Thursday, April 27, 2006
quick...quick...like a rabbit
just real quick... for those that are regulars to my little blog here. Surgery went fine. No complications, should be back on the streets by mid June... My spine doc is "very optimistic" that I soon will be doing ambulance acrobatics and getting spit on by the haters. I got a email from my cyclist, he too is doing well, ran a marathon just recently. Very proud. I still can't believe how well he is doing. I will do a more in-depth post soon. Im still hopped up on percocept, weening myself off. Only taking it at night. the staples are really sore and screaming to come out. Friday....they come out. till then...I will post soon
Friday, April 21, 2006
Sunday, April 09, 2006
Pictures from the edge
Okay I lied. I will do some more posts. My surgery isn't until Thursday and Its 0330 and I can't sleep. Ill post some more photos for your enjoyment.
Friday, April 07, 2006
The paramedic becomes the patient...
Well...it's official I am going under the knife. The paramedic becomes the patient. For those who don't read my little blog here, I have been out of work for a month and a half now on injury. I have ruptured another disc in my back. I ruptured one 11 years ago and now I have popped the one below it. Luckly, maybe, Well not really, because it means I did a number on my back, I am not having much in the way of pain, but I have significant weakness and numbness in my left leg. Walking with a slight limb, I feel like a cripple. So now many doctor's visits, ineffective injections, an ambulance ride, and one ER visit later, my doctor and I have desided that if I am to continue in my current line of work surgery is my option now. Trufully, I just want it fixed. I just want to go back to work. Surgery is scary, but I just want it fixed. I have been dealing with this for 11 years now. And now it's getting fixed. So after next week it might be a while for my next post...but I ll get back as soon as I can...until next time
Tuesday, April 04, 2006
Back to Basics
I was watching "Grey's Anatomy" last night with a bunch of friends. Something we do every Sunday night. Dinner then "Soparanos" and the "Grey's'' Whatever... beside the point. Anyways...So in the show they were showing one of the interns (Cristina for those familiar with the show) and The Cheif were taking this class about Laperscopic surgery. Cristina, the intern, beat the Cheif with one of demitrations using the Laperscope. During the second one The Cheif was stitching the "patient" using the scope, all while doing it with his eyes closed. When Cristina asked how he did it he said not to Forget the Basics. This statement got me thinking...how many of us as Paramedics have forgetton the basics. How many of us have become flustered, lost our train of thought and forgot some of the basic assessment skills that we learned in our years of training. For years and years Airway, Breathing, Circulation. Disability, Expose...ect. was drilled into our heads. I have, my partner's have...maybe it was ignorance, maybe it was nerves, maybe it was arrogance, but it happens. My mama (the nurse) has always told me even if you have no idea what the hell is worng with your patient, you can always go back to the Basics...ABC. When you have a patient that is just SICK, sometimes that happens they are SAS (Sick as Shit) and need a doctor, not a paramedic, and you can't figure out WHY the hell they are SAS. Your fall-back is ABCs. Make sure your pt as an Airway, that they are breathing and that they have circulation. If they don't that is something you can fix, all w/o knowing the exact cause of SASness. This also works for trauma.
We have a great Head of Trauma Attending at our local Trauma Center. First off he respects the Medics, he know what we do and compleatly trusts us. Second, he trains his residents to LISTEN TO WHAT THE FUCK THE MEDICS SAY. I brought in a Fucked-up trauma, MVA 19y/o Head and chest trauma..oh and bilateral open tib fib fractures. Now, First thing we say when we walk into the Trauma Bays is "okay, Listen up, because we are only going over this once..." Because there is normall close to 20 people in the bay, everyone from Attendings to ER tects to RTs. And so hence you don't want to repeat your turnover 20 times. So Dr N. (the truama attending) was down there for this MVA...and he noticed a few of his residents were not listening. They were asking questions to us that we had already stated the answers too. And SOme others were examining the leg ( it being the bloody gore that draw in the interns) before even the primary assesment has been done. Right in the middle of the trauma Dr N. got up on the CPR stool and started yelling "OK people everybody STOP! We are missing something...Can anybody tell me what we are missing...No. Well for one thing...Can we please listen to the Medics. Contrary to popular beilf they are not just glorified taxi drivers. They are your eyes out there. They can tell you things...things that you need to know....like was your patient talking on scene, or was he always unconscious. Second thing....we have seem to have forgotten our ABCs...So lets start over...A...A is for........." a small voice came from one of the interns, "Airway?"
"Very good...Airway if you pt does not have a Airway lets fix that, Well it seems the medics have fixed that for us with the large tube shoved in the mans throat. Seems that B is also taken care of. But we still need to assess it. How are the Lung sounds?... is the tube properly placed? Did it get moved during transport?" If it has let's fix that"
"Good lung sounds, Equal and clear. No sound heard over the Epigastric" Stated a resident.
"Excellent...No what comes after Breathing...and no despite what the Nurses tell you, Foley cath does not come after Breathing.
"Circulation?"
"is that a question...or the answer Dr.whatever?
"Answer..."
"Good does your patient have a pulse and BP. If not let's fix that..."
He went on like this till about I think the letter T. I didn't know there was something for every letter. I just knew ABCDE...I also quit listening because I had a bloody unit to hose out.
So even doctors need reminding to go back to basic. We all do...it's easy to forget, you know with all the shiny, blinky ,boppy things we have access to like EKG monitors, CPAP machines, and transmitters of all kinds. We can sometimes get so wrapped up in transmitting that 12 lead EKG that we can overlook something else...And that something else can mean the all differance.
We have a great Head of Trauma Attending at our local Trauma Center. First off he respects the Medics, he know what we do and compleatly trusts us. Second, he trains his residents to LISTEN TO WHAT THE FUCK THE MEDICS SAY. I brought in a Fucked-up trauma, MVA 19y/o Head and chest trauma..oh and bilateral open tib fib fractures. Now, First thing we say when we walk into the Trauma Bays is "okay, Listen up, because we are only going over this once..." Because there is normall close to 20 people in the bay, everyone from Attendings to ER tects to RTs. And so hence you don't want to repeat your turnover 20 times. So Dr N. (the truama attending) was down there for this MVA...and he noticed a few of his residents were not listening. They were asking questions to us that we had already stated the answers too. And SOme others were examining the leg ( it being the bloody gore that draw in the interns) before even the primary assesment has been done. Right in the middle of the trauma Dr N. got up on the CPR stool and started yelling "OK people everybody STOP! We are missing something...Can anybody tell me what we are missing...No. Well for one thing...Can we please listen to the Medics. Contrary to popular beilf they are not just glorified taxi drivers. They are your eyes out there. They can tell you things...things that you need to know....like was your patient talking on scene, or was he always unconscious. Second thing....we have seem to have forgotten our ABCs...So lets start over...A...A is for........." a small voice came from one of the interns, "Airway?"
"Very good...Airway if you pt does not have a Airway lets fix that, Well it seems the medics have fixed that for us with the large tube shoved in the mans throat. Seems that B is also taken care of. But we still need to assess it. How are the Lung sounds?... is the tube properly placed? Did it get moved during transport?" If it has let's fix that"
"Good lung sounds, Equal and clear. No sound heard over the Epigastric" Stated a resident.
"Excellent...No what comes after Breathing...and no despite what the Nurses tell you, Foley cath does not come after Breathing.
"Circulation?"
"is that a question...or the answer Dr.whatever?
"Answer..."
"Good does your patient have a pulse and BP. If not let's fix that..."
He went on like this till about I think the letter T. I didn't know there was something for every letter. I just knew ABCDE...I also quit listening because I had a bloody unit to hose out.
So even doctors need reminding to go back to basic. We all do...it's easy to forget, you know with all the shiny, blinky ,boppy things we have access to like EKG monitors, CPAP machines, and transmitters of all kinds. We can sometimes get so wrapped up in transmitting that 12 lead EKG that we can overlook something else...And that something else can mean the all differance.
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