I'm being a very slack medic recently

So I have been productive in some aspects of my job and so slacking in others. To be quite honest, my day to day responsibilities, like washing the truck and making sure that we have all six tires I'm slacking. Because who really care how many transfer needles there are in the IV tray. All I really care about is if there is plenty of oxygen tanks to get my through a shift and if the narcotics and RSI drugs are safely under lock and key and tucked away in the fridge. Is the CPAP machine sitting on the actionary and the laptop plugged in in the back...then I'm going to go take a nap. Those 15 reports sitting in my EMSpro box can sit for a few more hours. I haven't worn civilan clothes in a month and a half. I haven't put on lipstick and masacara for two. I Pay rent for an aparentment I haven't slept at since I moved in three months ago. So forgive me if I don't count the 4x4s(If I you are grabbing more than say 6 4x4 for one wound, you need something other than a 4x4 I might add) nor I'm I going to polish my boots...so there.

But what I have been productive in is reasearching Versed as an alternative for Ativan for contolling Seizures. I recently got an order of IM versed for a 3 year old Status Seizure. This is an order I cannot follow becausse per our state I cannot giver Versed to Pediatric patients. After the call I spoke to the doc, some RNs and other medics and most will agree that Versed is becoming the drug of choice for seizures management. Works faster, higher serum levels for longer (meaning it's longer lasting) and ICU admissions post arrival to hospital are shorter. So if it works better, lets change it. I wouldn't mind hearing from fellow medics who use Versed as first line...what are your thoughts...are the studies true? or are they just blowing smoke up my ass.

Doh!

In the immortal words of Homer Simpson, all I have to say for myself is DOH!. Yep that was the statement of the night. we were called to an assault, ended up with a non transport which was good because as we were trying to manuver the ambualnce through the maze of police cars that lined the narrow winding street we made contact. Actually, let me back up a bit. To when I hopped out of the truck and started toward one of the officers to go "Hey lets move either this car or this car a bit either this way or that way so we have room to get by" Now keep in mind there are like 9 crusiers on this street all with the blue lights flashing and a large group of people all around...and no street lights. So our mirrors are useless...we can't see shit. While I'm talking to one officer another is guiding my partner from the front of the unit through the maze. He forgets that we are much bigger than a Crown Vic. Wider. With a very large box. So I turn around just in time to see the back corner of the box crack the headlight of a police car. What's even better is that the cop that was spotting us, that was HIS cruiser. My partner didn't find the humor in it. I, however, thought it was hilarious. I mean if you can't laugh at something like this, what can you laugh at. he guided an ambulance into his own police car. Comeon! That's funny. EMS comedy.

So there we sat for about two hours waiting on the sheriff's office to come to do the traffic report. No big deal. Kept us from running sick and stupid calls for a while. I could use the down time.

What have I told you people about lying to the medics?

I've been getting these weird calls in the middle of the night. Last shift was the assault that we thought was bullshit drunk guy that turned out to be bleeding internally going into shock guy. This shift was it was running from the cops got tased refused to sit up and talk to us guy, but not because he was that beligerant, but because he had a blood pressure of 70/squat and was tachy at 120. What the hell? He was intermitently responsive. The type of resposive that you had to fuck with all the way to the hospital to keep awake, but as long as you kept fucking with him, giving him a good sternal rub or hollar at him when his O2 sats dropped he came right back up to 100%. I did feel kinda bad when I first got him in the truck and kept yelling at him to talk to me "If you can run from the cops, you can sit up and talk to me, quit fucking around" then his pressure was 70. SON OF A BITCH! "What the fuck did you take?"
"mumblemumblemumble...nothingman...mumblemumblemumble...nothing"
"No really, what the fuck did you take!"
"mumblemumblemumble...nothingman...mumblemumblemumble...nothing"
"How much you been drinking?"
"I ain't been drinking man?"
"yes you have I can smell it, what esle you been doing"
"mumblemumblemumble...nothingman...mumblemumblemumble...nothing"
well knock me over I got a fucking angel in my possesion. So he bought himself a ride to the hospital with bilateral 16 gauge IVs a liter of fluid, some Narcan, and was going to get to meet a bunch of very nice nurses with a very large foley catheter at the ER. I also found out that I am getting very good at sliding in 16 gauges into handcuffed patients. Its a strange angle but it can be done.

With it being so hot here are some tips from your friendly paramedic. Because I don't want to pick your ass up.
1.Stay in the AC
2.Stay in the AC
3.Stay in the AC
There's plenty of Law and Order reruns on to enjoy, there is no reason to go outside in this heat, to run, play tennis, mow the grass or really do a damn thing
4. if you must go outside, you crazy bastards. Drink water. not Budweizer, not PBR, not vodka, WATER. or gatorade is fine too or my personal favorite, Revive VitaminWater.
5. Wear light cothing, both in weight and color. This does inclued the lowcountry favorite of searsucker. I didn't say it had to be flattering.

If you becaome unresponsive, stop sweating and your temp gets above 103 you are offically in need of my assistance. And I will be glad to come and get you but I do reserve the right to fuss at you if you do not follow the simple steps listed above. Because it's your own damn fault.

Balmy nights makes for miserable Medics

Hot, humid nights brings out two things here in the south. CHF and assaults. It was 93 degrees last night with 110% humidity. The air was also very still, nights like this are more bearable with a sea breeze, but last night there was none. So the sweat just sat on your skin. It made all who worked last night move a little bit slower, almost as if the air was so thick held us back. It also make people more mean I think. We got called to a stabbing. No when we got there, it was not a stabbing, well...it was, but it wasn't. He got cut with a knife and had an avulsion on his finger. Now it didn't raise flags when we saw him and he was all sweaty, we were all sweaty. It didn't raise a flag when he was slightly altered, he reeked of ETOH, it didn't raise flags when he kept saying he was thirsty, it was hot, he reeked of ETOH, and to be honest I was wicked thirsty myself. It even didn't raise flags when the blood pressure on the monitor said his blood pressure was 60/30. That damn thing had read a correct blood pressure all night. But when niether me nor my partner could find a radial pulse nor ausultate a blood pressure for ourselves was when we both looked at each other and then at the cops that were standing outside of the back of the truck and say at the same time "Fucker's actually sick!" I put in a 16 ga IV and threw him on a high flow oxygen my partner gets an 18 ga IV and gets him on the EKG (tachy as hell at 130) and We haul ass to the trauma center. He kept saying he was beat with a board in the abdomen (again no flags raised because ADB was soft, flat, non distended) But sure enough, according to the FAST scan at the Trauma Center he had a large amount of blood in his abdomen. I don't know how it works in some systems, but in mine we can, if they don't meet transport criteria, choose not to transport. The finger injury alone does not meet transport criteria. But the altered sensorium 2nd to what We initally thought was ETOH (which did in fact turn out to be shock) did. So you can say, being drunk saved his life.

The other thing we look fotward to on these balmy nights is CHF. This weather really exacerbates it. We gave over the night, 200 mg of Lasix, CPAPed just about everyone who got into the back of our ambulance, and gave more Nitro that even we of that bitter/ sweet orange nitro smell that all medics should be very familar with. I also went through the supply reqs for the night when I restocked after my last CHFer, and every single sheet listed the same thing Lasix and CPAP circuits. Every single one. Thats was all we did last night. But at least it is easy one you get it under control. It's just CPAP, NTG, and Lasix...CPAP, NTG, and Lasix...lather rinse repeat...

I'm afriad of horses

I'm afraid of horses. Really afraid of them. I never thought this would be a problem until last night when we had a potentially violent psych patient who was being taken care of by two mounted police officers. As we pull up my partner says to me, "Hey, look B, the horse cops are here. I didn't know they came this far up into the ghetto" Neither did I. I just looked at him and said what I thought to myself was "Okay, you can do this, just get out of the truck." Apparently, it wasn't to myself. "You are afriad of horses?!?"
"Uh..No...Yes...well..."
"Jesus, sit here, I got this"
"No..No. I'm not gonna leave you hanging, I'll be alright. I'm just gonna stand over here behind these other police officers across the street from the big scary animals. I got your back if you need it."

Then my partner and the other officers started cracking up. Glad I could be more entertaining than the crazy person who thought he was God.