Skip to content


Q word

No comments

I’m was kicked back in a blue recliner at Station 22, munching on popcorn and watching “The First 48″ on A&E. I’d done my station chores, finished the daily training, read some case reviews, inventoried the meds in our supply cabinet, deep cleaned our reserve truck and was seriously considering a nap.

My partner looked over at me and reached his paw into the can of popcorn. He threw a few kernels of kettle corn into his maw, chewed and then says, “Sure is quiet.”

I shook my head as the pager beeps.

Quiet, he says.

Boxed Doc

1 comment

This bullshit post nasal drip/cold/bronchitis/crud drove me to the Doc in the Box yesterday to get a scrip for a Zpak and some Flonase. I went after my shift, on my way home, so I was still in my uniform. Amazingly, the Nurse Prac just asked me what I wanted in the way of a scrip. I told her, she nodded, told me it sounded appropriate and with a few taps on her tablet, sent it in to the pharmacy. In and out in 10 minutes, with a 10 dollar co-pay. Why don’t the sniffle/snotty people who call an ambulance just visit the Boxed Doc? Oh, that’s right… Because they don’t take Medicare and there’s no Sierra Mist and Meal Trays to be had.

Sorry. I’ve still got a sore throat and a headache and I’m a little cranky. I’ll be better tomorrow, I’m sure of it.

Post bird.

1 comment

The shift, post turkey, was one for the books.

Our first call was a cardiac arrest that was downgraded to a delta response when the patient started hollering “Get yo drunk ass offa me” while the dispatchers tried to coach telephone CPR. Next was a seizure call that vanished into thin air. Following that wild goose chase was a Delta response to a scuffle over some Black Friday deals at the local Big Box store that rhymes with “Hall Dart”.

All I wanted was some nice, quiet, tryptophan induced snoozing along with Kari Byron and Punkin’ Chunkin’ on the Discovery Channel.

 

 

 

 

 

At least the rest of the night was quiet. I’ll do it again tonight.

Need the bird?

11 comments

In light of some of the discussion and recent news articles over the perceived delays in rotor transport vs. ground transport, let’s imagine a multiple vehicle accident with one Priority 1 patient who’s entrapped and requires extrication. On the initial assessment it’s obvious that this 23 year old female patient has severe chest trauma and will most likely need to be intubated as soon as the extrication is performed. The incident commander looks over your shoulder as you get a line set up and your partner leans in to the mangled car to slip a non rebreather on the patient. “I’ll start the helicopter”, he says.

You stop to consider the transport decision. You’re about 40 minutes by ground from a Level II trauma center and if you want to get the patient to the big Level I, that’s going to take a helicopter flight. As the patient is being extricated, you ask the dispatcher on the radio to advise the flight time from the scene to the Trauma Center. He has you stand by and a minute later he replies that Aviation states they can make it there in 30 minutes.

It was a simple door pop to get the patient out of the car and you glance over to see the firefighters are securing the patient on a long board and moving her to the ambulance.

“Cancel the helicopter!” you shout to the IC as you jog to the ambulance.

“What!” the bystanders exclaim.  “This is a priority 1 patient who needs a trauma center!”

You’re right. The patient needs a helicopter, but not at this exact moment. See, it turns out that I can get her to definitive care faster than the helo can. Remember, that optimistic “30 minutes to the hospital” doesn’t take all of the actions into account. Where I am, it’s about 6 minutes for the helicopter to get dispatched and off the ground. A 14 minute flight to the scene. 6 minutes to load the patient in the helicopter from the waiting ambulance. 30 minute flight to the Trauma Center. 6 minutes from the helipad to the resuscitation bay. That’s 62 minutes.

Now, if it’s a prolonged extrication, where it’s going to be 20 minutes or more before the patient is freed, it may be prudent to fly that person to the trauma center, but if I have to wait on scene for the helicopter to land, preflight intubation and other interventions to happen, the patient to be loaded… well, then I’m gonna just have the ambulance start rolling toward the bright lights and cold steel.

I can be on the road in 2 minutes. If I need to intubate this patient, I can do it en route. Same with bilateral lines, a chest decompression or any other intervention I may need to accomplish. There’s just not enough room for me to do that stuff in a State Police Bell 407.

This patient may very well need a helicopter, but not until I get her to the ED. If she needs to move to another hospital for advanced care and management, there is an air evac service that can take the patient to wherever she needs to go.

In my book, I’m almost always going to cancel the helicopter. The time it takes to transport a patient via rotor vs ground is really worth a second look if you’re placed in the position of “helo or no helo”. Don’t fall into the trap of “hurt people always go in the helicopter”. It may make more sense and lead to a better outcome if you just drive.

 

Hey, things change

1 comment

A few months ago things were looking rather bleak in Medic 22 land. I was in a funk. Unmotivated. Depressed, if you will. I never thought it would happen to me. I was always pretty chipper and cheerful and people usually liked being around me. Thanks to a slew of bad decisions, a divorce, an incredibly toxic relationship and some other issues that hit all I was once, I was whacked hard with the depression stick. I was in a hole and it wasn’t looking like I could climb out.

I blogged about it a few months back, and Mark Glencourse posted a comment that said, “I’m sorry you are having such a hard time at the minute mate. You are describing exactly how I was in my own life about 10 yrs back. Mine went on for a little while, but things have a way of finding a route back to where you start to feel better, whether that be through counseling, medication, self help, or a new opportunity in life. Whatever it is for you, I hope it comes along soon. Thinking of you.”

I saw that comment again today and it struck me. Mark’s line, “…things have a way of finding a route back to where you start to feel better, whether that be through counseling, medication, self help, or a new opportunity in life…” was so so true. I feel better than I’ve felt in years. Counseling, a small dose of an SSRI and a new job, and the home to go with it, have made all the difference.

So, to any of my readers who may be going through a tough time, remember that things WILL turn around. And if you get to the point where you need to talk, drop me an email. I’ve been there. I understand.

Cardiac Arrest? Make it snappy!

No comments

WARNING: Academic info follows!

SNPeCPR or “Snappy CPR” may eventually change the resuscitation model. We know that pressors like Epi and Vasopressin have little value in increasing survival to discharge, but vasodialation with Sodium Nitroprusside looks promising in this early pig study. To my medic friends, READ THIS ARTICLE! It’s amazing stuff!
http://www.ucdmc.ucdavis.edu/emergency/education/residency/journalArticles/NitroprussideInProlongedCardiacArrestCritCareMed2011.pdf

The dark side

2 comments

So, I’m single again and there’s a nurse at one of the local EDs that caught my attention. She’s blonde, bubbly, looked to be about my age. Always really nice to me when I handed over a patient.

Hmm. No wedding ring.

Well, that doesn’t mean anything. Maybe she doesn’t wear it at work. Who knows? It can’t hurt to do a little detective work.  The ED secretary told me she was single. Aha. The plot thickens.

So, I decided to ask around a little more. Yikes. All of the other medics told me to stay clear. “She’s a bitch.” and, “She hates medics.” I also heard “She’s got an attitude.” and, ”She thinks she knows it all.”

Never one to to listen to advice, I forged ahead, asked her for her number and if she was interested in getting a drink with me.

Well, what do you know? Indeed she was! “And thanks for asking!”

Then, as we were planing on when we’d get together I mentioned that I was on shift Friday night, and I wouldn’t be able to meet her until later in the evening. So, instead of a drink, she offered to cook dinner for me, saying she’d make me a better steak than Morton’s. After my shift, she came over to my place, took over my kitchen, seared a couple of amazing fillets and whipped up a salad, we drank wine and talked and laughed til midnight.

 

The moral of this story? Don’t let other people make judgements for you. And, if you drink 2 bottles of wine, take aspirin before bed. :/

The trip to Haiti

4 comments
I promised I’d write a little about my Haiti trip from March… so here ya go. Better late than never.First, let me say that the amount of sheer destruction and devastation in the city of Port au Prince can not be believed. Over a year after the quake and the city is still destroyed. People living in rubble, huge piles of garbage on the street…more about that later.

My then girlfriend (also a medic) and I left Seattle on a Monday night and flew to Miami on a Red Eye. Thanks to Benadryl, I slept the whole way. We hopped an Air France 737 to PAP and arrived on Tuesday morning around noon. Absolutely no problems with the flight, customs or passport control. When you get to Haiti, the first thing you notice is the heat. Damn. It was around 95 and humid and the smell of burning garbage hits you when you walk out of the air conditioned airport. (And that’s one of the last times I experienced AC in Haiti, ’til my last day in the country.) Prepare to be mobbed by “baggage guys” that will swarm all over you and try to grab and carry your bags. We had a translator meet us at the exit,and he sent the hordes of “helpers” packing. We had each been loaded down with over 100 pounds of supplies, clothes, food and whatnot, so grabbing a baggage cart was important. It was 2 bucks US, and well worth it.

Our translator lead us out to the parking lot where I had my first experience with a Tap Tap. A Tap Tap is the Haitian taxi, usually an old pickup truck with some metal frame in the back for seats and a canopy on top to provide shade and shelter from the rain. Everyone rides in Tap Taps. It’s not uncommon to see 20 people crammed in the back of one of these trucks, careening down the road. The only rules of the road, as far as I could tell were; drive as fast as you can, use any flat portion of the road or sidewalk as a travel lane and use your horn as much as possible. We rode in Tap Taps during the whole trip and while the driving made me close my eyes and assume the crash position a few times, we never hit anyone, nor did I see a Tap Tap MVA while I was in Haiti. Good thing, because if a Tap Tap crashed into anything, it would eject EVERYONE in the back and would result in a legitimate mess.

While in Haiti, we stayed in Petionville, an eastern suburb of PAP, on the side of a mountain. The group I traveled with has a house there, rather spartan by American standards, but pretty damn nice to the Haitians. We had agenerator for electricity, some cold running water for showers and toilet flushing and army cots with mosquito nets to sleep on. Not bad. Our crew of translators lived there and really made us feel at home. Our first day in country was a “chill out and take a nap day”, followed by a nice dinner and some cold Prestige, a fantastic Haitian lager. Over beers, we got the lowdown on what had been happening in the country, what our crew of translators was up to and what we could expect the next day at the Project Medishare Hospital.

Project Medishare, a service of the University of Miami, is running Hospital Bernard Mevs, the only critical care and trauma center in Haiti. The hospital is staffed by volunteers that rotate every week and oversee an ER, ICU, OR suite, PACU, Med/Surg unit, Ortho clinic, wound care clinic, a pharmacy and a “fast track” type urgent care. Below is the ER/ICU crash cart. I love the sign on it. “This is the CODE CART. Do not use the supplies if no one is coding!”

WhileI was there, I overlapped with two separate teams. First was a group of nurses, docs, medics and others from Urbana Illinois. They left on Saturday and were replaced by a whole new crew from the Bay Area. All great people, really dedicated to what they were doing. I met a maxoillfacial surgeon who rebuilt a guys face, a pedi trauma surgeon who worked 14 hour days in the OR helping kids, an ortho doc who seemed like he never slept and a ton of nurses who worked round the clock to keep patients alive in the ICU. Amazing people. Every one of them. My job at Bernard Mevs was to work in Triage with other medics, a nurse and a Doc, when he could get free. We were designed to be the gatekeepers to the hospital. In theory, we’d be seeing only emergent patients, stabilizing them and moving them on to the ER.

(That little hut abouve is the Triage area.)

In reality, we saw just about everyone. We referred as many to the day clinic as possible, but the flood of patients was almost non stop and we we wound up doing procedures in the triage area and then sending them home them without an ER visit. We had several docs (both Haitian and American) with us throughout each day, and they were more thanwilling to let the paramedics treat patients under their supervision. I learned to suture wounds, provide antibiotics, get treatment for Cholera started and how
to call the “Cholera team” to transport those patients to the “Cholera Camp”.

Supplies were always hard to come by, and if I hadn’t brought some boxes of large gloves, we would have been out of luck. Finding meds could be a chore, too. Pyxis, schmyxis. We had a box!

We went through hundreds of grams of Ceftriaxone, gallons of betadine, piles of 2×2 gauze and miles of kling and tape. It was an experience that most paramedics will never have, but one I highly recommend to everyone.

Some highlights? I had a guy come in with a foot that had been crushed after the quake. He had some medical treatment shortly after, but none since. I was told he simply needed a dressing change, but I was not prepared for the maggot infested mess that remained of his foot when I unwrapped the dirty diaper he had been using as a dressing. He had a BKA about 2 hours later.

I watched a Tap Tap come screaming up to the gate with a 20 something female in the back, in cardiac arrest, after being electrocuted while bathing outside at a refugee tent camp. We worked that code for 45 minutes, with no luck. The medics ran the code, while the docs and nurses looked on.

I did a “CCT transport” of a head injured male, intubated and sedated, in the back of an old ambulance without a stretcher lock or straps. We had to take the guy to St Luc hospital for a CT scan, as the scanner at Bernard Mevs was not yet operational. No drug box, no vent, no monitor. Just me, a doc, a nurse, a BVM and a scrub top pocket full of Benzos. No kidding. One of the scariest rides of my life. The stretcher was sliding around… we were bagging the guy and checking the lung sounds every minute or
two to make sure the tube didn’t become displaced.

There was a ton of trauma, lots to learn, amazing sights to see, great food, an amazing beach… and some of the most fantastic people I’d ever had the pleasure to meet. I feel in love with my new Haitian friends and can’t wait to go back.

Want to know more? Just ask… or visit http://www.papmo.org

 

I’m back

2 comments

The last few months have been crazy.

I mean, straight up, move across the county, leave your friends, end a relationship, start a new job in a place where you don’t know anybody, crazy.

But, I’ve done it and I’m back. I feel better than I have in almost a year and I think I’m starting to get things back in order. Back to a place where I feel like my life is back under my control and I don’t have to apologize for my past mistakes.

So, what’s the deal? Well, I’ve moved to the East Coast, I’m working for an amazing third service ALS only department, living in a small condo with my dog and loving life.

As in the past i’ll be writing about my daily experiences and sharing discoveries I make along the way. And, as always, I’ll be obfuscating any and all patient details and information to keep the HIPAA-potamus off my back.

It’s good to be back. I’ve got stories to tell and I’m ready to share them. Again.

 

I know these things are true…

7 comments
  • You can not kill yourself by taking 5 Nitrofurantoin.
  • Crank does not make you a zombie. Ativan makes you a zombie.
  • If you touch me again, you’re getting arrested.
  • You need to vomit in the little blue cup.
  • I need to know all of the meds you take. Not just some of them.
  • Spitting at me will also get you arrested.
  • You have to actually breathe to get any effect from a neb.
  • Taking ASA will not cure a UTI.

I said all of these things yesterday.

Now this is cool…

3 comments

I volunteered, and was selected, to be one of the medics that will be deployed to Haiti to assist with the ongoing medical missions that are still being conducted in country.

The current situation in Haiti is as bad, if not worse, than it was immediately following the earthquake. The number of people that are seeking medical attention, some for the first time, is simply staggering.

I’ll be deployed with EMPACT Northwest, a group of local medical professionals that has been operating in Haiti since the earthquake.

It looks like my team will be leaving for 10 days at the end of March. I’m pretty excited about the opportunity and I’ll write more about this soon.

My iPhone Apps

2 comments

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

4 comments

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

4 comments

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.

Status post yule

No comments

I just wrapped up a 48 at the ALS IFT job. It was pretty quiet, with only a few calls to interrupt by busy schedule of napping interspersed with the Mythbusters marathon on Discovery.

I had a G1,P0, 32 weeks with contractions 4 minutes apart who needed to go to a hospital with a NICU. She was very nice and, as usual, demurred when I offered my name for the baby. She did not deliver in my truck, thank god. I don’t mind delivering a baby, it’s the cleaning up the mess that I don’t need.

I also transported a 24 year old guy who, rather unfortunately, weighed 475 pounds and was experiencing some “palpations”. I put him on the monitor and saw he was in sinus tach with trigeminal PVCs. Interesting. Some O2 and away we went. We’re not treating PVCs here unless there are symptomatic, so no Ami or Lido was warranted. Nice guy, just a shame to see such a young guy in such a spot.

We ate like kings over the last few days. The BLS B shift made a huge dinner and treated the duty medics to ham, smashed potatoes, stuffing, green bean casserole and pie with ice cream. In return, the ALS crews covered some BLS calls to give the crews a break so they could relax and eat dinner in peace. They seemed to really appreciate the fact that we jumped in to cover for them.

I start a 72 at the busy 911 service tomorrow morning. I’ve passed the protocol test and 12 lead/STEMI test that the county requires and after one more rotation with a senior medic, I should be good to go solo. I’m excited, but scared shitless. This service is busy as hell, very high speed and has a LOT of trauma and very sick people. For example, on my last shift, there were 2 GSWs, several major MVAs, a couple of codes and all manner of priority 1 sick folks. That was in 48 hours, in a city of 75,000. Crazy.

Anyway, I’m laying in bed with a cup of coffee and the dog curled up next to me, just relaxing. I hope everyone had a great Christmas and Santa brought you everything you wished for.

More in a day or two.

Enough!

1 comment

Last night, while laying in bed with a cup of tea and the dog curled up next to me, I had a thought. I suddenly realized that I should be thankful for the good things I have in my life and stop wallowing in self pity.

Enough.

I’ve been punishing myself for past mistakes for far to long. I’ve had enough of the self flagellation. Publicly whipping myself with nettles only makes me look foolish and doesn’t do anything except prolong the pain.

So, to that end, I’m done with the bitching, whining and complaining and this blog will return to what it was intended for. A vehicle for me to talk about my ongoing paramedic education, interesting calls, learning experiences and ways I think we can further the profession of paramedicine.

I’m at work at my second job now, the IFT ALS service, watching ESPN and thinking about lunch. No calls so far today, and I actually hope it stays quiet. I had a crazy 48 hour shift at the 911 ALS job, and a day without anything major sounds good. I’ll be working a 48 over Christmas at this job, so the medics with little kids and families can have Christmas with their loved ones. It’s the least I can do.

I had a couple of good calls on the 911 shift, including a status asthmaticus that I found tripoding and unable to speak who was not opening up following non stop at home albuterol nebs. It made me pucker a little, but I managed to get his sats up with a Duo neb, Solu-Medrol and Mag by the time I got to the ED. I had the tube kit open and ready to go, but he was doing better and able to talk when we got him in the treatment room, thank God.

I also am the refusal king. In one 48 hour shift I managed to use all of the refusal forms in the medic unit. ALL OF THEM. Crazy.

Anyway… I’m back on track. I’m feeling better and I’m getting back to focusing on the EMS calls.

Man

3 comments

I bury myself.

I work a zillion hours. I take every overtime or coverage shift I can. When I get a text from dispatch looking for a medic for an out of town trip, I’m on the phone in moments. “I’ll take that shift.”

I immerse myself.

When I’m with a patient in the back of the rig, they are my singular focus. We talk, we laugh, I monitor their vital signs. Sometimes I give them medicine to make them feel better and forget their pain.

I’m drowning.

When I’m not on a call, in the rig or at the station BSing with the other medics and EMTs, I’m overtaken with such a wave of sadness that it defies any description.

I’ve been a bad person. Bad. I destroyed the trust and kind heart of a woman who did nothing but love me through my own selfish and heartless actions. I am beyond any penance. I know that I am past the point of forgiveness and I am destined to forever be submerged in this well of pain as punishment for the things I’ve done.

I just hope that I can be a good, kind caring medic for my patients and help them through their pain, even as I struggle to cope with mine.

It’s a small consolation, but right now it’s all I’ve got.

Oh, by the way.

No comments

I didn’t get hired at my fire department, but I am #1 on the list.

The decided NOT to hire a medic, even though we’re short a medic and we’re calling in per diem guys and racking up overtime like nobody’s business.

Eh. Oh well.

Long overdue update

2 comments

After a month or so, I think I’m getting back into the swing of things. It’s been a little unsettled in my world, but I’m feeling much better.

My fire department is hiring, looks like it’ll be a medic and I have a good shot at landing that spot. I’m still not sure I want the job, but having the option sure is nice.

I just started as a medic with a company that does ALS interfacility and it’s been GREAT! Lots of training, lots of opportunity and they treat the medics like gold. I’ve seen some really sick people and it’s an awesome learning experience for me. Next on the list for me is CCEMT-P. I’m fascinated by the Critical Care transports.

I got a new dog, and she’s great. Having a hound around really improves my mood.

Antidepressants. Awesome. ‘Nuff said.

There are still some downsides. I’m really working on getting in shape. The fire stuff just continues to kick my ass. Unlike some of the guys that can do this job like it was nothing, I’m not a great fireman. I’m still slow as hell when it comes to throwing packs and an afternoon of hose evolutions leaves me wiped out. But, I’ll get there.

My personal life is getting better. Lots of stuff to think about and work through. Good friends help with the bad days.

I’ve missed writing here, and I’m looking forward to getting back on the horse.

a rough go

7 comments

I have been having a rough time with stuff lately. All of the changes in my life have been weighing heavily on me and I often feel like I’m on the brink of collapse.

Depression? Me? Nahhhh.

I’m always cheerful. I make my partner laugh and smile. I’m a cut up at the fire station. I joke with patients and the ER staff when I bring someone in. I’m always quick to hop to my feet when someone needs a hand or there’s a job to be done.

But when I’m at home, I find myself simply sitting. Unable to move. Not motivated to put away the clean laundry. Or hang the pictures that are leaning against the wall. Sleeping for 12 hours at a time. Justifying my inactivity by claiming I’m tired from the shift the day before.

Forcing myself to tie my sneakers to go for a run is an hour long process.

I wish I didn’t feel this way. I wish my life was really as carefree as I let others believe. I wish I wasn’t so goddamn sad all the time.

Back to work tomorrow. Gotta practice smiling.

…a quick hit

No comments

It’s been busy.

Had a couple of good calls lately. A multi car MVA with two critical patients. One by helo, one in my rig. I got to RSI, had multiple lines. The typical trauma patient. Helo patient died, mine didn’t. Eh. It goes that way sometimes.

I also ran a code as a solo medic. It was remarkably calm and less of a Charlie Foxtrot than I expected for my first solo code. No ROSC, but a good learning experience nonetheless. Firefighters did a great job with CPR and getting a shock on board before I got there.

I’ve been getting more involved in the fire side of being a fire/medic. I love cutting up cars.

A dash lift...

More soon… honest.

Another new blog

1 comment

One of my former radio buddies has also joined the ranks of EMS. After becoming an EMT a year ago, he’s decided to take the plunge and become a medic.

A year of 48s as a BLS EMT didn’t dissuade him from his “quest for the disco patch” and you can read about his exploits here:

Future Ditch Doctor

Good luck Bro!

I’m still here…

5 comments

Is this thing still on? It’s been ages since I’ve posted, but work has kind of gotten in the way of little things like blogging, sleep and eating. But, I’m still here and if you’d like to hear what’s up, I’ve prepared an update.

You’re still reading? Good.

Okay. So, I’m a medic. I finished medic school with an incredible 4.0 for the curriculum and an overall GPA of 3.89. And that was no small feat. It kicked my ass. As I wrote a few weeks back, ‘What now?” Well, here’s what’s going on.

I just started with a small rural department as a resident FF/PM. I’ll be referring to this department as UNFD (Up North Fire Department) A resident at UNFD is a compensated volunteer that functions exactly like a career firefighter. I work a 48/96 and I am expected to perform all the duties of a FF/PM during my shift. We have a couple of career guys on shift with us and we work side by side with them. I just completed a month of orientation/”mini academy” and will attend the state fire academy this fall. The department already had several guys scheduled to attend the session that starts in August and there wasn’t room for me. I’ll be in the next wave. Do I like working as a fire medic? Well, I have to admit I do. I really enjoy enjoy the brotherhood in the station and frankly, 90% of what we do are either medical calls or MVAs and I feel like I have a good grasp on that stuff. Plus, cutting up cars, climbing ladders, venting a roof and putting out fire is pretty damn cool. I like it.

There is a downside, however. We don’t do many calls. As a matter of fact, on my last 48, we didn’t turn a wheel except to take the medic unit out for driver practice. That blows. I am not going to get a ton of experience at UNFD.

So, on to job #2.

I was just offered a per diem job as a medic at FFAAS (Far Far Away Ambulance Service), the place where I rode as a medic student during my last quarter of school. It’s an awesome place, very busy, great people and lots of trauma. From my experience riding there as a student I know I’ll get a ton of tubes and see some sick people. They actually wanted me to work full time, but I couldn’t juggle the schedule between UNFD and FFAAS and make it work. I’ll be picking up one or two 24 hour shifts there during my 4 days off. That still doesn’t leave a lot of time for sleep, fun, life and whatnot… but I’ll manage. Right now, getting good experience as a medic is much more important.

Other than that, life is pretty good. I was offered a new pair of steel toe duty boots to wear and review and I’ll do that as soon as I get a few more weeks of wear in ‘em. It was fortuitous, as my 5.11s have been MIA since I moved!

Also, I would be remiss if I didn’t take a moment to congratulate Epi for her fine job of completing paramedic school. Well done kiddo!

So now what?

2 comments

Hmmm.

My life feels a little empty. It really feels strange to not be running around like a headless chicken careening from a clinical site to a third ride to a class session. I woke up yesterday morning at 0800, SURE that I was late for a shift. My heart was pounding when my eyes jerked open and I glanced at the clock…

“Oh. That’s right. Class is over.”

So now what?

Well, here’s what’s going on. I’ll fill you all in as best as I can.

My wife and I have decided to split up. I’m not going to go into any details here, but you should know that she is a fantastic woman who put up with a lot from me. I still love her, but it was just not something that I could continue. And yeah, the dogs are with her.

I’ve decided to stay in the PNW and pursue some paramedic jobs. The last service I rode at has expressed interest in hiring me and I’m going to take them up on that. At least as a part time medic. They know that I know their system and they consider me pretty much a turnkey employee. Once I take the protocol test and get signed off by the MPD, I’m good to go.

The other thing that’s cooking is the opportunity for me to work as a resident firefighter/paramedic at a department north of where I currently live. (More about that in sec…) This is a great chance for me to get a LOT fire experience, get a TON of training, attend fire academy on the department’s dime and work as a medic. Sounds great right? The down side is, it pays for shit. Like a hundred bucks a shift, but I’m going to do it just to get the experience. We work 48/96s there…and I’m sure it’ll will be an experience beyond all others. Just think, this 40 year old fat guy will competing with super fit 22 year old kids on the drill ground. I know I’ll be working harder than I’ve ever worked before…and I’m looking forward to the challenge. Of course, it’s not official yet, but they did measure me for bunker gear after my interviews, so I think I may be in. I have to agree to work there for 2 years or untill I get a full time career firefighter position. It’s a win/win.

OK… the move. I’m moving to the big city south of Seattle to a small apartment. Moving my share of the household goods is a stressful endeavor. My new little apartment is in a funky little neighborhood. I’ve got friends that live close. It’s a LOT cheaper than Seattle. There’s cool restaurants and stuff close by. I have a really good feeling about it.

I’ll be moving over the next few days and I’ll be checking back once I’m plugged in at the new place.

Medic friends, be safe.

Fin.

24 comments

Paramedic school has ended. I’ve passed the program. I’ve passed ACLS. PALS. PHTLS. I’ve taken both the practicals and computer based testing for national registry. And yeah, I passed those too.

I am now an NREMT-P.

Now, I just need a job. (Anyone hiring?)

Friends, there are BIG changes happening in my life. I’m a little busy with moving and stuff right now, so I’ll write more about what’s going on in the next few days. But it’s all good!

In the mean time… allow me the pleasure of one big “WOOOOHOOOO” to celebrate that I am now, at long last, a medic.