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My Johnny and Roy moment

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Back in the early 80s’, when I was just a kid, I would rush home after school, grab some Chips Ahoy cookies, a glass of milk, and turn on Channel 38 from Boston to watch reruns of Emergency! After the crew from Station 51 wrapped up the day’s adventures, my friends and I would hit the streets to play paramedics in the neighborhood. Our bikes were shiny, red, two wheeled versions of Squad 51, my dad’s old fishing tackle box  the med kit. I always played Johnny and my partner in crime, Mike Petroski, took the role of the more stoic Roy. Mike’s younger brother Joey was invariably pressed into service as the patient. Our favorite “rescue” involved Joey, feigning unconsciousness, on the roof of the the Petroski’s garage. Perched on that roof in a raincoat and plastic fire helmet, in my mind I was far above the ground on an oil drilling rig, getting ready to rescue a roughneck that had a bad day. As Mike was busy strapping Joey to a chaise lounge lawn chair, our version of the stokes, I would yammer about “Sinus Rhythm” and “Ringer’s Lactate” into an old telephone handset that we carried in a lunchbox that my dad had spray painted orange.

One of the best parts of Emergency! was that all of the medical problems were quickly solved with an IV of D5W or a defib shock. “Rampart, we shocked the victim, he’s in sinus rhythm.” The guys showed up, worked as partners doing some paramedic stuff and BAM! The patient was better. These guys were super medics. Plus, they had a bitchin’ refinery fire or chemical plant explosion in every episode! But I digress.

Who knew that yesterday, almost 30 years later, I would have my own, real Johnny and Roy moment.

My partner and I were watching an amazing TV show about amazing wedding cakes on A&E when the tones dropped for an “unconscious and unresponsive” patient. We arrived at a nice house in an upper middle class neighborhood to find a 72 year old female who had suddenly become unconscious during a canasta game with her husband and another couple.

When I walked in, a couple of fire fighters were attempting to obtain a BP on a very gray, diaphoretic woman who was half slumped in a kitchen chair. Holy shit. This lady looked sick. Her husband, standing behind her, holding her up in the chair, looked scared to death. The woman could be aroused only with painful stimuli and would only answer yes or no questions with a mumbled “yuhhh” or “nuhhh”. “OK,” I said, “Let’s get her lying down.”

A couple of firefighters quickly got her on my cot, took a pressure, which was 50 over nothing, and hooked up the monitor. Sinus brady at 42. My partner got a line established and I pushed half a milligram of Atropine. I started a fluid bolus and about 4 or 5 minutes later she was pink, dry and alert, wondering why there were so many people in her kitchen and wondering why we were making such a fuss.

Yeah, that was the stuff. That was my Johnny and Roy moment. It was smooth and pretty. Like an Emergency! episode. Everyone worked as a team. The treatment was fast and appropriate, the patient improved, the family saw some efficient EMS, and we did it all in about 7 minutes before we were on the road for the hospital.

Thanks again to my partner. Unfortunately, you’ll never read this, but you are the reason I was able to be a good medic yesterday. I’m new and still learning and almost unconsciously, you worked as my right hand, doing the things I needed before I could ask you to do it. You helped me more than you’ll know.

I’m not Johnny. He’s not Roy. We’re not super medics by any stretch, but, we work pretty damn well as a team and we do good stuff. It’s not a man trapped in a well or a 5 alarm refinery fire, but I’ll take it.

I’ll take it.

My iPhone Apps

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As promised, here’s the post about my favorite EMS iPhone apps. These are the apps that I use to make my life easier. And yeah, I didn’t receive any compensation for this post.

my iPhone

First, The Paramedic Protocol Provider. I work in several different county systems. All have very different protocols. With the PPP, I can have them ALL at my fingertips. This is WELL worth the $7.99.

The Informed ALS field guide. A must have. And the new version rocks.

EMS Tracker is a great way to track scene times, vitals and procedures. Valuable. And, IT’S FREE!

When I work a code, I hand my iPhone with Full Code Pro to a firefighter and just have him push the buttons to mark what we’re doing. It makes charting the code so much easier.

Weight Calc? Pounds to Kg. Yeah. Find one you like. Easy and free.

My most used app is Epocrates. It’s the PDR, in your iPhone. Man, I love this app. Also, free.

Medscape is from WebMD. Some interesting stuff in here. Worth the sign up. The app is free.

MedCalc is handy for drug dose calculations. I don’t use it often, but it has come in handy.

If you ever have a burn patient and you need the Parkland Burn Formula or you can’t quite recall the Rule of Nines, you should have uBurn Lite. Another freebie.

I lost my DOT ERG, so I bought the app. You may not need this, but I do a lot of response on the highway and I want to know what’s in that tanker that’s leaking.

PALS Advisor was bought simply for the resuscitation drug dosages. I don’t know if I’d buy this again, but I already have it… so, there ya go.

PEPID is another great Go-To app when I’m stymied about a drug overdose or a toxic ingestion. Another great free app that you should grab if you don’t already have it. Did I mention it’s free?

So? Did I miss one? Is there a great app you can’t live without? Let me know!

I’m pretty lucky

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If I stop and look at what I’ve accomplished in the last year, I guess I’m pretty lucky. I managed to finish paramedic school at the top of my class despite some rather harrowing personal issues, I’ve managed to find a full time job as a 911 medic, a part time job as an IFT medic, pay most of my bills on time and I still manage to feed myself most days.

A bunch of my friends aren’t working and there are guys from my medic class that may never find work as medics. It’s bad. There are so few jobs out there, it’s tough to find anything. I’m lucky, and I know it.

I’m lucky that I’m getting great experience. On my last shift I cardioverted a guy in Afib with RVR, treated a couple of STEMIs, had patients with symptomatic bradycardia, a CVA, a couple of good assaults, a major trauma MVA and a GSW. That’s ONE shift. That’s the kind of stuff some medics in slower systems may not see in a year. It’s so damn busy that I’m becoming a faster medic just by working with the other guys. If I don’t get my 12 lead and IV within a minute or two of getting in the truck, I simply won’t have time before I get to the ED.

I’m having a great time. And I’m learning every day. And I don’t take any of it for granted.

My next post will be a list of MY must have EMS based iPhone apps. The stuff that saves my ass.

Inside, Outside, Upside Down

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It had been a pretty quiet shift so far. It was just after lunch and the other medic and I were discussing the merits of the particular games were we playing on our smart phones. He was bombing pigs with Angry Birds and I was pummeling a buddy of mine in Words with Friends.

“You see,” I started to explain, “it’s just like scrabble, but I’m using an iPhone, which is eleventy million times more sexy than that droid you’re playing with.”

WhoopWhoopWhoopWhoop!

The radio interrupted me.

“Medic 22, an ALS response to a one car rollover, 1652 McGilvery street.”

We jumped up and headed to the rig. I hopped in, grabbed the mapbook and my partner put us in route.

“McGilvery is only a couple of blocks from here,” my partner said. “It’s the third right off Division Ave.”

I knew where it was. A quiet street, lined with well kept houses built in the 60s. Nice yards. Lots of trees. No curves and a speed limit of 25. And 1652 would be smack in the middle of the block. How did a rollover happen there?

“Medic 22, the RP is stating the vehicle is on it’s roof in the front yard of 1652, one patient, unconscious, trapped in the vehicle.”

Are you kidding me?

We rolled up and sure as shit there was a small Toyota or Nissan on it’s roof in the front yard of a nice split level ranch in the middle of the block.

As we eased to a stop, I could see that the patient had somehow self extricated from the mangled wreck and was now hunched over against a tree with a bloody towel held to his face. The medic that was doing my county check off stood in the background while I approached the scene and sized up what was happening.

Here’s a better picture of the scene.

One unstable car on it’s roof. Car parts and assorted flotsam and jetsam scattered everywhere. One patient, covered with blood. About 50 bystanders crowded around, several screaming. Police and fire not yet on scene, but approaching quickly, based on the number of sirens I hear in the distance.

This would be my first major trauma as a solo medic. Yeah, there was another medic there, but he was just observing and he specifically told me he would function only as a basic, unless I really was screwing the pooch.

So, yeah. Back to the bloody kid.

“Wha happen? Wha happen? Wha happen?” That’s all I could get out of him. At least his airway was patent.

A fire engine rolled up and I had a firefighter grab c-spine while I pulled the towel away from the kids face.

Wow.

He had a huge open wound that ran from the bridge of his nose into his hairline. A wide open, gaping hole in his head.

Jeez. If I shoved my finger in there I could touch his piano lessons.

I grabbed my portable radio and notified dispatch that I was calling a trauma alert for a head injury.

In less than 12 minutes, we got Mr. Rollover packaged, loaded in the rig, a 16ga in his AC, a full set of vitals, a call to the ED and delivered to the waiting trauma team at the hospital.

It was quick. We were moving with a purpose.

Who am I kidding? I’m not taking credit for that. It was the work of some kickass firefighters and my EMT partner getting the kid packaged up expeditiously.

12 minutes from dispatch till we were at the trauma center. The trauma doc was happy. That was good stuff.

And, it turned out well, too. The kid didn’t scramble his brains, only suffering that huge lac and a broken nose.

I stopped into the trauma bay later that day. He was sitting up in bed, a huge dressing covering that lac. His whole family was there; sisters, older brother, mom and dad and his girlfriend holding their 1 year old daughter.

He looked up when I walked in.

“Hi. Do you remember me?” He shook his head, wincing at the pain it caused.

“I’m the paramedic that brought you in a couple of hours ago. How much do you remember?”

He looked down and said, “I guess I was hauling ass up McGilvrey, doin’ about 70 and I flipped my car, but I don’t remember that. I just remember not being able to move and somebody telling me that I was gonna be okay and that they were taking care of me. Then I was here.”

His dad walked over and shook my hand. He looked me in the eye. “Thanks,” he said. He didn’t have to finish “…for taking care of my dumb ass kid”. His eyes said it for him.

I said goodbye to everyone and headed back to the rig.

The senior medic climbed in the back seat and shoved his evaluation sheet at me through the hole leading into the cab.

“Approved to practice independently”.

Once again, I’ve been cut loose. Once again, I’m scared to death.

God… Or whoever is calling the shots, Thanks for letting me do this job. I’m glad I found something I’m good at.