Promotion

Well it's offical now. I am no longer an "acting" crew cheif. I have offically earned my Sargent stripe, whicch means I have gottan a pay raise, my own truck and the ability to say to pateints that don't meet our transport criteria that they can get the hellout of the back of my ambulance because there is no way I'm taken their dumb ass to the hospital for a broken toe. It also means that I have to keep up with the keys to the controled meds (I can barely keep up with my car keys what the hell are they thinking giving my the keys to the narcs), make sure my very sweet, but very green partner doen't get himself killed because he keeps getting out of the truck on the interstate without a traffic vest, and figure out how the hell I am supposed to get the 400lb inablilty to ambulate down from the third floorto my awaiting truck in the driveway. (How did you get up here, you're on the third floor?!? Why didn't you stay on the sofa in the huge open living room right by the front door?) Actually, it's not a bad gig. I learning to like being in charge. As a crew member, you can't really say much. You just take it. But as a crew cheif, if your CM gets out of line, you can take thier radio from them. Only letting them speak on the radio when you tell them they can. And when working with ParaGods, you can put them in their place if need be. Teach them they don;t know everything and when to ask for help is not a sign of weakness or stupidity. It's just smart sometimes.

HAHAHHAAHA!

This is...well listen...
http://gprime.net/flash.php/llamasong

had to share, welcome to earworm hell

Angel of Death

Angel of Death. Dr. Death. Double Oh Seven. These are just a few of the names I have earned because of yesterday. You know when you are on your third uniform, you have had a bad shift. When you come home wearing you bunker boots because your work boots are soaked through with blood you have had a bad shift. When the Fire Dept keeps a tally on how many full arrests you have worked you have a had a bad shift. Two full Arrests, One traumatic Arrest (GSW who bleed 2 units of blood all over my boots), and six DOAs (one Nursing home and 5 from a massive 4 vehicle MVA that burned up) is the offical death count. Tweleve calls in 24 hours. The AutoPulse batteries didn't even have a chance to charge back up. The Monitor batteries also didn't have a chance to charge. And of course the AC goes out in the box and of course its 122 degrees in the shade and OF COURSE it was 100% humitiy. Oh and the memory card from the monitor was lost along with my cell phone. Its been a bad day. Fucking Friday the 13th.

But I'm home now, with three days off. I have a big glass of wine. And I'm going to bed.

Babies and Social Work

So our EMS family got an addition last night. A Baby Girl. Pretty Little thing, (5lbs 9oz) with a pretty name of a southern belle, Grace. Now most day old newborns, I must say are pretty funny looking, all wrinkled and weird shaped heads. But Grace..Little Grace is beautiful. She had a whole paparazzi waiting on her. Kid's gonna have to get used to flash bulbs, being that this paramedic "aunt" is a photographer in her other life.

Today was Social Worker day. I was more of that than a Medic today. No life saving, just getting the gears in motion so that my patients today could get the help they so desperatly need. Terminal Cancer patients shouldn't have to spend the last few months on earth in dirty squalor. Geriatric couples should live out the rest of thier days not having to worry about what to do when they fall down and can't help each other get up because they live alone. So I played Social Worker today. It's time consuming, spending all shift on the phone with the people who help us take care of these particular type of problems.

But, I'm laerning my place in my new role. And these types of calls are some of the most difficult. I can fix Congestive Heart Failure, I can take pain away using Morphine, but these people need more than a paramedic. But we are the ones that start the ball rolling.

Learning Curve

So this Crew Cheif thing is tough. The whole decision making process is tough. The being in charge part is tough. The working with brand new EMTs is tough. Not that I mind any of the things I have listed, just two weeks without a day off makes for very long shifts. I had a few calls that tested me, like the syncope I went to who done fell out in the middle of the street. When we got her in the back of the unit and hooked up to the monitor, she was in an accelerated Junctional, then her heart just stopped for like 3 seconds, then one complex, the another 3 second pause then converted to just a regular junctional. Mind you she was CAOx3, vitals better than mine, and compleatly pain free. Her only complaint "I'm just dizzy" So we took a ride down to the ER where she never had an episode like that again. I did nothing for the woman other than IV and O2. She was more stable than I, so why fuck with something if it's fine, right? Thats how I justified it. Plus we were litterlly 3 mins from the ER. Had we been further I might have put the TCP pads ON her, you know, just in case Then there was the status seizure who I tried IV lorazapam, line infiltrated and I sat for the rest of the transport trying to figure out how to get the drug out of the vile to give it IM. It was one of those things that you don;t think about until you are sitting there going "I know there is a way to get this out, why didn't I ask my FTO. Damnit" Well, the pt still breathing, and thats what matters, a breathing, circulating patient is just fine. Its when the air quits going in and out and blood stops going round and round do I really worry. From what I understand this man spends most of his life in one long continuous Seizure.

So it's all a learning experience, every call prepares you for the next. We work unsavable full arrests so that when that one savable one comes along we are confident in our treatments. Everyday we learn something new, even if it is something as simple as figuring out how to draw out the lorazapam into a syringe, or something as complex as figuring out a dopamine drip or RSI algorhythm. We practice so that with the next one we can go without pause. Everyday I figure out something else that makes my job easier, makes me even treat with thinking, just doing, and doing it correctly and quickly. Makes it easier to save that one. To be able to go, he's alive because of what I did.

Moving on and moving forward

It has been a rough week. Well two weeks for me, this was day 14 of a 14 day stretch. But this past week especially bad. Driving past all the Fire Stations, seeing the bouquets, the signs, the letters. It make my choke up every time. I even feel bad calling for Fire for man power, or for a driver. I just want to leave them be to grieve. But alas, life must go on. It must move forward. Their will still be fires, paramedics that need help, and patients and citizens that need them. So we grieve this week and start to move on slowly the next week. We can't be sad forever, we must think, they lived and died doing what they love, what was in thier blood to do. You don;t become a firefighter because the money is good or because you like how you look in the bunker gear. You do it because you are made to do it you bleed fire.

Alright enough about that. I was promoted this week also. They handed me the narc keys and told me to go forth and pretend I know what I'm doing. 80 percent of this job is making educated guesses and making it look good. You could have NO idea what is wrong with you patient, but if you make it look good and keep your cool ( and know when to ask for, or call for, help) nobody will ever know, right? I learned how to deal with a difficult partner on a multi patient, multi trauma, very bad MVA (and patients that don;t speak any english on top of it all). Apparently, you threaten to take away said partner's walkie, as they continuiosly kept screaming on the radio before you (as Crew Cheif) could even get a bairing on how many patients, what Category the are and how many more units you need. (The answer is 3 patients, 2 CAT2, 1 CAT3, and two more units.) The following two day were better, as yesterday I had a very green, but very competent EMT, who is so set on doing the right thing, asks permission to do everything. A nice change from the day before. Not that Im on a power trip or anything, I just need to keep control. It's my scene, it anything happens, it's my fault. I'm the grown up.

Moment of Silence

Please take a moment today in remeberance of the nine City of Charleston firefighters who lost their lives in the line of duty tonight. Thank you.

Okay...not a Failure

Okay Okay Okay...I'm not a failure. I passed. I actully passed. They are now putting me in charge of an ambualnce for a shift. And I passed with an 80 freaking 7.5. Who knew? Damnit. I happy I guess, scared outta my mind. What the hell am I supposed to do now? Someones life could very well be in my hands. Oh and I'm moving to 12 hour DAYS. Sunlight makes me melt, I say! My brain can't work when it's light outside. Son of a bitch!. Oh well, I'll take a good partner on a bad truck over a bad partner on a good truck anyday. So this is quick a sweet, but I have to go. I have a 48 hour shift ahead of me.

I'm a Failure

Well, I did it. I finally took my Acting Crew Cheif test today. And to be quite honest, I probally failed. Not because I'm an idiot, but because the questions were off the wall policies and procedures that I don;t know off the top of my head. I know where to find them if I ever need them, like the 10 contraindications for thrombolic therapy in a acute Myocardial Infarction patient. I personally don't need to know what they are. We don't give tPA in the field here. But I would have to know them by the time I encode the hospital, which gives me plenty of time to look them up in my field guide. Same goes for the pediatric dose for an epinepherine drip in a bradycardic pedi or if and when we are supposed to ever transport a DOA (they ain't getting any deader, so again I would look it up in our field guide, or just call a supervisor and go "Can we transport this DOA?) I know the doses for all the drugs in our RSI protocol (1.5mg/kg for Lidocaine and the Succs. .3mg/kg for the etomidate) I know that we need online med control for Dopamine and our controls. Athough, Ativan we can give up to 4mgs on standing order if the patient is activly Seizing. I know that any patient complaining of Chest pain, regardless what the 12 lead EKG shows, gets Oxygen, Nitro, and Asprin. And possibly Morphine if the Doc will let you. I know that CPAP has to stay on the patient so you don't cause flash edema. I know that D50 in administered in a patent IV line as to not cause necrosis. I do get slightly confused mixing D12.5, but help is just a radio click away really.

I also know the proceduere if we break or lose a vial of Morphine...or if we wreck the truck...or what to do if a monitor, drug/ airway combo bag, 4 nasal canulas, a laryngoscope handle (why just the handle?) and 3 D-tanks of oxygen gets stolen from the back of a unit while on a respiratory call in the ghetto. The answer to all three of those questions is "Call a Supervisor"

But, still as ready as I think I am to be putin charge of a truck, I still have to pass the test. Which I don;t think I did this go 'round. Damnit.

Oyst P R

Oyst P R
Originally uploaded by artist in the ambulance 190.

Ark Drive In

Ark Drive In
Originally uploaded by artist in the ambulance 190.

It's too damn hot for me to care

I didn't relize how long it had been since my last post...So here goes. Alright, so I've been moved YET AGAIN. This time to the opposite end of the county. To a fucking hell hole of a truck. I hate this truck. Its busy, the station's too small for the FD and EMS that live there, it's way to busy in the summer, loud, the people in the area are pretentious snobs, oh and it's fucking busy. We ran call after call after call. And because I'm on the truck for my Acting Crew Cheif training it means that little ol me gets to run all the ALS calls. Which is 90% of the call volume. We had 12 calls yesterday, 10 of which I ran. 9 of which were because it was 112 degrees outside and people think drinking several cans of PBR is a perfectly good and healthy way to stay hydrated while mowing the lawn at noon. Everyone was passing out and had a systolic of 70. Oh and apperently it was also moving day for the whole goddamn county, which people also kept hydrated with Budwiezer. I felt like I was working on the surface of the goddamn sun. I lost 10 lbs just sweating. I was a pretty sight when I got off an hour ago. And the smell, oh my, ripe. But I have since had a shower and am about to go to bed. Fucking people.

Then there was the crazy ass woman who passed out, who hit my partner, who grabbed my ass while yelling at me to "Don't you fuck up my wig! This is my good wig!" The mid sentance passess out only to wake up again and finish her thought. She told me about riding along with the narc team with the local PD. "We busted up some college kids selling dope" Jesus help me.

Well thats all I got, going to sleep. night.

Okay, now I'm just rambling...

Well, I slayed the monster. The headache/ migraine from the devil himself ended yesterday. No more laying in the dark, moaning. I would like to thank the ER, my primary care MD and dilaudid for the help. I was beginning to think I was never gonna go away. I have had migraines for about 8 years now and that was by far the worst. Mostly because the damn thing would not go away. But anyways on to better news.

I move in two weeks! Yippie! My new home is this awesome old house in downtown. Walking distance from everything. Bars, restaurants, little shops, even the medic station. Which is great now that gas is up to 3 bucks a gallon. It is on the Historic Registry, build around 1801. I'm wondering if it is haunted. My new roommates seem great, laid-back people. And the room is freaking HUGE. Its got 12ft ceilings, windows that go almost floor to ceiling, and a fireplace in the bedroom. Non working mind you, but still a great little design feature. The one and only bad thing I can find is there is no real closet, just a bar in a little indentation in the corner. But that is a small price to pay for an otherwise wicked cool place. I have my boys and their trucks lined up for moving day. I am counting down the days.

Work is pretty slow these days. I'm out on the island. Spend my day sleeping and my nights watching Futurama. I have a chill partner, who is funny as hell. Doesn't get worked up over anything. Which I find makes all the differance when you're out in the middle of nowhere. I worked out on the east end of the county once, also in the middle of nowhere, with a partner who I had absoulutly nothing in common with. And it was in a one room station, with no internet, no where to escape. Now that was a hard six months. But this time, I like the guy I'm working with. We listen to the same music, we will chat about photography (he shoots too), sometimes we drive around our district , stopping at old churches or farms so I can snap off some photographs. He will sit and watch cartoons with me in the morning while we eat our oatmeal...or grits. He tells me about his wife and kids, who from the stories seem to be as much of a trip as he is. So, yeah, I like working out there with him. Plus I can work an ass of overtime, then go out there and sleep off the night in the city.

They are still pushing me to get my Acting Crew Cheif. I'm fighting as much as I can, but it seem to be a losing battle. It's not that I don;t think I can handle the medicine. I can, I am a good medic. It's just I don't want to be in charge. I don't have good managing skills. I find it difficult to sit someone down and tell then why they suck. I also don't deligate very well. I just feel I can do it better myself, than to have to explain something to someone. Or tell someone what to do. I know thats how people learn and all, but I feel I'm just as capable to re-stock the truck as my basic partner can. I hate telling people what to do. I'm just not that kind of bossy. I mean I can tell my friends and family what to do all day long, but a co-worker, a partner, it's just diffrent somehow. Plus, I don't want to have to write evals. I know I'm not perfect, so I don't want to have to point out someone elses flaws. I'm just too nice when it comes to things like that. Even in photography school, when we would do group critiques, I was the Paula Abdul of critiques. Even it the photograph sucked balls, I never could say that. I always said things like "Well, the lighting in nice" So, Im fighting the powers that be. I'm quietly refusing to take my acting test. I will continue to fight it until they either pushed the test into my hands or they threaten me.

The Monster in my Head

I think I'm dying. Well, maybe not dying. But, close. Since Friday afternoon I have been fighting a migraine. I get them occasionally. I take my Maxalt or my Imitrex, lay down with a cold compress for a few hours and they normally go away. On rare occasions, this doen't work and I make a trip to the local ER where I get a small dose of Dilaudid, that normally knocks them out quickly, never to return. This time however something is painfully wrong. I have taken the Max dose fo my Triptans (300mgs every 24 hours) for three days, Alernating Advil Migraine and Excedrine Migraine every four hours. I have made two trips to the ER, one trip to my Primary Care MD, got two doses of IV Diluadid in the ED and a script for 4mg PO Dilaudid from my Primary and the monster is still raging. The whole right side of my head is ripping open. So here I lay, in the dark, stoned on painkillers wishing for either my head to crack open to relieve the pressure or for the narcs to kick in fully so I can just sleep. Sleep would be good.

Status migrainosus is what it's called. A drug- resistant mirgraine lasting longer than 72 hours. I googled it. A rare species of Migraine who is a particularlly nasty, mean little bastard. The little fucker has caused all kinds of trouble this weekend work-wise, money-wise, health-wise. I had to leave work, forcing somebody in. Which I HATE doing, because it sucks being on the receiving end of that phone call with a Supervisor going, "You have to come back in, someone's called out sick" and it really sucks when that sick person works on an outlying truck, an hour from anywhere, and it's 4 o'clock in the afternoon. Thus, making you drive out there only to be relieved in two and a half hours later. This has also caused all kinds of finacial issues because each ER visit is $150, then $25 for my doctor visit, another $8 for the RX, then $50 more on Thursday when I go see my Neurologist, who will probally give me new abortive and prophylaxtic meds. So even more money because most Migraine abortives are band name only, there is no generic form of Imitrex. And of course, being that I work in the medical field and that I watch way too much "House" I have all these thoughts of "Maybe it's a brain tumor" or "Maybe its a AVM" or "Maybe the kid I took care of a week ago with a fever had bacterial Menigitus" or "Maybe it's a rare African parasite that crawled into my head through my nose while I was sleeping and it is now snacking on my brain" or Maybe it's just a fucking Migraine. But whatever it is, It's not going away. So here I lay, possibly dying from a rare African parasite, who I have now dubbed "Bang Bang" after the way he makes my head feel, missing a TRMT knot-tying class that I need to get into all the rest of my Confined Space and High Angle Rescue Classes from the Fire Academy.

!@#$% You Drug Companies

Been working my fingers to the bone recently. My normal shift is 36 hours right now. Sounds alot worse than it is though. It ususally goes I work the first 12 on a busy urban truck, run 9-12 calls then I travel almost 40 miles out to the islands run maybe 2 calls in the last 24 hours. So sleep is easy out there. In fact yesterday I ran one call then we made it back to the station where I then slept until almost 2030. So no case of the poor mes. You alsmost feel bad taking the systems money, getting pain to sleep and all. Almost. Then you remember what EMS stands for. Earn Money Sleeping.

Quick change of subject...this is something tah really chaps my ass...

I have Asthma. I take Albuterol. I get two MDIs for 6 bucks. Well... I used to get two MDIs for 6 bucks. I went to get my refill the other day and apparently they changed the canister that the inhalers come in. Changed the propellant or something. My new inhaler was 52 bucks and some change. "52 Dollars?!?" I said the the pharmacist. "52 DOLLARS for ALBUTEROL!?! Are you high? Have you guys been snorting the Vicoden back there or something?" My brand name Migraine meds are even that much. This is for just plain ol Albuterol. I refused to pay it. I still have a puffer thats about half full. I'll suck that thing dry before I pay that much for what should noramlly be a very cheap drug. It's cheap like asprin's cheap. What the hell is this world coming too that I, a hard working American, who works in healthcare, who has great health insureance otherwise, has to pay 52 dollars for what any Medicaid recipiant can get for less than $4. But I digress... Just because Warrick Pharamaceuticals is "going green" with some new fancy propellant, they think they can rape the American people and charge this obscene amount for what is a life-saving drug. This is no Viagra. People who use Albuterol use it because without it their airways tighten up and they could die. It's not like the asthmatics of the world can go "Fuck You Drug Companies, Shove it up your assess HMOs, I just not gonna take it, see how you like them apples!" Because they would be doing it while on a ventilator. And as dramatic as that would be, it's nearly impossible to talk with a tube shoved down your throat. So we can only do one thing and pay 52 dollars for a MDI, or 85 dollars for Verapamil (a cheap Calcuim Channel Blocker used to treat hypertension, among other things, like my migraines) or 120 dollars for 8 pills of Imitrex a month. (yes, That is what they wanted to charge me for my Migraine RX before I paid my annual $100 deductable, which is also insane, but again I digress) It's not fair. I already pay almost 90 dollars a month for health insureance. I pay my deductables and co-pays. Why is it now I being made to dig deeping in my pocket for my medications that I need to survive. Are these drug companies not getting enough of my money.

Girl...what you call your Husband?

We were busy little things. Running all over the city, picking up people from all walks of life. Okay I lie, it was only one kind of walk, the downtown ghetto pimp walk. We had psychs, we had diabetics, we had diabetic psychs, we had people just making shit up for a ride. And I got hit on twice and one marriage proposal that went a little something like this...
"Girl. What you call your husband?"
"I call him Officer.
"For RRRREAL!"
"Yeah, for real."
"Girl, you tripping. Where's yo ring?"
"Man. It's diamonds and platinum. You think I be wearing it to work? You crazy."

I was actully suprised the man took a gander at my ring finger and the fact he knew which finger to look at. I wear a silver ring on my right hand, he knew to check the left. Even though the drunken haze he was fairly observant. Too bad he couldn't tell me what happened to his wrist. "Man I broke or sumpin." Genuis. Then there was a schizo diabetic who would hollar gibberish at the top of his lungs unless I I spoke to him. Then it was "Yeah darling whatever you want, you gots a purtty smile" The cops loved that. We saw one of the officers later and he kept saying "You gots a purrty smile, what you call your husband?" I call him "Doctor" officer. I told my mom who was working at the ER tonight about my sorted adventures with the city crowd and my marriage proposal she asked what kind of fantasy world did I live in? All in a days work I guess. Man. I love the city trucks, you get to meet all kinds of people. Tonight will be my last scheduled night on a city truck though. I get shipped off the the islands for a break, even though I just got back on the truck and don't need a break. But whatever I go where I'm told.

Sleepy...

Brutal, fucking brutal. I forgot how bad a 24 hour shift is on 12 hour trucks. (just for those who don't read regularly we have 12 hour shifts in the busier parts of the system, and the norm 24/48 hour shifts in the slower parts) We are so short-handed that we sometime work up to but not exceding 36 hours on the busier 12 hour trucks. (Yes, we do get shipped off to slower outlying trucks to try a get some rest if you are on a 36.) Most of us are used to the long hours of runing and running, but I, my friends, am a bit out of practice. this was my first long shift since comming back to the streets. My body aches, my foot hurts and I am getting ready for bed. One more 12 hour shift tonight, then a long three day weekend that is well deserving. Lckly I have a paramedic partner who can help pick up my slack (We run a ALS on every truck, SInce I am still a crew member I will always have a Paramedic Crew Cheif) Also Luckly, even though it was busy, it was busy with alot od crap calls. Nobody dying, nobody in dire need, Nobody really in need of an ambulance. Just some sick party calls, some ETOH over indulgence, and some non cardiac chest pain. I started IVs because the hospital like them, not because the people were truly dying. I did 12 leads because I was told to, not because anyone was having an active MI, I gave O2, not because anyone was Short, but because it comforted and calmed my patients. I gave Morphine to ease the pain of a very angulated ankle, but it was more out of kindness and comfort, than nesessity. But now, I am going to bed only to get back up in 9 more hours to go and do it all again tonight. But fear not citizens, we are used to it.

Eh...

Run...Run...Run. Thats what we did all night. We went from assault to assault. To CHF then to Asthma. The more assaults. Man I don't know what was going on but people just felt like beating the crap outts each other last night. Nothing serious, mostly Lacerations that might have needed a few stitches... but still. Alot of ass kicking going on for a Monday night. Everybody seemed to have a case of the Mondays too, I got cussed at twice, swung at once and restrained one guy who tried to eat my fingers off. Crack is seriously wack. Oh and we went to this one house because her Imagianary friend was having shortness of breath. (Yes the same one who's other imagianary friend was stabbed a last week, he must have notof made it) But this time, knowing better, we didn't go hunting for 45 mins like we did last week.

I'm gonna end today by saying my heart goes out to all of the students, faculity and families of VT. I don't know you, but you are in my thoughts today... And to the first responders...You did good work yesterday. Medicine in the streets is hard enough when you don't know the people you are helping. I can only imagine what it must be like to work on fellow classmates, friends.

Blegh! OKAY I get it.

Learned two very important lessons last night. One of which that should be taught is every paramedic school everwhere. Narcan causes, no matter how slooowww you push it, Exorcist type vomiting. I knew it could cause vomiting because that is listed under side effects in the formulary, but what it should say is May cause vomiting that will put your unit out of service for 45 mins and need a mop and a hose to clean up thats what it should say. I have never seen anything like it. It was one the ceiling. Dripping like some brown alein goo you see in horror space flicks. And the second lesson is if you sit on the ambulance bay for long enough outside of the Level One Trauma Center, bloody stabbing victims pull up in POVs causing you to get yet another clean uniform bloody. I had just taken off the vomit shirt. Damnit. Luckly, it was just a little bit of blood and peroxcide got it out, but still. I also have a deep seeded aversion to feet. It goes back to when I was a brand new ER tech, and not knowing better pulled the socks off a homeless person c/o feet pain. With the sock came off three necrotic toes. Since then I don;t do feet. I'm not gonna touch yours and you're not gonna touch mine. I don't get pedicures and my orthopod thought this was hilarous. (He said I was the only patient's he's ever had that he couldn't do a compleate physical exam on because he thought I would freak out. I told him I wouldn't freak out, but make the exam quick) But We had not one but three patients with necrotic diabetic feet. I made my partner ride them in. I couldn't handle it. I said I would take the next five intoxicated assaulted college kids and/or smelly homeless if he would ride in the feet. Thats how bad my Feet Aversion is. Seriously.

Well lessons learned. Add that to my growing list of "Things Every Paramedic should Remember" Right above, push Lorazapam slow and keep a BVM near by, just in case your patient goes apenic. (Yep, learned that one the hard way too)

First Night

First night back after 5 months of recovery. Foot held up nicely. Only needed one dose of Aleve to calm the screaming bones, and only limped a couple of times, mostly when we stayed still for longer than 30 min. Took about 10 min to work all the kinks out. Which was well, twice in 12 hours. Had 8 calls and one wild goose chase though an apartment complex looking for what turned out to be an imaganary friend of one of the residents. The voices in her head told her that someone had been stabbed. It took 45 mins of looking for this person before us and PD figured it out that she was basicly talking to herself. Ah the joys of urban EMS. I slowly caught on the the new ways the radios worked (we went to digital 3-4 months ago) and working the AVLs. I figured out very quickly that I need to build my muscles back up when I tried to put the stretcher back into the truck fully loaded with a 300 lb patient. And I also need to clean up my now rusty IV skills so I don't turn my poor patients into a human pin cushion. (I did get one, and he was a tough stick) But everyone was right, it's like driving a car (or riding a bicycle) you don't really forget. You just are out of practice. But... I still felt like a new EMT. I drove a bit, running code once or twice, trying really hard not to throw my partner around the back. All and All an pretty tame night back. Now I'm off to bed so that I can do it all again tonight.