Sunday, August 24, 2008

Thanks

I want to thank my boys in blue today. My system gets along very well with the other public servents. Fire gets along with police, police gets along with EMS, EMS gets along with Fire and the circle goes round and round. We all take care of each other. It's like we all know we are here for the same job, to make sure that the public of our coastal city stays safe. Even if the person we are taking care of is a violent crack dealer. I had a very large, potental violent patient today that was tased. He had been using cocaine all day. Possibly injested another couple grams more of crack, then was tased several times to be controlled. We were called for a posted tasing exam, as per protocol, we placed him on an EKG and her was extreamly tachy, in the 150s. But The Cops, because of the patient's violent potential and his size (he was a BIG BOY) did not want to put him in the box with two female medics. "I know you girls can hold your own back there, but he tried to kick MY ass and I have a gun AND a Taser, I AM NOT putting him back there with you two." I explained to the cop that he needed to go to the hospital, his heart could explode due to the tasing and the coke. The cop offered to take him the hospital in his crusier, which was a great. In the same breath I also wanted the best for my what was now my patient. A cop, even on the way to the hospital has little medical training. If he was to arrest in the back of his crusier the cop would be in a world of hurt. So For the good of all invovled I convinced the cop to let me ride with him. With my partner driving behind us in the ambulance. That way if anything happened I could work the patient, the cop would stay out of trouble because he did all he could to keep us, the medics safe, and the patient under medical care. And Pateint care was not compromised or discontinued. It was in the best intreast of all parties involed. So we look out for everyone. Not just the sick and Stupid.

Friday, August 22, 2008

Zebras

Weird medical calls. That seems to be my specialty. Think is psych, wrong answer. It was a bi polar trying to make the manic thoughts go away took to many of the friend's medications. Ended up with the body eating it's own muscles and kidney failure...oh and hallucinations of spiders, lots and lots of spiders. Next one...Panic Attack. No way. The EKG showed a strange narrow complex bigemeny and ecscape PVCs. I did 5 12 leads because the rhythm kept changing. One did show a type 2 AV block, but then the heart onverted itself back into the odd sinus arrhythmia I started with. I looked it up in one of my cardiology textbooks. Escape-capture bigeminy (ectopic atrial escape, sinis beats with prolonged P-R) apparently. It was in the chapter of Blocks. Turned out pt had infarcted several days ago. An Inferior MI. Makes sense, inferiors tend to have strange blocks and such. How about a drunk homeless frequent-flyer. The last time he was in my truck he spit at me, then proceeded to urinate all over the back of the box. The only reason cops won't take him in is because he refuses to ambulate, so they call us to "check him out" so they can arrest him. Only this time he has a BP of 70. Goddamnit. Turns out he has been drinking and doing herion all day.

This is why I am a good medic. I tend to be overly cautious. I have come across to many strange "zebras" to think otherwise. Like my young patient who stated it hurt to breath "right here", but whose vitals were all normal. He ended up with a spontanous Pneumo. Found that with a stethescope. I do 12 leads on just about everyone. But I have found more MIs on Pts with NO Chest pain , than pt with classic signs of Heart attack. Old lady vomiting...Huge Head bleed. Middle age SZ...brain tumor. Athlete in training has abdminal pain...Aortic anyrism. Young woman violent and hallucinating...bacterial menigitis. No wonder I'm a hypocondriac. I think everyone is sick and dying. Good thing I guess in a medic. You don't want a medic who thinks everything is bullshit. But sometimes the hoofbeats are just horses, just not with me. It's always a puzzle. The EMS gods playing little games with me. Like they sit up there in their ambulance in the clouds going "Let's see if she can figure this one out..."

Thursday, August 07, 2008

My Reality In B&W

http://www.youtube.com/watch?v=AOsGIE56g5M

A YouTube video of stunning B&W photos. This is my reality.

Enjoy the Ride. I do.

(I believe this is somewhere in South Africa)