19 March 2005

A Picture Tells a 1000 Words II

19 March 2005

"A Picture Tells a 1000 Words II"

The World we live in is filled with many different aspects of life whether it is good or bad.

Unfortunately, we focus on the evils of our society and take for granted the sheer beauty of the world we live in.

Below are some pictures that I have added to marvel at until I return to the grind on Monday.

I hope you enjoy and let me know what you think.

Have a great Weekend...

 

 This first one is called "Holding the Sun"  An incredible shot taken with only a simple digital camera.

 "The Edge of the Hurricane" has to be my favorite. Just the sheer and raw beauty of nature is speechless.

 This next one is called "Fire-Starter". Just and overall amazing picture.

 I call this one "Wish you were here."

See ya all soon

Rounding Third and Heading Home,

M-

 

 

17 March 2005

Absence of Malice

16 March 2005

"Absence of Malice"

Somewhere in the heavens above us, a greater, yet unknown, power somehow controls our lives and the actions we do while frequenting this planet that we live on for however long that shall be.

While not only giving us life, we are granted other, what may seem insignificant, portions of our life. 

Breaking down to just one, the focus of this will be on emotions.

Happy, sad, angry, depressed, giddy, suprised. These are just a few emotions that have overshadowed us and actually play a role as to who we are and why we are here.

But what happens when we let our emotions get the best of us? What happens when we let emotions control our lives and our actions? 

Regret, sympathy, fury, remorse. More emotions, more loss of control.  At the end of this vicious cycle, someone or something gets hurt. The damage is done. The life has been altered irrelevent of the outcome...forever.

2105 Hours

Heading home from a long twelve hour day, the road that was oh, so familiar signified the anticipation of just being home.  As the travel lengthens, the landmarks around host a sense of reaching the final destination of the day...home.

Admiring the crisp, starry night, it seems refreshing as the stress and mundane routine that has occurred, slowly begin to melt away. The curves in the road are known all to well. Passing this tree, only 15 minutes till a nice, warm bath. This stop sign shows 10 minutes until the gaze of the loved one is met for the first time all over again. 

Stopping at the stop sign which was crossed several hundred times, the intersection laid deserted. To the right, a train crosses the tracks and illuminates the sequential red lights of the crossing. To the left, a school lays quiet for the evening. Resting from a day of busy activity, preparing for tomorrow. It is only her and what seems to be an approaching vehicle that has just come around the corner some ways down.  Time to continue to the promised land.

__________________________

Fury, that is all that is going through her mind right now.  Taking the turns sharply, it is imperative that she gets away from the one that has upset her and has induced this unorthodox pursuit. 

Hard to believe that just under an hour ago, a party entertained two people very into each other.  The inhibition of alcohol and the increasein emotion has triggered the fight or flight system.  The only thing that is in focus now is to disengage and walk away.  Not so easy when the argument takes to the street.

Twelve miles later, the argument persist, or so does the pursuit.  Fury turns into panic. Fear has replaced rage.  The chain of goals has prioritorized into only one finish mark now...and that is to get away.

Taking a corner a little to fast, it seems as if the pursuer has not lost a step. Desperation sets in. Pulses raise. A quick turn has left a stop sign in the peripherals failing to negotiate.  He is still there only getting closer. The gas pedal is squeezed even more as the need to get away increases.

Looking over the shoulder to see where her aggressor is, the second stop sign closes in even faster. Without regard, speed increases, fear fuels the soul. The need to flee is at a pivotal point.  Turning to look ahead, the intersection has been approached faster than she thought. It was too late to stop for this sign also. But unlike the first one that was blown through, this intersection carries something that the first did not. This crossing has a heightened value.  This intersection has a car in the middle...and stopping now has become a luxury that is no longer an option.

2110 Hours

Grabbing something to drink, Shawn and I sat two of the three couches preparing for the season premiere of "The Shield". 

In the far, back couch, Ken sat doing his last run report on the PDA.  Grabbing the remote from the floor next to him, Shawn sprawled out increasing the volume with his left hand while sipping his Diet Coke with the other.

It felt good to relax. School had only taken part of my energy admist the busy night that we had after coming in afterwards.  My knees felt like hot, rubber tires that had just run a 500 mile race. Sizzling under the intense pressure simply exausted. It felt good to sit. It felt even better to stretch.

The Motrin that Ken gave me had finally set in enhancing the relief that I began to felt with the relinquish of fatigue that had set in early.

Feeling the blood begin to rush back to my legs, I took a sip of my beverage only to be interupted mid-gulp for the phone ringing.

"91 and 94.  _____ and _____ for a two car MVA with entrapment.  I have gotten multiple calls for this so both respond code 3. Fire is en route also." The digitally enhanced voice came from the the other side of the line.

Ken was already up. I relayed the news to Shawn. It was go time.

For some reason, it seemed as if the stakes were heightened. Both crews ran to the squads as if we were fighter pilots scrambling for an intercept of enemy aircraft. Confirming the address, Ken hit the garage door with simultaneous activation of 94's door. The once dark and gloomy bay room that housed the three squads, quickly turned into a spector of red and white strobes and halogens illuminating, not only the room, but the surrounding blanket of night.  As the squads roared to life and the smell of diesel filled the air, marking the beginning of another rescue. Someone needed us. We were on the way.

Almost literally around the corner from where we are stationed, the accident got up to us in a hurry.  Coming around the corner, I saw a line of cars with their hazard lights blinking. It almost looked like a runway at an airport as the sequence of amber lights flashed guiding our way. 

As we approached, my visualization focused on the pick up truck directly in front of us surrounded by two police cruisers.  Passing by to park, I quickly surveyed the damage to the truck with my big focus on the passenger compartment...which was empty, the way I wanted it to be.

CLimbing out of the rig, I put on my reflective jacket, grabbed our jump kit, and headed over to the truck.  In front of me, many people lingered, including the driver of the truck, who appeared unharmed.  Asking if everyone was alright and accounted for, their eyes shifted down the road. Suspended in terror and shaking with the situational fear, a female pointed barely getting out "Please go check her. I think she is hurt really bad."

The woman appeared to have the fear of God enbalmed in her. Her trembling obvious. Her emotions genuine. She was the driver of the truck.

Looking down the street, I noticed a small car that was wrapped up in a chain linked fence with mild smoke coming from underneath.  The damage to the car was severe. The entire driver's side door had been crushed and intruded about a foot into the passenger compartment. The front end of the car was buckled leaving it smoking and completely destroying the engine and transmission.  An array of glass had been stream-lined well beyond just the point of impact.

And...the driver was still inside.

Hurrying to the car, I noticed our patient. A female in her 50's who was awake, but barely responsive.  She got hit hard.  She needed to get out now.

Assessing further, I realized that the only way to get her out was to cut her out.  The impact had folded the dashboard in half pinning her legs under the pedals of the car. The door handled laid evenly in line with the patient's stermum. On my side, the center console had become detached and elevated eliminating the possibility of getting her out there.  Time to get to work.

Shawn came up behind me and proceeded to get into the back seat.  Making his way in , he grabbed a book to kneel on as the glass sprawled out all over the rear seat.  I turned the car off and put it in park. It really didn't make a difference, the engine wasn't attached anymore.

Shawn grabbed c-spine control and I began to assess the patient a little better.  Calling her name which was identified by the name tag from her company on her right lapel, the only response that I got was moans and occasional eye contact. No "please help me", no "I hurt", no "what happened".

Not even a minute later, the fire department showed up. The lieutenant in charge was a buddy of mine surveying the damage.  Peeking in, he asked as to the game plan.

"Hey Mike, what do you want to do?" He asked.

Without thinking further "Cut it. She has to get out now." I told him.

Before finishing my sentence, the rescue truck had arrived on scene already preparing their "Jaws of Life" unit.  Light towers went up illuminating the scene like a ballpark in the summer's night.

The sounds of generators cancelled the quiet of the wintry night. Shawn and I began our survey. 

Working feverishly to get her out, Ken had supplied me with the equipment that I needed to assess the patient better.  We collared her and began our rapid trauma assessment while still in the car. A fair amount of bleeding came from her head somewhere, coupled with her altered level of consciousness, the critical hour began to tick louder and louder.

Shawn began to cut the clothes of the patient as I took over spinal control as for easier examination once placed on the board. What seemed like hours were only minutes. The intensity began to create sweat on my brow.  I could feel me getting warm.  It didn't matter, I wasn't about to leave to adjust.

Within eight minutes, the door was free of the car and the extrication resumed getting the panel free fron her legs.  Working with the firefighters, we used tin snips to cut away the destroyed plastic freeing the patient finally. 

The group effort continued and placed the patient on the board where she was secured, then moved to the squad.

I ran ahead to the truck and prepared for her to come.  Pulling two liter bags out of the IV warmer, I hung them so Ken could start lines if needed.  Locking her in, Ken was up in rotation, so he was in the back...and he was ready to go. He would do everything en route.

Jumping up front, I began our decent to the hospital. Traffic at this time of night is light leaving us a clear shot to the emergency room.

Unloading her, we were met by the staff whisking us into a trauma room. The craziness began. Nurses, doctors, techs, everyone began to rush in to lend support and stabilize the patient. Then a head poked out...asking for a helicopter.  I knew that this was coming, she was in bad shape.

Ending here, I got the cot  back to normal and restocked the truck for the next run.  I don't know what the follow up was on her but I am anxious to find out.  If I do, I will let you all in.

Well, off to class. Today is my ACLS refresher (Avanced Cardiac Life Support).

Everyone, have a safe holiday and think before you drink.  The above accident was alcohol induced...and could hav been prevented..with a little common sense.

Rounding Third and Heading Home,

M-

14 March 2005

One Wild Ride

14 March 2005

"One Wild Ride"

Today is day one of my paramedic refresher so as I turn to a week of sheer boredom and review, I thought each day that I would add a video as to things we have to take care of and some excellent footage of chases and crashes..

This will help me with my trauma assessments.

Stay safe.

Rounding Third and Heading Home,
M-

Pursuit Number 1

11 March 2005

Clarification

11 March 2005

"Clarification"

Okay, for all of you who are going off the deep end as to reason 10 of the last post, let me clarify something.

I agree with the last commenter as to the pleasantries of the patients that have abnormal values. They are usually pleasant and fun to talk to. Yes, I realize that something needs to be adjusted with thier chemistry, but do you have to dial 9-1-1 for it.  I would be more than happy to come and take that person over to the local hospital for you so they can get better. I do it on a daily basis. My question is, can't you just call the regular number and schedule a transport for this patient. 

I realize that there are some values that need immediate attention such as pulse ox that is low. That requires immediate intervention which is crutial with time. 

I guess that I should have added to the prior entry that when I DO get these people, they have had the critical values back for well over eight hours and it is usually the middle of the night that they need to go.  This is due to some of our lazier nursing homes.

Now, you can't tell me that "Oh, well we have to wait for the doctor to call." No doctor is going to take over eight hours. My girlfriend is an RN in a home so I know the system.

I didn't mean to offend anyone in the profession and even though your comments are that of, well, let's just say approving, your opinion is your own and that is part of this journal.

In retrospect, I do know that there are paramedics that have VERY short leashes and treat everyone as if they were subservant. This I disapprove of and try to respect those who call. I DO have trouble with the ones who call us and act like their crap don't stink. They usually point to the patient's room and say "They are in there" and are not seen again so I have no idea as to what is going on.

So, to sum it up, I apologize for those who are offended and think that I am belittling their skills, however, it is the method as to HOW they do it sometiome that qualifies them for that list.

Thank  you for your time

Rounding Third and Heading Home,

M-

07 March 2005

Top Ten Stupid Reasons People Call the Ambulance

07 March 2005

"Top Ten Stupid Reasons People Call the Ambulance"

As the weather begins to melt somewhat here in the great northwest, so do the brains (or lack thereof) of some of the residence that we service.

With this, call volume has alomst tripled where I work and we are on pace to break close to 63,000 total runs for the year. 

Now, with the cold and flu season that has dawned on us, more people are in need of the rescue squad for a combination of multiple things.  For the most case, these calls are legitimate and have warranted the need to go to the emergency room.

However....

There are a few select people who think they can beat the system, or are just sheer clueless as to why to call the squad.

Below is a list that I have put together based solely on the people that I encounter.

Look behind you, these people are out there.

10.  "He has critical lab values" This comes from the nursing home staffs after they take blood from a residence and get the results back.  Now you may be asking "what is considered critical?"  Here is the last one I took for example.  A nursing home called for a female who had a low hemoglobin count.  Hemoglobin is the thing that makes oxygen bond to your blood cells to travel throughout the body.  Hers was 7.1. Normal is 11.  Would she have died from this? No. Would she have gotten sick from it? Perhaps, but you are in a nursing home...with nurses...who have more training than I do...and a doctor in arms reach. Oh, and did you happen to factor in that this patient has cancer which is already gonna alter your values.

So, what do I do for these people? Nothing. What CAN I do other than take them over to the ER so they can get more blood drawn, find out it is not critical, then I go to take them back...where the next shift will call and do the same thing all over again.

9.  "I didn't want to wait for a cab" WHAT?  Because you thought that the 20 minute quote that the cab company gave you was unacceptable, you decided to dial 9-1-1 so that I would come and get you for your hangnail that you have had since sometime around Christmas...of last year.  Instead of paying $5 dollars for your trip, you are now going to get a bill for $500 and I don't have the evergreen tree air fresher in my squad.

8.  "She needs to go with you" Nothing upsets me more than the caregiver who calls the squad for, well, the basic reason is that the person they are taking care of is annoying them and they need a break.  Hey..look....POOF...you have shortness of breath.  We get there and talk to the patient who is more with it than us who really doesn't want to go but is, for lack of a better way to put it, forced to go by the care giver. Vitals taken are better than mine and the griping of the patient has increased due to the haphazard caregiver who pretty much, just wants them out.  I hope they come back and make you turn the channel for them...every two minutes.

7.  "I heard this on the news..." Whether you agree with it or not, the media is the one who controls this country and ultimately the knowledge that you and I have.  People see on the news, that the latest flu virus has killed a person and that you, as the general public, should get checked out immediately if you show symptoms.  One has died....out of 10,000,000. So here we go. You get the sniffles, here we come. You get a sneeze, here we come. You get nauseated, (not factoring in the large Mexican dinner you had), here we come.  The media, in whom you consider a source that is educating you, has induce a panic in which they think that the end of the world is near.  When I read Revelations in the Bible, it never mentioned ANYTHING about the death of the human race due to congestion. Maybe that page got torn out of my book.

6.  "I ran out of medicine" Um..okay...and what would you like me to do about it. I mean, if it is a true medical emergency where you may need an Albuterol treatment for your asthma, then I would be more than happy to help you, but because you ran out of your antibiotic for your infected toe...Sorry if I am laughing here.  This actually has happened so this is why I add it to the list. C'mon people, it says rescue squad, not Pfizer Pharmecuticals...Hold on...I have to check the squad to make sure.

5.  "I don't have a car"  This is a subset of the cab thing.  These are the people that you roll up on scene, have every single family member there, and out of the small sales lot of cars in the driveway, doesn't own one of their own.  There is a prerequisite for this too...It HAS to be around 2 AM. This is a given.

4.  "I thought it would go away" Now before you crucify me with this one, this is for a special breed of patients. These people are the ones that have beensick for over a week, have not gotten any better, and on a late Sunday night, need medical care with the excuse "my doctor is not in so I called you." Well, most private physicians are usually NOT in at midnight on a Sunday morning and I could see how they were not in the office ALL WEEK that you were sick.

3.  "I need to go to this hospital where I am being admitted". Okay, A) They are usually dressed and waiting for you with all their luggage that will require a U-Haul truck to transport. B) They are in NO immediate need for emergency assistance and C) The hospital that they want to go to is about 30 miles away.  Now, I can give you a number where they can arrange for a transport for you and guess what...the number is NOT 9-1-1.  You get to go to the ER. This is where the phrase "you call, we haul" comes from.

2.  "Ohhh Lordy, I think he is going to die"  Okay, this is where someone falls after tripping on a curb, is complaining of some minor knee pain, and really is more embarrassed than anything....but did all this in front of a church group.  While bandaging the patient's leg and having them sign the no treat form because they don't want to go, a bombardment of Hail Mary's flicker back and forth with hands being held, eyes closed, looking up toward the heavens with one voice stating "Oh heavenly father, please bless brother Richard in his time of need and shine your mercy upon him and raise him to the kindom of heaven...blah, blah, blah." Hey mister.....HEY MISTER....he doesn't want the squad. He is fine.  Then they rejoice as if their prayer saved this person.  Hey, anything to throw a party I guess.

1.  "I didn't want to wait in the triage area".  Boy, you just told me the wrong thing.  When hearing this, I alter my radio report SPECIFICALLY for this person.  "...I am inbound with an alert, oriented, and AMBULATORY male..." I have had people who were waiting in the waiting room actually call 9-1-1 from the pay phone because they didn't want to wait.  Guess what...you get to go to the back of the line...again....Here's your sign.

Welp all, that is it for now. I hope tohave something more substantial for you next time.

Until then, Wear your safety belt, don't take candy from stangers, and most of all....use the force.

Rounding Third and Heading Home,

M-