I have not blogged in a little while now, so I am going to try to catch you all up with some miscellaneous ramblings.
Yes again, I have I had to pull a lifeless teenager from their motor vehicle. A few nights ago I responded to a multi-vehicle accident and found one of the victims to be deceased. As there were multiple victims and I was there in a supervisory capacity, I sent someone immediately to confirm the DOA and assisted with triage of the other patients until the last was transported. Then I remained on the scene for a while later to ensure the deceased was transported appropriately by our contracted service. If they weren't going to respond timely, I was going to arrange to transport him myself via ambulance, but since we had multiple ambulances tied up alread, I didn't want to go this route unless I had to.
I never saw the deceased until some time later when I was tasked with removing them from the vehicle while awaiting our transport service. I realized quickly that this was another teenager. For the first time in a long time I had to take a second look. This particular person resembled a close friend of mine. I then looked back at the vehicle and at the person's license and knew that this was a stranger to me, yet the resemblance shook me. I could only imagine in my mind the feeling this child's parents would feel when the patrolman delivered the news to the family. I looked into this particular victim's eyes, looked at their hair, their teeth and for the first time quite a while, I felt terrible inside knowing I could not help this child. I guess in recent years as the sheer volume of fatalities has increased, I have become slightly hardened and have not felt that personal "connection" with each one as I did in my early years of EMS. For some odd reason this one was different. I truly felt the loss and wished more than anything that I could have done something to help this poor child. This victim was no longer a number. They had a name, a face, distinct facial features and they stuck in my mind.
Perhaps as I wind down my EMS career each one will become more and more personal. I remember my father saying after 20 years in Fire and EMS "I don't care if I never go to another wreck" recalling how so many times it was someone he knew, or the parents or children of someone he knew. I guess perhaps I am starting to feel what he did.
One thing I did today that I have always done is I read this child's obituary. I read the names of the parents, siblings and the short biography that accompanied the photo of the face that I remember all too well. My advice to new EMTs is to do just that. It helps remind you that each DOA you encounter was a real person. They had a family that loved them and friends who will miss them. For many years I have gone to the funeral visitations of fatal accident victims if they are local. I have a feeling that tonight I will make that trip once again. I generally go alone, and find that the travel time to and from the funeral home or church gives me time to think about my life, my family and the ones that I love. This time helps me to realize just how lucky I am. It also helps me reflect on how priviledged I am to work in the best profession in the world. I realize each time that my job as a paramedic is NOT always about the ones that I save - but about the ones that I couldn't save and the lessons they teach us all.
So many young EMTs and Paramedics focus on saving lives and feel they are a failure when they are unable to save a life or if they are not given the opportunity. I do not feel that way at all. Each patient we encounter, whether dead or alive is a patient to me. Though I may not can physically help them, I can ensure they are treated with dignity and respect. I can also guarantee to them that in their last minutes of life, a paramedic cared very much, treated them with dignity, and assisted their family in dealing with the loss. We cannot and will not save every patient. We must remember that we can impact the lives of the dying and their families.
Thank you for listening - I know I feel better.
Wednesday, May 20, 2009
Thursday, April 2, 2009
What Happened to the Patient Assessment?
Ok, I may open a can of worms on this one - but here it goes. What happened to the quality of our patient assessments, and why aren't the students of today being taught the importance of the patient assessment?
The new breed of student that gets on the truck nowadays is VERY skill oriented. They want to do skills and get signed off on certain things - but they don't want to "run the call." They want you to figure out what is wrong and then let them step in and start an IV - or intubate? I have a HUGE problem with this.
I personally feel that we can train monkeys to start IVs and Intubate, so as good preceptors, we should NOT emphasize the skills, but rather should ensure they can accurately assess a patient. The shift should always start by asking the student what they're comfort zone is. When they begin talking about skills and IVs, you should redirect the conversation to go something like this. "So are you comfortable walking into a house and interviewing the patient with no assistance?"
I personally offer to assist them with skills and even do some of the skills for them - if they're willing to concentrate on the patient assessment and work on "getting the big picture."
Another thing - don't allow them to use the pulse oximeter and glucometer until they can tell you what THEY think the satuation level and glucose levels will be based on their physical exam of the patient. I say, "so what do you expect their O2 sat to be?" or "what do you expect their glucose to be - are they alert and mentating appropriately?" The good students will suddenly "get it" and think, "Wow, I figured this out without the machines!"
Also come up with a signal ahead of time that the student can use to ask for your help without having to embarrass themselves by asking. I always say, "you go in the house and begin your assessment. I will be standing off to the side. If you get stumped or need me to help you with your questioning, just look up at me and nod your head." This certainly is better than them saying, in front of the patient, "Can you come help me" or "I don't know what else to ask." You will also gain a lot of respect as a preceptor when you treat the student in this manner.
I do lay a lot of the blame with the instructors of today. My friend DJ (9-echo-1) has blogged about this recently. People fresh out of EMT or Paramedic school are now being allowed to teach and they don't have the assessment skills sharpened themselves. I would like to ask all of my fellow preceptors to consider my approach and take away the machines until the student can perform a quality physical exam and interview. Then allow them to confirm their findings with the machine - not base their treatment path on a machine.
Enough for now - keep reading and commenting! Thanks so much to those of you who follow my blogs!
The new breed of student that gets on the truck nowadays is VERY skill oriented. They want to do skills and get signed off on certain things - but they don't want to "run the call." They want you to figure out what is wrong and then let them step in and start an IV - or intubate? I have a HUGE problem with this.
I personally feel that we can train monkeys to start IVs and Intubate, so as good preceptors, we should NOT emphasize the skills, but rather should ensure they can accurately assess a patient. The shift should always start by asking the student what they're comfort zone is. When they begin talking about skills and IVs, you should redirect the conversation to go something like this. "So are you comfortable walking into a house and interviewing the patient with no assistance?"
I personally offer to assist them with skills and even do some of the skills for them - if they're willing to concentrate on the patient assessment and work on "getting the big picture."
Another thing - don't allow them to use the pulse oximeter and glucometer until they can tell you what THEY think the satuation level and glucose levels will be based on their physical exam of the patient. I say, "so what do you expect their O2 sat to be?" or "what do you expect their glucose to be - are they alert and mentating appropriately?" The good students will suddenly "get it" and think, "Wow, I figured this out without the machines!"
Also come up with a signal ahead of time that the student can use to ask for your help without having to embarrass themselves by asking. I always say, "you go in the house and begin your assessment. I will be standing off to the side. If you get stumped or need me to help you with your questioning, just look up at me and nod your head." This certainly is better than them saying, in front of the patient, "Can you come help me" or "I don't know what else to ask." You will also gain a lot of respect as a preceptor when you treat the student in this manner.
I do lay a lot of the blame with the instructors of today. My friend DJ (9-echo-1) has blogged about this recently. People fresh out of EMT or Paramedic school are now being allowed to teach and they don't have the assessment skills sharpened themselves. I would like to ask all of my fellow preceptors to consider my approach and take away the machines until the student can perform a quality physical exam and interview. Then allow them to confirm their findings with the machine - not base their treatment path on a machine.
Enough for now - keep reading and commenting! Thanks so much to those of you who follow my blogs!
Monday, March 30, 2009
Ambulance Operation Tips
I feel compelled to blog about Emergency Vehicle Operations. I have some friends and co-workers who are just now operating emergency vehicles for the first time, so I offer you some tips:
1. Stop at all red lights and stop signs - and SLOW down for ALL intersections regardless, even if you have the right of way. Some fool will run a light and you'll still hit someone - but if you've slowed down, the impact may can be avoided or not be as severe.
2. Watch your speed and follow your department's policy regarding what is acceptable. In some places it is no more than 10 or 15 mph over the speed limit. Remember, just because your department allows that, doesn't mean you have to drive that fast - operate at a safe speed for existing conditions.
3. Do not park anywhere but on a hard surface when it is raining and/or the ground is wet. This includes grassy yards and dirt driveways - stay on the street if it is wet!
4. ALWAYS pass on the left. The general statute tells motorists to pull to the right and stop. If you start to pass someone on the right, and the person does what the law tells them to do, they'll pull in your path and you will hit them - and it will be your fault.
5. Do not stay so intent on staying in the lane if you are the only person on the road. The wind blows ambulances easily - if no one is beside you, it may be a good time to change lanes if this happens. The "jerky" movements trying to keep a unit in perfect alignment throws your crew around and makes the patient and crew SICK.
6. Drive around curves (and start/stop the unit) as if you had a full glass of water sitting in the action area in the back of the unit and you don't want it to spill. Start and stop slowly - you will make up your speed once you get going.
7. DO NOT use a cell phone when operating an emergency vehicle.
8. DO NOT drive to a call with the AM/FM/CD player blasting. This is a major distraction.
9. ALWAYS drive a clean vehicle. The public and fellow public safety agencies know when your truck is dirty and they also know that it is a reflection of you!
10. You SHOULD get upset if you get lost while transporting a patient to the hospital. You should consult the map book/computer for directions if you need them. Remember, the patient is paying by the mile and I would be HIGHLY pissed if I was following you to the hospital with my loved one and you went around your elbow to get there - or missed all of your turns. Place yourself in that family's shoes.
11. DO NOT leave the back doors open on the scene in the summertime!!! BUGS are attracted to those lights and your attendant does not appreciate having to swat bugs off of the patient the entire way to the hospital.
12. It IS your responsibility to know where you are going if you get in the driver seat.
13. Do NOT speed back from the hospital. You should obey the same traffic laws as anyone else. As a Chief I have instructed our local law enforcement to NOT have leniency on my folks who speed all over town when they're returning from the ER or are not on a call. Don't ask me to try to get you out of a ticket!
1. Stop at all red lights and stop signs - and SLOW down for ALL intersections regardless, even if you have the right of way. Some fool will run a light and you'll still hit someone - but if you've slowed down, the impact may can be avoided or not be as severe.
2. Watch your speed and follow your department's policy regarding what is acceptable. In some places it is no more than 10 or 15 mph over the speed limit. Remember, just because your department allows that, doesn't mean you have to drive that fast - operate at a safe speed for existing conditions.
3. Do not park anywhere but on a hard surface when it is raining and/or the ground is wet. This includes grassy yards and dirt driveways - stay on the street if it is wet!
4. ALWAYS pass on the left. The general statute tells motorists to pull to the right and stop. If you start to pass someone on the right, and the person does what the law tells them to do, they'll pull in your path and you will hit them - and it will be your fault.
5. Do not stay so intent on staying in the lane if you are the only person on the road. The wind blows ambulances easily - if no one is beside you, it may be a good time to change lanes if this happens. The "jerky" movements trying to keep a unit in perfect alignment throws your crew around and makes the patient and crew SICK.
6. Drive around curves (and start/stop the unit) as if you had a full glass of water sitting in the action area in the back of the unit and you don't want it to spill. Start and stop slowly - you will make up your speed once you get going.
7. DO NOT use a cell phone when operating an emergency vehicle.
8. DO NOT drive to a call with the AM/FM/CD player blasting. This is a major distraction.
9. ALWAYS drive a clean vehicle. The public and fellow public safety agencies know when your truck is dirty and they also know that it is a reflection of you!
10. You SHOULD get upset if you get lost while transporting a patient to the hospital. You should consult the map book/computer for directions if you need them. Remember, the patient is paying by the mile and I would be HIGHLY pissed if I was following you to the hospital with my loved one and you went around your elbow to get there - or missed all of your turns. Place yourself in that family's shoes.
11. DO NOT leave the back doors open on the scene in the summertime!!! BUGS are attracted to those lights and your attendant does not appreciate having to swat bugs off of the patient the entire way to the hospital.
12. It IS your responsibility to know where you are going if you get in the driver seat.
13. Do NOT speed back from the hospital. You should obey the same traffic laws as anyone else. As a Chief I have instructed our local law enforcement to NOT have leniency on my folks who speed all over town when they're returning from the ER or are not on a call. Don't ask me to try to get you out of a ticket!
Tuesday, March 24, 2009
Cancer
So today I got up a little early to go eat at the Pizza Inn at 40/42. Today from 3p to 8p a percentage of earnings were given to Relay for Life. I had a great meal and gave an extra donation for the cause. I also got to have luminaries placed in memory of my grandmother, and in honor of my sister (who is a cancer survivor). I would like to encourage each of you to participate in Relay for Life as the local events in your area are being organized at this time.
Cancer touches each and every one of us in some way and we must do our part to contribute to finding the cure.
Cancer touches each and every one of us in some way and we must do our part to contribute to finding the cure.
Kids in the Creek
I believe the year was 1997 - I will research soon to find out exactly.
While returning from another call, one of our neighboring agencies was dispatched to an MVC, vehicle in the creek, children pinned. Shortly thereafter, our agency was paged mutual aid. We were on the beltline enroute back from RCH (DHR now) and they called and asked us to respond as well. As we approached the scene, the incident commander said, "prepare to intubate upon arrival, we have 4 pediatric trauma codes." At this point, I remember driving down the center yellow line and cars falling off of each side of the road. We arrive and find my dear former preceptor Becky doing mouth-to-mouth on a child and another guy Terry doing chest compressions (there weren't enough BVM's to go around until more units got there).
So you ask, what happened? A lady and her children, along with a child she was babysitting, ran off of a winding country road into a creek. This was either January or February. So, did the 4 children retrieved from the creek suffer cardiac arrest from blount trauma - or was it cold water drowning? To be honest, I think it was a mixture. My patient had an obvious head injury. Some of the others did not have obvious injuries - so we honestly didn't know. We worked all of them until they were at hospitals and were warm and dead - or revived.
Now - what did we do? Well, remember back then, we did not have consistent paramedic coverage county-wide, so the first-in unit was an EMT-I level unit. Our agency was on the 2nd in unit and was Paramedic level, and I was returning from a 2nd duty call and was an EMT-I. Paramedic intercepts were dispatched from all over Johnston County to assist as well. Back then, trauma care and "appropriate facility" weren't nearly what they are today. 3 of the children were transported to a trauma center and one was transported to a community hospital. Guess what the outcome was? The one who went to the community hospital on an EMT-I level ambulance was the lone survivor! That child received warm NG lavages and aggressive warming - and survived. It was also likely that this patient was the victim of cold water drowning and not trauma.
Now - the heroism that day was ever so present! The first arriving EMT-I jumped into the water to begin rescuing kids, and 2 deputy sheriff's were in the water rescuing the kids who were trapped in the vehicle in the water. Several volunteer firefighters also jumped in this freezing water - including one firefighter who was transported for hypothermia.
Everyone on the scene that day pulled together and worked as a team. There were no boundaries, district lines, or arguments. I will never forget pulling up and seeing veteran EMT personnel doing mouth to mouth because there weren't enough BVM's to go around. This is what heroes are made of! I am proud to have been there that day. My patient did not survive, but the lessons learned were paramount.
That was one of the first times as a young ALS professional that I realized that superior BLS and non-paramedic care is what truly saves lives. I also learned that you can have compassion and be in EMS. I saw my heroes crying as they did mouth to mouth on lifeless children - yet they kept their composure and did an outstanding job. It is ok to care, it is ok to cry - but the show must go on. Remember, early rescue squads began as neighbor helping neighbor. My father knew at least 50% of the patients he transported if not 75% yet he did a great job and didn't break down on every call. It seems like today if a provider treats someone they know, it almost incapacitates them and becomes "dramatic." Think of our predecessors and how the principle of neighbor helping neighbor is one of the foundations of rural EMS. Always remember, this could be your next call!
While returning from another call, one of our neighboring agencies was dispatched to an MVC, vehicle in the creek, children pinned. Shortly thereafter, our agency was paged mutual aid. We were on the beltline enroute back from RCH (DHR now) and they called and asked us to respond as well. As we approached the scene, the incident commander said, "prepare to intubate upon arrival, we have 4 pediatric trauma codes." At this point, I remember driving down the center yellow line and cars falling off of each side of the road. We arrive and find my dear former preceptor Becky doing mouth-to-mouth on a child and another guy Terry doing chest compressions (there weren't enough BVM's to go around until more units got there).
So you ask, what happened? A lady and her children, along with a child she was babysitting, ran off of a winding country road into a creek. This was either January or February. So, did the 4 children retrieved from the creek suffer cardiac arrest from blount trauma - or was it cold water drowning? To be honest, I think it was a mixture. My patient had an obvious head injury. Some of the others did not have obvious injuries - so we honestly didn't know. We worked all of them until they were at hospitals and were warm and dead - or revived.
Now - what did we do? Well, remember back then, we did not have consistent paramedic coverage county-wide, so the first-in unit was an EMT-I level unit. Our agency was on the 2nd in unit and was Paramedic level, and I was returning from a 2nd duty call and was an EMT-I. Paramedic intercepts were dispatched from all over Johnston County to assist as well. Back then, trauma care and "appropriate facility" weren't nearly what they are today. 3 of the children were transported to a trauma center and one was transported to a community hospital. Guess what the outcome was? The one who went to the community hospital on an EMT-I level ambulance was the lone survivor! That child received warm NG lavages and aggressive warming - and survived. It was also likely that this patient was the victim of cold water drowning and not trauma.
Now - the heroism that day was ever so present! The first arriving EMT-I jumped into the water to begin rescuing kids, and 2 deputy sheriff's were in the water rescuing the kids who were trapped in the vehicle in the water. Several volunteer firefighters also jumped in this freezing water - including one firefighter who was transported for hypothermia.
Everyone on the scene that day pulled together and worked as a team. There were no boundaries, district lines, or arguments. I will never forget pulling up and seeing veteran EMT personnel doing mouth to mouth because there weren't enough BVM's to go around. This is what heroes are made of! I am proud to have been there that day. My patient did not survive, but the lessons learned were paramount.
That was one of the first times as a young ALS professional that I realized that superior BLS and non-paramedic care is what truly saves lives. I also learned that you can have compassion and be in EMS. I saw my heroes crying as they did mouth to mouth on lifeless children - yet they kept their composure and did an outstanding job. It is ok to care, it is ok to cry - but the show must go on. Remember, early rescue squads began as neighbor helping neighbor. My father knew at least 50% of the patients he transported if not 75% yet he did a great job and didn't break down on every call. It seems like today if a provider treats someone they know, it almost incapacitates them and becomes "dramatic." Think of our predecessors and how the principle of neighbor helping neighbor is one of the foundations of rural EMS. Always remember, this could be your next call!
EMS History and Emergency
So last night after trying lobster for the first time, my friend and I came to the house to watch a movie. He is fairly new to EMS and is currently in EMT school. When I turned on the TV, by habit I looked at my DVR recordings. Daily, I record Emergency!, Adam 12, and Kojak. So my friend had never heard of Emergency! I could not believe it. So I gave him a preview and we watched an episode.
I explained that they used true "online medical control" per the definition in his EMT book. I also explained the role nurses and doctors played in early EMS. I then explained how the treatments rendered in the series were extremely realistic and appropriate for that time period. I then explained what D5W and LR were! I also gave an overview of the EOA and compared it to our modern day KING, combitube and LMA.
He was HOOKED! I explained that I consider these "training films" and that ANYONE who is new in the EMS profession MUST purchase, own and view the series in order to know where we came from. One of the victims in this particular show was in a crop duster crash and had organophosphate poisoning. I explained the importance of the "excessive salivation" that was assessed and why high doses of atropine were ordered. The light bulb came on!
So if you are new to EMS, you really must purchase this series and learn about our heritage. For new EMTs you will actually learn a lot of helpful tips, teaching lessons and see excellent examples of injuries/illnesses. If you are a promising student and are in this line of work for the right reasons, and cannot afford it, I will assist you with the purchase if I can.
So, many of you are requesting war stories. I will start telling them shortly. Stay tuned! Thank you so much to each one of you who reads by blog.
I explained that they used true "online medical control" per the definition in his EMT book. I also explained the role nurses and doctors played in early EMS. I then explained how the treatments rendered in the series were extremely realistic and appropriate for that time period. I then explained what D5W and LR were! I also gave an overview of the EOA and compared it to our modern day KING, combitube and LMA.
He was HOOKED! I explained that I consider these "training films" and that ANYONE who is new in the EMS profession MUST purchase, own and view the series in order to know where we came from. One of the victims in this particular show was in a crop duster crash and had organophosphate poisoning. I explained the importance of the "excessive salivation" that was assessed and why high doses of atropine were ordered. The light bulb came on!
So if you are new to EMS, you really must purchase this series and learn about our heritage. For new EMTs you will actually learn a lot of helpful tips, teaching lessons and see excellent examples of injuries/illnesses. If you are a promising student and are in this line of work for the right reasons, and cannot afford it, I will assist you with the purchase if I can.
So, many of you are requesting war stories. I will start telling them shortly. Stay tuned! Thank you so much to each one of you who reads by blog.
Monday, March 23, 2009
Lobster
The weekend went by way too fast for me. I guess that is because I did 12 hours of EMS Friday night in Garner and 24 on Saturday in Clayton. Man was I asking for it. Luckily, we weren't too busy in either place. It's just the lack of sleep that hurts me. I generally sit up at night, so I didn't sleep either night.
So on Sunday, I rested. I slept until about 4pm. I then went to visit a friend who had a death in the family and later met another friend for dinner. We went to Red Lobster. Being the typical southern joco guy, I like fish and shrimp, but have not tried much else in the seafood world. So I was coerced into trying lobster. Let me tell you, it was a wonderful experience. I have a new appreciation for all seafood, not just my standard shrimp and fish. I used to be terribly picky as a child and would NEVER try new things. I guess as I've aged, I'm venturing out more. I will now make Red Lobster a regular trip, and male lobster a priority on my seafood menu the next time I go to the coast and go to a real seafood restaurant.
So on Sunday, I rested. I slept until about 4pm. I then went to visit a friend who had a death in the family and later met another friend for dinner. We went to Red Lobster. Being the typical southern joco guy, I like fish and shrimp, but have not tried much else in the seafood world. So I was coerced into trying lobster. Let me tell you, it was a wonderful experience. I have a new appreciation for all seafood, not just my standard shrimp and fish. I used to be terribly picky as a child and would NEVER try new things. I guess as I've aged, I'm venturing out more. I will now make Red Lobster a regular trip, and male lobster a priority on my seafood menu the next time I go to the coast and go to a real seafood restaurant.
Sunday, March 22, 2009
Heroes
Here are a few photos of EMS heroes of mine. Among them is my father who served citizens of our town with over 20 years of combined Rescue/EMS and Fire service.
This is Grady. He was an EMS pioneer, and later worked until retirement as a dispatcher of ours at the local police department. Notice the original Minitor pager - not the Minitor I, but the Minitor (the version before the square brick, this one had rounded edges and had no monitor function - it wouldu squelch until reset). Grady always started his broadcast with, "Attention Clayton Rescue Monitors go 10-8"
Marvin Parrish was my first Chief. He continues to serve our squad with over 20 years of service.
David Eatman and David Edwards were EMS Education pioneers in our County. The most prestigious EMS award given in our County is in their name.
My father and Art treating a patient from the motorcycle races.
Jerry, Eunice, Danny and Steve - the best of the 80's at Clayton Rescue
I consider this to be one of my favorite photos. It is of a husband and wife team, working together, sharing a passion for helping the community. I think all many of us could ever want would be to save lives along side the one you love and share the same passion for helping people.
Another two photos of my father in action.
EMS Vehicles of the Past
I am posting a few photos from our EMS past for your enjoyment. I will be adding other old photos at least once per week. Please look at these vehicles and compare them to what you ride today.
Original Station in the background
Original Station in the background
Car 40 (love the lightbar)
Car 40 and Unit 45
Unit 47
The original 44, new paint
The Original 44
Thursday, March 19, 2009
Knee Update
So I went to Raleigh Orthopaedic yesterday. You know how I don't like to go to doctors because I'm always afraid of the "bad news" that I've seen so many people get. Well, I got good news. I was x-rayed all over (both knees and my elbow) and NOTHING is broken. I found out that my knee caps have always been abnormally lateral (out to the side) and not midline like most peoples. The doctor said taht he is surprised that I've not had dislocations before. He presecribed some physical therapy to strenthen the muscles on the medial (inside) part of my knee to help keep those kneecaps from rotating outward again. I do still have a lot of fluid on them, but we're also working to get that off.
So, wow, a good report overall. I was really scared that I had permanently messed something up. Work was again QUIET last night and I am off to bed now so I can get up and do it again.
JT
So, wow, a good report overall. I was really scared that I had permanently messed something up. Work was again QUIET last night and I am off to bed now so I can get up and do it again.
JT
Tuesday, March 17, 2009
The "Good" Nurses
Speaking of old friends, while dining tonight at Logan's in Garner, I ran into one of our former ER nurses, Bobbie. She worked for over 20 years as an ER nurse, and after an accident, now works in another arena of nursing. Most of those 20 years was spent in the JMH ER. I remember well how she helped me to improve my IV technique and gave me the confidence to use large bore catheters. I'll never forget her handing me a 14 guage IV catheter and telling me to insert it into a dying trauma patient's arm while he was awaiting transfer to a trauma center. I started that IV successfully with her at my side and I'll never forget that one moment in my career.
She was from the era when nurses were heavily involved in local ALS programs. They were our instructors in the classroom and our preceptors in the ER. They were MICN's and came out to ride on the trucks with us. We gained so much from our working relationship then. I'm so glad to have run into Bobbie tonight. It brought back wonderful memories talking to her. It also made me sad that those times are long gone. Thanks Bobbie, Lee, Karen (Sugar), Ladon (rest in peace), Karen E, Billy, Jimmy, and to every other nurse who helped me along the way. I have never forgot any of your lessons, and I continue to pass them on daily through my new adventure in mentoring a young paramedic student.
She was from the era when nurses were heavily involved in local ALS programs. They were our instructors in the classroom and our preceptors in the ER. They were MICN's and came out to ride on the trucks with us. We gained so much from our working relationship then. I'm so glad to have run into Bobbie tonight. It brought back wonderful memories talking to her. It also made me sad that those times are long gone. Thanks Bobbie, Lee, Karen (Sugar), Ladon (rest in peace), Karen E, Billy, Jimmy, and to every other nurse who helped me along the way. I have never forgot any of your lessons, and I continue to pass them on daily through my new adventure in mentoring a young paramedic student.
Old Friends
So I have become addicted to Facebook! Thought I don't like the new layout, I do enjoy the fact that I have reconnected with some of the most memorable and imporant influences in my life. I don't know why, but for some odd reason I have been on a quest to reconnect with people from my past. This includes friends, classmates, coworkers, romances - basically anyone who has played an important role in my life.
Case in point - my dear former coworker Phyllis. We had some of the best times - and worst times of my career working together. She was a staple of the communications center for a long time. She worked back when "you worked." It wasn't nearly like it is now with so many folks in there. You worked solo and had to handle business and multi-task like none of our newest generation of telecommunicators has ever had to do. She taught me so much about communications, and just life in general. She was kind, funny, generous (a great cook) and kept you on your toes. If you got out of line, she had a "homey the clown" bat that she would swing at you! She could even sing (Hey Loretta, and Strangers in the Night stand out the most). She endured the tragedy of losing coworkers in the line of duty and also through natural causes. She was amazing and helped mold me into the telecommunicator I am today. She impacted the lives of so many through her public service and continues to do so working with her family business. Now through Facebook, we have reconnected and I am extatic! I could never repay her for the lessons she taught me - but I have, through Facebook, got a way to reconnect with her and share memories of old times, and update each other about our current lives.
I have no idea why I am on this quest to reunite with people. I feel like somehow it is helping me put closure on something - I just don't know what! I guess the older I get, the more important my past becomes - it's not about looking forward anymore. It is more about remembering the best times of my life, and those who shared them with me. Thanks Facebook, and thank you to all of my old friends that I have reunited with.
Case in point - my dear former coworker Phyllis. We had some of the best times - and worst times of my career working together. She was a staple of the communications center for a long time. She worked back when "you worked." It wasn't nearly like it is now with so many folks in there. You worked solo and had to handle business and multi-task like none of our newest generation of telecommunicators has ever had to do. She taught me so much about communications, and just life in general. She was kind, funny, generous (a great cook) and kept you on your toes. If you got out of line, she had a "homey the clown" bat that she would swing at you! She could even sing (Hey Loretta, and Strangers in the Night stand out the most). She endured the tragedy of losing coworkers in the line of duty and also through natural causes. She was amazing and helped mold me into the telecommunicator I am today. She impacted the lives of so many through her public service and continues to do so working with her family business. Now through Facebook, we have reconnected and I am extatic! I could never repay her for the lessons she taught me - but I have, through Facebook, got a way to reconnect with her and share memories of old times, and update each other about our current lives.
I have no idea why I am on this quest to reunite with people. I feel like somehow it is helping me put closure on something - I just don't know what! I guess the older I get, the more important my past becomes - it's not about looking forward anymore. It is more about remembering the best times of my life, and those who shared them with me. Thanks Facebook, and thank you to all of my old friends that I have reunited with.
Monday, March 16, 2009
EMS Ramblings
I must say that this past weekend was most uneventful at work - for the nightshift that is. Dayshift had a few rockin' and rollin' moments - but it certainly didn't carry over to us. Our 12 hours seemed like 120 each night and I am glad to have have had the day off to rest today (Monday).
Tomorrow will be pretty steady - we have interviews at EMS all afternoon and into the evening for a full-time EMT we will be hiring and for a vacant Captain's position we will be filling. We have great candidates for both positions and it will be really neat to see how well they excell in the scenarios. Without giving the interview away, people who have interviewed before me before know that I do a triage scenario with every interview I do. I feel this is important because whether you're an EMT or a Paramedic, you must learn to prioritize patients and treat the most serious things first. You would be surprized how many EMT's nail the scenario and Paramedics do poorly!! Whether you're an EMT or a paramedic, you must be able to arrive on the scene of multiple patients and rapidly decide who to treat first - and who not to treat at all!
I have also been disheartened lately at the number of EMT's graduating class who don't learn "street smart skills" as I like to call them. They don't know what to do when the "ankle hitch" doesn't come with the traction splint, or what to do when the traction splint is longer than the backboard. They have never used MAST (granted they are a thing of the past, but like everything else, they'll be back - give it about 10 years LOL). They also have no idea what the scoop stretcher does, nor have they ever physically touched one to take it apart.
Young EMT's- learn what your equipment does. If there is a piece of equipment on your truck you don't know how to use - ask someone to show you how it works. I am espcially fond of certain "street smart" tools on the ambulance: Short Spine Board, Triangle Bandages, Scoop Stretcher, O2 tubing (as a drinking straw for charcoal), and 5x9 (or 8x10) whichever you prefer, and a trash can with a bag in it (not for trash but for vomiting patients). I could care less if I have a 2x2 on my truck, a 24 guage IV catheter, 5 lsb's (why so many when we can't carry that many folks), and all of these nifty new contraptions.
Lord knows, don't forget the damn glucometer. What is up with everyone nowadays checking the glucose of every patient we encounter???? If they are not altered, and do not have a diabetic history - DON'T DO IT! Heaven forbid, I make the mistake of reporting a glucose of 95 when it read 92 on the scene and one of these new folks says to me, "it was actually 92." Hello, what happened to the Visadex days and matching the colors - take me back to those times!!! We are machine happy on ambulances now and we need to get away from that! Treat the patient, folks.
Enough rambling - ttyl - have a safe week!
Tomorrow will be pretty steady - we have interviews at EMS all afternoon and into the evening for a full-time EMT we will be hiring and for a vacant Captain's position we will be filling. We have great candidates for both positions and it will be really neat to see how well they excell in the scenarios. Without giving the interview away, people who have interviewed before me before know that I do a triage scenario with every interview I do. I feel this is important because whether you're an EMT or a Paramedic, you must learn to prioritize patients and treat the most serious things first. You would be surprized how many EMT's nail the scenario and Paramedics do poorly!! Whether you're an EMT or a paramedic, you must be able to arrive on the scene of multiple patients and rapidly decide who to treat first - and who not to treat at all!
I have also been disheartened lately at the number of EMT's graduating class who don't learn "street smart skills" as I like to call them. They don't know what to do when the "ankle hitch" doesn't come with the traction splint, or what to do when the traction splint is longer than the backboard. They have never used MAST (granted they are a thing of the past, but like everything else, they'll be back - give it about 10 years LOL). They also have no idea what the scoop stretcher does, nor have they ever physically touched one to take it apart.
Young EMT's- learn what your equipment does. If there is a piece of equipment on your truck you don't know how to use - ask someone to show you how it works. I am espcially fond of certain "street smart" tools on the ambulance: Short Spine Board, Triangle Bandages, Scoop Stretcher, O2 tubing (as a drinking straw for charcoal), and 5x9 (or 8x10) whichever you prefer, and a trash can with a bag in it (not for trash but for vomiting patients). I could care less if I have a 2x2 on my truck, a 24 guage IV catheter, 5 lsb's (why so many when we can't carry that many folks), and all of these nifty new contraptions.
Lord knows, don't forget the damn glucometer. What is up with everyone nowadays checking the glucose of every patient we encounter???? If they are not altered, and do not have a diabetic history - DON'T DO IT! Heaven forbid, I make the mistake of reporting a glucose of 95 when it read 92 on the scene and one of these new folks says to me, "it was actually 92." Hello, what happened to the Visadex days and matching the colors - take me back to those times!!! We are machine happy on ambulances now and we need to get away from that! Treat the patient, folks.
Enough rambling - ttyl - have a safe week!
Thursday, March 12, 2009
The Knee
So, I worked EMS in Garner last night and had an OK night. We weren't too busy, worst thing was the structure fire this morning about 4:30 which went through shift change. So overall, it was a good night. I rode with David and then we had a 3rd rider named Cheryl who was super nice. She is a minister! I parallel the two professions - EMS and the ministry because I feel they are very similar. I feel that EMS is a ministry of sorts and have always thought it takes a special someone to do this profession justice. Anyone can obtain the paramedic patch, but only a few people can minister to people through this profession and really impact people's lives.
Now for the bad part of my day. I got up today and walked through the house to check my CAD computer/laptop to see how bad an EMS call was and if I may need to check-in. Well, I was standing in my living room when suddenly my knee cap rotated to the side and I collapsed to the floor (yes the house shook!) So I looked at my knee and could see the obvious deformity, but had no idea if I had broken it or if the knee cap was just dislocated. I didn't know what to do. I couldn't reach a telephone, and I couldn't get to the door - I had no clothes on - so what in the world was I going to do? Well, I rationalized that it was probably dislocated and that if I straightened it out, it may go back in place. Well, it did! I still had to lay here for 20 minutes on the floor while my leg was numb and was praying that I hadn't torn up major ligaments and nerves. I finally was able to get up and hop to the bed. I took 4 advil and went to sleep. I called David in Paramedic class and told him that if I called, I would be needing him to come unlock the door so help could come in and get me! He came home a little later and was here when I got up to make sure I didn't fall and bust my head or something. I think it's ok. It is swollen but I have a brace on it. I will be making an ortho appointment tomorrow just in case. The problem is now I think I hurt my elbow/arm in the fall (I must have landed on it with my fat ass) because now my arm hurts. My knee - which was totally deformed earlier today doesn't hurt, but my dang elbow hurts like crazy.
Anyway, I'm home, knee propped up, hoping that when I wake up tomorrow I will be able to bend my knee.
Until next time - keep up the fire, soldier!
Now for the bad part of my day. I got up today and walked through the house to check my CAD computer/laptop to see how bad an EMS call was and if I may need to check-in. Well, I was standing in my living room when suddenly my knee cap rotated to the side and I collapsed to the floor (yes the house shook!) So I looked at my knee and could see the obvious deformity, but had no idea if I had broken it or if the knee cap was just dislocated. I didn't know what to do. I couldn't reach a telephone, and I couldn't get to the door - I had no clothes on - so what in the world was I going to do? Well, I rationalized that it was probably dislocated and that if I straightened it out, it may go back in place. Well, it did! I still had to lay here for 20 minutes on the floor while my leg was numb and was praying that I hadn't torn up major ligaments and nerves. I finally was able to get up and hop to the bed. I took 4 advil and went to sleep. I called David in Paramedic class and told him that if I called, I would be needing him to come unlock the door so help could come in and get me! He came home a little later and was here when I got up to make sure I didn't fall and bust my head or something. I think it's ok. It is swollen but I have a brace on it. I will be making an ortho appointment tomorrow just in case. The problem is now I think I hurt my elbow/arm in the fall (I must have landed on it with my fat ass) because now my arm hurts. My knee - which was totally deformed earlier today doesn't hurt, but my dang elbow hurts like crazy.
Anyway, I'm home, knee propped up, hoping that when I wake up tomorrow I will be able to bend my knee.
Until next time - keep up the fire, soldier!
Tuesday, March 10, 2009
Fire tonight
So tonight before I could leave the office to come home, we got called to respond just up the street a bit to a structure fire. I was most impressed with how our local fire department (Clayton) conducted themselves tonight. It was a first rate operation, with a well orchestrated command team. I am most impressed that at any moment, the incident commander can tell you where anyone is on that scene, including the EMS personnel. This is something you can't find everywhere. I'm proud to work alongside our brothers at the CFD and am so proud of their accomplishments. I grew up in the Clayton Fire Department with my father serving 2o years between EMS and Fire service in Clayton. I've been around emergency services my entire life - seriously. I can honestly say, I'm the proudest that I've ever been of our Fire Department and our EMS System. I've watched it grow up just as its watched me grow up.
Ode to Sam
So today I will attend the funeral of a great man, Mr. Sam Strickland. I have known Sam all of my life - in fact his wife and my grandmother were first cousins (both now deceased). Sam was quite the character! He always made everyone smile and ALWAYS told every woman he met that she looked as pretty as Brooke Shields - or "I know I've died and gone to heaven, because I have woke up and seen you." He was full of those sayings and flattered every woman he came into contact with.
On the serious side, Sam was our long-time rescue squad photographer. This was back when VHS first came out and the camcorders were HUGE. The squad gave Sam a jumpsuit and there he was at all of our serious incidents and training exercises filming us. It kind of had the "Blair Witch" feel when you watched them because there was always walking, the ground, and then some of the subject on the video LOL. In addition to being involved himself, his biggest sacrifice was that of his two sons. Charles still serves on the squad and is in his 33rd year, and Steve retired a few years ago with over 25 years of service, but he is still quite active and rides along with us some. This is back in the day when we all stayed at home and came running when the pager went off - so he had 2 sons, both on different duty nights, both leaving the house in the middle of the night at varying times. I never heard Sam nor his wife Nancy complain. They gave selflessly to the rescue squad in so many ways. If not through running calls, Mrs. Nancy Strickland would be our receptionist at fundraisers. There has constantly been a contribuation by the Strickland family to EMS ever since I was born!
In addition to serving EMS, Sam was the treasurer of the methodist church for MANY years. He also operated all of the AV equipment and recorded sermons for shut-ins. He delivered meals on wheels and was an avid CB and shortwave radio enthusiast. What a wonderful man, full of personality that we all will miss.
Well this has been my tribute to Sam Strickland. Welcome home Sam!! You're in a better place now.
On the serious side, Sam was our long-time rescue squad photographer. This was back when VHS first came out and the camcorders were HUGE. The squad gave Sam a jumpsuit and there he was at all of our serious incidents and training exercises filming us. It kind of had the "Blair Witch" feel when you watched them because there was always walking, the ground, and then some of the subject on the video LOL. In addition to being involved himself, his biggest sacrifice was that of his two sons. Charles still serves on the squad and is in his 33rd year, and Steve retired a few years ago with over 25 years of service, but he is still quite active and rides along with us some. This is back in the day when we all stayed at home and came running when the pager went off - so he had 2 sons, both on different duty nights, both leaving the house in the middle of the night at varying times. I never heard Sam nor his wife Nancy complain. They gave selflessly to the rescue squad in so many ways. If not through running calls, Mrs. Nancy Strickland would be our receptionist at fundraisers. There has constantly been a contribuation by the Strickland family to EMS ever since I was born!
In addition to serving EMS, Sam was the treasurer of the methodist church for MANY years. He also operated all of the AV equipment and recorded sermons for shut-ins. He delivered meals on wheels and was an avid CB and shortwave radio enthusiast. What a wonderful man, full of personality that we all will miss.
Well this has been my tribute to Sam Strickland. Welcome home Sam!! You're in a better place now.
Boring Night
So tonight was a boring night at work. In fact, the 12 hours seemed to take 100. I've not checked, but based on the people I have talked to tonight, I bet it is a full moon!
I am going walking this morning as soon as I get off work. I am planning to walk around my subdivision this morning, changing up the scenery a bit from the usual downtown Clayton walk. The week ahead is a long one for me. I have to go to Nash Community College to turn in paperwork from a class I taught, I have to attend the EMS Advisory Council meeting to represent our organization and plead to them not to cut our budget this year. I have to attend the Women's Club meeting and receive a donation for our EMS agency and then immediately afterward attend the funeral of the father of two of my dearest friends. All of this is on the schedule before the end of the day on Wednesday! I then work EMS in Garner on Wednesday night.
My biggest obstacle right now is stopping the sweet tea that I drink daily - several times daily. I realize I'm going to have major caffeine withdrawals but I know I must stop the tea and go to "all water" sooner than later - pray for me to overcome the tea addiction!
There will be more to come later today when I wake up and can think clearly!
I am going walking this morning as soon as I get off work. I am planning to walk around my subdivision this morning, changing up the scenery a bit from the usual downtown Clayton walk. The week ahead is a long one for me. I have to go to Nash Community College to turn in paperwork from a class I taught, I have to attend the EMS Advisory Council meeting to represent our organization and plead to them not to cut our budget this year. I have to attend the Women's Club meeting and receive a donation for our EMS agency and then immediately afterward attend the funeral of the father of two of my dearest friends. All of this is on the schedule before the end of the day on Wednesday! I then work EMS in Garner on Wednesday night.
My biggest obstacle right now is stopping the sweet tea that I drink daily - several times daily. I realize I'm going to have major caffeine withdrawals but I know I must stop the tea and go to "all water" sooner than later - pray for me to overcome the tea addiction!
There will be more to come later today when I wake up and can think clearly!
Sunday, March 8, 2009
Paramedic Class
Today (Sunday) was a great day for me. The day began with me assisting with skills check-offs for the local paramedic program. I am not a morning person, so I struggled initially; however, it was a very rewarding and worthwhile experience. So many people in the EMS field fuss about the quality of EMTs and Paramedics being placed on the streets, but they do nothing about it. I enjoyed helping these folks out and more than anything, love waching their eyes light up when they start their first IV or give their first injection.
I make no bones about the fact that I think at times my EMS days are over. I've come to realize that this isn't about me - it's about the others. My purpose for continuing in EMS is help others and give them what I was given by so many awesome mentors early in my EMS career.
I have little desire to learn new material or read the newest version of the paramedic text, but I do have the desire to impart street smarts on every student with whom I come into contact. I enjoy teaching the "tricks of the trade" and helpful hints that will take them far in their careers. I can honestly say, I got as much out of working with them today as I hope they got out of being there with me. I've been so NON-motviated as of late with regards to EMS. Today made me feel better and reflect with fond thoughts, the help given to me by seasoned paramedics when I began my career.
I make no bones about the fact that I think at times my EMS days are over. I've come to realize that this isn't about me - it's about the others. My purpose for continuing in EMS is help others and give them what I was given by so many awesome mentors early in my EMS career.
I have little desire to learn new material or read the newest version of the paramedic text, but I do have the desire to impart street smarts on every student with whom I come into contact. I enjoy teaching the "tricks of the trade" and helpful hints that will take them far in their careers. I can honestly say, I got as much out of working with them today as I hope they got out of being there with me. I've been so NON-motviated as of late with regards to EMS. Today made me feel better and reflect with fond thoughts, the help given to me by seasoned paramedics when I began my career.
First Blog
Well folks, this is my first blog. A good friend (thanks Adam) suggested that I write a journal. Afer checking out my friend Dale's blog (9-E-1), I think blogging may be a great start. I have for some time contemplated writing a book, and in years past dabbled in writing short stories. This blog is my means to gather thoughts, express feelings, and DESTRESS. I would love for the thoughts and ramblings to some day make their way into a book, but who knows. My disclaimer (must have one) is simply that these are my personal thoughts and opinions. In no way do they reflect the opinions, policies or positions of any of my employers.
I look forward to you reading my blogs, and very much welcome any feedback that you may have.
I look forward to you reading my blogs, and very much welcome any feedback that you may have.
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