30 July 2005

Dear Friends

30 July 2005

"Dear Friends"

My Dearest Friends and Family-

Every time I sit here, I think to myself "how can I entertain my readers today?"  Bringing you all into my life has become a fulfilling and has brought a completeness with it that has become second to none.

I have met some of the most wonderful people here at my site and these will be the ones that I cherish even when I am long gone from here.  With that, I thank you.

On Thursday, I got a frightening phone call from Beverly telling me that she was having severe pain in the belly.  Normally, I would have not thought as this to be severe.

But Bev was 20 weeks pregnant.....

And we lost the baby.

There is no words to describe the emotions that I had going through my mind and trying to keep it physically and emotionally together for her was, no question, the hardest thing I have ever done.

Bev is doing very well physically and still struggles with the emotional loss from time to time, but I have convinced her that her still being here is all that I am concerned with at this time.

So, for now, I will be stepping back from my entries here and concentrating a little more on my immediate family. 

Don't think of this as a farewell, but a "see ya later" type of thing.  I will resume this journal, in its entirety sometime soon. It could be next week, it could be next month, but for now, I cannot give it a time factor.

Thank you all for coming to this site and I will be back soon....I promise.

Rounding Third and Heading Home,

M-

24 July 2005

EMS FAQ

24 July 2005

"EMS FAQ"

I found this on line and I thought I would share it with you. This is from a paramedic in California...and holds true for all of us.

Q. Do you need to go to school for this or can anyone do it?

A. You have to go to school, it is long and hard and most of the people involved like to abuse the hell out of you while you are doing it.

Q. Hey, Ambulance dudes, how do I get to the Dead concert at the Oakland Coliseum? (or any other request for directions)

A.Hmm, well,uhhh. I'm sorry I don't think you can get there from here.

Q. I'm seeing things, will you take me to the hospital?

A. Sure, if you are seeing rats and bugs we will take you to County Hospital, if you are seeing music and hearing colors we will take you to the Berkeley border and drop you off, you'll fit right in.

Q. Do you like you like your job?

A. Yes, in spite of everything I do like my job.

Q. Do you make a lot of money?

A. Not enough by a long shot. At least not after my State, Local, and Federal Government gets through with my check.

Q. How come the Police come to the call with you?

A. Investigation, crowd control, and to keep me from getting my ass kicked by an irate bystander/family member/patient.

Q. How come all the Firefighters come to the call too? What do they do?

A. Beats the hell out of me, it's not like the patient is on fire or anything!

Q. Have you ever seen a dead body?

A. Yes, in all the various states of decomposition and putrefaction. I've even seen maggots in ones that weren't dead yet.

Q. Do you have anyone (like maybe a patient) in the in the back of your ambulance right now ?(asked while we are sitting in the unit eating lunch in the parking lot of Doug's Bar B Q)

A. No patients. Only the Paramedic Student; don't bug him, he's a stress case and might crack.

Q. What antacid is best for a stomach ache (asked in the parking lot of 7-11 at 03:30 a.m.)?

A. Pink, white or green pay your money and take your chances.

Q. Do you have any spare change?

A. Take a hike, I don't believe there is such a thing as spare change.

Q. Can I have bus fare to get to the hospital?

A. Yes, if it means you won't take an emergency rescue vehicle out of service so you can get to a routine appointment for your toothache and if you promise to quit bugging me.

Q. How long have you been doing this (asked by a recently hired rookie Paramedic)?

A. Let me figure it out. Since you were in second grade, partner.

Q. How come you are smoking that pipe , don't you know that is bad for you?

A. How can pipe tobacco be bad for you? If it was bad for you they couldn't sell it at Walgreens Drug Store. Right?

Q. Can me and my four kids ride in the back with my boyfriend to the hospital?

A. No.

 Q. Can I ride up front on the way to hospital?

A. Maybe, if I like you and think you wont bug my partner in the back.

Q. How comeis painted on your front grill?

A.There is a device on motor vehicles that is known as a rear-view mirror, some people have even been known to use it to see what is behind them when they are driving.

Q. How fast will your ambulance go?

A. I don't pay that close of attention, faster than my employer would be comfortable with, most likely.

Q. Is he going to make it?!! Is he going to make it?!! (asked in reference to a patient who puked after too many 40 ounce bottles of Old English 800 Malt Liquor).

A. Yes, I am sure that in spite of our best efforts , he will survive.

Q. Can I have a band-aid?

A. This is an ambulance, our band-aids are 8 inches x 6 inches. How many do you need?

Q. What happened? (at an minor fender-bender auto accident).

A. Plane crash!

Q. What happened? (outide of a house where a person was having shortness of breath).

A. Plane crash!

Q. What happened? (at a plane crash)

A. Shark attack!

 Q. What does EMT stand for?

A. Every Menial Task, Eggcrate Mattress Technician

Q. What does the EMS on the side of your rig stand for?

A. Earn Money Sleeping, now please let me get back to earning some money, thanks.

Q. Does this tie go with the rest of my suit? (asked by a guy on his way to church).

A. Sure, a red, purple , pink, and black tie always goes with a gray pinstripe suit.

Q. Do you have an extra one of them urinal bottles. I have to piss real bad.

A. No. We don't carry those any more but thank you for sharing.

Q. What is the worst thing you have ever seen?

A. A 12 gauge shotgun blast to the left side of a woman's face that didn't kill her, so she was writhing on the floor and trying to scream through the blood running out of her mouth with a good part ofher face missing. Either that or it was the 6 month old baby who died because his drugged out parents left him on the floor heater grate until he was so cooked that the flesh of his fingers split away from the bones. Now aren't you sorry you asked?

Q. Are you always this much of a smartass? A. No, I am usually much worse, but the medication is helping. Q. Why did you bring the patient here?

A. I guess the sign out front that says "Emergency Department; Physician on duty" fooled me into thinking that this was a hospital that treated patients!

Q. Do you think the patient can be triaged to the lobby?

A. Since they demanded transport for a refill on their prescription I am sure that the lobby is more than an appropriate place for them to go. Unless you can triage them to the parking lot or the nearest bus stop.

Q. How come the patient didn't just call a cab or take the bus?

A. Because the taxi services and the bus lines are smart enough not to take Medi-cal instead of cash payment.

Q. What are the patients bowel sounds? (On a critical 'auto vs. tree' patient).

A. Since we were on the side of the freeway and now are enroute to the hospital the bowel sounds pretty much resemble a diesel engine.

Q. Did you look for ID?

A. Sorry, no. I might find guns, knives razors and crack pipes during the physical exam but I am not going to reach into his pockets looking for ID and find a needle.

Q. What's the patient's name? What's the patient's name?!! (on a cardiac arrest victim).

A. I don't know, I asked him four times after he coded and he wouldn't answer me once!

Q. What are the vitals? (Different Nurse, same code).

A. If we're doing CPR right he should have a pulse rate of 80-100/min, 24 respirations/min, and a blood pressure of maybe 40 systolic.

Q. Can the patient sign the insurance and permission forms? A. Only if they use your pen. Q. (On the radio) Are you sure she's in ventricular tachycardia? The complexes are rapid and wide not narrow, right?

 A. Uh, yeah I'm sure it's V-tach, we covered this rhythm in some detail in Paramedic school. Is this a pop quiz?

Q. Can we clear? We don't do this medical stuff. (Fire Captain).

A. Yes, you can clear. I am sure there is a La Z Boy recliner and a quart of ice cream waiting for you somewhere.

Q. Is he dead? (Different Fire Captian, same department).

A. What tipped you off? The dependant lividity, the rigor mortis, or maybe the ants crawling in and out of his nose?

Q. Why can't you hold over for a few hours this morning? (Managment).

A. Why not? I've only been awake for 26 hours straight and been puked on twice, I think it is safe to say I would rather floss my teeth with barbed wire.

Q. Can you guys hear the siren when it's on while you are in the cab of your ambulance?

A. What?! You will have to speak up I can't hear you from all the years of listening to the siren inside this ambulance.

Rounding Third and Heading Home,

M-

21 July 2005

Getting Your Money's Worth

20 July 2005

"Getting Your Money's Worth"

What does a buffet, a rock quarry, and an umpire have in common?

No, it isn't the fact that you want to bury a fat ump in the rock quarry.

The answer...

Maximizing the situation.

At a rock quarry, many places have all you can load for one low price.  Hell, for my 20 bucks, I would get enough stone to build a castle...with a moat....and a fire breathing dragon (but I would have tic-tacs on hand in case its breath gets too bad...cinnamon ones).

At an all you can eat buffet, the horns go off to chow down on as much red meat and fixins that you can get in a sitting.  No matter if a sunflower seed fills you or you can eat so much red meat that you aren't allowed in the plain states anymore, if you are the participant of a buffet type restaurant, then you will find yourself lifting the moderation of your diet to consume as much as you can in the period that you are there.  Don't try to deny it. I have been to Golden Corral (yes, on purpose) and I have seen what happens in the food line. One plate becomes two, two becomes four, next thing you know, you ar checking the 7 year old boys against the wall in order to get the new, fresh chicken they have put out.  Don't worry, they have support groups.

Finally, if you follow baseball as I do, you occasionally see a manager going ape shit over a call that has been blown by an umpire.  These men are usually very animated and just by looking at them, you can feel their blood pressure go up.

Take this guy here...

Can't you feel the love?!?!?

There is one other person, in the EMS field, that really gets a run for their money. It is a person that is always present, even when you aren't looking. It is someone that can either steer you for the good, or for the worst.

We call them students.

Yes, the rookies of EMS are a lot like the full moon.  They can produce off-color waves of activity making your day so busy that by the time you finish your reports, it is the NEXT shift for you, or so slow that boredom has even left to go look for something to do.

We all have to start somewhere. 

1718 Hours

Is there some point in EMS where you just "give up" trying to keep up?  A point where you hold up the white flag, throw in the towel, or even ring the bell?

If there is, put my name on the list.

Today had been ridiculously busy no thanks to the student rider that we had who come to fulfill his mandatory ride time by the state so that he can become an EMT, move on to a paramedic, write a journal like this one, get famous, have a movie star play him in a movie, make millions, buy the EMS company he works for, and retire with more gray hairs from the headaces of being rich AND famous than he could ever imagine. Whew, that gave me a headache just thinking about it.

Finally getting to sit down after a cluster of calls had my legs feel like they had just run a 500 mile race (no, I have never run 500 miles so I really don't know what it would feel like). The air conditioned room had become a reward after constant runs to the emergency room in the intense heat that had taken over a great majority of the eastern time zone. It was time to relax and get our bearing once again.

Ken and I were both down reports and instead of getting them done, we bothed opened a soda with the student in tow and started a search for something good to watch on television.

It seemed as if the early day chaos has come to a close and that a break in the action is about to grant us some relief and recoup time.

Gosh, it sure feels good in here.

Then the phone rang. (like you didn't know this was coming)...

Ken answered, gave a few "uh-huh's" and put the receiver back on the hook.

"C'mon.." he motioned to us as he started for the truck.

Too tired to ask what the call was for, I stumbled into the truck only to see that we were going for a 2 car MVA with injuries.

Let me take a step back and explain something to you readers as to what a call for an MVA (Motor Vehicle Accident...in case you went to the kitchen during a commercial) entails.  90% of the time, when a call comes in for this, the details are very sketchy as to the severity of the accident (a little foreshadowing going on here).  I would have to say 9 out of 10 times, the accident is nothing more than a fender bender and the patients that claim to be hurt, have a distinct illness called Acute Prudentialtosis.  (This is pain in the neck and back that one gets from a car accident when they are hit and it is not their fault...also called Ineedthegeckosis, or, Progressive Agent Syndrome).

Looking at the location of this accident, it was ALMOST safe to say that this is what we were going for, but on the verge of a full moon and having a student, anything could change.

Hitting "en route" on the MDT, we began pull out into the great unknown and journey to out destination to yet, save another life (or get them to sign a refusal if they don't want to go). Below us was the secondary radio which is tuned into the police frequency within the city. It spoke...with intensity.

"Get the squad here really quick" a voice overpowered the little speaker that we had on it.

Already halfway there, I am thinking to myself, is this cop getting a little antsy thinking someone is going to die....or is it the fact that someone may die.  I guess in a matter of seconds, we were going to know.

With two blocks left till we got to the scene, I could see that a crowd had formed on the adjacent sidewalk...a rather LARGE crowd.  I guess there isn't a whole lot of action in the city that you have to stop to watch an accident (yes, I know this is read by ambulance chasers all around.)

Getting closer, I could see two vehicles involved in the accident. What I didn't see were people...I would soon find one of them....

The first car was actually a mini-van.

(Yeah...it looked something like this...minus the front end now)

The second was a Chevy Blazer that was on its side.

View Photo Of The 1995 Chevy Blazer For Sale in Tempe, Arizona

Getting out of the truck, I grabbed a radio, my gloves, and my soul...when I heard the screams coming from around the truck...or rather under it.

Coming to meet an officer who had shown up prior to our arrival, I found the driver of the vehicle pinned underneath the passenger door which laid flush with the pavement. 

Her screams for help were deafening as the terror in her face grew more and more imminent.

From her nipple line up, she was exposed outside the SUV, the rest of her body remained dormant, still inside the truck.

The fire department was still not within visual distance and the pain of the SUV's weight and the heat of the blacktop made getting the patient extricated from this wreck an extreme priority.  We had no time to wait, she needed out now.

Suggested by one of the officer's, we got a few other cops, myself, the student, and one of the bystanders to lift the truck up enough to slide her out.  Lifting the truck, I yelled for someone to get her out from underneath and pull her clear of the wreck. Ken grabbed her and with one swift jerk, he cleared her from the danger that had her trapped.

Setting the car down, I began to assess the patient while Ken got the immobilization gear.

Doing a rapid trauma survey, I could see that both her arms were broken with one having sever deformities. (Her arm looked like the letter Z..and that is BELOW the elbow..for all of you who are trying to make your arms do that at home).  Continuing on, I found that she was wearing sunglasses...which were embedded under her skin....about 3 inches above the hair line.  The glasses had degloved her scalp to the point where you could see the pressure cracks in her skull...visibly.

I had the student help Ken immobilze the patient while CJ (who came to back us up) got the cot ready.

Blood began to pool from the open wound on her head and burns from the hot, sultry ashphalt had began to turn into deep second degree burns.

Pulling the radio from the belt clip, I had called for the dispatcher to get a helicopter to meet us at the hospital. I knew this one was going to fly..if not for the sheer fact that she was pinned.

Getting her onto the board, Ken, CJ, the student, and I loaded her into the truck and immedately took off for the hospital.

Fast Forwarding here (Because the rest of the story is mundane and actually pretty boring) she was flown away to the trauma center with an excellent prognosis from what I gathered.

As for the student....

What a hell of a day to do a clinical.

Rounding Third and Heading Home,

M-

 

18 July 2005

The "J" True Hollywood Story...Part II

18 July 2005

"The "J" True Hollywood Story...Part II"

Lynsie: How long are your shifts?

Michael: I work 24's. I am on for 24 then off for 48.

 Lynsie: when do you sleep?

Michael: You sleep when you can. In my city, we run 3 trucks and we cover roughly 40 square miles so you can see how busy it can get.

Lynsie:  how many hours of sleep do you average a night?

Michael: 3 hours and that is on a good night.

Lynsie: When do you eat?

Michael: Whenever you can. God bless the man who invented carry out.

Lynsie: How many hours of work do you average a week

Michael: 56 give or take a few.

Lynsie: What is the difference between an EMT and a paramedic?

Michael: The level of training. Paramedics are actually EMT-P which is, for now, the highest level of care that I can give. As a paramedic, I can interpret cardiac rhythms, give medications, do advanced airway maneuvers and manually defibrillate a patient if needed. Basic EMT's are allowed to do first aid, CPR, oxygen therapy and basic life support. Ironically, they are the ones that keep us sane.

Lynsie: What are some of the things you have to do during your shift (include things you do with patients)?

Michael:  In the morning we take about an hour to check the truck and wash it. Then we see if there is anything on the docket that needs to be done at the station as far as maintenance or perhaps visitation. We always check our updates of new protocols or things from the administration center. On a call, every call is like being in CSI. You have to be very aware of the surroundings and the slightest little discrepancy must be noted and questioned for validity purposes and to help you treat your patient better. All calls get the interview, vitals, continuous monitoring, and delivery to the emergency facility with care transferred to the appropriate staff.

Lynsie: What is First Responder?

Michael: First Responders are used as the initial start of care for callers who require assistance. They are people who can get on scene before us and start initial basic treatment of the patient. Their roles are pivotal in creating a safer and more successful environment for us to work in.

Lynsie: What kind of certifications/licenses must you have to be a paramedic and why?

Michael: I think I mentioned this up top somewhere. In the State of Ohiowe are certified by the Ohio Department of Public Safety as a paramedic. I also am on the national level as a National Registry Emergency Medical Technician - Paramedic. I have ACLS, PALS, BTLS, and CPR also.

Lynsie: What about paperwork are there different forms?

Michael: Everything where I work is computerized and is done on a PDA device. For patient reports, they are pretty much the same.

Lynsie: how much paperwork do you do during the shift?

Michael: More than I can begin to share.

Lynsie: what information must be recorded?

Michael: Patient name, address, SSN, information to that extent, then their medical history, medications they are on, allergies, physical findings, vital signs, interventions performed, transport information, and a lengthy narrative as to the events and how and what you did.

Lynsie: when do you do the paperwork?

Michael: Ideally, after every run. We have fax capabilities that are linked into our system which makes it able for us to leave and send the report via fax machine.

Lynsie: why is paperwork so important?

Michael: Not only is it a part of the patient's record as to how to treat them better and what you have done in their care, but it is a legal document also that tells a story if litigation is ever to come about for purposes outside the realm of EMS.

Lynsie: What are some of the things you have to know how to do?

Michael: As far as the actual job, things to know are bleeding control, airway management, basic patient comfort, and so forth. Things that you need to know that are not taught to you are what, in my opinion, is the crucial role in EMS. Those things are deductive reasoning, adaptively, common sense, compassion, intrigue, and most of all, confidence.

Lynsie: What is ALS?

Michael: ALS, or Advanced Life Support, is that greater level of care where medications, advanced airway management, and cardiac interventions are taken place and performed. This is usually at the level of paramedic.

Lynsie: What are the things that are kept in an ambulance and what are they for?

Michael: Wow. I could go through a whole list of things that are on the truck, but I am not sure that I have that much room.

Lynsie: What is the most important tool you use, what is it for and why is it important?

Michael: The most important tool? The truck, If I don't have the truck, then I can't do my job. Every piece inside is intricate and vital to the calls that we go on.

Lynsie: How do you stay in touch with the hospital and the base?

Michael: Well, with the hospital, we have two means of communication. First is the med radio which is specifically designed to call a certain facility and that facility only. This is located in the patient compartment. We also have cell phones that can be used in a more discreet setting.

As far as "base" or dispatch, we are in constant radio contact with them also. However, we have an advanced feature also. In each of our trucks, we have MDT, or mobile data terminals, which is a small computer that gives information as to the run we are going on, previous incidents there, mapping, and other info that may be needed. Each vehicle where I work is equipped with GPS (Global Positioning System) which pinpoints our exact location in case a closer call may come in.

Lynsie: What are some terms you are use when communicating back and forth and what do they mean?

Michael: Well, I can't give the security ones to you seeing that it may violate some sort of rule, but some of the codes we use are "Code 7" or lunch. "37" which is our specific hospital code. "Code White" is a dead on scene. SOB is a shortness of breath. ETA = estimate time of arrival. Other than that, most info is given via the MDT's.

Lynsie: When taking a patient to the hospital, what are some things that you must tell the hospital before the patient arrives?

Michael: Well, when calling, it might sound like this if I had a female with chest pain.

"Lifecare 93 to EMH, I am inbound with an alert and oriented x 4 86 year old female, complaining of chest pain times 2 hours. Patient states sudden onset with no alleviation with rest. Pain is substernal and radiates to left arm. Patient rates pain a 9 on pain scale. Vitals assessed and are 164/90, pulse is 103 and regular, she is breathing at a rate of 20 and lungs are clear and equal bilaterally. Oxygen saturation is 98% on 4 liters via cannula. Monitor is showing a sinus tach without ectopy. I have an IV established normal saline TKO (to keep open) with labs drawn times 7, I have given 4 baby aspirin and one nitro (nitroglycerin) with moderate relief. I am about 4 minutes out. If there aren't any further questions or instructions, I will continue transport."

Lynsie: After dropping off a patient at the hospital, what must you do before you leave and what do you do after you leave?

Michael: You must give a brief yet thorough report to the staff so they know how to continue care. If you are in the back for the call, then your partner puts the truck back together by restocking and redressing the cot. I would then go to get the patient registered and if needed, get the drugs that I used replaced. After we leave, I have to do the run report and log in the call so that we can track it for billing purposes.

Lynsie: When you are not dealing with patients what do you do?

Michael: Relax...that is a luxury. I usually play on my X-Box or watch a movie with some of the other crew. Everybody does their own little thing whether it is together or apart.

I hope this helped with your interview and that you get a good grade on it.

Good luck and hope to talk again.

M-

 

The whole interview, in it's entirety, can be sent to you if you Email Lynsie at laekhardt@aol.com.  I recommend it for anyone who is interested in the field.

 

By the way....she got an "A".

 

Rounding Third and Heading Home,

M-

17 July 2005

The "J" True Hollywood Story...Part I

17 July 2005

"The "J" True Hollywood Story"

Recently, I was asked by one of my readers to participate in an interview for a project at school that she was doing on paramedics. Lynsie had E-mailed me the questionaire for me to fill out and return so that she could use in her school work.

Today, I thought I would publish some of it (with her permission of course) so that you can see if the FAQ are part of what you have wondering about paramedicine.

This interview was done by email on May 28, 2005 and I interviewed a man name Michael.

Lynsie: What is your name and where do you work?

Michael: My name is Michael . I work For Lifecare Ambulance Inc. in Elyria, . It is a private company that has been awarded the  9-1-1 contract to two of the major cities within that county. I also work for Elyria Township Fire Dept. as a firefighter/paramedic.

Lynsie: How long have you been a paramedic?

Michael: My one year anniversary has approached as a paramedic. I have been in the EMS field for roughly 13 years now. 3 Years as an EMT-Intermediate prior to becoming a paramedic.

Lynsie: What made you want to be a paramedic?

Michael: The standard "To help people" is alittle text book so I will tell you 3 reasons. First, it was the show "Emergency". I would watch religiously every time that it came on and wanted to be like Johnny and Roy. Second, when I was 112 and on vacation with my family, I witnessed a car accident from start to finish. I felt helpless as there was nothing that I could do for it and even at 12years old that frustrated me. From that point on, I felt the need to do "more". Finally, we had a career day when I was in high school and one of the speakers there was a firefighter/paramedic from the local fire station. From that point on, I knew what I wanted to do and what I was destined to become.

Lynsie: What do you like most about the job?

Michael: Driving the wrong way down a one way street at 60 MPH. LOL. No, seriously, nothing is ever the same and the challenge is always there. It doesn't matter if the back-to-back calls are the same in nature, the calls will differ and I like the changing scenery.

Lynsie: What do you dislike most about the job?

Michael: Pediatric cases. These are draining both physically and emotionally. To see a child in need is heart wrenching and makes you want to go that extra mile...even when the outcome is potentially hopeless.

Lynsie: What is the worst case you have ever had?

Michael: Two years ago, I had a call on the interstate for what came in as a "motorcycle accident". It was roughly 2 AMand anytime you hear those words, you have to paint a picture in your mind as to what you will find. When we got on scene, we found our patient in the middle of the roadway. He was already dead, but half his body was ripped off and twisted around his head and neck. His intestines were spread for about 100 feet and his brain matter went into the next town (which was over 200 yards away.) Apparently, the male was drinking and was going an irate speed (approximately 85 MPH according to reports) when he decided to pass a car. Not looking, he drilled a vehicle that was already there, launched over the handle bars, and went into the rear window of the car. Because of the speed, he was ejected from the car, tossed into the road at over 70 MPH, where he was run over by an 18 wheeled semi and a tow truck that couldn't get out of the way. The sad thing was is that he was only 31. Had a child, and was to be married in 2 weeks.

Lynsie: What do you do to help yourself deal with those cases that are hard?

Michael: I write. In case you haven't seen, I have a web site here that helps me get off my chest as to what I want to say and how I feel. It helps me alleviate some of that pain. I also talk to my soon-to-be wife as she is in the medical field and listens contently without pretending to know how I feel. It is good just to vent sometimes.

Lynsie: Is it hard for you to not take your work home?

Michael: If you have absolutely no feeling after you are off and on your way home, my theory is that is it is time to quit. Part of this job is compassion, and compassion is never supposed to die.

Lynsie: What is your most favorite case?

Michael: The ones I don't have to write a report, just kidding. My favorite cases are the ones that you know you made a difference and that person has an excellent prognosis for full recovery because of the work that I may have done.

Lynsie: What is running through your head when you arrive at the start of each shift?

Michael: Did the prior shift sleep at all? As dumb as it sounds, what they do bleeds over to us. If they are busy, then we are busy. If they are quiet, we usually follow suit. I also wonder if the truck is broken. Now I know that sounds stupid, but this is my office and I know where everything is. The rules say that all the trucks are supposed to be set up the same, but there is nothing like the comfort of running in your own vehicle.

Lynsie: What drives you through those shifts that seem to not want to end or when you have a difficult situation?

Michael: This is going to be an off the wall answer because it changes from person to person, but not falling behind on run reports. My partner and I average anywhere from 12- 16 calls a shift and it keeps us very busy. I hate falling behind because I feel like I am in quicksand then. Also, food, Ken (my partner) and I love to shop and cook new things. It takes a little of the stress off the day and makes time go a little faster.

Lynsie: When people find out that you are a paramedic, what is the number one question they ask and how do you respond?

Michael: "What is the most horrible thing you have ever seen?" I think this is locked into everyone's mind. People have the premonition that this is like "Third Watch" where every call is a critical call. This is not the case. It is tough for them to grasp that there are points when we do absolutely nothing too.

Lynsie: Has there ever been a situation where you were off duty and you had to use your training and can you share what happened?

Michael: New Years Eve about 4 years ago. I was on my way home from my dad's when I saw a car jet past me. A mile up the road, I saw the car upside down in a drainage ditch. It had failed to negotiate a curve and with the rain slicked road, darted off and flipped. When I got there, no one had showed up seeing it had just happened. I had someone call for help and I went to check on the passengers. A guy and a girl were inside, the male driver was unconscious and the female was pinned in. I had to get a flashlight from my car and break the rear window. The car had a good amount of water in it and it was important to get the patients out. Bystanders helped me release the girl and get her out. I had a troubling time getting him out. I didn't have equipment so I had to make do until the fire personnel got there. I kept his head above water and made sure he didn't fall into total unresponsiveness. He ended up getting flown from the scene. I had ripped my leather coat. Guess it is the price you pay.

Lynsie: What is the simplest case you have ever had?

Michael: Psych patients are the easiest usually. I had one the other day who just wanted to go because she was depressed. From the time of call to the time I got her and to the hospital was 6 minutes.

Lynsie: What is the youngest/oldest patient you have ever had?

Michael: The youngest patient I have ever had was 6 hours old. I had to transport her into Cleveland to a bigger, more appropriate facility due to being born prematurely. The oldest was actually last shift. The lady was 103 years old and just needed her vitals checked. She was doing better than I was.

Lynsie: What do you think it takes to be a "good" paramedic?

Michael: Street smarts and common sense. If you realize that you can't fix everyone, then it will make you a better medic because you will only hurt yourself if you dwell on the bad. Compassion and a good ear to listen is always a plus. And multi tasking, Not everything is the same and you will have to adapt quickly by doing many things at once.

Lynsie: What type of classes/training must you have?

Michael: In the state of Ohio, the absolute MINIMUM is roughly 1000 Hours of training both in class and clinical settings...to be a paramedic, you mist be an EMT-Basic first which is additional training. Also, I have Advanced Cardiac Life Support, Pediatric Advanced Life Support, Basic Trauma Life Support, CPR, CEVO (Certification of Emergency Vehicle Operation).

Lynsie: How much does it cost?

Michael: As of June 2004, the cost of paramedic school where I attended was roughly $3600. This is actually quite a bargain as to what is out on the market.

Lynsie: Where did you go to school?

Michael: The company where I work has a state accredited training academy where all levels of EMS are taught. I took it there.

Lynsie: What type of training do you need to continue and why is it so important to continue your education?

Michael: In the state of Ohioyou are required to complete 80 hours of continuing education every 3 years. At the National level, you are required 72 in 2 years I believe. So, in essence, you are always in school. Why is it important? Medicine is like technology, just when you think you have it figured out, something new and better comes along and mastering it is of utter importance. Things change and times change. This is why it is essential to keep on top of them,

Lynsie: How long does it take to become a paramedic?

Michael: I can't speak for other states, but in Ohio, if you are going from Basic EMT to paramedic, the average is 13 months.

Lynsie: Are there different levels of being a paramedic?

Michael: There will be soon. It is in the works in the state of Ohio. As for now, paramedic is as high as you can go in the pre-hospital setting.

Lynsie: Ho much does a paramedic make per hour?

Michael: I really am not at liberty to discuss wages; however, it is based on where you work and what kind of company you work for. On average, a starting paramedic in Ohio will make roughly 10 dollars an hour. Many fire departments run EMSservice and are government funded so they obviously get more but have dual role as a firefighter too. AOL listed paramedics in its "10 most underpaid jobs" in 2004.

 

Continued in the next Entry......

RoundingThird and Heading Home.

M-

 

14 July 2005

What if God was One of Us?

14 July 2005

"What if God Was One of Us?"

What if God was one of us?  Would you know it? Could you pick out him or her from a crowd of people?  What would you say to them had you met them?

All thoughts to ponder, yet someone out there will always debate the fact that "there is a God" and will always have some "rational" reason for the running of the cosmos.

There are handfuls of people in this world who claim that they are God or are his only son Jesus Christ.

We usually call them psych patients.

Now, for the most part, psych patients aren't always that "I am the anti-christ, you will bow to me" couple-nuggets-short-of-a-happy-meal kinda person.  A high percentage of them are depressed, or hear voices, or just plain want someone to talk to kind of people whom I usually have the utmost sympathy for and try to make the little time I have with them more relaxed and at ease for the tramatic situation that they are already going through.

But there are some that you just have to let go, and test to see how squashed their noggin really is.

2312 Hours.

Preparing to unwind after a long, stretched-out day, Todd and I made our respective beds with our sleeping bags in order to try to race to sleep before another call came in.

Now, if we had made it to sleep, do you think that I would have written about the darkness and the frigid, atric-like temperature of the room we were in?

Well, yeah, I probably would have, but for the sake of argument, we will assume that we never made it that far.

That would be a good assumption.

Getting a call for a transport to a hospital that is more suited for a psych, Todd and I were called as the late night taxi for a male who had a few screws out of place.

Arriving in the emergency room, the security guards looked at us and smiled. (If this ever happens, this is not a good sign by any means.)

Larry, one of the security guards, told us how we were about to transport a young 19 year old male who was "Jesus Christ" and that he was from Israel.  Well, cool. I have never transported a celebrity before.

Our "guest of honor" also has had 20 mg of Geodone (a HEAVY tranquilizer that makes Valium look like a decaf latte'".  Apparently, the Lord our Savior has a bit of a temper.

Taking a peek into the room that he was being held in, I observed a bigger than normal gentleman who looked more snowed than a birthday party at Robert Downy Jr's house. (And no, that is not slander, this is public knowledge. Hey, I loved him in Wierd Science).

Getting the info for the transfer, we loaded his almighty onto the cot with little resistance and moved to the squad.

Todd rode in the back as he was more appropriate to handle himself had the Wrath of God struck Armegeddon in the patient compartment.

Hitting "transporting" on our MDT, it was off to see the Wizard.

The trip there was rather uneventful and, actually, pretty dissapointing.

Here I was geared up for some interesting conversation dropping and, instead, nothing.

Unloading his highness, we went through their emergency room to registration to set him up with the penthouse suite.

Now, with the little words that were spoken this whole way out here, I just couldn't help but to ask the almighty one some questions as to "the meaning of life".

So, this is a little as to how the interview went:

M: So, you highness, out of all the places on Earth, why did you pick Ohio to spread your good wealth.

JC: We are not in Ohio, we are in Germany, Israel is right over there (pointing aimlessly to an unspecific direction).

M: Sorry, Jesus, you aren't in Germany.

JC: I'm not?

M: No, you are six time zones off. Doesn't Jesus have Triple A?

JC: I did a long time ago.

M: Hmm..maybe you should have gotten one of those Trip-tiks to the promised land. They have maps and all.

JC: (nods in agreement)

M: So, who is gonna win the world series, I thought I would ager a bet.

JC: Who is playing?

M: Well, you tell me, I thought you could see into the future.

JC: One of those teams with a "Y"

T: (This is Todd) you mean the "Yahoo's"

JC: Yes, that is them. They will beat the Houston Oilers.

T: Bro, the Oilers don't exist anymore.

JC: Oh yes the do, they just don't tell you that.

At this time, he looks at my wrist which has the yellow "Livestrong" bracelet on it.

JC: Are you that guy that rides the bike?

M: Umm...yeah, that is me. After I drop you off, I have to get back to France to race. It will be daylight soon.

JC: I will make it dark a couple more hours so that you can get there.

JC: Do you work out?

M: I have to in order to ride the bike.

JC: I do too. I am here to finish my Steriod treatment (Pointing to his flexed arms which has more fat than a steak in Texas)

T: How much to you bench?

JC: Three hundred kryptillion pounds.

T: How much?

JC: Three hundred kryptillion pounds.

M: I benched that once, but when I was doing push-ups, I altered the path of the Earth and caused the psunami's. I got a letter in the mail saying I wasn't allowed to do that anymore.

JC: Who sent you that?

M: Who do you think?

JC: Ahh (shaking his head in acknowledgement) it was the CIA wasn't it? Those bastards.

At this point, I am biting my lip HARD as to not to laugh. Todd has his head buried with laughter.

Singing the song "What if God Was One of Us" By Joan Osborne, we got the clearance to go to the top floor where his excellency will be housed.

With security guiding us to the elevator, the halls were vacant and dark. It was as if the pathway to the otherside was just a few feet away.

So I whistled to lighten the mood.

What did I whistle?

"We're off to see the Wizard" from The Wizard of Oz.

By the way. That conversation actually happened.  I shouldn't get struck by lightenening.

Jesus told me I wouldn't.

Rounding Third and Heading Home,

M-

 

11 July 2005

Behind the Scenes

11 July 2005

"Behind the Scenes"

Today, I thought I would give you a little look as to where I work and a little about the company that I work for.

Below is a link to our new website which has a pretty extensive photo gallery in it.

FYI, the link that says "Hear Live Radio Traffic" does not work yet, but when it does, I will let you know. At that time, you can hear our trucks go out and what they are going for.

I hope you stop by and take a peak. I am in a couple of the pics. Hope you can find me.

If you have any questions about the pics, drop me a comment and ask and I will try to do what I can to answer them.

Also, Donna (Behind the Headset) has a new look journal and is among the AOL J-Land. Her link is on the right of this screen. Stop and say hello.

http://www.lifecareambulance.com/

Rounding Third and Heading Home,

M-

08 July 2005

When Good People Go Stupid

08 July 2005

"When Good People Go Stupid"

What makes a good person go stupid? 

 Is it a certain flux in the cosmos that alters the brain cells of individuals blocking their common sense abilities? 

 Maybe, it is the weird gravitational pull that rapidly changes the weather causing the sudden drop in atmospheric pressure to activate a dormant horomone within the body that affects the part of the brain that controls stupidity.

In the field I am, stupidity is like alcohol, the more you use, the dumber you look. 

For most people, it doesn't take much and least with alcohol, you can take something to cure it.

0735 Hours

Refusing to hear the phone ring, I rolled under my sleeping bag groaning with the realization that I will have to get up and dressed within the coming seconds.

Todd, my partner for the night, hung up the phone and started to chuckle. You know that really evil chuckle that is equivilent to "na-na-na-na-na-na"? Yes, that one.

"Boy, I am sure glad I didn't get that full arrest" He said as he hung up the phone.

I smiled also knowing that an arrest probably would drain what little energy I had out of my overworked body.

"Cool, so what are we going for?" I asked rubbing the sleep from my eyes.

Giving me that shit-eating grin, he looked straight at me and said "a full arrest".

The laughing continued as he left for the squad bay.

You see, when I run with another medic on the truck, we alternate calls so that not one person is swamped all day long with reports while the other has the luxury of driving Ms. Daisy all over God's Green Earth.  In the end it all works out.

Except when it is your turn in the back.

Strapping myself into the passenger seat, Todd raised the garage door and away we went into the wild blue yonder.

Preparing mentally for the call, the radio almost exploded with the amount of traffic that was being broadcasted just for this call.  With all the units that conversed and all the updates that were given, you would have thought that Timmy fell in the well and Lassie was barking her head off trying to lead the brigade to extricate him from his own personal stupidity.

Murphy's Law of EMS #31

The call that is the most critical will always be the call that is furthest distance from where you are responding from.

The location of this call, a dialysis center, laid on the northern most border of our city and at the very edge of our service area.  Even with lights and sirens, a good 6 to 8 minutes will go by before a squad can arrive on scene.

Unless you're Todd and you are driving.  Then the time is like 46 seconds.

Arriving at the speed of sound, we parked behind the two (yes two) fire apparatus that had arrived just before we got there.  Our boss had also first responded to the scene to initiate any treatment that he could.

Flipping a new battery into the monitor, we got our gear and went inside to try and grasp another from the clutches of death. (I know, that is really mellodramatic).

Going inside,  it was easy to see where the patient was.

1. There were partitions all around.

2. There were a lot of people in that paticular corner.

3. People waving to us (Like I can't see you already).

Coming up to assess the patient, I noticed one thing about her that differed from all my other cardiac arrest patients that I have had in the past.

This one was alert and talking.

Hmmm....

Well, so much for getting a tube today.

Getting my preliminary assessment out of the way, I began to ask the staff what happened. 

The conversation went something like this:

"Okay, what happened?" I asked in a calm, yet polite manner.

"She was about 20 minutes into her treatment when the alarms went off. I went to look and see what they were and it (the dialysis machine) said that there was no pulse and no blood pressure." One of the techs told me.

"Okay, How long did you do CPR?"

"We didn't." Was the response I got.

At this point, I got that look on my face like the rock has when one eye is higher than the other.

 (Yeah...that look.)

"Okay?.?.?. so did she just spontaneously come back?" By this time I was puzzled. I knew the sarcasm wanted to bust through the door, but I dead-bolted that idea offering the benefit of the doubt.

"No, we shocked her." Was the response I got.

"You shocked her? What rhythm was she in?" I felt the flood gates beginning to open up.

"We don't know, we just got our crash cart and shocked her once."

By this time, I felt my face flush red as the heat that imminated from my face began to melt the plastic cart that was in front of me to molten goo (again...mellodramatic). 

For all you readers out there that are not medical savvy and have no idea what a sphygmomanometer is, (by the way, that is the technical term for a blood pressure cuff), I will give you a little in site as to what we do  for a person without a pulse as a paramedic.

First thing we do is what is called a "quick look" or place the monitor paddles on (although our new monitor doesn't have those) to assess the rhythm.  Then we do one of two things.

1. If they are asystole (no electrical activity in the heart...boy, you are all learning a lot today), then we start CPR.

2. We shock them if a certain disruption of electrical activity presents.

Either way, you are required to take a look first before you do any action.

Remember, they just did a "run and gun". Idiots.

Sarcasm found its key and opened the door at this point.

"So, let me get this straight. You ASSUMED (which is where we are going with this) that because the machine told you there was no pulse, that indeed there wasn't and instead of seeing if there was a viable rhythm, you just grabbed the paddles and juiced her?!" I asked in my best Law and Order tone of voice.

A blank look arose on her face followed by disgust looking at me like I had kicked her dog while it was down.  (At least I would have checked the dog first.)

For those of you who are not following. Here is the cliff notes version of what I am trying to say here.

There is a chance that she could have just passed out and still had a heart beat.  It is totally possible that the equipment that they used fails below a certain range which this patient fell to and just registered as a zero.

Dumbfounded and frustrated, I hooked the patient up to our monitor and found that she did, indeed, have a heart beat. Not wanting to waste a whole lot of time trying to figure else what other suprises are to be in store for us, we loaded her into the truck and began our journey into the city.

The trip was pretty uneventful until I had to give report to the nurse when we arrived at the hospital.

Asking me what had happened, I gave her a quick smirk and fed her the line no one wants to hear. "Are you sitting down."

Relaying the story to her, her mouth dropped to the floor (we picked it up for her and put it back) and the dumbfoundedness that was once part of my repritorie (my spelling sucks) was quickly shadowed onto her.

Thank God that was the last call of the day, that one would have filled me for the shift.

You know, I don't condone stupid people. I mean, without them, I would be unemployed for the most part.  They make me laugh and also make me appreciate my own megear life just a little bit more.

However, there is a fine line between stupid and assinine.  Today, we crossed that mark.

But for their defense, they did it with flying colors.

Rounding Third and Heading Home,

M-

P.S.  I just got the wedding photos so I will soon tell you about the trip.

02 July 2005

Suburban Infantry

02 July 2005

"Suburban Infantry"

Ahh...

The the city in Summer.  As the temperature grows to its midwestern climate highs, so does grow the amount of people that are out and about enjoying the summer sun, partying with family and friends, and just enjoying the warmth that the summer soltisce has to offer.

However, with the good, there is the bad, and with the bad, there is the crime. There is always the potential for violence in any type of climate or season, but it seems as if the summer months seem to progress in the amount of felonious activity that incurs within our community. (Probably because everyone is too lazy to come out when it is cold.)

Where I am is no exception, and it doesn't look to end anytime soon.

2230 Hours

Although it is only the First of July, the city decided that today would be the annual fireworks display in the local metro park as Monday (the actual holiday) is proceeded by a work day causing a potential drop in attendance.  Here, in Elyria, the show is rather big and brings in twice the population (which is already at 65,000) to witness the show and mark what is the beginning of summer for a lot of folks.

Like any big show, there is a lot of preparation taken with such a display that can only hope to contain what some consider disaster and keep any wrong doing at a minimum.

From the EMS stand point, we had sent 2 squads, 2 EMT's on bikes, and a supervisor SUV to canvas the area in case there is a need for medical attention. 

As the sky got darker, the traffic to the show increased only leaving to the mind as to what kind of night we should have and how busy it will be.  Adding into the mix, the recent acts of violence that had showered our fair city changed the question of  "if" to "when". Bottom line....time to get our "A" games out.

Watching from the front of the driveway, the clear, blue night displayed the Marboro reds, the sunfire yellows, the neon greens, and the deep water blues, of the pyrotechnics that had been shot off to show and celebrate our independence.  It was a rather impressive show that was set to music and it brought a feeling of patriotism to those that watched it...or is that hunger?

Feeling the coolness of the air begin to take effect, I could tell without looking at the watch that it was beginning to become late and that the show would soon come to an end.  With that thought processing, the grand finale began to rise and it was time to start monitoring the radio.

As the sky returned to darkness, the crowds began to line the street with the feeling of tension beginning to arise.

Being the next squad to go out, I felt like Maverick from Top Gun, sitting on the deck of the carrier waiting to be launched.  Listening in on the police radio, the fears and notions that were forthcoming began to take shape.

A fight had broken out at the bottom of the hill and the police that were already there began to ask for more help.

Actually, they screamed for more help.

Now, what was once a peaceful crisp, blue night, was interrupted by the reds and blues of the lightbars on the cruisers as they raced down the street to the scene of the crime to render aid and try to stop the madness before it grew larger. 

As the radio traffic grew longer, the crowd grew bigger and the need for even more additional help became imminent.  It was only a matter of time before someone got hurt.

And then....

"...Have Lifecare come down here for a man down...." blurted over the police frequency.  Here is where it time to glove up and dig in.

The radio traffic from the police was overshadowed by the primary radio in the truck sending the posted crew at the function to the call. "Man down" could be nothing...or it could be hazardous...to OUR health.

As 91 began to ascend to the need for EMS, the supervisor called for another truck to come and post until the crowd cleared.  That would be us.

This is the point where Maverick launches into the sky to help Iceman at the end of the movie. If you haven't seen Top Gun...where the Hell you been?!?!?

Getting the call, Kelli (my partner for the night) and I began our trip into the DMZ.  Not even a block up into the soup, the traffic became almost impassible.  The amount of people walking around was overwhelming and, in some senses, intimidating.  Well, we were just going to post anyways. I mean how bad could it be???

Then the tones dropped...for another "man down" in the same vicinity.  Showtime now.  Time to light it and bite it.  Turning down the main entrance into where the war had started, a lane was created by the police for us to squeeze through.  Intermittent blast of the siren, cleared the road of people.....well almost everyone.

Coming close to where we were to stop, a young kid decided that he was too good to move for the big white truck with all the lights on and airhorn blasting.  Kelli, stuck her head out and began to yell at him.  The cop began to scream at him too.  Billy Bad-ass decided it was his road.

Now..you all know my temper with stupid people.

Seeing the verbal ascertaion was not functioning with this kid as he began to strut a little as if he was winning. I decided a new technique to move him....I bumped him with the squad. Not enough to hurt him, but just enough to get his attention. He turned and looked at me, and I looked back at him.  His "What the Hell you doing look" was overshadowed by my "Get the @#$% out of the way" stare that I doubled back.  Acting like he was king of the road still, I began to proceed forward with another bump.  This time he moved, this time he didn't look back.  What a butt head.

As we found our posting assignment from the police, we looked around at the immediate crowd only to begin being mobbed by people who were pushed down while trying to flee from the ensuing fight.

There were only 2 of us...and there were dozens of them.  Quality became quantity at this point. Looking at Kelli, we agreed that treat and release was the only way that we were going to get out of this with some shred of sanity left.

Handing out band-aids like they were Halloween candy, Fireworks began to fly over our heads exploding within inches of the truck. The ground was littered with debris and the who place looked like something that you see on CNN in Baghdad.  If you had never been to a war, this was as close as we were gonna come.

It only got worse as the night went on, and I could go into more graphic detail, but I won't...for now....

The last thing I remember that it was the next morning and it was time to go home....for a long rested slumber.

And to think..the fourth isn't even here yet.

God Help us all.

Rounding Third and Heading Home,

M-