Monday, February 22, 2010

Okay, seriously. I'm sitting here at a quarter to six in the morning tapping out a post in the front of an ambulance on an iPhone, mostly because I want to get up on my soapbox for two reasons.
Reason #1 Full Arrests should have an age limit.
There is no goddamn good reason to put 98 year old granny on an AutoPulse machine, shove ET tubes down her throat and drill fucking holes in her tibia. NO FUCKING REASON! Let me say it again, NO FUCKING REASON! There is atime and a place to work like hell to save a life and there is a time to let go and let them die with dignity and peace. That means not with a bunch od paramedics and firefighter pumping and blowing, desicrating the hell out of a corpse. So say your goodbyes and let your elderly go.
Okay
Reason #2 Consolidated Dispatch.
Fuck off.
This shit isn't working, bitches. You are not sending the closest units and apparently have no idea even where your units even are. I do not sit at my station all the time, mostly because I am a social creature. I like to talk, socialize with my other street walkers. I either am sitting at the hospital chatting with the staff or I'm sitting on some street corner with the cops, shooting the shit with them... Because really what else am I going to do? Watch reruns of Law and Order on TNT? When I'm sitting in my district, 10-8, don;t sent another unit to a non emergent bullshit call just because they are four damn feet closer. They are getting supplies or writting a report or whatever. It's my district, let me handle it. Unless it is a dying baby or someone trapped under a building and those four feet are gonna matter for whatever reason, let them finish whatever they are doing because it is much more pressing than that finger laceration that needs a damn band-aid and a blessing before he can go to jail. Or the complete oppisite, people sending me 45 fucking miles to a call when you have a unit sitting 2 damn feet from it. Are you seriously forgeting where you put your trucks? You have a GIANT fucking map up at dispatch that updates every 1 goddamn second that showes you where every single unit in the county is. It's in real time. Just fucking look at the damn thing and figure this out. You get mad when we dispatch from the street, but we get pissed when we pass each other going to calls. So do your job. There is One person up there who sole job it is to watch that map. and figure out who needs to go where. Thats all you do, so Fucking do it.

Okay, that is all.

Im getting down.

Rant over

Wednesday, February 10, 2010

SNOW DAY!!! er...night. This is just crazy talk for my little coastal town. If the roads weren't still wicked icy, I would drive out the the beach and get photos of the snow on the sand. So just because it snowed, didn;t mean that people were any less retarded about calling EMS. Middle of the freaking blizzard (By beach people standard) "Medic One respond to such and such address in the ghetto for a sick person, no further 43 (information) this came from a 3rd party caller. We will send 90 (police), however they are also extremely 10-6 (busy) dealing with...well...you know what it's like out there" First problem with this transmission the address they gave us does not exist. I know this from working The City for a lifetime and a day. There are two streets in The City one is a Street and one is a Court. They dispatched us to the Court, however, I did know that it was in fact the Street. Second problem with this was 3rd party caller, unknown why we were going and we were not getting police? I know they were just as busy as us, but hell, the last time I got sent on something like this we were sent into an unsecured, violent scene. I call dispatch, knowing full well how busy they were, but I needed to know what the Fuck I was getting into. Turns out it was a house with a call history, and a nonviolent dude living there. So okay, we went along. Pulled up, I slipped on the ice a few times and made it up to the door. knocked several times, no answer. "County, Medic One, no answer at the door any more 43?" "Neg Medic One, go ahead and get 10-8 (back in service) if they need us they will call back and you have three more calls in your district" Okey-dokey. We got called to a psych, psych, assault, psych and a chick with her period. I had one guy ask me "What took you so long?" after he called because he had non traumatic leg pain times three days. "Sir, have you looked outside your window? " "Yeah, I looked...thats why I called, I can't drive myself, it's snowing." "Well, then you should know I can only drive this top heavy 3 ton skid machine only about 20MPH right now, you are lucky we even made it here, so get into the ambulance" We had 12 calls last night, not one needed a trip to the hospital, but all of them called EMS to take them for there perceived "EMERGENCY" I heard at one point another truck go out for a "depressed person at the pay phone at the KMART" And another go to some "my power is out and I need you to check my baby's feeding tube" Last I check a PEG Tube does not require electrify to work. I think out of the hundreds of calls we ran last night, maybe a handful needed EMS, several MVAs, and a couple of significant SHortness of breaths. But all and all I think people were just sitting around thinking of reasons to call 911.

WHen the snow finally quit and turned to sleet, the roads got all slushy and slick, people running in the guardrails, other cars, mailboxes. For as many Yankees as we have in this town you would think they would at least know how to drive in the snow. But no, its like they cross the Mason Dixon and forget about the white stuff.

I did get to do one thing though...Make a snow angel...OF DEATH!!!

Wednesday, February 03, 2010

CSPINE

Oh man. So You know that little voice in your head that tells you things, no not those voices, but the voices on scenes that tell you "Why don't you do that 12 lead" or "Take a deeper look at that laceration" or "CSPINE!!!!!" Listen to them. Especially the Cspine one. You will never ever get questioned for cspining a patient, but you can always get question as to why you did not cspine one. For those of my blog followers who are not EMS or healthcare workers cspining is when we put a hard collar around the patient's neck and then log roll them or slide them without manipulating the spine (or as little as possible) onto a long boars. This acts as a large splint as sorts to keep the neck and spine in line. This is to minimize further injury and hopefully if done correctly or if the spine isn't already too injured to minimize the risk of paralysis. Okay teaching over.

Okay. So we come across patients all the time that enter that grey area of "to cspine or not to cspine" all the time. Drunk, fell down, answers some questions, but slurring a bit, has a lac above the eye, not c/o neck or back pain. or How about got into a foot pursuit with police, collapse, unresponsive on your arrival, but "didn't really fall that hard" or Found down, no idea how he got there, no idea where he is, no trauma noted. or Seizure pt sitting on floor, still kinda postical, but can't tell you if he fell on the floor or was already sitting. I say ALL of these need Cspine considered if not just done. It takes five minutes. Yeah, its' kinda a pain in the ass, but it's five minutes that can totally save your ass later. You have no idea if that fall caused a C4 fracture to that drunk kid because he's too drunk to know his neck hurts. So you board and collar him and there's nothing that can come back on you when it shows up on his CT scan that he has a broken neck. And you will never have an ER doc fault you for putting your patient in Cspine precautions, if you do, that ER doc should have his head scanned right along with your patient's. So until they start putting Xray machines and CT scanners in the meat wagons, keep on listening to that little voice that screams at you to put that patient ON THE DAMN BOARD. Because it may mean the difference between having a job as a medic or having one as a taxi driver. And I'm talking a real taxi, like little yellow and black ones, not Cabulance that we sometimes are.