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Some Fantastic Chronicles of EMS News!

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I would have to say that most of the people I know who have worked in EMS for any period of time have found themselves questioning why things are done a certain way.

If that person is brave enough to actually ask “Why do we…” they are typically answered with, “Because this is the way it has always been done.”

Maybe a better way exists out there.  Maybe if we stopped talking about wanting things to be better and actually got off our backsides and did some work we could be a part of the change we want to see.

I know that I’ve talked about the project Chronicles of EMS a few times in the past…  I have to ask you to put up with me one more time…   The gentlemen behind this program are all Paramedic’s working the streets, just like us,  who have an interest in bettering EMS for all involved.  From the road crews to the most important people, the public who depends on us in their time of greatest need.

So they set out with virtually no budget, just unabashed passion for an industry that is often the red-headed stepchild of public service, and they made something amazing.

If you haven’t watched the first episode of the Chronicles, you can see it here.

In just eight short months, this project has gone from an idea between a few guys to something that’s being shopped to TV executives.  This is where we come in.

We need to come up with a tagline for the show other than “The Reality Series”. Something that better states what the show is all about.   And there are prizes, folks.  The person with the winning name will receive round trip flights and 3 nights accommodation to a location of their choice where the Chronicles of EMS will be filming. This could be New York, San Francisco, Germany, Austria, IRELAND *cough cough* If the show is going there, the winner can go with them. They will also receive show credits and some ‘on screen time’ in a future episode too.

If thats not enough, they also get a 16GB Wi-Fi, 3G iPad.

If the winner is under the age of 18, they will win a top of the line 64GB ipad Wi-Fi & 3G.

The only requirement is that you have to be a member of the Chronicles of EMS community. This is free to join and can be done in mere seconds.  You can do it here.

Thanks, ya’ll… Be safe out there!

App Review: Emergency & Critical Care

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I’ve carried an Informed Pocket Guide in one way shape or form since my very first day on an ambulance (not nearly as long as most, but longer than some).  The paper versions of the popular guide have proven themselves to stand the test of time, not to mention some of the…er… less popular elements we sometimes run into (or attempt to dodge) as EMS folk.

My BLS/ILS copy.

The ALS version is in there somewhere… And of course the ALS version for iPod…  If one is good, two is better?!?

Many of my coworkers have one.  The Life Squad I worked on the other day had a copy. So when given an opportunity to evaluate the new Emergency and Critical Care Pocket Guide for the iPhone/iPod touch, I jumped at the opportunity.  I had purchased the ALS version the very day that I bought my iPod, and I’ve used it a bit.  I should also start out by saying that this is the first version of this app that I’ve owned, so I’m looking at it with new eyes.

The first thing that I noticed was the improved navigation over the ALS version for the iPhone.  Everything is easier to find.  It’s all laid out for you from the point that you touch the title screen and gone are the days of having to skim over countless pages PDF pages to get to get to the topic you’re looking for.  This saves a considerable amount of time.

Another feature that I absolutely love (and would pay the price of the app for on it’s own), are the calculators.  There are built in calculators for everything from the glascow scale to the Parkland Formula.  What I’ve found myself using the most in the field and in the ER during clinicals (even convinced the charge nurse one shift to purchase the app) is the conversion calculator.

Need to convert your pt’s weight into kilo’s?  Check.

What size ET tube does your pedi patient need?  Forgetaboutit!

Need to convert your pt’s temp from degrees to celsius?  Not a problem.

Can’t remember the APGAR scale or the dosage for dextrose for a preemie because you’re too busy, er, sweating?  Done and done.


The Meds section, the information on ventilators, the hemodynamic values…  Win, win, win!

So, yes, I’m a definite fan.  I would have paid twice what they’re asking.  A great app for anyone who works as a Medic, a tech, RN, RT, etc.

Have an iPhone or an iPod touch?  Pick up your copy here. It’s only $9.99, and it’s a steal at that.

Viva la heart!

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I’ve always known that there was this hunk of muscle about the size of my fist in my chest.  I knew it pumped blood through my entire body, and that as long as it kept beating at a somewhat regular pace, say about 80 beats per minute, that that was a good thing.

Then I started Paramedic school.

The Cardiovascular system is one of the more challenging chapters for many.  Some dread it.  I looked forward to it like a kid being let loose in Toys R Us with a million bucks.  Or a certain medic student being let loose in a Coach purse store with 10 million bucks.

Yep.  I’m a geek.  Sue me :)

The more I learned, the more I wanted to learn.  I would seek out cardiac patients during my ER time.  I would frequently read articles from various websites and blogs written by people who have forgotten more about the heart than what I’ve learned (big shout out to Prehospital 12-lead and Paramedicine 101).  When I couldn’t quite understand something, I went to my people.  Blogdaddy Ambulance DriverMedic Matthew, and JB.

I learned about the atria, ventricles, conduction pathways and coronary arteries.  I learned about 3 leads, memorized rules to rhythms, and eventually began to understand what was going on in the heart to cause a certain rhythm to march across the monitor.  We learned about AMI’s, and 12-leads, and how doing something as simple as moving V4 can mean the difference between nitro and fluids.  I didn’t just memorize drugs and doses and that you push Adenosine really freaking fast, I learned the why behind it.

And that was  just scratching the surface. What I’ve just begun to learn… It’s hard to wrap my head around.

We’ve been done with the chapters for a few months now, and I’m still eating up all of the information I can get my hands on with a big ole spoon.  Today, for instance, was a very cool day.  Today I was fortunate enough to be able to spend some time in a cath lab.

The first thing I learned was that I look awful in scrubs.

(And yes, that’s a Chronicles sticker on the back of my phone :)

And wearing boots certainly didn’t help.

Wow, way to get off track.

Not five minutes after getting into my lovely ensemble I found myself donning a lead vest and skirt, a cap over my hair and a mask.  I was invited to watch someone have a dual chamber pacemaker put in.  The Doctor, I wish I had remembered his name, was fantastic. He really took the time to explain what he was doing as he did it, and inviting me to stand directly to his right.  I had a front row seat.  And it was so unbelievably cool.

Electricity.  It’s good stuff when it works.  When Sydney Sinus gets sick, however, all kinds of wickedness kicks up.  I watched the patients rate and rhythm change like the weather does in NW Ohio.  Which is to say often and unpredictably.  At one point there was a sinus arrest that lasted just long enough to make my heart race, about 15 seconds before returning to RSR.

The rest of my shift was equally as cool.  I was able to watch a few PCI’s being performed, and watched with held breath as pefusion was returned to what had been a blocked RCA.  And again, everything was explained to me as it was done, everyone went out of their way to answer any questions I had.

This is how it’s done, folks, these people were amazing.  And I am so grateful for the opportunity that I was given to learn and observe.

**********

I’m within a few short weeks of finish the course, and I couldn’t be more excited.  Right now my days are pretty much consumed by class and clinical time.  The next 30 days, for example have me doing six 15-hour third rides on a life squad, two eight hour OR shifts for intubations, two OB shifts (cross your fingers, I still need a live birth!), seven ER shifts, a major exam and of course the days of lecture and lab.

Am I complaining?  Absolutely not. Still, some days are easier than others, and I when I need a swift verbal kick to the backside, I know who to call.  Honestly, though, I’m doing well.  I knew this would be a challenge when I started, and it should be.

Take care ya’ll, and again, thank you for giving me this amazing opportunity!  I wont let you down!

I know.

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I know I haven’t written anything worth reading in just about forever.

Forgive me…  I’m doing my best.  School and life and everything else is kicking my butt.

That being said, a friend of mine wrote something that if you haven’t read, you really need to.  “In an Instant”

CKEMTP is a paramedic from the great state of Illinois.  Check out his blog here.

So It Was Like This…

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No, this isn’t a post about how to explain the damage you did to the ambulance bay to your EMS Director.

That’s another post for another day. 

Let’s just say that Epi has issues when it comes to backing up an ambulance.

ANYWAY…

So… It was like this….

I was drinking my coffee and perusing the aisles of my favorite book store looking for a book on crocheting patterns nursery rhymes ways to barbecue baby duck a study guide for the NREMT-P test when I came across a book with a name that I found familiar….

And I might have had a fangirl moment for a second.  I might have, if I didn’t know the guy.

It was kind of cool though :)

If you have a passion for EMS (or know someone who does) consider picking up a current version  of Ambulance Driver‘s/Kelly’s book. You can pick it up here, and it has a story about an ostrich that has haunted my dreams for a couple of years now.

*Shiver* Ostriches.

Be safe out there ya’ll.

And avoid the ostrich.


Fair Thee Well, April.

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Peace, April.

Bring on May.

Two months to go.  Just two months.

The finish line is so close I can taste it.  (Don’t ask me what it tastes like, you probably wont like the answer.)

Be safe out there, and I promise to put something up worth reading as soon as I can find enough time to actually breathe.

CoEMS. Let's Do This.

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Have you seen these two?

Maybe they look a little more familiar here.

The EMS blogging world is abuzz with talk about the Chronicles of EMS.  If you aren’t familiar with this project and you’re involved in EMS in any capacity, anywhere in the world, you should check it out.

I might have mentioned this inspired project once or twice.  Please, bare with me while I beg you to show your support once again.. This wont cost you a penny, just a few seconds of your time.  Go over to the Discovery Channel Facebook fan page and let them know how you feel about the  program.  How cool would it be to see a realistic EMS program on TV that focuses on making improvements to the system?

I know that I’m a fan.

Thanks, Ya’ll!

Check out those involved in the Chronicles:

Happy Medic

Medic999

Ted Setla

Chronicles of EMS on Facebook

Chronicles of EMS on Twitter

A Quick and Dirty Bleg…

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Or beg if you prefer.

A good friend of mine is a relatively new Medic and a college student who needs some EMS folks to participate in a survey on EMS.  Please, if you have the time, take her quick survey.

Thanks so much!

http://www.surveymonkey.com/s/9ZLFTGP

Ill Equipped.

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6/2007

“Are you okay?  You look a little pale.”

My preceptor was talking directly to me, and I heard him, but I couldn’t bring myself to answer.  The truth was that I was most definitely NOT okay.  I was not okay.  But that wasn’t something that I wanted to put on display.  I wanted to be the portrait of strength, not the sobbing wreck who wanted to toss her cookies right there next to her preceptor’s partner in the ambulance bay.

**********

“This, folks,  is what I love about this job.”  Scott, aka “The Preceptor” was sitting on the step on the side of the truck that led into the patient compartment.    His partner, Danny Boy, was snoring loudly in the back of the truck.  I sat in the front passenger’s seat, window open, just watching.  He was physically beat, hell, we all were. 12 runs in ten hours.  12 runs that took twice as long as they should have because he had me with him.  I was slow.  I’ll admit it. I was being ridiculously thorough.  Paperwork took longer, assessments took longer, everything took longer.

It had been a long day, but it was ending in spectacular fashion.  We were on standby at a house fire.  For a girl who has had zero fire experience, it was fantastic to watch.  Every color in the spectrum was lighting up the summer sky.  It was the first time in my life that I thought that I might want to learn more about this “fire stuff”.  I was watching the flames when I heard a frantic voice.  A screaming voice.

“WE HAVE A KID!”

No.  No no no.  No kid.  No people.  The house was supposed to be empty. Scott jumped from his seat and was in the back of the truck before our information had a chance to make it’s way from my brain to my body.  He was screaming at Danny Boy to “Wakethefuckup” while he furiously grabbed at whatever equipment we could possibly need.

“Epi, getyourassbackhere!” Whatever calm Scott had in him had gone out the window.  I was out the door before he had a chance to finish yelling.

Almost as quickly a large man with a mixture of steam and smoke coming off of his shoulders deposited a tiny limp blackened body into Scott’s arms.

I can’t repeat the string of expletives that escaped my lips.

I found myself ill equipped.  I worked on a transfer truck for crying out loud.  I didn’t see burned babies… I saw dialysis patients.  I saw wound care patients.  On occasion I took a stable MVC patient to the ER or got the chance to dodge vomit. Once in a great while I was on a truck for a chest pain patient or a CVA. Certainly not a charred baby the age of my littlest one.

I jumped into the empty captain’s chair and reached for the airway bag while Danny Boy tore the boys clothes from his little body and The Preceptor checked the little one’s vitals.

As we suspected.  Pulseless.  Apneic.

**********

Continued tomorrow night.

A Challenge.

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And God do I ever LOVE a challenge.  So from me to you…

This is more important than some story about some run.  No matter how spectacular that run was.

This is about not sitting back.  This is about not being a wallflower.

This is about doing something.

My people over at Chronicles of EMS have issued a challenge and it’s a must read.   And it’s simple stuff.  For my EMS people in particular.

So many of us have sat through CPR classes, over and over.  We know it backwards and forwards. Some of my medic school compatriots would go a step further and roll their eyes as we’ve just recently gone through ACLS and have had it driven so deeply into our already overstuffed (and slightly fragile) brains.  That being said, we know it.  We KNOW it.  But do they? Does your Mother?  Your next door neighbor?  Your Babysitter?

So here’s the challenge.  Hit the streets, as Happy Medic has said.  Find five people.  I don’t care who they are.  Find five people and TELL THEM HOW THEY CAN LEARN CPR.

Simple enough, yeah?  This is not rocket science.  Yet it’s so important. What if the victim was you or one of yours?

Let’s not just be passive.  Let’s not just talk about making a change.  Let’s do something that provokes that change.

CPR Illustrated

Where you can find a CPR class in NW Ohio

Where you can find a CPR class anywhere else

Do more than just talk.  Print out some numbers.  Do something that makes a difference.

And you know, if you tell me how this process went, or post at the Chronicles of EMS site about it, that’s fantastic.  If all you do is talk to someone about CPR and how important it is to know it, I’m FINE with that.  Just do something.  Don’t just sit back and hope that someone knows what they’re doing if God forbid that time comes.

This is for you.

I’m in.  I’m all in.  My challenge to you is, are you?

Cardiac.

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The dreaded cardiac chapter is officially behind me.

I made it through.

And while my scores were marginally lower than they were the first time I went through the class (and I beat the crap out of myself for that), what I learned this time around far surpassed my experience at the last program.

Next stop is “Big Test #1″ on Wednesday.  It covers everything from day one through now, and it’s one of those “make it or break it” tests.

Another milestone.

Myself and my classmates are getting a little crispy, but once we conquer this next challenge I have a feeling a few of us will be able to breathe just a bit easier.

Pockets.

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A few of my friends have played along and I really needed to do something mindless, so here goes.

After an ER clinical I decided to empty my BDU pockets, and GOOD GOD when did I start carrying so much crap?  I thought the longer you worked in EMS the LESS stuff you carry?  When I started all I carried was my drivers license, a pen and my cell phone.  Five years later, here’s what’s on me most days.

Key chain complete with O2 tank key (it’s there for a reason, at a former employer there was never a wrench to be found), keys to the pumpkin mobile and keycards to all of the local gas stations.  Gotta get my speedway points when filling up the squad ya know!

Change purse with cash and the DL.

Pens (I’m always losing them).

Carmex (don’t leave home without it).

Scissors (expose, expose, expose).

Ipod touch loaded up with various med apps.  Perfect for doing a little research in the downtime.

Rhythm strips from that shift.

ID badges to the clinical sites.

Roll of tape (that particular roll has an interesting story behind it, another post for another time).

Drug cards for studying and blank cards for taking notes.

Cell phone.

Field guide.

No wonder I feel like my pants weigh three times what they should.

Let's Give 'Em Something To Talk About!

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I’m excited, folks.

And that’s saying something.

I’m a passionate girl, sparky and excited to do anything and everything to promote EMS to the level where it belongs. That being said, with each year that I do this, I feel like I lose a little bit more of that sparkiness. The problems we have here in NW Ohio are the same problems that you have everywhere. It’s a little rougher on the private service people, but the truth is that in essence, we’re all in the same boat.

But change is coming, folks. I can feel it. And that change starts with you and me. And three others like us, Justin Shorr, a Paramedic from San Francisco, Mark Glencorse, a Paramedic from Newcastle in the UK, and Thaddeus Setla, a Paramedic/film maker from the San Francisco area.

Just three guys with an idea who got together through the power of social media.  Blogs, Twitter, etc.  What they’ve come up with is extraordinary. Watch the video… I dare you to walk away and not be at least a little bit curious. It’s all about finding out about each others best practices. What works, what doesn’t. It’s about just getting together and talking.

It’s called Chronicles of EMS. Below is a just a taste, the premiere is Friday, February 12. Check it out.

Chronicles of EMS – Trailer (Premiere Feb 12th @ 5pm ChroniclesofEMS.com) from Thaddeus Setla on Vimeo.

Baltimore…

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So there’s a pretty big conference coming up. In Baltimore.

In less than a month.

I’m making the drive, are you?

One More Step Forward

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I know I’m supposed to be taking a break from the blogging thing…

And I am. Seriously.

Okay, cut a girl some slack.  It’s a Sunday night.  The Super Bowl is on for crying out loud.  I know I’m not the only student out there who put their big red book down in order to watch some football! (Or to write a quick post while watching some football…  GO SAINTS, btw.)

Friday was a big day.  Friday was the day our class (as well as half the company who happens to own my school), tested out for ACLS.  Not such a big deal for them, hell, they’ve been there before.  Some of them several times.

For us, for the students, it was a biggish thing.  It was a milestone.

The class started with a handout.

Yikes. As if I wasn’t nervous enough already. (Excellent article btw!  I highly recommend it.  I’m working on locating it online.)

It continued with me several times forgetting the importance of ventilation.    At one point I was ordered to “exhale” by a classmate because I was “paler than usual”. My hands shook, my stomach hurt, and basically, I was a train wreck.

I stumbled through my practice run.  I didn’t make any critical mistakes, but I did have issues with the print button on the LP resulting in a few two foot long strips. I was a little slow on one of the rhythms that I would have known without thinking about it any other day.

I feel like I’m right where I was the last time I did this, minus the dislocated and fractured bones.

I headed out for lunch on my own, just needing some time to clear my head and give myself a little pep talk. I thought back to a classmate who just three days before had slid a note in front of me that said “YOU GOT THIS!”

And all of a sudden, I realized that I did.

I got this.

**********

The switch was flipped.

No shaky hands, no forgetting to breathe.  (I was still a little pale though.)

My point is, I was focused, I wasn’t nervous, and *this girl* emerged with a card.  (And for my old school Medics out there, I realize what ACLS has turned into, but at this point I have to take every step forward as a victory.  I reject your reality and substitute my own!)

For those of you who coached me, or studied with me, or maybe a little bit of both, Thank you.

One more step forward.

A little kick in the backside…

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For the students out there.

Courtesy of my Blogfather, Ambulance Driver.

Thanks, AD, for getting my head straight yet again :)  Now, back to studying.

Time is muscle…

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Now before you yell at me, I’m just popping in for a second because I wanted to share a video with you.

This is a PSA from the UK that we were shown in class yesterday on the importance of not ignoring the signs of an MI. It’s good stuff.

Back to studying!

The Takeover.

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P school is not easy.

And it doesn’t matter if it’s your first attempt or your third.  Nothing about constantly having your nose in a book, balancing work with school (and clinical time, and third rides) is fun or easy.

And it’s not supposed to be.

And then you hit the dreaded Cardiac chapter.  And even though you might have been through this before, you realize that you have to read the same paragraph three times to retain the information.  Information that you had down pat just a few years earlier seems to run away to the parts of your head that you can’t access at the most inopportune times.

You find yourself unable to remember what you walked into the kitchen for.  You start calling your four-year-old little girl by the wrong name.  Repeatedly.  And She’s less than impressed by this.  Then again she’s less than impressed by just about everything you do and at least it’s a name she recognizes…

The truth is that I’ve hit a brick wall.  And something has to give. Unfortunately for now that has to be my posts here.  For just a little bit.

That being said an amazing group of people have stepped forward and offered to takeover the blog for a bit. Some of them you’ll know, some you might not be as familiar with.  All of them are far better at this writing stuff than I am.

I’ll be back as soon as I’m through cardiac.

With that being said, I’m very honored to present you with our first guest blogger, Greg Friese.

**********

5 Things I learned in Paramedic School

In May of 2005 I completed a nine month paramedic program. Nearly five years later I can barely comprehend how I attended class two or three days a week, finished all my clinicals before the end of March, worked full-time, and welcomed our first child into the world eight weeks before graduation.

Along the way I learned a few things that I don’t recall seeing in the syllabus and as I look back may be the most important lessons I learned.

  1. Everyone has advice, but that advice is not always for everyone. Lower the bevel angle. Who showed you to use such a low angle? Approach from the lateral edge. Plunge right in. Move real slow. Tension the skin here. That is not enough tension. That is too much tension. Start high. Start low. I could probably write a reasonably sized book with all the various IV insertion advice I received. Like most things there are many techniques, tips, and tricks. Once I focused on just doing it with confidence the cascade of advice dried up and my success rate increased.
  2. I couldn’t learn it all. Not in nine months, probably not even in 24 months could I learn everything about being a paramedic. What I did get though was a foundation so I could keep learning and growing as a paramedic.
  3. The people that smile a lot were always helpful. Kristen, an ER nurse, had an amazing smile. I remember pushing and pulling a recently deceased patient onto the funeral home gurney as she continued to explain and teach me about the code we had run an hour earlier. I gravitated to Kristen even though she was not my “official” preceptor because she was friendly with her patients. Her enthusiasm for being with patients and their families overflowed onto me and other students. Spend time with the people that genuinely smile the quickest when you enter the room.
  4. Neonatal Advanced Life Support certification is way more information than any expecting dad should have seven days before their first child’s due date. As the Doctor explained the worrisome fetal monitor tracing, copious red vaginal bleeding, and weakening contractions I wished for ignorance. Instead my mind raced with things like placenta abruption, uterine rupture, and breach birth as the surgical team rushed into the room preparing my wife for an emergency c-section. Thankfully, less than an hour later a ten and half pound boy entered the world healthy and screaming and NALS worries drained away.
  5. Priorities can change really fast when something big happens. There were several big events during my paramedic training – a large work project, a dramatic situation with a friend, and our first child. Each time something big happened I reshuffled the deck and came up with a new plan. I would love to tell you I studied as hard, listened as well, and read just as many pages in the last two months as I did in the first seven months. But there was no way I could hammer out another hour of studying when little Michael just needed to be cuddled.

Finally, stress and fatigue for me come in waves. Throughout paramedic class there were highs and lows. Then and now when I recognize I am at the peak of the stress wave I try to step out of it for a moment, reaffirm where I am going, eliminate any obvious clutter, and reenergize for the next manageable chunk of time and tasks.

Greg Friese is paramedic, educator, and online CE designer. His blog is http://everydayemstips.com and he co-hosts the http://emseducast.com podcast.

I'm Sorry…

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I am so sorry.

I’m sorry that getting our stretcher into your home, let alone down that hallway and around a corner was impossible.

I’m sorry that we had to wake you up, particularly when you have such a hard time sleeping recently.

I’m sorry that I looked to your daughter, your caregiver, for information because you weren’t able to communicate with us. I know that in your head you knew what you wanted to say, you just couldn’t say it.

I’m sorry that you were scared. You had so much more going on to worry about, and the way that we had to get you out of that house was less than comfortable for you. I could see it in your eyes and it just about killed both me and my partner.

I know that you are a proud, strong woman. If anything we said or did today made you feel any less than that then we failed as providers. And that’s unacceptable on our part.

I’m sorry.

Number 15

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“Mom, I hate your job.”

His softly spoken words stung far worse than any slap to the face.  There was my little guy, the one that used to recreate EKG’s in his own notebook, standing in front of me. He was angry, hurt and disappointed.  Mom was missing another holiday.

I ran my hand through his sandy hair and pulled him towards me.  “Baby, I’m sorry.  We need the money, and I’ll be home first thing in the morning tomorrow.  You’ll have fun with SWR and Dad!”  I squeezed him tight, but he didn’t return it.  My heart broke a little more. “Why can’t someone else go?  Why does it always have to be you?”  He turned on his heel and headed for his room, not bothering to wait for an answer that I couldn’t give him.

I grabbed my stethoscope, shoved it half-heartedly into a pocket of my BDU’s and dragged myself towards the door.

Sometimes I hate this job too, Little Man.

**********

The shift had for eight hours straight consisted of mind numbing boredom.

Completed the squad check.
Stocked the squad.
Took the last crews trash out.
Washed the squad.
Sat down and attempted to study.
Fell asleep.
Watched Marine Partner take out some insurgents playing Xbox.
Open the Big Red Book yet again.
Fell asleep (again) reading about airway adjuncts.

I couldn’t have been dreaming of King tubes and NPA’s doing the Paso Doble more than a few minutes when I was rudely awakened.

“Medic  four you have a run.  Medic four, you have a run.”

Nothing like waking up to the voice of a very bored dispatcher. I slowly got up and took three steps towards the ambulance bay before I realized that my boots are sitting on the floor next to my bed.  A string of four letter words slipped from my mouth while my favorite Marine looked on laughing.

“You’re a bright ray of sunshine today, Missy.  You kiss your Momma with that mouth?”

“No, Sir.  Never, Sir.”  I managed to crack a sleepy smile his way as I zipped my boots up and followed him out to our truck.

**********

In four short minutes an  “unknown medical” had turned into “syncopal episode” which then (naturally) progressed into an “unresponsive”.

“Epi, are you a black cloud?” MP wasn’t smiling anymore.   He was behind the wheel, driving code for a run where we were going to probably be sweating literally and figuratively for a few minutes on our own.  It wouldn’t be the first time we were in this position, but given the few number of shifts we had worked together… It HAD to have him thinking.

“Why does everyone keep asking me that?”  I dug through the glove boxes (the one thing I neglected to check during inspection) for a box of non-latex mediums.  I was rewarded with one glove, which I promptly threw at MP.

“Medic four, come in.”

I swatted MP’s hand away from the radio.  “You…  Drive.”   I keyed up the mic, “Go ahead, dispatch.”

“CPR in progress.”

I exhaled and closed my eyes.  “We’re clear, Sir.”

Fan-fricking-tastic. I climbed into the back of the truck and threw the LP, airway bag and drug box on the stretcher before sitting in the officer’s seat.

14 codes I had worked in just under five years.  I wasn’t looking forward to number 15 with the same enthusiasm as I did with number one.  Knowing that the patient was two years older than myself didn’t help.  I sat in that chair with my head in my hands going over what I’d need to do to help my partner and my patient the most.

“CPR in progress” kept replaying in my head.  I swallowed hard as MP slowed the truck down and shifted into park.  When he flung the back doors of the truck open the biting cold wind rushed in.

Sometimes I really hate this job.

**********

It was a small trailer, the couch just a few feet away from the TV and practically on top of the kitchen.  Four TV trays were set up, and the smell of turkey hung heavily in the air. We knew getting the stretcher in was going to be an impossibility and settled on carrying in a backboard loaded up with what we’d need.  Even without the stretcher we struggled to navigate the closed quarters.  MP cursed out loud when he stepped a something that resembled a hand held game system.  My thoughts went to my little man, the one permanently attached to his Nintendo DS.  That birthday present that I had worked three overtime shifts to cover.

I really need to not work on personalizing every single fucking run I go out on.

To say that the home was less than hospitable to an EMS crew who had to try to entice a person’s heart to snap the hell out of it, behave itself and just act like it’s supposed to would have been an understatement.

On thanksgiving yet.

Our patient was laying in his bathroom wedged tightly between an overflowing trashcan, a bathroom cabinet and the tub.   The good Samaritan who was struggling to do compressions sprinted out of the crowded bathroom before I could even open my mouth.  I could hear him throwing up nearby.  I hoped he made it out the front door.

“Help me move him, Epi.”  MP’s voice was the picture of calm.  I was doing my best to mirror him, but my hands were betraying me, shaking like I had just mainlined a few pots of coffee.  We managed to move our patient a few feet further into the center of the tiny room.   I checked his pulse, ripped apart the gray button down work shirt and jumped on compressions without thinking about it.

The next few minutes were a blur of activity. I didn’t even notice when a BLS unit had arrived until one of them slapped me on the back.

“Let me take over.”

Four simple words had never sounded so sweet.  My arms were on fire and I could literally taste the salt from the sweat running down my face.  My ability to do effective compressions had come and gone.  I moved out of the way and took a spot squatting next to Marine Partner and the patient.

“MP, what do you need?”  The tube was in, a line was started, compressions were being done, there were sharps on the floor.

“We need to get moving. “  I watched as MP looked at our patient, the basic doing compressions and the patients wife who had made an appearance at the door to the bathroom, complete with two little boys who looked absolutely terrified. The sound coming out of her… was something that I’ve heard before, but never fail to take home with me.  It was gutteral.  It was the sound when you make when your worst nightmare is multiplied exponentially.  It’s the sound you make when you’re watching your best friend and the father of your babies die.  Right in front of you.

Sometimes I really REALLY hate this job.

**********

The back of the truck was a tornado of activity.  Wrappers were everywhere, I had vomit down my left leg, and there was a fine spray of what I assumed was arterial blood on the wall of the truck.

That’s what you get when I try to start a line in the other arm. Sorry about that, MP.

Basically what I’m trying to say is that the crew on our truck was wrecked, and the truck itself had seen better days. We were running the code, sure, and doing it well.  That being said, I’m pretty sure we were all convinced that this wasn’t going to end well for our patient.

And then, the clouds parted.

Right there in the back of that jacked up ambulance on a bumpy Michigan country road.

Marine Partner inhaled sharply,  “Fuck me sideways.”  Everyone’s eyes instantly went to the LP that he was watching intently.

Where there had been fine VF was now something that was at least hopeful.  My fingertips (and everyone elses’s) fought for a position along the closest pulse point.

I felt it.  I felt a pulse.  “That’s a fucking pulse.  It’s a pulse!  I feel it!!!”  Yes, I said that out loud.  I practically shrieked it.

I’m still being reminded of that fact.  To this day.  I have a feeling I’ll have coworkers squealing “THAT’S A FUCKING PULSE!” whenever they see fit for the foreseeable future.

And you know what?  I’m more than okay with that.

It took him almost a week but he walked out of the hospital.  Well, he was wheeled out of the hospital, in a wheelchair, but he was wheeled out knowing his name, the names of his babies, and the fact that he was married to the love of his life.

And we had something to do with that.

That’s a very cool thing.

Little Man, you’re right.  Sometimes this job sucks.  It’s not fair, it takes me away from you, after all.

But sometimes it really rocks.

Honesty.

15 comments

In the interest of complete honesty and accountability…

(Eeek!)

I failed a test.  Not only did a fail a test, but I did it in spectacular fashion, and it was on the one subject I pride myself on.

Cardiac.

I’m cringing as I type that.

To those people who have given so freely from their pockets so that some poor chick from Ohio could go to achieve a dream… And to those people who have listened to me freak out either through email, or IM’s or on the phone…

Jesus, I let ya down.

Know this.  It wont happen again.

Life happened and I slacked off.  That fact in combination with an instructor who knows how to put a test together spelled disaster for me.  I knew it was coming.  And I’m unbelievably embarrassed by that.

The retest is on Thursday and I have been and will be studying until I sit down and start circling letters.

And you will never see another post like this again.

Changes.

8 comments

1/07/10

I’m sitting here in the station in complete darkness surrounded by a symphony of snoring men.

Yes, Boy Wonder, you snore.  D.  You snore too. We all knew the Lt. snores, although tonight he seems to be bringing his own version of shock and awe to the mix.  Shock and awe, ya’ll.  If only they could get their gasps coordinated I would You Tube it in a heartbeat.  Maybe with a little creative editing…

So I’m sitting here, the insomniac that I am, and I can’t help but think about how much has changed in my life in the last year.

It’s like night and day.

12 months ago.

12 months ago after a few months of being hopelessly unemployed, McHottie dragged me down to Ma and Pa EMS to apply for a Basic spot. We were both hired on the spot without having to do as much as filling out an application.  Gainfully employed, this girl rejoiced. It wasn’t pefect, but it was a job doing what I loved.  And no, I didn’t make the above cot. And yes, that’s a backboard strap wrapped over the side rails, but who am I to judge?

Eleven months ago.

11 months ago we had a new addition to the family, our first puppy, Dasher. We quickly learned how much fun it is to raise (and in particular house train) a puppy.  Dash, for his part, chewed everything in the house with the exception of the toys and bones we bought him.  Eleven months later he’s quadrupled in size and still chews everything but the toys and bones.  But he is house trained.

10 months ago my little boy was an anxious wreck.  He needed everyone’s acceptance, he wanted to be a friend to anyone who would talk to him.  This put a tremendous bulls-eye on his eight-year-old back.  He had one friend in the class, and that “friend” was only interested in playing on the Wii or the computer when he’d come over.  Ten months later he’s got more friends than he can count on two hands and he’s constantly on the phone.  His self confidence has grown by leaps and bounds.  He’s accomplished this all while retaining his love of learning.  I couldn’t be prouder.

Nine Months ago…

9 months ago my own precious little snowflake, SWR (that was sarcasm for those of you who are slow to pick up on it), was pushing four-years-old and had been defying me where potty training was concerned for over a year.  This was a massive point of contention between my Mother and I.  I was at my wits end, nothing was working. I read books, I listened to anyone and everyone with advice…   She was completely defying me.  Anyone who’s met her in person would understand what I’m saying completely.  She’s a mini me. Nine months later she’s very much potty trained.  She’s still stubborn as hell (she is my daughter remember), but her meltdowns are fewer and farther between.

8 months ago I met a patient who would change my way of thinking forever.  I met Regina. Up until this point I had tremendous emotional issues when it came to Hospice runs.  In just under three weeks of visits with Regina, watching her body rebel against her, seeing the pain involved where something as evil as Cancer is concerned… I finally learned that death is a release for these patients.  I will never forget Regina, one of the most amazing people I’ve had the honor of meeting.

Seven months ago…

7 months ago my Mom married the man I’ve called my second Father for the last 18 years.  The clouds parted, the birds sang, and for a day our world was all sunshine and roses.  My baby Brother and I rejoiced.  Seven months later she’s finally gotten around to changing her name on her work voice mail.  And my Brother and I are still rejoicing.

6 months ago I determined that P school was going to be an impossibility.  I was resigned to it.  It wasn’t the end of the world, but it was a disappointing setback.    67 people decided that this was unacceptable.  I am to this day, and will always be absolutely humbled by the amazing support of the blogging (the EMS bloggers and readers in particular) community.   It renders me speechless when I try to explain the way it makes me feel.

5 months ago…

5 months ago I started my second attempt at that glitter badge.  I quickly made 13 friends with a common goal and addiction to caffeine.

Four months ago…

4 months ago I stood proudly on the sidelines and watched my boy play his first game of soccer.  Four months later, despite being one of the slower, less experienced members of the team, he still loves the game and wants to play.  His skills are improving and next month hopefully he’ll be starting a six week indoor season!

Three months ago…

3 months ago I realized that I wasn’t getting everything I needed from the P program I was in, which just about killed me.  I was with a group of people who I absolutely adored, people who I felt  at home with.  People who I was very much attached to.  After more than a few phone calls with Rockstar Partner, much soul searching and more than a few tears, I made a phone call to another school.  And the instructor accepted me into the program with open arms.  Three months later I’m frazzled as hell but loving every single second of it.

Not so long ago…

2 months ago I made yet another move.  I applied to a new company in town and was hired on full time.  I had a really good feeling about this company from the start, and knew I was in the right place from the first time I walked in the door.  Lt. T. (THE best supervisor I’ve ever worked with), D (who lost his intermediate card to me in a fierce game of Monopoly, but keeps me smiling ), and Boy Wonder (who would be my partner I’m VERY proud to say) have been the most amazing crew to work with.  McHottie, Tall Dark and Irish, K., and AJ are also working here.  I’m surrounded by the best and brightest, and there’s no stopping us –  or what we can do with this new opportunity!

1 short month ago I finally was able to see the sun shine through the clouds.  I’m in a good place, surrounded by my people.  I’m moving forward toward obtaining that damn P card (come hell or high water!!!) For the first time in I dont know how long, everyone around me is all good.

A far cry from 12 months ago.

A far cry.

365 Project – 01/07/10

7 comments

Heading home.

Date:  January 7, 2010

Time:  2030ish.

Subject:  We got SNOW ya’ll!

Ha HA Supervisor T.  I’m still in it.

Even if today’s pic is just a quick shot as I ran screaming from the station.

Today was the first “significant” snow of the season (and don’t you dare laugh at my choice of words Medic Matthew, it’s Ohio, not Maine), and in true NW Ohio fashion everyone lost their damn mind and drove like fools.  It didn’t help that the salt and shovel trucks were nowhere to be found.  Seriously though, if you drive 65 mph on top of packed snow and hit your brakes, chances are things are going to get kind of interesting for you.  Real quick and in a hurry.

Be safe, ya’ll.

365 Project

6 comments

No, Lt.  I didn’t miss a day, so you don’t win the pool :)

Date:  1/4/10

Time:  2300ish

Subject:  The teacher becomes the student.

The shift Lt. loses his backside at Monopoly.

Date: 1/5/10

Time:  0445

Subject:  Lots of room at the inn.

We’re the only truck at the local level I trauma center.  Oddly enough I had no problem parking. Number of yellow poles hit: Zero.

We Get It Done.

7 comments

And we do without the benefit of a brightly lit, clean, sterile environment.

In our patient’s home, surrounded by pictures them on better days, trying to do compressions while calming down their hysterical family members.

Squatting in a puddle of God only knows what while soaked to the bone on the side of a busy road.

In the back of an ambulance rumbling down the road at three in the morning after having running our butts off and having been up for 22 hours.

In a facility where there isn’t a nurse to be found and the only person who has any idea what’s going on is the patients roommate.

We do what we need to do.  We get it done.

So cut us some effing slack already.