Rain moves through the area, bringing a flurry of accidents. We're dispatched to one after another. Often times, perhaps due to the construction of cars these days, there are no injuries. We arrive on scene, look around at busted cars and get legal signatures from people who don't want to go to the hospital (and probably shouldn't.).
We clear one accident and are on our way back to the station when we get called back to another one not far from the first. We're in stopped traffic on a two lane road. I pop on the sirens and lights. execute a 3-point turn and we're off to the races again!! Wheeee!
To get into position, we've got to go past the accident on the opposite side of the divided highway and turn around at the next exit. Some clown, on their cellphone while driving, almost takes me out with a 3 lane swerve. I suppose he couldn't see the 16,000lb, 9 foot tall, rolling ambulance with flashing strobes, wailing sirens and an air horn that's beating out a rhythm that sounds oddly like the cowbell in the beginning of "Honky Tonk Woman" by the Rolling Stones. Yes, I'm weird like that.
I start wading our way through the traffic to find the Medic unit in front of us and a trail of bashed, wrecked cars on the shoulders as we proceed. None of them appear to have injured people and we diligently report each one to the dispatch center as we go along.
Traffic is backed up because there is an SUV in one of the travel lanes. It's surrounded by police vehicles from the nearby military base, the state and the particular federal agency that patrols this stretch of highway. (Odd, I know but that's how things go sometimes). The patient is on the shoulder, out of the car already. RT immediately dives in with the medics doing patient care so I take the opportunity have a look at the vehicle.
It's got only 3 wheels. The front, passenger side wheel has only an axle stump where the wheel should be. Somehow, this driver has lost the entirety of the front wheel assembly. Tire, rim, brake caliper, ball joint...the whole mess. Both front fenders look like crumpled aluminum foil and there's not a single piece of intact glass or plastic on the vehicle from the doors forward. The busted grill of the SUV makes it look like a hapless boxer after a bad night.
Inside the car is another story. The patient is already out of the car and on the ground. The side windows have been broken and there is glass on the seat inside. This means that something broke the side windows from the outside. Rescuer? cop? rock? Errant Bird? I don't know. File that away for later.
Both airbags have been deployed. (significant) I can't tell if the driver (who is now being wrestled by the medics and RT) was wearing her seatbelt but the windshield has been broken from the outside and there is no evidence that a head hit it from the inside (hair, blood, brains or skin embedded in the glass). The seats are still bolted to the floor there is no blood or other evidence of trauma inside the car. The dashboard, steering wheel and other interior components are not deformed. This is good. It appears that nobody bounced around too much inside this vehicle.
Our patient has been living a life that is in no way deficient in calories. I dive in to help getting her to a backboard and then to the stretcher. During all this, I notice that her collar has slipped up her face. I go in to correct it and she wiggles her head around to get it out of the collar. She's already got a pretty short neck and her "upper body development" is not making it any easier. We improvise something useful and get her immobilized to the backboard, onto the stretcher and into the waiting medic unit.
While RT and the medics wrangle with the patient, I take a moment to query all the police as to how she got here. Broken windows and a busted windshield: Did she roll over? "No we had to break out the windows to get her out of the car."
Where's the missing wheel? "About 3 miles back. After she hit the 3rd car, she kept driving, on the road and in the median, with only 3 wheels and up to about 75 miles per hour!" I look at the police car that stopped her and see that it's covered in mud on the front of the car from the bumper to the lightbar. Woooh!
How long were you chasing her? "About 3 miles. Once we stopped her, she said that she was not allowed to stop for any police as she's the daughter of the top colonel of the army." Oooookaaayy.
"We pulled her out of the car and cuffed her. She immediately started to complain that her chest hurt. I put her on her side and then she started shaking."
Right-O! I hop into the medic unit and pass all this information onto them. RT is going to drive their unit and I'll follow in mine to take RT home once we get to the hospital. We get rolling onto the nearest trauma center. Halfway there, our dispatch starts calling the medic unit asking for their status. That's when I realize they haven't called with their patient information and destination yet.
After a few calls from dispatch to no avail, I hear RT mark up on the radio and advise them that we're all en-route to a particular trauma hospital and we'll advise upon arrival. Mind you, I'm driving an empty ambulance behind the medic unit and don't have a full appreciation of what's going on inside.
We arrive. Once we do, I park in a convenient spot and pop over to help unload. The doors to the unit are still closed and RT is still up front. What's going on? I pop the back doors open to see two medics looking frazzled and each trying desperately to hold down the patient. She's thrown off her collar. and thrashed around quite a bit. In the confines of the ambulance, the medics are holding her down to keep from getting hit. The looks on their faces are pleas for help. Apparently she's been fighting them for the whole drive and has even tried to fake a seizure or two. The medics have been so busy trying to hold her down and not get hurt themselves, they haven't had time to call anyone on the radio.
"RT! Come open up and get us out of here!" I say as I hop up to the head of the patient to help out. I try to put the collar back on her. Just as she snaps at me with her teeth, one of the medics says, "Watch out! She bites!"
I jack both of my thumbs into the space behind the angle of her jaw and below her ears. This is called the infra-orbital pressure point for law enforcement types and causes a LOT of pain without any tissue damage. I look her in the eye (both of which are very open right now).
"You bite me, I'm going to knock you out!"
Her whole body relaxes enough for us to get her out of the ambulance and into the loving arms of a waiting trauma team. I don't put the collar back on her but I do hold her head to keep it from moving. I also have my fingers placed in the same spot I "zapped" her before as a reminder that if she gets frisky, she's going to pay for it.
The trauma team is ready and, really, not very impressed with her antics. If you thought I was cruel. the trauma doctor is an absolute sadist.
As we clean our gear, one of the medics says to me:
"Man, this is what it's all about!"
The stress of the call sloughs off of us and we laugh and laugh.
We get dispatched as the 2nd ambulance on a car accident.
On our way to the scene, the incident commander (the chief of the neighboring station) asks us if we have a problem taking 3 stable kids in car seats.
RT and I look at each other. He knows he can "tap out" and drive, leaving me in "the back" to handle things if he's over his head.
"Ambulance XXX, We're direct. No worries" I reply.
Here's the deal on scene:
Mom's driving the minivan with two 11 month-old twins and a 22 month-old son in car seats. The minivan gets rear-ended. Kids are fine (that's what car seats are for) but mom's neck and back hurt. RT and I work on mom. We get her extricated to a long board & immobilized to our stretcher. Into the ambulance we go and start doing our trauma assessment to be sure we haven't missed anything.
While we're doing this, firefighters start loading car seats and kids into our ambulance. By the time we're on the road, we have a 38 year old woman in full spinal immobilization as a precaution, 3 screaming children in car seats and RT being a stuffed-toy-laden octopus who's spending equal time entertaining toddlers and treating his patient.
At the hospital, I have to go in and get help from one of the waiting ambulance crews. We roll in. One EMT with a kid in a car seat and two others pulling a stretcher containing a woman on a backboard while holding identical boys on their hips.
At the nursing triage station, it's wait wait wait.
The oldest boy is content to play with his toy while still strapped into his car seat. No escape there. RT has one twin with a biblical name. Biblical name #2 is on my hip.
As I shift Biblical name #2 from hip to hip, I notice a particular smell.
Now, RT has a son but his ex left before the boy was born. Even though RT is very much involved in his son's life now, he's never dealt with toddler management. Mind you, we're already a spectacle in the emergency room with one patient on a cot and three little kids being wrangled and corralled by two harried-looking EMTs.
I catch a nurse's eye.
"Can u get me diapers and wipes?"
Her eyes widen in recognition. I look significantly at the toddler on my hip and nod at her with a knowing look.
"I'll be right back!" She drops what she's doing and dashes off.
Five minutes later, I've got this little man on his back on an exam table and am fighting him to get his onesie off.
Clearly he has a healthy diet! Bleah!
Another 3 minutes pass and he's clean, changed and dressed.
I walk out of the exam room and mom puts a hand out to touch her baby. Her hand finds my arm.
The nurse from before comes bustling by.
"They teach you that in Paramedic school?"
We get on scene to an accident after the rescue squad. I had to plow through some pretty heavy traffic to get there.
I see a car with front end damage, a spiderwebbed windshield and a knot of firefighters around someone on the shoulder of the road.
I take a moment to look over the car while my partner gets in to see the patient. There is no passenger seat. The driver's seat is there but the front passenger seat has been removed. The windshield has a spot on the passenger side where something round (most likely a head) has struck it from the inside and caused it to shatter and bulge outward. It seems to me that whoever hit that windshield came from the back seat. That's a far way to travel.
Lying on the side of the road, there's a crying kid of about 7 or 8 years of age who's bleeding profusely from his chin. The attending firefighters are as distraught as he is. He's a kid, he's bleeding and he doesn't speak a word of English. Something about hurt kids makes us all get silly. All of the crew from the rescue squad are pretty worked up. these guys are top notch and I've rarely seen them so upset. They won't let my partner get close. It's like a rugby scrum!
In short order, I get everyone to take a moment to catch their breath, slap a dressing on his cut chin, talk to the kid in Spanish and find out the following:
1. He was in the back seat.
2. He was NOT wearing a seatbelt
3. He doesn't remember much
4. The back of his neck hurts A LOT.
From the cut on his chin and his complaint of neck pain, cut chin and the shape of the windshield bulge, I surmise that this kid flew from the back seat and face-planted into the windshield causing his head to hyper-extend, or bend backwards as much as it will go, as his body kept moving forward with the force of momentum.
This is bad.
I look over to the scene commander, my Lieutenant. I point my finger in the air and spin it around a few times. I'm telling him we need a helicopter NOW. This kid is potentially really messed up and needs to get to a children's trauma center ASAP.
"Called for it when we got on scene. ETA is 3 minutes." He says as he winks at me. LT's got my back!
We get the kid packaged (cervical collar, backboard, immobilized) and moved into my ambulance where I have room to work and light to see. The bleeding on his chin, however dramatic, has stopped and appears to be superficial. Good. His pupils are normal and reactive and he's not leaking out of his ears, nose, mouth or eyes (other than the crying). Good. Skull appears intact, no problems on the front of the neck but the back of his neck is very sensitive to touch. So much that I don't have a chance to fully see if anything is out of place. He's too tender for me to probe that deep.
Lungs are clear and he's breathing without too much effort. No apparent injuries to his chest or abdomen. Pelvis stable. All his limbs are solid, intact and have pulses with appropriate sensory and motor response. His other vital signs are pretty normal considering he's in a lot of pain and scared.
Other than his neck this kid's fine! His neck, though is really troubling me.
By the time I finish my assessment, the helicopter has landed and the medic is at the door of the ambulance. He's a tall, stern cop/medic with a no-nonsense, don't-get-in-my-way look about him. His eyes are scanning and talking in the whole scene.
I run down the basics and tell him my assumption about the mechanism of injury. I also fill him in that the kid doesn't speak English. He doesn't look at me until I explain my thinking on how the kid's face hit the windshield and how that relates to his severe neck pain. His eyes dart to me, he nods once and says, "Let's do this."
less than 90 seconds later, the kid is in the helicopter that is roaring its way skyward. I hear the medic on the radio indicate they're taking the kid to the local children's hospital, Priority 1.
I take a moment to watch the flashing lights of the Bell Jet ranger in the clear night sky and then turn around to clean up my ambulance open up traffic and clear the scene.
Though I am still a paramedic and, from time to time, still get out and do some “paramedic-izing” my full time job is a college teacher.
This semester, I am teaching several lecture classes. One of them is a seminar for freshman who have declared my department's major as their own. It's one of those, “introduction-to-college-life-this-is-you-in-the-big-bad-world” kind of things. Each week we meet for an hour and talk about things that impact them as students and as emerging adults. We've done group problem solving exercises, we've discussed campus life and where each student is from. We've done icebreakers and “getting to know your neighbor” exercises. All in all, these kids are a really neat group of people.
Today, My assigned topic was “diversity.” On the face of it, it's a tricky and possibly onerous subject. Many have tried to teach it and have done it poorly. I did my best. I worked up a nice presentation with minimal powerpoint bullets. I referred to campus resources for student culture organizations, built in time for the students to discuss their perceptions of people and even fit in a homework assignment having to do with dissecting your own bias or prejudice (everybody has one).
Well, I walked out to the lobby and saw my students lounging around. Through the window streamed pure sunlight, dappled by the green leaves of a Bradford pear tree. Two of my students are Muslim and were pretty weak after about 5 days of fasting during Ramadan. I looked at my students, I looked at the classroom (two small windows) and I looked out the sunny lobby window again.
“Hold on.” I dashed out, printed up my lecture notes. Tossed my laptop into my office and returned to the lobby.
“Follow Me!” We all traipsed out to the sunny courtyard. I took the class outside!
I went through my notes. I delivered my lecture well. My students responded well and we had a pretty good time. I tackled some tricky issues (race, religion and sexual orientation) but a lot of discussion came out of it and it was good.
Somewhere in there, we wandered off the lesson plan. We were talking about respect. Respecting people's basic human rights, their humanity and their individuality. During our discussion, I realized that a core principle of accepting and appreciating the lovely diversity of people around us is respect.
“What is the golden rule?” I asked the students in a moment of inspiration.
“Treat others the way you wanna be treated” replied a bright-eyed enthusiastic freshman.
“Exactly! 'Do unto others as you would have them do unto you.'” I replied. Something was happening, I felt this idea coming up my brainstem into my cognitive lobes. Sparks were flying!
I looked at another student in the eye. “Do you wish to be treated with respect?”
“And you?” to another student
More nodding, and on and on.
“Well, how do you pay for that?”
“How do you ensure that you are treated with respect?”
The bright eyed student piped up, “Treat them that way!”
“YES! That is the thing!” (The idea was really boiling now!)
“We MUST treat others the way we want to be treated! And the only way to be sure we do that is to look at that person and say to yourself:”
I paused. I looked right at a student in front of me.
“You are me.”
She looked a little confused.
I waited. I knew this was a doozy.
Her eyes did that: “get wider because I suddenly get it” thing! It was awesome!!
“That's right! Each person I encounter is NO different from me in the ways that really matter. Each person I meet is another one of me and I will treat them and accept them as if they were myself!”
“This is the most important thing for you to realize. If you get this, I mean really get it, then you can have compassion, acceptance and all the other fancy words. Most of all, you start to enjoy the amazing and wonderful range of people that move through our lives. Skin color, nationality, religion, physical shape, sexual orientation or politics cannot change the fact that, fundamentally, we are reflections of each other. We are alike in the ways that really, really matter! It's so GREAT! It really is!”
“When you become medical providers, you will start to look at each patient and see them as yourself. You will start to develop compassion because you can feel how you'd want to be cared for in their place. You'll treat your older patients as your aunts, uncles, grandparents, and your younger patients as your own brothers and sisters. Once you find a way to recognize yourself in the face of everyone else, regardless of where they're from and what they look like, you will find the key to all of this. You'll find it a natural thing to respect people, accept people and take joy in the broad range of people that move through your life!”
I find myself really worked up!! I was really onto something (and I still think so!)! This is really, really it!!!
Each one of my students' faces are shining at me! I mean it they're really shining like they get it too!!!
Then they start looking past me into the rest of the courtyard. Eyes shoot off to the side to the nearby lecture hall entrance.
I turn around.
My class of 15 students has suddenly grown to about 40!
Their faces are shining too!
..Honestly! It isn't!
I made a promise back in an early post that I would not discuss politics. This is not about my political views but it is about how politics can affect us all.
There was a decision made by the director of NHTSA. It, basically, says that no engineer, scientist or anyone else who does research into safety standards may speak to the press or the public on record. The only person who can do that is the director. An attorney appointed by a politician.
This is BIG news for us safely people but it is not caught by the front page press. It appeared in a blog in the automotive section of the New York Times online.
To this, I posted a brief but, I think, cogent comment. While many were raging about the lack of journalistic access and how our government is becoming more and more fascist, my angle is more along the lines of safety.
Here's my comment verbatim:
"This is exceptionally disturbing even beyond the journalistic perspective.
The NHTSA was responsible for starting the entire industry of EMS in the US today. It responded to a paper called, "Accidental Death and Disability - The Neglected Disease of Modern Society" that was published by the National Academy of Sciences by establishing a set of guidelines for highway safety and driver safety.
From this came the seatbelt law, the establishment of the guidelines for emergengy medical transport and countless safety laws that were imposed upon, and fought by, the automobile manufacturers.
As a paramedic, I'm appalled that this agency seems to be suffering a "throttling" effect by a political appointee. The "conspiracy theorist" in me sees a connection between this and the influence of the automobile manufacturer's lobby. (then again, I'm sure I see a lot of things like that)
The main disturbing point is that the engineers and scientists of this agency produce data that has a direct affect on the safety and injury prevention of all of us. I can't tell you how many times I was amazed to find an unhurt driver or passenger due to an airbag, seatbelt or rollover protection.
If the straightforward, factual information produced by these men and women is filtered through a person who may be influenced by a political agenda, I fear that we, as the public, may not recieve the full benefit of their work. This is what this agency does! It actually saves a lot of lives. It should be allowed to continue to do so."
Here's my cat in my lap. He's been out for far too long. His coat is scraggly and he's getting kind of thin. My hands move over his little bony body and I feel what's going on. I can feel the big wad of food he just ate It's a hard lump just below his ribcage. I can feel him breathing and rumbling as I pet him. As I rub his shoulders, I can feel the ropy latissimus muscles moving across his scapulae. I know all of his parts. I'm worried about his kidneys and bladder. As I feel around his ribs to where his kidneys should be and down his belly to his bladder, he complains no more than usual. Good.
Thirteen years ago, when I got this cat, he was no more than a bundle of attitude wearing fur pajamas. Today, I still have great affection for my cat but he's more than just a fuzzy beast who demands food and pets. I see him as an organism. I know his parts. I have a greater understanding for how these things work.
I do this to people too. I can see both parts of the gastrocnemii in my dad's calves as he hikes up the trail ahead of me. He's got great legs from so many years of hiking and playing soccer. When I'm sitting still, watching the world stroll by, I can spot the woman with cardiac problems from her pedal edema, the COPD patient from his barrel chest and bottle of oxygen as he walks by. I also can see the worrying signs of aging in my parents as I've never been able to see before.
My perception of people has changed since I've become a paramedic. People, for me, are more than just their outward appearances. My awareness goes deeper than that. I can see their muscles, bones, tendons. I can see where they're moving wrong. Scars tell me a story like they never did before. Yes, those railroad tracks on someone's chest? That means they've had their heart open and if they're gasping for air, bad things are happening. The intellectual part of me finds this infinitely fascinating but the human me is alarmed at times to see the frailty in those I love.
I know that everyone's got a heart, two lungs, an enteral tract, a liver, eyes, brain, blood, a lymph system, IgA and all his companions, etc.. In fact, I know it more than I ever did before. I could become alarmed and frightened by how fragile all these creatures are but I'm not. I'm in a constant state of wonder that someone so wonderful and complex as my brother, my wife, my niece my cat, my dog or my father can be so much more than a simple collection of anatomical structures.
We are so much more than the sum of our parts.
If we were just meat, there would be no place in the world for people like me.
This is why we (EMTs, paramedics and rescuers everywhere) do what we do.
I had a different job this weekend.
Check out the Kinetic Sculpture Race in Baltimore, MD.
I was the RampMaster:
It was pretty Awesome!!
As the RampMaster, I was in charge of making sure the sculptures entered and exited the water safely and without any spectators being run over, hurt or otherwise damaged.
I even helped out when one or two capsized:
..and, yes, the costume was intentional.
(thank you Mark Barry for the photographs!)
The killings at Virginia Tech are horrible and disgusting.
I'm reacting to them on many levels. I'm an EMS provider, I'm a former Federal Officer with a lot of tactical training and I'm also a college teacher.
Ugh! Heavy stuff!
I promise a lot more words soon. I really need to get it out and here's the place.
I just need to process it a bit more.
I've been contemplating trying to make some money off this thing. It certainly would move me to write some more. I've checked a few other blogs and see that some of you are using Google's Ad Sense program and one or two have more specific ads.
I have a few questions:
People with Blogs that have ads: How much are you making? Roughly? Is it worth it? Any suggestions?
Readers: Is my blog being Ad-Free an important factor? Will you be totally turned off and accuse me of "selling out" if I put Google's Ad Sense into my blog?
I'm leaning more towards Ad Sense. When I've seen it in people's blogs, it looks pretty unobtrusive.
Let me know what you think by email or comment below.
On Friday night, I propose we have a blogmeet at DSX, it's a sports bar across the street from the convention center at 200 Pratt Street.
I'll be there at around 6:30-ish an I'll be hanging around a while. I'm tall, bald and wear glasses. Come introduce yourself and have a beer! Let's see how many blogger and bog-readers are going to be in town.
This'll be neat.
PhillyDan suggested it and I hope to see him and everyone else there!
We'll see how well it works. I really don't like having to write my blog through a web browser. nor do I like using a word processor to write and then cut and past. Too gunky. I have been using Firefox but, again, the web browser thing prevents me from writing off-line.
Ok, Enough of the test. Let's publish!
I'm forced to use this stupid, clumsy web-interface that still does not support Safari.
Here's the text of the message I tried to send:
"Well, since Google (TM) has taken over Blogger, none of the 3rd-party clients or applications I use to post to my blog work. Never mind that I've been using them for 3.5 years.
That's the MAIN reason I haven't been posting so much. A lot of cool things have happened. Before, It was a matter of writing it up in my journal software (where I've been working on other things, including a few manuscripts) and hitting "publish."
Well, NO MORE!
Now I'm forced to use a Google (TM) portal which Still does not recognize Safari.
I'm writing this one by Email.
The message sent out successfully, according to my e-mail client. It never made it to the web page.
Apparently, Google (TM) wants everything done through their web portal. Or they don't like the subject line.
I know I'm getting all this for free but, I'm so frustrated, I'm ready to dump and delete the whole blog!
Meanwhile, I have 2 items to share:
1. Who's coming to EMS Today, 2006 and should we arrange a "BlogMeet?" Email me or hit the comments.
2. I ran a small vehicular accident today:
Amazingly, the driver was completely unharmed! I checked him twice and he was truly uninjured!
He did it with his service pistol.
I wasn't his closest friend but we got along pretty well. I have no idea how he got down this road but it sucks.
He did it with his service pistol.
He died by his own hand.
He did it with his service pistol.
He did it with his service pistol.
Cops everywhere can understand how disturbing that is.
He did it with his service pistol.
I'm very upset. Herself and I talk about it (one of the 1,000 reasons I love her).
He did it with his service pistol.
There's something particularly disturbing to police when another officer kills herself/himself with their own service weapon. This is the gun is issued to them by and owned by the city/county/state/agency that gave them their police powers. It is the physical representation of the trust placed in them. This is a trust to carry and wield the power of deadly force and to wield it wisely. This is the trust placed in the officer to make the right decisions every time!
He did it with his service pistol.
When he/she turns that weapon on himself/herself, it is a violation of that trust on many levels. The trust to use that force wisely, the trust to know oneself, the trust to call for help when needed.....
He did it with his service pistol.
Any officer of the law can feel this tragedy. Especially as it comes from the end of the symbol of that trust.
He did it with his service pistol.
I may not be a healer, but I'm in the profession of healing.
He did it with his service pistol.
This can't be healed. If only I had known....
He did it with his service pistol.
It hurts me everywhere. It's a sore that hurts no matter what I do. There is no salve for this.
He did it with his service pistol.
He's gone and has left a jagged, painful hole in his absence.
He did it with his service pistol.
Louis, What have you done?
The police called us in to check out one of them. When we arrived, the police were rushing out of the apartment on their way to the next instance of violence.
My patient is a native Spanish speaker with a severely swollen face. Otherwise he's OK. He doesn't want to go to the hospital.
But he likes me!
"What's your number?"
"Well, If you need us, call 911."
"But what's your number?"
"What number do I call if I want you to come to my house?"
"911!" (I'm still thinking my Spanish is not up to par.)
"But what if I want you to come to my house? What's your number?"
"Nuevo-Uno-Uno(911 in Spanish) es el numero para los paramedicos (...is the number for the paramedics)!" Perhaps his face is swollen to the point I can't read the nuances of what he's trying to tell me.
"No, no, no! What's YOUR number?"
Bean puts her hand on my shoulder: "Time to go!" She doesn't speak Spanish but she knows what's going on.
All the way back to the station:
"Maddog's got a Boyfriend!...Maddog's got a Boyfriend!...Maddog's got a Boyfriend!..."
I look to my right.
There's the husband.
He's wearing the "I can't believe what I'm seeing!" look.
"...and fifteen and sixteen and seventeen......"
And so it goes.
I got this comment from a reader:
"Whatever happened to Bulldog? (or is she now Bean?)"
Well, that's a good question and it illustrates some confusion I have allowed to occur.
I volunteer at my local firehouse as an EMS officer. I mostly drive the ambulance, train new kids and occasionally provide care. In my writing, I refer to this place at the Firehouse with a capital "F". This is where most of my fun "hometown EMS" stories come from.
Bean is one of the volunteers there and I've known her for over 10 years.
My crappy job, at a private ambulance company, was where I worked with Bulldog. I went to a part-time position when I got hired by a nearby University. Bulldog still works there. I just don't see her as much. :(
So, I hope that doesn't create too much confusion. I volunteer at the Firehouse. I occasionally work at the Crappy Job. I work full time at the University (teaching paramedics!) and have applied for a part time paramedic position with a regional emergency response agency that I'll call "The Boonies" if I get the job (It's kinda way out there).
Perhaps sometime I'll post a "cast of characters" for my dear readers.
I just found the patent's cellphone in the pocket of my turnout Jacket.
He was probably too drunk to remember what happened to it. I'm going to try to get his home address and mail it to him.
The chiefs & other line officers at my volunteer Firehouse have been bugging me for a while. There is a position of "EMS Sergeant" that has become open recently. Due to my education and possibly the fact that I'm the highest trained and qualified EMS person at the whole station, they've been pestering me to apply.
I really don't have the time. I'm worried that if I commit to doing more for my Firehouse, I won't have the time to do it and I won't come through. I'd rather say "no" than say "yes" and let everyone down. I've been deflecting their requests and encouragements with this very argument.
Then they got sneaky.
Herself and I had stopped by the Firehouse after walking Mr. B in the woods. He was all muddy and needed to be hosed off before we took him home. While we're there, the deputy chief, Sunshine, comes up to us and asks me if I've put in my application for the EMS sergeant position. I begin the usual argument that I really don't have the time to do all this, yada yada yada.
Meanwhile, Herself saunters over to the bulletin board where the position announcement is. She reads over the list of duties and responsibilities and says,
"You can do this. Hell, you do most of this anyway."
Sunshine smiles at me.
Well, it turned out better than I had hoped. Helga had applied for the position too. She's on an opposite duty rotation from me. her strengths lie in the administrative and organizational areas and less so in training, field operations and orienting new members.
Chief decided to split the position in two. Helga is the EMS Administration Sergeant and I'm the EMS Operations Sergeant. I'm in charge of all EMS training, stock and supply on the ambulance itself, quality assurance of field practice and skills and making sure new people get trained and turned over in a timely manner. Stuff I already do.
I did roast a delicious leg of lamb. The house smells wonderful.
Not much that's EMS-Blog-worthy. Nor was I particularly inspired to go on about anything.
Well, it is Sunday!
I'm driving to an accident that's downstream from all the rush hour traffic. This means I have to wade through the congestion on the highway. We usually ride the shoulder if it's big enough. In this case, the shoulders are all too small for my huge ambulance. This is when I get to perform a "Moses."
Just like Moses parted the Red Sea, I drive my ambulance right down the middle of the lane divider. I'm sounding 2 sirens at different frequencies and patterns as well as working a diesel air horn in a way that cannot be ignored.
Just like the Red Sea of legend, the traffic parts in front of me.
Most of the time.
This one instance, an SUV decides to take advantage of the break in traffic that I caused to get over 3 lanes to the exit.
His doing so causes me to stand on the brakes with both feet to keep from making an accordion out of him.
He moves out of my lane. I pull abreast of him and Bean and I look at him.
He's on his phone. He gives me a dirty look.
It's worth mention at this point that the air horns on my ambulance are mounted on the front fenders. This happens to be at almost the exact height of a person's head when they're driving a typical American car or SUV.
I don't know who hit the horn first, me or Bean (we both have a pedal for the diesel air horn).
His window was open.
He almost jumped into his passenger seat. (and he dropped his phone)
Bean is trying to put a collar on his neck. He's alternating between trying to hit her and give her the finger. His truck is against the side wall of a bridge. Every time he smacks her helmet, she teeters over a 25 -foot drop to another highway.
All the while he's on his mobile phone.
I take the phone from him and talk to the caller.
"Who's this?" the voice asks.
"This is Paramedic [Maddog] from [Somwehere] Fire department. Who are you?"
"Oh, He's my boy. I'm his homey."
"Were you hanging out with him tonight?"
"Oh, we was just chillin' you know?"
"Yeah, I know. Cool. Been drinkin' some?" (I suprise myself at how easily I slip into character)
"Oh, yeah. We wuz fo' sho'! Where he at? I'm'a come pick him up."
"Duuude, if you been' drinkin' as much as him, you bes' stay at home, knowhaimsayin? Else I'll be scoopin' you off the road next. You feel me?"
"Aw Sh**, man. He gwoan be aiiit?"
"We'll do our best. He'll be at [somewheretown] hospital tomorrow, if you need to see him."
"I'll pick him up tonigh!"
"What! nonoNO! You stayin' right THERE, Fool! I'll take care of 'your boy'. You sleep it off before you drive a car, aiit?
Wow! I think I saved someone's life!
I've gotten qualified as a driver for the ambulance. This is especially relevant in a volunteer station like mine where qualified drivers are scarce. Even more scarce are qualified drivers who would be glad to drive the ambulance vs. ride on the fire engine to a fire call.
This means that, with a few exceptions, when I arrive at the Firehouse, I'm the Ambo Driver. Kind of silly for someone with 3 years of schooling, a degree in prehospital emergency medicine and a certified Paramedic. But, that's how it goes in my silly, backwards jurisdiction.
Let me tell you about driving this thing...
The bell rings and the printer spits out a paper. Off we go.
Climb up into the driver's seat. The bottom of the seat is about chest-height on me when I'm standing on the floor. I'm 6'4", or 2 meters tall, that's some altitude! On my way up to that lofty seat, I turn on the battery, click over the ignition so the 300+ HP engine can warm up before starting and hit the button to open the door to let the ambulance out.
While the door trundles its way up, I turn over the engine. Bean and I put on headsets. These serve to cut out the outrageous amount of noise from the ambulance, sirens and air horns and enable us to hear each other and the radio.
I hit the button to turn on the "lights" or flashing beacons that tell all the idiots in the world that we're on our way to an emergency. Meanwhile, Bean has "marked up" or notified dispatch that we are en-route.
I press the button marked "D" for drive, push in the huge air-brake button and 7 tons of emergency transport vehicle lurches forward against my foot brake.
"HeadSets! SeatBelts!" I yell to Bean and anyone who has happened to hop into the back. Once I confirm that everone is belted and I can talk to them, off we go!
Well, we roll out the door and I pause long enough to close the bay door with the remote. Then it's siren, steering and looking in four directions at once.
When you drive your car, you point the wheel where you want to go. You steer from the front of your vehicle or from what's in front of you.
When you're driving a vehicle that is 9 feet wide (3 meters), almost 30 feet long (9 meters) and over 7 tons (6500 kilograms), you drive from the rear wheels to the side mirrors to 1/4 of a mile ahead of you. And you do it all very fast!
I've learned to look at my old neighborhood in terms of where my ambulance will fit, when I need to start my turn to get onto that street and what houses are best accessed from the back vs the front. After having driven boats and ships in the Coast Guard, an ambulance of this size is not much different. Except people tend to ignore you more (that's for another post).
So, yeah. There is a LOT of fun in driving 7 tons of aluminum and steel at outrageous speeds while legally violating traffic laws. But that's not the best part.
The best part is pulling up to the local coffee shop. In the fire lane. Behind the mercedes that is illegally parked so someone doesn't have to walk the extra 10 feet.
(Cycle the siren "Bweeeeooowww!") "Hey man! This is a fire lane. You can't park here!" Bean and I hold our hands out to our sides, palms up as if we're saying, "See?"
Mercedes-man gets a dark look on his face and goes back to his $65,000 car like a 5-year-old caught in the act. He parks in a regular space.
Just to prove a point, so do I!
Inside the coffee shop:
"Did you just chase that guy out of the fire lane?"
"Well, I guess I did."
Suddenly, breakfast is free!
"sour smelling urine breath"
--Yeah! Same to you, pal!
"happy anniversary cardiology"
--Aw! How sweet! Been together long?
"dangly-bits my hospital"
--Um....I'll keep my dangly-bits in my own hospital, thankyouverymuch!
Here's my question for you readers:
How do you handle someone who frequently flouts that they're "senior" to you?
If they truly are, then that's not a problem so much. The real rub is when the person is using the time she/he has spent at the station as the only criterion. You are more qualified, better trained and more experienced in every way. This person only has 2 months more time in this particular jurisdiction and 1.5 years more time in this station.
All the time: "I'm senior to you."
It's about to get worse. We both applied to the same EMS Sargent position. All signs point to it being awarded to me.
This is going to be a fun year.
I have performed absolutely zero amounts of EMS or even much EMS-related thinking today.
I got a couple more comments on my earlier post and even an email. I'll be writing a follow up later in the week.
I did, however, make the most wonderful split pea soup in the entire world!
That's it for Sunday.
One readerhas commented on my earlier post. If you've got some input, drop it into the comments for that post.
See ya tomorrow!
As I pulled over, I passed another car in the median that was perpendicular to the travel of traffic. It was straddling the ditch in such a way that it could not have driven there. Add the lack of skid marks and the considerable damage to the roof and windshield, it was clearly a roll-over.
Well, out I go. I see a car about 25 yards further up the road. The driver is in the trunk and I see him put on a turnout coat. Cool. I have help.
In the roll-over car, I find a shook up woman with a bloody hand, sore head and neck who's conscious, alert and oriented to person place and time. (shorthand: CAOX3). The firefighter shows up with a bag that's got basic bandages, a blood pressure cuff and stethoscope. It's enough for us to get started on checking her out. He also has gloves so I don't get blood on me.
Did I mention that it was raining? Did I mention we were in a ditch? Did I mention that I was dressed for a day at my office at the university (professorial cap and all) not for a day on an ambulance? Boy was I grateful for the waterproof dress shoes I got for Xmas!
There wasn't much we could do other than calm her, get a good history and hold her head to protect her cervical spine. In fact, we didn't have much as far as tools. All I had was my stethoscope that lives on my rear-view mirror.
Here's my question:
What should I have in a "go" bag if I get one?
I don't want to have a massive duffel bag that prepares me for the Armageddon. Most places I go EMS support is not more than 10 minutes away. I'm not thinking I need ALS gear. It would have been nice to provide a C-collar and some better bandaging. I love my station wagon but I don't want to give up all my cargo space for a bag.
Here's what I think:
Pocket mask with one way valve and filter
4X4 and 2X2 gauze
Tape 1, 2 and 3 inch width
An OB kit
Oral airways (basic)
BP cuff (adult and pediatric)
Stethoscope (in case mine on the mirror is not available)
I can think of a lot of things like hare traction splints, full intubation kit, ACLS Drugs, a lifepak 12 and more but, my VW Jetta is not an ambulance. I'm thinking that can handle most of the ABC's and life threats. While it would be great to have a mini AED, I don't think it's worth the cost.
Those of you who have bags, Sound off! What do you carry in your car? Hit the comments link or email me and I'll post a summary.
I was discussing this after the meeting with a few senior members. I said we have to now get another 12 people in to the stations to do ride-alongs because one in three of them will actually apply and one of those four will actually become a long-standing member. I further pointed out that we need to get at least one new, funtioning member a month in order to keep up with the natural attrition due to life changes, retirement, injury, etc.. I, personally, have brought in about 12 ride-alongs in the past 2 years, of which 3 are now members (cleared to ride and run calls) and three more are seriously considering it.
It's all about selling yourself and your firehouse. It doesn't hurt that my firehouse is awesome and filled with a great group of people.
Since then I:
have had 33,355 visitors
Treated an eviscerated patient
Went to the funeral of a shipmate
Lost my twin daughters
Lost my uncle
Made someone wear a dress
Lost my mother-in-law
Took my dog on Vacation
Get told I'm an angel
Had a "Save"
Ran a marathon
Learned IV skills from a junkie
Ran a code on a neighbor (No "save")
Ran another marathon
Lost my Grandfather
Lost my Dog
Became a paramedic
Graduated from college
Wrote about love
Got a job I didn't like
Got another dog
Got a job I like much better
Whew! Busy times! Thanks for reading. See you all tomorrow.
Um...right. Yeah. Not much going on today as far as EMS. I went to work. I was the only one there. It's kind of creepy being alone in a building on a college campus. There were a few classes down the hall (Today was the first day of the winter session) and a few students came by my office looking for their classroom.
I also got all the deliveries for the entire floor. There are now 6 boxes in my office that are not for me! Whee! The funny part is I won't be in the office tomorrow. Whoever they're for has to get into my locked office and get them. Hee hee.
Tomorrow I go and interview for a regional 911 service. I took their application test a month and a half ago. It consisted of three stations from the national registry test: Dynamic Cardiology, Trauma Assessment and Advanced Airway Managment (Intubation and Combi-tube).
I, of course, Rocked it!
One of the evaluators in the Trauma assessment station said, "Dude, you went right down the list. By the book. I don't think I ever do that myself!"
So, it'll be cool if I get that job. It's a part time gig doing 8, 12 or 24 hour shifts in an area that's a good mix of totally rural (tractor roll over and ATV accidents) and pretty dense urban (gunshots, assault and car accidents.). I flew down there when I was doing my air medicine clincials. I've seen some of the area.
So there you have it! Until tomorrow, "Good night and good luck."
Ok! New Year = New Start. I'm going to make no less than 365 posts this year. Even if it's to post that I've done nothing today, I'm going to stay current.
I've been out a while because much has been going on. Herself has recently quit her job and is starting her own business. This is a large consumer of both of our times. Ugh. To catch you up to what's been going on I'll refer to a previous post:
A life is saved:
Bulldog and I run a call down to a small hospital in a nearby military base. We're being sent to transport a patient from the emergency room to another hospital to be further evaluated for pneumonia. It's sent out as a Basic Life Support call.
At the ER desk, the nurse is telling me how the patient has a history of pulmonary fibroids, had a fever when he came in and responded well to antibiotics. He's a 57 year old retiree from the Air Force. I have a peek at the patient and he's snoozing (it's midnight) comfortably except he's sweating a lot. I wake him up and ask him how he feels (fine), is he feeling hot (no), does he have any pain anywhere (no).
Ok, back to the nurse as she's pulling out his chart to fill out the transfer paperwork.
Whoah! What's this? A 12-lead EKG! I love to read these things.
"Um, Is this EKG recent?" I ask the nurse.
"Yeah, an hour ago, why?"
"He's having an anterio-septal MI." (This is where the heart is starving for oxygen because the arteries are clogged or clogging. Often referred to as a heart attack. It shows up very distinctly on an EKG.)
This patient went to a cardiac center rather than an unmonitored bed in a community recovery hospital.
An alma-mater speaks:
I've been teaching a 3-credit course at school from which I just graduated. The person who was hired to teach the course became seriously ill two weeks before the semester started. I "stepped into the breach" and took over the class.
In the middle of October I get an email from the department head. "Can you meet with me tomorrow?"
Uh oh! I might be in trouble! I'm thinking I've goofed up or the students have complained or I'm not teaching very well or something. Who knows. So I go meet with him.
I'm in bigger trouble than I thought. Again, the university has a sudden vacancy. Again, I'm asked to "step into the breach." Only this time it's a full time position on the faculty!
"I need a salesman, paramedic, project manager and drill seargent all rolled into one." says Dr. Boss. "Maddog, you're perfect for this job."
Awesome! I don't punch a clock. Dr. Boss cares about results and that's about it. The job is very demanding and there's a LOT to do (that's one reason I've been so freakin' busy) but I'm enjoying myself very much. I'm the clinical coordinator, in charge of setting up all the clinical field experieces for the paramedic students, keeping track of their training goals and seeing to it that they are on target to meet them. The clinical coordinator postion was the weakest part of my whole education. There had been 4 people in the job in 3 years. I now have a chance to fix what's wrong with the job. I'm pretty stoked.
The pay is nice and I'm getting my Master's degree for free!!!!
Maddog succumbs to gravity:
The day after I get my awesome job offer I'm back at my less-than-pleasant job. It's the night shift and I head out of the garage to my ambulance. All of the ligts in the back of the building have burned out and it seems management is not in much of a hurry to fix them.
I fall off the loading dock.
This time, Bulldog gets to drive ME to the hospital.
I'm better now but not in much of a hurry to go back there.
So there you have it. I've mostly caught up with you. I'll post again tomorrow!