Moving.

I am leaving this little space of internet for a different location.

check me out at www.notanemergency.tumblr.com for random rambles and awesome photos and also www.shutterpunk35mmphotography.tumblr.com for all my roller derby greatness.

thanks for reading
and continue at my new and improved blogs.
Painter

"I don't like you"
"Well, Sir. They don't like me either" I pointed to my partners and the police officers that were standing around me. Apparently, my patient did not like me because I represented everything he hated about The Socialist Healthcare Machine....and I was there to take him away to his "Obama Death Panel" This was not my only difficult patient of the night. They seemed to all try my patience. Either they wanted to argue with me. ie; "I'm not going with you...but what happened?" You hit your head on that wall "Well, I'm still not going with you, but can you tell me why I'm bleeding?" or we were told about the call in a fucked up way ie; "Medic, MVA at the corner of Ghetto and Dirt Streets...but stand-by there, possible shooting involved." 10-4, Stand by at the Corner of Ghetto and Dirt for the MVA with the shooting?? "That's affirmative, 10-12 for 90 (Stand by for police) to secure the scene." Um...so you want me to stand-by at the CORNER WHERE THE FUCKING GUNS ARE?? I DON'T THINK SO DISPATCHER. I want you to repeat back what you just told me and ask yourself if that made any goddamn sense to you. Then after this exchange we get cancelled by The Police only to be sent to an MVA at 432 Ghetto St. WHICH IS THE SAME CORNER THAT THE MVA WITH THE SHOOTING WAS. Can they not see the map? I call attention to this by saying 10-4 MVA corner of Ghetto and Dirt St. with a response of "Negative Medic the numerics are 432 Ghetto." At this point I threw my hands up and just asked if police were on scene...to which I get a nasty "Affirmative" I'm not the one being the dumbass here, so you can quit with the attitude. Seriously.

I'm just hoping to make in a couple more weeks. Then I get a short break from The City. I will be going out to The Islands for a bit. "I need a rest" or so I was told. WHatever, if they think I need a rest, so be it. I'll go out there for a little and get paid to watch NCIS reruns and sleep.

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

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!!!

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.

So I'm having a bit of a life crisis as such. As some of you may know...or not know I turned 30 last November. I also started Art School studying Photography and had a bit of breakdown at work (mostly because of lack of sleep) I am now looking to relocate to a new city. As the lyrics of the Modest Mouse song The World At Largesay "Gonna find another place, maybe one I can stand. I move on to another day, to a whole new town with a whole new way" So I'm in a bit of a spinning panic. Looking for a job, a place to live, and new school to finish my degree. Then when I get done, what will I do? Photography is not exactly the best paying job. And weddings aren't exactly my favorite thing to do, mostly because I think brides are a bunch of whiney bitches. But I don't want to be a Paramedic for the rest of my life and my spine isn't going to let me be a paramedic forever. I don;t want to be a drug addicted 40 year old cripple because my spine has turned to dust. Should I study graphic design too? Should I study Art Management? Should I scrap the whole thing and study squidfish in Borneo? WHen did I wake up 30 and all my friends develop a life but me? When did they get settled into their lives and I'm still figuring mine out like some 19 year old.

Things I have Learned Working Nights in The City

I love working nights downtown. I have now been in The City for about two years now. I have gotten to know my cops, my firefighters all by name, they have gotten to know me, even if most of them know me by Angel and not by my actual name. They know that I am afraid of the horse cops and that I although the drunks can cuss at me the minute they start swinging or worse spitting is the minute the lose the ride in my truck and they earn a pair of bracelets and a free trip county jail. They also know how I take my coffee (soy or cream depending on who's buying, lotta sugar) So in the two years working in The City of Dixie I have learned :
1) The statement "Fuck You" will earn you a beat down, a tasing and most likely a public drunk and disorderly. And the cops don't like when that statement is aimed at either them or us.
2) Crazy is not illegal nor does it mean you need to go to the hospital. Unless you are a threat to yourself or others there is no need to go anywhere. Just because you put tinfoil in your hair to keep the aliens from stealing your thoughts or that you talk to your dead cousin that lives in your shopping cart does not mean you need to go anywhere, sometimes you need to explain this to the officers or the people that run the shelter.
3) Drunk is NOT a medical complaint, I was drunk two nights ago, woke up with a terrible hangover. Took advil, drank gadorade and plowed through it. The college kids can do the same. Unless they are unconscious and can't hold their own head up, they can sleep it off in their dorm room, not in an ER.
4) The projects are a safer place to park an ambulance than outside of the dorms
5) It's Sugar not diabetes. It's High Blood, not Hypertension, It's Water Pill, not Lasix. It's fluid on the heart or failure, not CHF. "Sticky Pain" is a legitimate description of chest pain and a 12 lead needs to be done. "Shortness" requires O2, Skesures require Ativan
6) Sometimes it's just easier to take them than it is to argue with them.
7) Cspine EVERYONE who in laying on the sidewalk and smells even a little like alcohol
8) When the COPS say he's dead...Fucker is D-E-A-D
9) On shooting scenes, look for tiny things like business cards marking the shell casings, especially if the crime scene unit isn't on scene yet.
10) They all lie.

It's like the EMS gods knew I needed that. A shock, a wake-up, a little thing to keep me going, Something to tell me why I do what I do. Why I deal with the bullshit, why I listen to the lies my patients tell me. They gave me a magled car with a twisted up patient and didn't kill him. They let me care for him, let me get an impossible IV, let me administer drugs that are so powerful I literally take away the patients ablity to breath on him own...just so I can turn around, put a tube in his throat and breath for him. And though he tried, he did not arrest on me. I got him to the hospital. I saved this person at 60MPH. I needed that. The Gods just know...that on the verge of burning out compleatly,that they need to give me some reason to put on the uniform and go to work.

When you pull up to a scene like that and see all the lights and then the twisted up metal, and after your first thought of "What the fuck now? How did that person get in the situation he is now trapped in?" something just turns on and you are ready to go. I just threw on my little blue helmet and dove in. Really...what the hell makes a person do something like that? Most people try to GET OUT of the mangled vehicle, not get in while the Fire Depatment cuts and bends the mess off and around you. Instead, we climb in cover ourselves and the person we are trying to get out with a fire blanket and wait to be rescued. It's sort of a wierd logic. But we do it, we don;t (hopefully) know whoever this is that we now share a small cramped space with, trying to figure out the best way to clear the airway, check a pulse and then get them out. We blindly jump in and hope for the best. Sometimes, like last night it works. Others, not so much. And then later you relize that EVERY scene is like this...You are going on blind faith that who ever just summonded you at 4 in the morning is not going to answer the door with a shotgun. What makes a girl come roll up in a huge flashing box on wheels into the projects to find a GSW laying there, surrounded by cops and bystanders, and go well, just another day at the office, better get to work. This is my office. The streets are where I do my paperwork. and it sure as hell beats sitting in front of a computer all day everyday. And then there is Naptime. yeah, If I'm not doing anything, I get to sleep...on the job...or watch episode after episode of 30 Rock and NCIS.

So yeah I have a pretty cool job. I drive a 3 ton truck with sirens and lights. I show up and can actually bring someone back From DEATH. Which is sweet. How many people can say that their job is helping people and driving fast.

I have been neglecting my little space of the interwebs. I don't know if has been writer's block or school or work but It's been to long. I had a bit of a breakdown at work. I think it was a mix of lack of sleep and taking on too much schoolwise. Art school, contrary to what you might think, is not easy. Creativity is something you either have or you don't and you can't switch it on and off. When it's on, baby it's on, but when it's off...it's off. So I had two weeks off from work, concentrated on my art for two weeks, cleaned my apartment, uncluttered my mind and started over.

I came back to work much better. Back to The City. I love The City at night. The characters, I have my regulars, like one who calls because "the shadows are smoking crack and makes me short of breath" I know which addresses are sick, which are not sick, which are crazy, which just want someone to talk to, which need the police to come with me. I love walking up and even though we were called to a nosebleed I hear, "Man just shut up and let EMS look at you, You got a stab wound in you damn chest..." So I am back, back to work. Both medically and creatively.

http://digg.com/people/EMT_Fired_Over_Facebook_Photo_of_Murder_Victim


I read this was sickened by it. How could anyone is my line of work think this was okay? Not only was he violating all kinds of HIPPA laws, but that poor family. Now, I know I blog about my experiences as a paramedic. But I like to think I keep it light, I want people to understand that I love what I do, even when I'm up to my eyes in alligators, I still enjoy the little world I live in.

Now...

I have a real paying gig. The Derby team that I have been working with (pro bono, portfolio work) is having me shoot during thier promo night out. This little Medic is excited.

I had a friend of mine demand I post, I told her I have about 7 unfinished posted saved, So I'm gonna try and finish this one becuase it's been quite a while since I've posted. School has kept me quite busy. Im living on Starbucks and very little sleep. But I creating some of the best work I have in a long time. I forgot what it was like to truley love photography and taking photos. Along with working, I have hooked up with the local Roller derby team and have become thier photographer. They have taught me alot, not just about photography, but about being part of a team. And it's a great release and change from the work on the ambulance.

I also got a phone call from my cyclist yesterday, he is doing well and it was good to hear from him. He is speaking to group of graduating class of paramedics today and needed me to fill in some missing gaps from his accident. He is my reason I put on my uniform every shift and to be honest, that phone call came at a good time. I needed that reminder right now.

So this was just a quick post, just to let everyone know I'm still around, I'm still on the ambulance. School is keeping me busy (I made Dean's List too!) I'll try and do better about posting.

I ain't that normal

I ain't that normal
Originally uploaded by artist in the ambulance 190.

The Pineapple

The Pineapple
Originally uploaded by artist in the ambulance 190.

Chasing after it

Chasing after it
Originally uploaded by artist in the ambulance 190.

Life has gotten a bit easier. No less busy, but easier. All this in spite of having a difficult partner and school keeping me running around, with a camera most of the time. I'm am on a truck I enjoy in a district I love. Though I do occasionally have the urge to duct take my partner to the the stretcher and sent her down the ramp at the Old County Hospital. But the Firefighers and police are cool in The City. We are busy enough that the night goes by at a decent speed. We also have more of our "frequent flyers" in this area. The ones when you hear the address, you know exactly what you are walking into, whether its a bad CHFer, the dialysis crackwhore who is fine when you get there and within seconds of arrival goes downhill, or the crazy old lady with all the cats and vodka. You just know them, you know their names, you know thier allergies, you know that NTG doesn't touch the pulmonary edema and the only thing that will save them is a fast ride and CPAP. There are always suprises, like pulling up to the Stretch Limo that was involved in a minor MVA, with 22 drunks piled into it. You know it's bad when I yell, I had to yell on that call. "You. Yeah you, go stand over there. Unless you legally make this patient's medical descions for her, your input is no longer needed"

And why is it that Overdoses ALWAYS lie to you. Even when you just brought them back from the brink of Death with the "wake-up medicine" Even when you pulled the needle out of their arm so you could start your IV.
"How much Herion did you use"
"Dude, I don't use that fucking shit"
"I'm gonna ask you again, slower because maybe you misunderstood me and don't lie to me How...Much...Herion...Did...You...Use? And don't call me Dude, I'm not your buddy. I'm the medic that just brought your dumbass back to life, show some respect"
"Dude...I mean Ma'am, I don;t use herion"
"so that was just...what?...insulin in the needle I just pulled out of your arm."
They truly think I'm stupid.

Art school is harder than you think. It's not just drawing and taking pretty pictures.

Hello friends. Yes, again I am sorry about the long breaks between posts. I have been suffering a severe case of burn-out and haven't flt much like writing. But alas, maybe it will make me feel better just to let the word flow...good or bad, without a real care on who reads this. I'm not gonna speak about any strange or twisted calls, because really, I havent had any. They all have been your normal Shortnesses, Chest pains, catching seizures and "I gots the Sugar". Oh wait, I did help with the delivering of a baby. That was cool. Death (AKA, me) bringing life into the world. Nice change of pace. Got to tuck those Wings of Darkness back into the uniform for the night. But really other than that, been pretty uneventful on the call front. I'm back on nights with partner who frankly...sigh. Yep, I think my Senior Crew Chief is afraid he gonna come into work and find that I have strung 'em up from the ceiling with my technical rescue harness, refusing to let her down. I promised him that I wouldn't do that but I could not promise that the words Fucking and Idiot would not cross my lips. Especially now since I'm going back to school and I will be running on Nicotine and Coffee instead of real actual sleep. My fuse was gonna be a little shorter than normal.

So here I am, 29 years old, on the eve of my first day back to College, well Art College, I mean my first class is entirely dedicated to the View Camera, working towards a goal to get me the heck out of EMS. To go be creative. Away from the Death. To make pretty things.

Well people, two things today. Did you know that one can shear the ENTIRE IV cath off? Not a peice, the WHOLE DAMN THING. Me neither. But it happened. I saw it, I was witness to it. My trainee for the day did it. I was on the radio, encoding, forgeting that I still had the radio keyed up, when he told me what happened, I went over the channel "You did what...fuck." Then cussed again when I relized that I had dropped the F-bomb over the radio. I apologized, then told the hospital they were not gonna believe what happed and I will explain when we get there. That was impressive. I have never seen anything like that, and apparently, it has never happened before with a peripheral INT; at least not where we could find over the internets. Centeral lines, sure. But not peripheral sites. But everything worked out, and the pt was turned over to the hospitals staff with a slightly brusied arm and a missing Cath tip. The hospital is still trying to find it.

2nd thing...I got my acceptance letter to school....and my loan approved. So I am now $27000 in debt. But I'm gonna learn me somthing. I am still working full time for a while at least. So I will still be posting as my paramedic self. With school updates thrown in. And more photography, of course.

Well I have decised to go back to school. These past few weeks at work have made me rethinking paramedicine and the reason I'm in it. The cincher was after I got moved out of a district I love, away from a partner I get along with, and am not longer under the supervison of Supervisors that have grown to trust me. And they did it at the holidays, which has me working on every holiday but Thanksgiving day. I had my whole holidays planned. But because I am single with no kids, the holidays apparently mean nothing to me. The move was caused by something that didn't even involve me either. This among many other things have been leading me to this conclusion of going back to school to finish my BFA in photography. This job has gone away from Emergency Medicine and has turned into a "let us hold your hand and sing fucking Kumbaya" with the so called sick and dying. I am now forced to be nice. If I don't coddle my patients I may get a complaint and then I'm called into the principle's office for an ass chewing. Now I am normally kind to my patients, but then I have a patient throw a stack of Medicaid cards at my feet telling me "If you want it, you can pick it up and find it" I have a hard time biting my tounge and continuting to play nice. It's the ones that demand respect, but refuse to give it to me that piss me off. They feel that I am there to service them, not care for them. They talk down to me. That I am below them on the social ladders. So to them I say "I am here to save your ass, not kiss it"

I have grown tired of this. I am burned out and all thats left is a broken medic with a broken spirit. So When I walked into Art School, I could feel the energy in the halls. The creativity came back. I walkedd the halls of that place and I felt alive again, amoung the creative misfits. I had forgotton that feeling. I used to get it getting on the ambulance and running the lights. Not anymore, so I now think my lifespan as a medic is coming to an end. Art is calling me home. So now, a year shy of 30. I am going back to school. I can now see the light at the end of the tunnel.

Today's horoscope

I'm not one to put a whole lot of thought into horoscopes, but this was mine for today

Scorpio (October 23-November 21)
11/13/2008
You may not be willing to accept the advice of someone else today if you don't think that he or she has enough information to form a clear opinion. It seems to you that others are willing to oversimplify the situation for the sake of expediency while you would rather delve into the complexity, even if you can't decide what to do. Be patient; solutions will continue to surface over the days ahead.

I'm dealing with a problem at work right now that I don't really have a solution for. Well, I do...but it includes explitive ladden phone call and a possible day off without pay. Not really a solution. I want a REAL answer. A fix. So I shall be patient. Let some of the feelings settle. Form actual thoughts, and maybe get something done

Lesson learned

So I along with most of America voted yesterday. I am not stating here on my blog who I did or did not vote, nor my veiws on, well anything, as this is not a political blog. If you want that go read Slate or something. I am just a paramedic and this is my blog. So Back to my adventures in voting. I had just got off work, after working all night. I didn't even go home to change out of my uniform. My back hurt from lifting patients up off the floor. I had been puked on and had just gotten off the phone with the coroner 20 mins prior. (I had a woke-up dead) I was tired. I was ready to just go to bed. But I am an American, and this is just something I had to do. So I drive to my voting place ( a local Elementary school) and the parking lot was packed. I had to park a few blocks away in someones front yard. I walk in and get into the line. I'm there for an hour. I'm playing a game on my iPhone, listening to music. Blurring out the maddness, the bitching about the lines, the politcal bickering. I'm in my own world. until I feel a tap on my shoulder. I pull the ear buds out of my ears just in time to hear "She's done caught herself a seizure!"

Sure enough, next to my, across the hall, an elderly woman had passed out in line. Her neice thought she had a seizure. So I go over, and see if I could be an assistance. (I'm still in uniform, remember) The woman was out cold for a few seconds but was coming back around by the time i got down on the floor to her level. Someone screaming about Seizures and "Sugar". I block them out for a minute
"You Okay?"
"Yes. I think so."
You hurting anywhere?"
"No."
"You have Sugar?"
"No, but I didn't eat breakfast."
"Well you fell out, Sit here for a second, Whats your name and how old are you?" She told me and I called my dispatchers. As I'm doing that I get pushed out of the way by some woman screaming about "Is there a doctor in the house!" and "Does any one have a BGL machine" I get off the phone. And in my head...Who is this woman ( she never idenified herself as any sort of medical person) and what the fuck, Lady, you are in an ELEMENTARY SCHOOL, who do you think has a freaking BGL machine? I lean back down and continue speaking with my now patient. and this woman continues to yell. "she has no radial pulses!. She severaly hypotensive!" she has no radials" Good Greif. "Mrs. M? do you think If I get some helf you can make it over to that bench so we can get you up off this floor?" She said "I can, I'm just a little weak"
"Well lets get you up."
Screaming lady-"You can't get her up she has no radial pulse she will pass out again, she is severly hypotensive"
Me-"Then we will deal with that, But I would like to get her up off the dirty floor, out of the crowd. I already called an ambulance. I work for EMS."
Screaming lady-"Well I ..." and she walked off. well damn if I knew it was that easy I would have said that 10 mins ago. I got some help to get her up and we when to sit down. We got her taken care of. She got to vote. When I went back in I had lost my place in line. I stood there for a second, contemplating what to do. The people running the polls were no help. I didn't want to get back in line a wait 4 more hours, but I still wanted to vote. It wasn;t until a young woman about my age holding a 6 month old infant said "You missed the riot".
"Did I? was there Bloodshed, I hate it when I miss bloodshed."
"Na, you helped that woman?"
"Yep, and now I've lost my place in line"
"Here jump in front of me, you were here at least as long as I have if not longer I saw you." Now she had been holding this kid for god knows how long
"I can't do that, you have you son with you and have been waiting too."
"Don't worry about it, jump in."
So I did. We talked for a few minutes and her little one kept babbling at me and pulling at my hair. I asked her if he would let me hold him. Since she let my cut the line. I held the little one for a while. we had a very deep conversation about the economy ( a little one sided) and health care. Then he napped on my shoulder. Mom and I chatted with the others in line. The rest of the voting was uneventful. No more falling out or seizures.

So I voted. My patient voted. And I learned not to wear my uniform to the voting booth if you have been up all night.

Competition

These are photos from this years Competition. Link to my Flickr Page.

This Competition was in Charleston SC this year. It is a competition open the EMS systems in North and South Carolina. This years winner was Greenville County EMS. Congrats to them.

Senerios were: an explosion at a camp site. One DOA, One with 2nd and 3rd degree burns with Airway involvement, the ambulatory pt who was deafened by the blast, and the "distracter patient" an unresponsive, apenic pediatric with airway obstruction.

The 2nd one was: A pair on a motorcycle rear-ended a construction truck full of rebar. Several impalements, that make C-spining somewhat creative. The critical go unresponsive and vomits (I will never look at pea soup the same again) The "distracter patient" was the driver, who was having CP, now collaspes and codes.

So here are the photos...
http://www.flickr.com/photos/strangelittlegirl190/sets/72157608361515378/

The Innocents

Again, It's been a while since my last post. Had a few calls that made me want to walk out and take a long needed vaction, one that made me sad, one that made me angry, both Pediatrics. First. I had my first pediatric arrest. We, as paramedics, dread this call. We train over and over for it. We run the drug calculations in our heads, the tube sizes, the algorythms, so that when that day comes and a screaming mother hands you that limp, not breathing child, you don't freak and fumble your way through. And yes, your first you will freak and you will fumble, but do it on the inside. The ET tube was too big, I needed the smaller one, shit! it's not ready, what the dose for the epi again? how many doses was that? is it time for another? Is that IO still flowing?....Watch the fucking turns, I just got the fucking tube!... Are those readings right on the end title CO2. Keep up the CPR...FUCK! I gotta encode the hospital! All on the inside. On the outside, we worked like a machine, nobody screaming, everyone doing the task at hand. Except the Fucking turns remark, I did scream that. But despite all the good we did, the airway, the drugs, the CPR, the child had been down too long, the tiny heart had been still for too long.

We work for peds. We want them so badly to live, even though we know, in that paramedic part of our brain, that there is no hope. They are so young, they haven't had time to play, time to learn. So we fight for them. We get thrust into these calls, and this for me was my nightmare call, tiny little baby in cardiac arrest, but we get thrust into it, the parents looking at you with such hope. Hope that you can perform some miracle and breath life back into this child. I still have the mother's screaming in my head. When We got to the hospital, I could barely give turnover to the hospital before I fell apart. Even though I knew there was nothing we could have done for this child, this child had been down way too long, You cry for these tiny little patients. You pray to whatever Higher Power you pray to....then for the next few days you play the call over and over in your head until you are satified that everything that could be done was done. And you are still sad. I didn;t sleep for several days. But you call your support system, those other paramedics that you call after calls like this and you lose it. If they are good, they will talk you back from the edge and back onto the truck so that you can help the next one.

My next one came yesterday, We rescued a 6 year old and 9 month old sibling, who had been abandoned...for 8 days. The 6 year old kept as good of care of the infant as a 6 year old could. Fed the infant a bottle twice a day and also made toast and jelly for himself (he was covered in strawberry jelly). When asked how he knew how to make the bottle, he answered very matter-a-factly "You just mix the powder and water together in the bottle and shake it up" and looked up at me like DUH, don't you know anything? You ARE a grown-up. The I asked if if he changed the baby's diaper, "No, I don't know how. I'm only Six!" But because he took good care as he could of his brother, this had a good outcome. I wasn't working two sick children. Other than a severe case of diaper rash, a snotty nose and a slight fever the baby was really okay. The little one when I held him just curled up close to me and slept. (not lethargic, limp sick baby sleep, but normal baby sleep) The six year old was very active, totally obvious to why the Police and Paramedics were there. He was just so excited to ride in the ambulance. He played with all the switches. He really like turing the suction on and off. I think it was because it was loud and we picked up band-aids with "Magic" We also like the stethescope. We listened to his heart then his brother's and it sounded like a drum!

I wanted to take them both home with me and watch Disney movies on my sofa. I wanted to show them what it was like to be loved and wanted. Then the anger came. Not toward these two children, but that mother who left them alone for so long. I had never wanted to cause physical violence to anyone. How dare she leave. I'm almost happy she was not found before we left, nor was grandmother. I would have gotten a complaint. I would not have held my tounge. I held both those kids all the way to the hospital. We played and sang. The baby looked at me like who is this crazy woman, singing with my brother. But he still giggled when I tickled his little round belly. They probally got a warm bath and the best sleep that night.

These innocents, We care for them, we fight for them. We want to love the unloved. It was hard to give them over to the hospital. But they now are getting cared for. And that is the best outcome.

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.

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..."

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)

Some needs to call the paramedics, Oh crap I am the Paramedic

So this morning I was sitting at the light in front of my house, waiting for it to turn green. Which sometimes it doesn't because it sucks and it stays red for ever and I have to call The Voices, who then call the city police voices, who then call traffic, who then fix the light. Well this particular morning, I was waiting for the light to turn, enjoyin my morning coffee an the new Death Cab for Cutie album, when I heard sirens and lots of them. I first think, how odd, I don't remeber Sirens in this song, them it dawns on me, its coming from outside. I see a fire truck, then another, then a ladder, the two squad cars. Phew, something big is going down. I cut off the car in front of my that won't turn and continue on my way. I find out when they were going in such a hurry.
I turn down the road on mu normal route and they are all clutered in front of the school with a bunch of cop cars, but no medic unit. I see the vehilce smashed all to hell and a man with all the fire guys franticly doing stuff over a man with lots of blood around the head area. I fly past all the chaos, and pull into the school parking lot, jump out of my car, barely remembering to put the damn thing into park and rush over. I am stopped by a police officer, mind you I am in uniform. "Can I help you?" He asked in that I'm a bad ass cop voice, even though he looked like my seventeen year old cousin. I look at him thn look down at myself, and go "Well I thought I might be able to help you, I'm a medic"
"Oh...OH....yeah...YEAH, go see what the fire guys need!"
I go walking over. "Hey yall, I was on my way in to work, thought you might need some help." I hear from behind me someone yell "Hey capt, he's CAT 1!" (Damn near dead) I turn around and he is guppy breathing, clamped down, blood everywhere. One of the fire guys, goes "We got a medic!, She needs a pair of gloves!" I get a pair of XL gloves thrusted at me from somewhere (I wear a small normally) And right at that moment I had a oh fuck moment. I was the only Paramedic. With nothing but a BVM and a pair of gloves. No drugs, no ambulance, no monitor. And at least six men turn to ME (gulp!) and go "What do YOU need us to do?" WHAT THE FUCK DO YOU MEAN "WHAT DO I NEED YOU TO DO" Oh Jesus Christ and all that is holy, I am now in charge. I am the senior Medic on this scene now. And All I could do was Bag this man. Breath for him. He still had pulses. We did have CSpine stuff, so we were starting to CSpine him when the medic unit pulled up. And never in my life have I been so happy as to see an ambulance. That 3-5 mins it took the medic unit to get there felt like an eternity. But when it did show up. I was happy to turn over care.

But I did have a Oh Fuck Me moment. A someone needs to call a paramedic, Oh shit! I am the Paramedic moment. When everyone, even though they were completly able and competent, turned to you. Because You have Paramedic in front of your name and goes, "Hey, what do you need?" I was alot of responsiblity that hit me all at once. I wanted to run away. But of course didn't. I had My fire guys taking care of me. And they did a wonderful job. So again I thank them too.

Gut feelings

My last post was about assessment. This one is about gut feelings. I get them. I know when I'm about to walk into something bad. And it's usually when I get it, very bad. I got it on the way to the Airport and when we walked in to a cluster of a cardiac arrest. (We brought him back, not only brought him back, but had him walking and talking, CAOx3 by the time we got to the hospital, they were doing CPR when we got there, he was D-E-D dead. and very much alive when we dropped him off at the hospital) I got one when we forced entry into a house and found a pt laying prone on the floor who looked up at us and took her last breath. I got one when I listened to that kids lung sounds from the last post. And most recently got one with a pt who called us after a syncople episode in his backyard. Pt was SOB and passed out. Even out in the heat pt was pale, cool and diaphoretic. You know how they teach that kis are either sick or not sick. Well this works on adults too. They are either sick or not sick. And this pt was very much sick. S-I-C-K. Cardiac sick. Pt had that look. Had a gut feeling. So pt got high flow O2, and a 12 lead. which came back normal. So pt got two more 12 leads 5 mins apart. Also normal. But something was not right. Pt was sick. Pt was hypoxic, fighting to breath. SPO2 was normal. But Pt was fighting the mask, and skin condiction never improved. Then as we were pulling into the hospital, pt respiration increased from 26 to 38. SPO2 dropped and near syncope. One more 12 lead. HUGE ST elevation in inferior and anterior leads with some slight elevation in lateral leads. The pt infarcted right in front of me. nearly arresting. I RAN him into the ER waving 4 12 leads in my hands. "Doctor! Doctor!, you need to come with me, He's literally infarcting right now! right as we pulled in. the bottom two are the first ones I did, the top one is the one I did right now like 30 seconds ago"

So gut feelings. Listen to them. They are normally right

Assessment

Don't you love it when nothing else is wrong, but there is one thing, one symptom, one minut finding that make you sit back and go, "Self, something is totally fucked up about this." You look at your patient, who looks fine, whose vitals are stable, but that one finding, that one thing is signifigant enough that your gut is screaming at you. I had that the other day. A young pt who had pain in inspiration "right here" and he pointed to a point on his chest on his right side. "A rubbing sharp pain?" I ask. "
"Yep. Excatly."
Pluresy. His vitals are ALL stable. Normal Sinus on the EKG, 99% SPO2 on room air, I put him on a canulla. respirations 16 non labored. Not fighting for oxygen at all. I listen to his lungs with my handy dandy stethescope. High tech little tool we have, not really, but very important peice of equiptement on the ambulance. So I instruct him to take a deep breath and hear very clearly breath sounds on the Left, but nothing on the right. Whaaayayayyttt? Okay do it again dude, Deep breath. And again, nothing on the Right. I look at the monitor and everything is normal. So ONE more time, deep breath, and once more....nothing on the right. But still vitals stable and pt not working to breath. I ask again any shortness of breath. No. None. Just a sharp pain and he can put his finger on it. He doesnt want to go to the hospital. I explain that I can't hear air moving on the right side, thats strange. I have a gut feeling that something is funky. But how do you explain to someone about gut feelings? I convince him to go. and we take a easy ride to the hospital.
When we get there, I tell the staff. "I know I sound like a crazy person, his vitals a completly stable, SOP2 is 99-100%, respirations are 16, and he denies SOB. But I swaer his has almost no lung sounds on the right. I know all I have in the feild is a stethescope, not exactly a chest xray. But I swear, I listened 8 times, my partner listened. neither of us could hear. So we brought him to ya'll. So you tell me...can this be a spontanous pnuemo even though no other signs and symptoms piont to one?"
The doc told me that I was thinking the more deadly Tension Pneumo, a small bleb wouldn't show up so seriously. SO I did what I could do in the feild and brought him to the hospital. So good job. They would do a chest xray and figure it out. He wouldn;t try an diagnose a pneumo in the feild.
Yesterday, I stopped by the ER, it was not only a pnemo, but a big one. Needing a chest tube.
This my friends is what you find when you do a good assessment.
Listen to Lungs, know what the sounds mean, do the 12 lead on that 78 year old whose only complaint is weakness ( I found a huge anterior MI once that way, again, pt was very stable, vitals, only complaint was weakness x 3 days, but there it was staring back at me plain as day). I have had several medical mysteries recently, where the patient was absolutly stable, but something told me, put them on the monitor and then caught the 2 degree heart block or the stable Vtach (yep, had that too) don;t put them with you EMT basic partner, as competent as he is, he can't give amiodarone or interpert a 12 lead. CHeck the drunks BGL. Oh shit it's 567. Thats why he altered. Yes there are times that sometimes a fall is just a slip and fall. Listen to your patient. They can tell you many things. And also listen to what they are NOT telling you. Sometimes that can tell you more.

Losing at dodgeball sucks

I'm getting lazy with my posts I know. Been busy, life takes over...blah...blah...blah and all. Getting settled into the new place. Work is work. Did ya'll know that losing at dodgeball warrants EMS being called. Neither did I. But when the player that gets tagged out refuses to speak and gets upset because they lost, EMS gets called. As does mom. Mom being no dummy realized what was wrong with dear sweet child, and kindly waved away the ambulance. Next time, she tells the kid, suck it up, we all lose at dodgeball every now and again. Today was calls like this all day. People who didn't call, third party callers. And also your typical hot weather calls. Faintings, falls at pools, jellyfish stings...the normal summertime on the islands calls. Not too bad of a day. At least it didn't storm today and flood downtown. Our fair city has terrible draining. Especially at high tide after a terential downpour. It tends to flood really bad over by the hospitals and on most of the normal routes to the hospitals. What should have been a 8 minute transport, turned into a 35 min roundabout tour of the city because the city was at a standstill because to the water. Glad it was only a broken ankle and not something life threating. Then when we left we run into a huge flooded area with a local news crew filming. I have learned from personal experience if you have to debate if you can make it or not, you probally can;t make it so dont try it, especially when a news crew is pointing a camera at you and your ambulance.

The new apartment is nice. The pool is even nicer. My days off spent by the pool.

back.

Yes, I know its been a while. But before you all go yelling and hollaring, I do have a very good reason for no posts. NO INTERNETS. My internet has been down since the crazy hobbit med student moved out of the apartment. But I am now in my own place, complete with TV and cable internets. So I am now setting up my new place, with a short break to type this post. Other than moving haven't been too busy. Work is still the same. Actually our system has had a few bumps, but nothing I want to comment on really. We all have our problems. So we will leave it at that. But in my work life, everything is smooth. I work hard. No death, but now extreme life saving either. I haven't shocked anyone back to life in recent weeks. And the most notiable thing that has happened was I got threated by a drunk, mentally hadicapped man who told me "Unhand me you crazy woman or else I will fuck you up!" But my partner and the cops kept any fucking up from happening. But not before he let loose a lugie the size of my fist in my general direction and then he just cackled at me. Oh well it happens. well I will make this short a sweet as I have more boxes to unpack.

Okay here it is a new post

Phew, I know I know I know. Been a long time. But I have good reason I promise. Had a bout of writer's block. Then I found out my lease is up alot sooner than I thought so I had to find a place to live otherwise I was gonna be living at the women's shelter that I have grown to know and love. But I have found a wonderful place to live. A place that is ALL my own. My first place that is mine all mine. I don't have to share with anybody. More rent and I have to work a little harder to actually afford it, but a space that is all your own is worth that extra two shifts a month I think. And it has a pool. So seriously, yeah, two extra shifts is worth a pool.

Man, yall...we were crazy busy this weekend too. That full moon thing is so true, and all but one was some BULL-shit. The one was one of our frequent flyers that everytime you see she is actully sick, but because of crack. You just go "Goddamnit!, You were doing so good! What the hell happened?!" and she shruggs, all while fighting to breath. You CPAP her, load her up with NTG and haul ass to the hospital, go any slower and you will be tubing her. You just pray the whole way that she didn't wait too long to call you, because you can't get a line so you can't RSI her and you for damn sure don;t want to nasally tube her, she doesn't care for the CPAP, so you know she ain't gonna like that tube shoved down her nose.

The rest were all just alot of uncooraperative people who thought that EMS were either taxis to downtown or "unresponsive" who were gonna "faint" everytime we tried to stand them up. And every one of our "fainters" were a good 3 bills give or take. i've already has back surgery once, I'm not having it again. so I' not gonna catch you. You can faint. Not one of our "fainters" hit the ground. They all somehow made it to either a sofa or a chair or somewhere soft. One even made it clear across the room to the sofa. It was a fucking miracle.

Then there was the drunk college kids. How do you drink that much? No Seriously? How? I've been drunk, really drunk. I broke my foot in five places I was so drunk. But I have never been so drunk that I was unresponsive and EMS had to suction vomit out of my airway.

Holy Crap Batman! I can raise the dead

So I thought that my streak of death was still following me. But apprently the EMS gods had other plans for me today. We get called to a near syncope...oh and can you also first respond to the Seizure too, it's at the same place, we have another unit coming, they are just 20 minutes out. Sure thing my dear dispatchers.
Medic on scene...Are you fucking kidding me, you didn't tell me the seizure was in fact in cardiac arrest! I can't give too many details about the call because this being the internet, a a very public forum and I would like to keep writing and this is the kind of call that walks the line of "can I write about it without reveling too much in this kind of setting" but I can say the pt was in fact in cardiac arrest, meaning he was not breathing, nor did have a pulse, he was...in not so many words...Dead when we got there, but my dear readers, do not fear, by the time we dropped him off at the hospital, not only did he have a pulse, not only was he breathing on his own...but he was sitting up, talking, conscious, alert and orenited x3 and holding a conversation with us. And when we left him at the hospital, he was on a nasal cannula, and they were trying to find a reason for why he went into cardiac arrest in the first place. Yes...We did some "Third Watch", "Emergency", "Baywatch", "only shit you see on TV" kind of Paramedic Magic today.

I have no idea what happened to the near syncope, the other unit came...nor frankly do I care. I was to busy saving a man's life. With a little help from my friends.

I would also like to say a BIG thank you to the First Responders. Without them sometimes our patient would not walk out of the hospital, like our cardiac arrest today. They started CPR right after he dropped and frankly, played the biggest part in saving their friend's life. So thank you. Without them we'd have nothing to work with. Just want you guys to know that the Paramedics, we do apprciate what you do. We may not say thank you all the time. But here's mine.

THANK YOU FOR ALL YOUR HARD WORK GUYS.