather boring shift and nothing worth writing about so, instead of making up some lame story, I thought that I would take a few moment to talk about something that is a little closer to home, and most of all...something I believe in.

Now, I know that everyone has seen the yellow bracelet either around town or on television. It is the biggest craze presently in the fashion world. Everyone from celebrities to ordinary Joe's sport this latest fashion statement as to be part of the "in" crowd.

But do you really know what they mean? Do you know what they stand for?  I will try to explain.

NEW LANCE ARMSTRONG LIVESTRONG ADULT BRACELET LOT OF 10First, the Yellow "LIVESTRONG" bracelet.

You all  know Lance Armstrong???

  Yeah...this guy.

He is the Ameerican that won the Tour de France...seven times..in a row.

Oh yeah...He beat cancer too.

For those of you who follow my journal, you know my battle with the disease within my family. For those ofyou who are new,  Click here to read a little more as to my journey with it in my personal life.

The Lance Armstrong Foundation is an organization that was created, in conjunction with Nike and Lance, in which, proceeds that are collected benifit cancer research and helping those in need that are associated with it. 

I am not going to dwell on this topic much more seeing that I have written about it and the clickable link will give you more insight than I can.  All I can say is that I cannot give enough praise to this organization and I hope that it exceeds any limit that it sets.

And as a cancer survivor (my mother had it, I didn't) I can say that the cause is well exceeded by the means.

ORANGE MULTIPLE SCLEROSIS YOUTH BRACELET * " I WILL" * Next, the orange "I WILL" bracelet.

Here is a bracelet that you may not be too familiar with but I will try to give a little insight on.

The orange bracelet represents, MS (Multiple Sclerosis),

Multiple sclerosis is a chronic, unpredictable disease of the central nervous system (the brain, optic nerves, and spinal cord). It is thought to be an autoimmune disorder. This means the immune system incorrectly attacks the person's healthy tissue.

Most people are diagnosed between the ages of 20 and 50, although rare individuals as young as 2 and as old as 75 have developed it. MS is not considered a fatal disease as the vast majority of people with it live a normal life-span. But they may face a struggleto live productively, often with increasing limitations.

 

Approximately 400,000 Americans acknowledge having MS, and every week about 200 people are diagnosed. Worldwide, MS may affect 2.5 million individuals. Because the Centers for Disease Control and Prevention (CDC) does not require U.S. physicians to report new cases, and because symptoms can be completely invisible, the numbers can only be estimated.

The information in blue is referenced from National MS Society website. I encourage you to read it.

So, why do I wear it?

Bev has MS..and I believe in her..so I believe in MS.  It is something that am in the process of educating myself in more and the more I read, the more I am fascinated with it. Again, it is a cause that I cannot say enough about.

The bracelets are only $1 and the proceeds that go from their purchase go towards their respective fields.   It is truly a way to state "I care" and take a piece of something close to you that has affected your life with you....everyday.

I hope all is well and I look forward to hearing from you.

Be safe and wear your seatbelt.

Rounding Third and Heading Home,

M-

10 January 2005

Load and Go

09 January 2005

"Load and Go"

Every three days, I don on my navy blues, finish lacing up my boots, and drive into town to pull, yet another, long and sometimes tiedious shift as a memeber of the EMS division of our city.

I don't do it for the money (because there isn't any) or for the glory (because you are only critizied for the things you do wrong). I do it for the challenge.  I do it because I love to have the oppurtunity of taking a stressful situation and turning it into my office work.  The more I get a chance to think, the more comfortable I get.  I would have made a great quarterback that was down in the count with 2 minutes left in the game. (but I have very little coordination and I really don't like getting hit.).

In the back of the squad, there is no nurse, no respiratory therapist, no pharmacist, and most of all..no doctor.  It is just you and you alone. Sure you may get an occasional firefighter to go with you but, even that, is a 50/50 chance that you have someone that knows what they are doing...or someone who is just taking up space.

Load an go takes on a new meaning...Unlike the full arrest where the only way for them to go is up.  Critical patients in which we put in the back and just take off (hence "load and go") are what makes us such great critical thinkers. Does your patient get better, or do they get worse?  It is up to you, and you alone when you are back there. The only thing between you and reaching definitive care for your patient, is that 6 mile stretch of road that is filled with traffic, weather hazards, and the hope that you get there in time.

The clock is ticking.....

1400 Hours

Hearing the back-up alarm echo inside the bay, I finished up my report from two calls ago. Apparently, the people of the city had miracuously remembered how to dial 9-1-1 and we are playing the "hey, is that the ambulance I hear? Hmmm, I may need it too" game. Ken put the truck in park and lookin gout both windows, it looked like we were up again for the next call.  Putting my PDA down, I decided to run inside and try to throw the Subway sandwich I stopped and got down my throat before the phone rang again.

In EMS, fast food takes on a whole new meaning. Itis more than something you can just get in a drive-thru. It is something that with three bites, you can finish it. Ususally, we don't have to taste it as that would be a luxury. Believe me, if paramedics and EMT's could get tube feed, I am sure that it would be a requirement when working in a busy city.

Unwrapping the foot long meatball sub, its Italian aroma stimulated my brain. the melted provolone drizzled the bread as the marinara produced a steam that made one's salivary glands kick into overdrive.  Mmmm..Lunch was here!!!

Then, of course, the phone rang.

Savory bliss will have to go into the fridge.

Walking out to the truck, I checked the MDT to see what it was that we were going out on.

"33YOM Shortness of Breath" the line read on the info screen.

Hmm...maybe he just needs a quick treatment, sign him off, and back to Jared's creation.

Still smelling my sandwich, we pulled out into the wintry wonderland and began our trek to the northwest part of town. I think you could hear my wimpers from the station.

Pulling around the corner, the fire department marked our destination by parking their truck right in front of the driveway. How typical.  I grabbed our bag and headed for the house. Time to play paramedic.

Walking in, I noticed a gentleman on his knees holding himself up in obvious distress trying to catch some air.

At this point, I forgot about the sub. My mind entered an "Oh S***" mindset.

Looking closer, I noticed the paitent was very diaphoretic (sweaty) and it was just a matter of time before he became too tired to breathe on his own.

Trying to get information from him, he was only able to answer in short, one word sentences. Another bad sign.  This guy was going down..and fast.

Listening to his lungs, I could hear very little movement of air exchanging in and out.  Puunching it into overdrive, I had a couple of the fire guys get our cot. Ken drew up some Epinephirne for me. I gave the patient an Albuterol treatment by mask and then injected him with the Epinephrine.

Nothing....

Time to pack up and go...and go really fast.

Loading him up, I told Ken to just take off and that I would do everything en route to the hospital.

Inside the truck, the patient became more sweaty and was having a tougher time breathing. 

The sirens kicked in, the truck shifted, we were on our way.

Hooking him up to the monitor, his heartbeat was WAY fast at about 145 beats per minute. The fact that I gave him the Epi and the Albuterol didn't help the cause much, but it was time to rob Peter to pay Paul.

I gave another treatment as I began to pray to God in the back of the rig.

Looking at the patient, I can see him getting tired...now I started to sweat.

"Sir, if you have anymore trouble breathing, do you want me to breathe for you by putting a tube down your throat?" I asked. I didn't want to, but I did.

He nodded.

I gulped.

I began to start my IV line while Ken called in the report for me from the front.

Taping down the line, I looked up to hear the patient wheezing. Normally this would  be a bad sign, but for me, it was a sign of relief.  From no sounds to wheezes meant that the medicine that I gave him was working. Good, I think I would need some medicine had it not.

"Are you breathing better?" I asked him.

"Yes...a little"

SOLD...I will take that.

Getting into the ER, we wheeled him into what looked like a war zone. Beds were lined up along the wall. There was hardly any room to walk.

Did a building fall or something that I should know about???

Within a minute or two...we found a bed.  Good, I was sweating this one a little bit.

He was discharged a few hours later.

I went to my Subway sandwich...it was cold..and just not appealing anymore...sigh..

I ate it anyways.

Hey, I gotta eat...

Rounding Third and Heading Home,

M-

 

 

07 January 2005

A Hop, Skip, and a Jump

07 January 2005

"A Hop, Skip, and a Jump"

Happy New Year to you all!!!

Yes, I know it is one week afterwards but I thought I would give you a chance to sober up a bit and remember how to turn the computer back on.

Ahh, with the new year is change, oppurtunity, aspirations, and most of all more stories to tell you.

As some of you know, I have spent most of the holiday season moving which had made my online time very limited and adding the gentle factor of snow...close to four feet total so far this year, the work load has increased as the need for EMS has also grew.

Well, it is time to put the drink down, pay the tab, and get back to work here. Life as a Paramedic returns......right now.

I know you all have heard the phrase "A hop, skip, and a jump" at some point in your life and if you haven't, consider yourself learned.  It usually refers to the point of being realitively close to a certain location. For all intents and purposes, I will use it to describe what has been going on in my life at work..or so the story goes.

A Hop.  More like Hopping. This is what we have been doing at work lately.  You know how they say that the flutter of a butterflies wings somewhere around the world is the start of a major storm here where we live?  This is true..and let me break down how and why.

The butterfly flaps its wings creating a disruption in air flow that changes the wind pattern slightly sending the downward draft in a more upward stream. Seeing that this current has now created a high pressure system in the atmosphere, the clouds are forced to stay at a higher altitude.  The higher you go, the colder it gets. The colder it gets, the denser the precipitation becomes turning water into ice and snow. That breeze becomes part of the jet stream that now pushes these clouds over the northern hemisphere. Because the clouds are heavier and darker, they make light harder to pass through creating a reflective barrier somewhere in the stratosphere eliminating the moon to regulate gravitational pull upwards. Meaning, things are heavier on the ground. Gravitynow pulls the snow down and it ices over creating a horrible storm front. Things freeze over, schools close, people don't remember how to drive in adverse weather, they crash causing a simple breakdown in emergency services. With the services stressed, people get impatient waiting for a squad, fire, or police so they tend to take themselves to a facility appropriate for thier needs. Gravity pulls them down. Now they HAVE to wait for EMS. And with all of this, I have to get dressed in the middle of the freaking night in more clothing that all of Sears sells just to stay warm, sit on vinyl seats in an already cold ambulance, to drive cross town so I can fall in the snow with a bag that weighs more than a Thanksgiving meal in your belly. This increases my swearing which imminates a steam seeing that my breath is warmer than the air around. That steam fluxes the air current around vectoring the beginning of a warm front that is carried across the ocean into some far off jungle warming the larva of what was once a catipillar that soon will become a butterfly that will break from its cocoon and repeat the circle of life...all over again.

I know..I have too much free time on my hands.

The Skip. This is what Kim did. Kim skipped out on me. (Not really) Kim and I got "divorced" as partners. No you all, we go along fine. We weren't fighting or anything like that. Kim got a better job working at MedFlight which is based out of Columbus.

MF_Closeup01.jpg (76760 bytes)

MedFlight is the primary medical helicopter service in the middle and southern part of the state.  Recently, they opened up a ground unit out in this area in which Kim is operating on getting her foot in the door as to go on the helicopters someday.  I already miss her and I wish her the best. She is in Bev's bridal party so I am sure that she will be around...besides...I know where she lives...

Take care Kimmy, I miss you already.

The Jump. Well, with Kim gone, I am jumping trucks. 91 was a transport truck for the first 8 hours out of the 24 that I work. After that, it falls into the rotation that we run at our location.  My new truck is 93 which I orginally started out on way back when.  Ken is my new partner.  I have known Ken since 1990 when we both worked for the big red-shoed clown shoving burgers in a styrofoam container, adding a medium french fry, and when 22 oz. was a large drink. 15 years later, here we are again.  Kinda like a reunion of sorts.  Ken is going to PA (Physician Assistant) classes and I am sure will be gone in a matter of time, but for now, I will enjoy his company.  93 is in the 9-1-1 rotation from the time we come in to the time we leave having to take the occasional transport.  It will give me more time to relax and should bring my burnout level down a hair or two.  It will also create for more great stories.

Well all, it is off to the races. Tomorrow is back to the grind and I have some running to do before hand.  I made a resolution as to write more and try to keep your attention better.

A quick thanks to you, my readers, who made 2004 a great memory for me and had lifted me through the ruts and creavases that I found myself in more often than not.

I promise to try and not let you all down.

Take care all....and stay safe.

Rounding Third and Heading Home,

M-