Sometime the people who call for an ambulance really piss me off. Of course, I never let them see it, but the absurdity of some of these calls goes so far beyond the ridiculous, it’s amazing.

But, when I feel like I’m totally being taken advantage of, when my EMT certification seems like it means “Elderly Mobile Transport” or “Every Menial Task”, I remember that most people will only call for help when they’ve reached the end of their ability to cope.

Maybe they’ve had nausea and vomiting for the past day and at 2am, now they are feeling weak and dizzy and they simply just can’t stand it anymore. Or their back pain is so bad that they can’t deal with it alone. It might be the 72 year old woman who’s been caring for her husband with dementia for the last 5 years and tonight he was combative. Perhaps it’s the worried daughter, kneeling next to her father’s recliner, where he sits everyday on 2 liters of home O2. She looks up at you, with scared eyes and says, “Dad’s always short of breath, but tonight it just seems worse!”

When the issue is too much to handle alone, people reach the end of their “cope rope”. They feel it slipping from their grasp and they just can’t manage it by themselves. That’s when they call in the reinforcements.

That’s us.

Maybe it’s some oxygen and a smooth ride to the ER for the elderly parent with the SOB. Maybe it’s more serious and requires a Medic. Maybe it’s just us showing up to hold your hand and calmly say to you, “It’s ok. You don’t have to worry. We’re here now.”

Sirens and C-Collars and traction splints aside, our real job is to help you make the right decisions and look out for you. That’s what we really do.

Every morning when I finish a shift, I can look back at our calls and recognize the people who had reached the bitter end of that cope rope. They always call in the early morning hours, and they’re always the people who squeeze your hand at the end of the transport and say, “Thank you, I feel so much better now.” In my mind I can separate those people from the abusers and free ride seekers. That way I get a little balance, and keep from getting totally jaded.

Most of the calls I do don’t require ALS interventions. Sometimes just being there to take the weight off their shoulders is the best medicine.

This morning wrapped up my last 24, and I’ve got 4 days off to recoup and recover.

Not much in the way of exciting EMS stuff. A couple of minor MVAs and a slew of Code Greens.

I came home to find my entrance packet for medic school. We’re using Nancy Caroline’s “Emergency Care in the Streets” as the text and workbook, along with a few extras to buy, including an ACLS manual and some arrhythmia books. I already had Dubin’s book, so that’s a plus. Lots o’ registration paperwork to fill out and I have to write that first check.

I’m at the water park on Friday and planning to enjoy the weekend with my wife. A nice hotel with a pool are in the plans. A little getaway is just what we need.

Good morning! We just returned to quarters after a field birth of a baby boy. It was Mom’s sixth kid, and nobody had time for much of anything other than “Holy smoke! Here comes the kid!” He just shot out like a greased pig. We arrived on scene at 0144, baby delivered at 0149.

Both Mom and baby are fine. I offered to allow them to use my name if they chose.

They declined

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I love those inadvertent comments that sound inappropriate. Usually it’s me or my partner shoving foot into mouth, but this morning it was a nurse.

We transported a rather large gent to the ED this morning after a syncopal episode. After we moved him (with some difficulty) to the bed from our stretcher and I had given report to the RN, she looked at me and whispered, “Oh my God, he’s SO big!” Something in the tone of her voice caused me to snicker. She blushed, then she cracked up too and shooed me out, laughing all the while.

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This might be a rough night. It’s 82 degrees outside and the AC at our quarters is on the fritz.

It’s 90 degrees in here now.

Whew.

Damn. Its 84 degrees today and the water park is packed. I’m working on the “wet side” and I’ve been cleaning minor abrasions and sticking on band aids all day. It seems like there are a fair number of “rug burns” when people get overzealous and dump out of the tubes while careening down the slides.

And it usually doesn’t get busy ’til after 3.

It’s just a hot and humid day. I’d kill to drop my radio and pack on the deck and dive straight into the wave pool.

***Update at 1920.

So, a small break in the action from band aids. Just about an hour ago, a 17yo female walked into my aid station, short of breath saying “her heart was pounding”. Sure enough, she was tachy at 185 and had been that way for the past 15 minutes. Over her protests I quickly got the medics en route, got a set of vitals and put some O2 on. The medics arrived shortly after and I saw a chemical cardioversion for the first time. The first 6mg of adenosine didn’t do it, so the medics drew up 12 and we all watched the monitor as the SVT broke. The girl took a deep breath and said “Wow. That was weird.” Ya think? Your heart just stopped for a second.

We loaded her onto the medic’s cot and off they went. Pretty cool end to the day.

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I’ve been contemplating my future quite a bit over the past few weeks. Where I want to go, what I want to do, where I want to live… my wife wants us to head back east eventually.

I’ve realized that I really miss New England. Connecticut especially. When I was growing up, I couldn’t wait to leave. I didn’t really know where I wanted to go but I knew I wanted to get out and get out fast. My career in broadcasting let me live the lifestyle of a well paid nomad for close to 20 years. (OK, admittedly the first few years weren’t very well paying, but you can live on Ramen noodles for a while before scurvy sets in.) Now that I’ve lived in 10 or 15 states, I realize that I want to go home. It’s not that I want to see my friends, as most of them are gone. I miss the place. I miss the smell. I miss lobsters at Abbott’s in Noank. I miss grinders from the pizza places in Norwich. I miss driving down 395 to New London. I miss home.

Anyone else ever feel like this?

Norwich Connecticut on a sunny winter day, looking toward City Hall

As far as work/school blogging goes, I haven’t really been in the mood to write for the last couple of days. The last two shifts just kicked my ass. We did lots of calls and got very little sleep and I had a headache on Monday that I just couldn’t shake. However, I did find the key for really restful sleep in my bed at quarters. Every shift, as soon as I get to quarters, I make my bunk up with fresh linen from home and toss a down comforter on top. When I do catch some time to sleep, I quickly yank off my boots, turn on the small fan in my room to provide some ambient noise and wrap up in that comforter. Early on Tuesday morning I slept for almost 2 hours, and they were the best two hours of sleep I’d had while at work. Of course it was interrupted by a SOB call around 4, but I’ll fondly remember those 2 hours of sleep as some of the finest.

If you call 911 from a cell phone, and you live on a private road, try to give the dispatcher the correct address. Also, if you give the dispatcher the WRONG address, you are not allowed to bitch about how long it took the ambulance to get there. After all, if I get a wrong address… especially one that’s over 30 blocks away, in a TOTALLY different area of town, its gonna take me a little while to get there!

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Sorry folks, today I’ve got nuttin’.

We had a steady shift yesterday, and didn’t get to sleep til after 3 this morning. We ran several of the typical “I don’t feel well” BLS calls and took a reportedly violent psych patient to the MHF. He slept like a baby during the entire trip, thanks to 10mg of Haldol. We also saw the medics at a few calls yesterday. In one instance, a motorcycle v. stopped car MVA, they should have been summoned a lot sooner then they were. (But hey, that’s just my opinion.)

I finally was issued a Key Fob, so now I can actually split the work with my partner. It was such a nice treat to not have to tech every stinkin’ call. I mean, I love the patient contact experience, but I get writer’s cramp from all those reports.

Now I’m waiting for the “you gotta get this done before August” letter from paramedic school. I’m excited to get my textbooks and start reading ahead.

Otherwise, nothing new to report. I’m just tired and and kind of out of it. Tomorrow is another day.

I’ve been looking for an easy to understand, simplified overview of Acid/Base balance. My A&P prof, great at just about everything else, made Acid/Base so damn confusing that I threw my hands up in frustration. I knew that I’d have to “relearn” it, so I’d been searching for a good primer.

This one is pretty decent.

However, If anyone has another site or resource that may help me master this, let me know.

I’m on shift at the water park today. Actually, I’m working on the “dry side”, the amusement/roller coaster section of the park. Its an overcast day, about 65 degrees, so attendance is light.

I’ve spent most of the day in the First Aid office checking out all the gear, snooping around and playing with the PC that the IT guy just updated.

It’s been an eventful day. So far I’ve given out directions to the bathrooms, lockers and pay phones and handed out two band aids to a couple of girls with blisters.

I will say the Aid station is nice. I have my own fridge and microwave, my own clean bathroom and a kick ass little golf cart ambulance. This isn’t a bad gig for off days, and the extra money is pretty handy as well.

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If you read any of the EMS message boards, the old timers say you can tell how new an EMT is by the amount of crap he or she carries on his or her Bat Belt. I agree, when it’s unnecessary crap. I mean, how often is an EMT going to use hemostats or a window punch?

But, when I was standing at dispatch this morning, one of the other crew members made a crack about what I carry and called me a “Super EMT”. It kind of pissed me off a bit.

First, I’m not a newbie. I’ve been working in EMS since the late 80s, and when I was new I did have the little belt pouch with bandage scissors, shears, hemostats, window punch, orange plastic bite stick and other goodies. Hell, I didn’t know what I needed or didn’t need. So I carried all that shit, as well as a pager and two, count ‘em, TWO radios, both bricks! (And BTW, all the EMTs had to carry all that stuff back then.) I’ve since learned what’s an absolute necessity and I’ve trimmed way down, but I still have the stuff that I’m required to carry and the stuff I need and use on my job.

Secondly, this jackoff that was busting my onions has less than 3 months of experience, wears his hair in a sporty “faux hawk” and said, with a sneer, “We’re just taxi drivers anyway.” That’s a great attitude, huh? He also said, “You use that boxy thing with the wires, too.” I looked at him, “You mean the PULSE OX?” Keee-rist. What a maroon.

Third, the stuff I need is never on the truck. No flashlight. The Trauma Shears are always missing. O2 wrench is always gone. And of course, they’re only missing when I need them. Otherwise the truck will have 3 pairs of trauma shears and an o2 wrench attached to the D tank bracket.

So, let’s talk about what I have on my person while working a 24 hour shift and you decide if I’m one of those “carry too much crap” whackers.

Left cargo pocket:
County protocol book.
Small notebook.
02 Wrench.

Right Cargo Pocket:
A pair or two of gloves.

Back pocket:
Wallet.

Front pocket:
Cash
Eyeglasses cloth (I’m always smearing my sunglasses)

Belt:
Personal Blackberry
Trauma Shears tucked in the back
Small Mag Lite
Leatherman

Now, I don’t think I need to defend my choices, but allow me to say I use all of this stuff almost every shift, with the exception of those damn ubiquitous trauma shears. For example, last shift, around 1 in the morning, we had a patient at the end of a long dark driveway. Used the mini Mag Lite so my partner didn’t kill herself on the loose stones. Our coffee table in quarters had a loose leg, so I used my leatherman. Our portable O2 tanks needed to be turned on, so I used my O2 wrench, because there is never one in the truck. Plus, I use my ‘berry on almost every call to look up drugs I don’t know in Epocrates, and the rest is self explanatory.

So, does this make me a whacker, or just prepared for the shift?

And no, I don’t have a trauma bag in my car or a backboard in my garage. I also don’t carry any of this crap, with the exception of the leatherman, when I’m not at work.

The thing on the underside of a semi trailer that connects the trailer to the tractor is called a kingpin.

It looks like this…

Since it’s the pivot point for the trailer, it’s VERY greasy. When underneath a semi trailer backboarding a worker who has fallen from the top while securing a load, it’s very important not to let your white uniform shirt come in contact with said kingpin.

Any effective grease stain removal tips are welcome in the comments section.

My partner is the Code Green Queen. When a unit is “greened” it means we’ve been canceled. The patient decided that they don’t want to go to the hospital; maybe they want to have a friend drive them or they simply “don’ wanna go in no ‘bamblance.” Perhaps they are sick enough that they require ALS and are going with medics… it could be any number of reasons. It usually happens when we’re en route, almost on scene. “CHIRP,” goes the radio. “You’re green,” says the dispatcher as the MDT terminal bleeps and the display flashes to “RETURN TO QUARTERS”.

Yesterday, Claire was wearing her Code Green Queen tiara, or carrying her scepter… or special “code green trauma shears” or something. We responded to over a dozen calls and transported less than half. We’d just about arrive on scene and the radio would chirp, “You guys are green again.” What the … ? And yes, it was all her fault.

As for the patients we did transport, all were minor. A couple of decreased LOC patients, possibly septic, a woman on Coumadin with a nosebleed that wouldn’t stop, a GIGANTIC obese/pregnant woman with the sniffles who made my stretcher creak and my back groan and finally a woman who woke up at 0400 and called 911. Her C/C? “Fear”. Fear of what, you ask? Well, it was hard to get a real solid answer out of her, but the best I could gather was a fear that she wasn’t well. No pain. No SOB. No real medical history. Just … fear. OK then ma’am; let’s go to the ER.

I “donated” my old coffee maker to quarters and Claire and I went shopping yesterday. We had to use some of the crew community funds to buy paper plates and stuff like that. Luckily all the shifts contribute to the kitty to keep the place stocked with the bare necessities. Having a working coffee maker at quarters is MY necessity. And boy oh boy, it sure was nice to brew a pot at 7 this morning.

On a somewhat funny note, my old station chief at IFT was fired on from his job as a Supe at The Borg on Friday. I had predicted 90 days before they sacked him for gross incompetence, and it was under 60. I believe what goes around, comes around. You reap what you sow, right? I hate to see anyone lose their job, but that guy… whew. ‘Nuff said.

Back on the truck tomorrow at 0800, and we’ll do it all over again. I’m also on shift on the 4th and I’m ready for a day full of EtOH and assholes.

I took these pics as we were responding to another call in the area. The smoke could be seen for miles and a whole block burned, destroying several buildings.

Apparently this started in a vacant apartment/condo building that was under construction.

This photo was ganked from a TV station‘s report.